Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2017 , and ending 06-30-2018
BCheck if applicable:
CName of organization
Sanford Group Return
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO Box 5039 Rte 5218
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Sioux Falls, SD571175039
D Employer identification number

45-3791176
E Telephone number

G Gross receipts $ 3,930,672,208
F Name and address of principal officer:
Kelby Krabbenhoft
2301 East 60th St
Sioux Falls,SD57104
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.sanfordhealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5851
K Form of organization:  
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: "Dedicated to the Work of Health and Healing"
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 6
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 32,693
6 Total number of volunteers (estimate if necessary) ............. 6 2,105
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 67,165,448
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 1,487,885
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 70,015,308 72,701,349
9 Program service revenue (Part VIII, line 2g) ......... 3,669,768,613 3,844,742,598
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -1,365,155 3,638,552
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,059,111 3,011,493
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 3,741,477,877 3,924,093,992
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 22,990,888 29,331,220
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) 2,181,401,280 2,285,593,789
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,398,380,656 1,496,162,556
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 3,602,772,824 3,811,087,565
19 Revenue less expenses. Subtract line 18 from line 12....... 138,705,053 113,006,427
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,760,585,976 2,835,813,206
21 Total liabilities (Part X, line 26)............. 1,598,658,494 1,553,506,154
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,161,927,482 1,282,307,052
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
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Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: Part of the Sanford Health System, Sanford is committed to the healthcare needs of communities throughout South Dakota, North Dakota, Minnesota and Iowa. Sanford provides a full range of primary and specialty health care services.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 3,244,372,653 including grants of $ 29,328,180 ) (Revenue $ 3,769,499,749 )
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 $ 24,181,248 including grants of $   ) (Revenue $ 3,873,734 )
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 $ 25,803,175 including grants of $ 3,040 ) (Revenue $ 4,203,667 )
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 expensesMediumBullet3,294,357,076
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part IClick to see attachment
31
Yes
 
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................Click to see attachment
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
3,195
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
32,693
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
 
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
6
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
MN , OR , CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJoAnn Kunkel CFO2301 East 60th Street   Sioux Falls,SD57104 (605) 333-1000
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Barb Everist......................................................................
Trustee
3.90
.................
1.70
X           725 0 0
(2) Andy North......................................................................
Trustee
5.90
.................
1.70
X           121,718 0 0
(3) Brent Teiken......................................................................
Vice Chair
3.90
.................
1.70
X   X       1,215 0 0
(4) David Beito......................................................................
Past Chair
3.90
.................
1.70
X   X       0 0 0
(5) Don Jacobs......................................................................
Treasurer
3.90
.................
1.70
X   X       0 0 0
(6) Don Morton through 1217......................................................................
Trustee
3.90
.................
1.70
X           1,353 0 0
(7) James Cain......................................................................
Secretary
3.90
.................
1.70
X   X       0 0 0
(8) Maria Bell MD......................................................................
Trustee/Research Administrator
58.30
.................
1.70
X           789,033 0 29,050
(9) Mark Lundeen MD......................................................................
Trustee/Orthopedics Services Chair
58.40
.................
1.60
X           726,619 0 29,050
(10) Mark Paulson MD......................................................................
Chair/Physician Regional Chair
58.30
.................
1.70
X   X       266,366 0 26,202
(11) Melissa Hinton......................................................................
Trustee
3.90
.................
1.70
X           0 0 0
(12) Michael LeBeau MD......................................................................
Trustee/Senior VP - Bismarck Clinic
58.40
.................
1.60
X           1,414,632 0 29,050
(13) Patrick Durick......................................................................
Trustee
3.90
.................
1.70
X           1,177 0 0
(14) Thomas Hruby......................................................................
Trustee
3.90
.................
1.70
X           1,360 0 0
(15) Kelby K Krabbenhoft......................................................................
Sanford President & CEO
46.10
.................
13.90
X   X       2,276,185 0 12,726
(16) Kelby K Krabbenhoft Def Comp......................................................................
Sanford President & CEO
46.10
.................
13.90
X   X       0 0 877,405
(17) JoAnn L Kunkel......................................................................
Chief Financial Officer
46.10
.................
13.90
    X       1,020,341 0 43,188
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Randy Bury........................................................................
Chief Administrative Officer
40.00
.......................20.00
      X     1,072,754 0 28,257
(19) Randy Bury Deferred Comp........................................................................
Chief Administrative Officer
40.00
.......................20.00
      X     0 0 15,683
(20) Bill Gassen........................................................................
Chief Human Resources Officer
55.00
.......................5.00
      X     663,044 0 28,245
(21) Kim Patrick........................................................................
Chief Legal Officer (through 12/17)
55.00
.......................5.00
      X     760,169 0 40,401
(22) Jennifer Grennan........................................................................
Chief Legal Officer
55.00
.......................5.00
      X     412,996 0 34,701
(23) Allison Wierda-Suttle MD........................................................................
Sr. VP, Chief Med Officer
60.00
.......................0.00
      X     844,889 0 35,182
(24) Bill Marlette........................................................................
Treasurer
55.00
.......................5.00
      X     941,344 0 1,470
(25) Bill Marlette Def Comp........................................................................
Treasurer
55.00
.......................5.00
      X     0 0 211,820
(26) Micah Aberson........................................................................
Chief Global Brand Officer
10.00
.......................50.00
      X     539,386 0 39,501
(27) Bryan Nermoe........................................................................
President, Bemidji
60.00
.......................0.00
      X     644,061 0 38,481
(28) Craig Lambrecht........................................................................
President, Bismarck
60.00
.......................0.00
      X     922,924 0 40,403
(29) Nate White........................................................................
COO, President Fargo
55.00
.......................5.00
      X     1,432,723 0 51,351
(30) Michelle Micka........................................................................
Sr. VP Finance, Corporate Controller
55.00
.......................5.00
      X     466,467 0 35,601
(31) Michelle Bruhn........................................................................
Sr. VP Finance, Health Services
55.00
.......................5.00
      X     630,740 0 27,195
(32) Paul Hanson........................................................................
President, Sioux Falls
60.00
.......................0.00
      X     915,810 0 44,601
(33) Paul Richard........................................................................
Exec VP Fargo
55.00
.......................5.00
      X     931,503 0 26,226
(34) Richard Adcock........................................................................
Chief Innovation Officer
60.00
.......................0.00
      X     675,499 0 19,916
(35) William Brunner........................................................................
Physician
60.00
.......................0.00
        X   2,668,987 0 29,050
(36) Larry Burris........................................................................
Physician
60.00
.......................0.00
        X   2,269,260 0 29,050
(37) Scott Pham........................................................................
Physician
60.00
.......................0.00
        X   2,897,398 0 29,050
(38) Adam Stys........................................................................
Physician
60.00
.......................0.00
        X   2,475,403 0 29,050
(39) Tomasz Stys........................................................................
Physician
60.00
.......................0.00
        X   2,657,592 0 29,050
(40) Daniel Olson........................................................................
Former Exec VP Bemidji
0.00
.......................0.00
          X 317,442 0 26,226
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 31,761,115 0 1,937,181
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet2,781
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Owens & Minor Inc

12199 Collection Center
Chicago,IL60693
Medical Services 70,984,503
GE Healthcare

1053 W Grand Ave
Chicago,IL60642
Medical Services 41,838,237
Medtronic USA

710 Medtronic Parkway
Minneapolis,MN55432
Medical Services 41,587,243
Henry Carlson Construction

1205 Russell Street
Sioux Falls,SD57104
Construction 24,870,115
Weatherby Healthcare

6451 North Federal Hwy Suite 700
Fort Lauderdale,FL33308
Locum Tenens 12,470,321
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1,107
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 43,056,142
e Government grants (contributions)1e 19,860,216
f All other contributions, gifts, grants, and similar amounts not included above1f 9,784,991
g Noncash contributions included in lines 1a - 1f:$ 1g 5,112,030
h Total. Add lines 1a-1f.......MediumBullet 72,701,349
 Program Service RevenueAmt Business Code
2a Patient Services 621400 1,939,146,185 1,939,146,185    
b Medicare/Medicaid 621400 1,539,089,097 1,539,089,097    
c 340B Revenue 900099 159,110,926 159,110,926    
d Durable Med Equip Sale 446199 114,564,142 105,143,496 9,420,646  
e Management Fee 900099 35,151,946   35,151,946  
f All other program service revenue. 57,680,302 28,338,725 22,592,856 6,748,721
g Total. Add lines 2a–2f .....MediumBullet 3,844,742,598
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 2,149,652     2,149,652
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 157,790     157,790
(ii) Personal (i) Real
6a Gross rents   4,845,011 6a
b Less: rental expenses   1,991,308 6b
c Rental income or (loss)   2,853,703 6c
d Net rental income or (loss).......MediumBullet 2,853,703     2,853,703
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 6,075,808   7a
b Less: cost or other basis and sales expenses 4,586,908   7b
c Gain or (loss) 1,488,900   7c
d Net gain or (loss).........MediumBullet 1,488,900     1,488,900
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See instructions.....MediumBullet 3,924,093,992 3,770,828,429 67,165,448 13,398,766
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
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 .... 29,226,624 29,226,624
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 43,613 43,613
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 60,983 60,983
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 32,554,058 28,227,789 4,326,269  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 329,622   329,622  
7 Other salaries and wages........ 1,872,038,031 1,623,539,477 248,498,554  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 80,740,429 65,000,431 15,739,998  
9 Other employee benefits ....... 184,604,087 153,673,259 30,930,828  
10 Payroll taxes ........... 115,327,562 97,633,077 17,694,485  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 12,581,225   12,581,225  
c Accounting ........... 1,180,761   1,180,761  
d Lobbying ........... 1,072,254   1,072,254  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 43,191   43,191  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 192,858,195 162,793,163 30,065,032  
12 Advertising and promotion .... 17,464,114 13,710,480 3,753,634  
13 Office expenses ....... 44,431,322 30,800,976 13,630,346  
14 Information technology ...... 60,104,165 6,276,991 53,827,174  
15 Royalties ..        
16 Occupancy ........... 90,743,005 70,517,087 20,225,918  
17 Travel ............ 16,869,498 13,459,344 3,410,154  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 7,133,467 3,616,788 3,516,679  
20 Interest ........... 39,460,042 39,160,189 299,853  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 164,619,813 136,224,634 28,395,179  
23 Insurance ... 14,931,964 12,246,521 2,685,443  
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 797,698,843 782,621,590 15,077,253  
b Certificates/Licenses 7,318,678 5,325,905 1,992,773  
c MinnesotaCare Tax 6,417,941 6,417,941    
d CME 5,702,199 5,702,199    
e All other expenses 15,531,879 8,078,015 7,453,864  
25 Total functional expenses. Add lines 1 through 24e 3,811,087,565 3,294,357,076 516,730,489 0
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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 32,062,918 1 64,909,066
2 Savings and temporary cash investments ......... 46,887,242 2 67,766,348
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 503,537,992 4 518,552,739
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 42,248,539 7 47,761,146
8 Inventories for sale or use ............ 75,876,025 8 79,897,564
9 Prepaid expenses and deferred charges ...... 34,055,950 9 43,448,694
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,299,410,347
b Less: accumulated depreciation 10b 1,587,845,833 1,708,586,916 10c 1,711,564,514
11 Investments—publicly traded securities . 2,021,421 11 2,465,285
12 Investments—other securities. See Part IV, line 11 ..... 389 12 0
13 Investments—program-related. See Part IV, line 11 .. 51,235,834 13 52,629,304
14 Intangible assets ............... 54,608,534 14 53,816,458
15 Other assets. See Part IV, line 11 ........... 209,464,216 15 193,002,088
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,760,585,976 16 2,835,813,206
Liabilities 17 Accounts payable and accrued expenses ..... 385,982,229 17 388,864,448
18 Grants payable ... 2,004,207 18 1,831,478
19 Deferred revenue ......... 1,759,629 19 2,167,502
20 Tax-exempt bond liabilities ......... 933,378,635 20 901,784,327
21 Escrow or custodial account liability. Complete Part IV of Schedule D 196,029 21 226,634
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 70,004,924 23 58,059,178
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 205,332,841 25 200,572,587
26 Total liabilities. Add lines 17 through 25.. 1,598,658,494 26 1,553,506,154
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 1,161,927,482 32 1,282,307,052
33 Total liabilities and net assets/fund balances ........ 2,760,585,976 33 2,835,813,206
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
3,924,093,992
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
3,811,087,565
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
113,006,427
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,161,927,482
5
Net unrealized gains (losses) on investments ...............
5
2,134,072
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
5,239,071
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,282,307,052
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................18
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
18
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) 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.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
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
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
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
 
 
Section B. Type I Supporting Organizations
Yes
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
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 2019 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-2019
(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2020. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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 orgaizations and public charity status: Sanford Health 509(a)(3) Sanford Medical Center 170(b)(1)(A)(iii) Sanford Clinic 170(b)(1)(A)(iii) Sanford Research 170(b)(1)(A)(iii) Sanford Home Health 509(a)(2) Sanford Health Network 170(b)(1)(A)(iii) Sanford World Clinics 170(b)(1)(A)(iii) Sanford North 509(a)(3) Sanford Medical Center Fargo 170(b)(1)(A)(iii) Sanford Clinic North 509(a)(2) Sanford Health Network North 509(a)(3) Sanford Medical Center Thief River Falls 170(b)(1)(A)(iii) Sanford Medical Center Mayville 170(b)(1)(A)(iii) Sanford Medical Center Wheaton 170(b)(1)(A)(iii) Sanford Hillsboro 170(b)(1)(A)(iii) Sanford Health of Northern Minnesota 170(b)(1)(A)(iii) Baker Park, Inc. 509(a)(2) Sanford West 509(a)(3) Sanford Bismarck 170(b)(1)(A)(iii) Sanford Living Centers 509(a)(2)
Schedule A, Part I Part I, Line 12b - Sanford Health, Sanford North, Sanford West and Sanford Health Network North are Type II supporting organizations. Detail for Schedule A, Part I Line 12, Column: (i) Sanford Medical Center; (ii) 46-0227855; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $38,470,450 Line 12, Column: (i) Sanford Clinic; (ii) 46-0447693; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $4,918,559 Line 12, Column: (i) Sanford Research; (ii) 46-0450378; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $788,155 Line 12, Column: (i) Sanford Home Health; (ii) 46-0282134; (iii) 509(a)(2); (iv) Yes; (v) $247,870 Line 12, Column: (i) Sanford Health Network; (ii) 46-0388596; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $10,830,536 Line 12, Column: (i) Sanford Clinic North; (ii) 91-1770748; (iii) 509(a)(2); (iv) Yes; (v) $5,707,821 Line 12, Column: (i) Sanford Medical Center Fargo; (ii) 45-0226909; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $45,166,271 Line 12, Column: (i) Sanford Medical Center Thief River Falls; (ii) 41-0709579; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $5,198,542 Line 12, Column: (i) Sanford Medical Center Mayville; (ii) 45-0228899; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $582,050 Line 12, Column: (i) Sanford Medical Center Wheaton; (ii) 27-2042143; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $500,988 Line 12, Column: (i) Sanford Hillsboro; (ii) 45-0230400; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $773,018 Line 12, Column: (i) Sanford World Clinics; (ii) 26-2707628; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $325,983 Line 12, Column: (i) Sanford Health of Northern Minnesota; (ii) 41-1266009; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $11,278,037 Line 12, Column: (i) Baker Park, Inc.; (ii) 41-1372480; (iii) 509(a)(2); (iv) Yes; (v) $25,255 Line 12, Column: (i) Sanford Health Foundation North; (ii) 45-0398104; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) $347,659 Line 12, Column: (i) Sanford Bismarck; (ii) 45-0226700; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $19,386,445 Line 12, Column: (i) Sanford Living Centers; (ii) 45-0416454; (iii) 509(a)(2); (iv) Yes; (v) $0 Line 12, Column: (i) Sanford Health Foundation West; (ii) 45-0397196; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) $158,665
Schedule A, Part III Detail for Schedule A, Part III Line 1 - column: (a) 625,251; (b) 232,693; (c) 221,829; (d) 159,929; (e) 279,310; (f) 1,519,012 Line 2 - column: (a) 195,263,418; (b) 214,359,949; (c) 229,728,673; (d) 205,167,015; (e) 159,680,023 (f) 1,004,199,078 Line 6 - column: (a) 195,888,669; (b) 214,592,642; (c) 229,950,502; (d) 205,326,944 ; (e) 159,959,333 (f) 1,005,718,090 Line 8 - column: (f) 1,005,718,090 Line 9 - column: (a) 195,888,669; (b) 214,592,642; (c) 229,950,502; (d) 205,326,944; (e) 159,959,333; (f) 1,005,718,090 Line 10a - column: (a) 970,589; (b) 671,284; (c) 718,153; (d) 713,259; (e) 1,664,637; (f) 4,737,922 Line 10c - column: (a) 970,589; (b) 671,284; (c) 718,153; (d) 713,259; (e) 1,664,637; (f) 4,737,922 Line 11 - column: (a) 279,896; (b) 400,943; (c) 274,195; (d) 410,742; (e) 783,554; (f) 2,149,330 Line 13 - column: (a) 197,139,154; (b) 215,664,869; (c) 230,942,850; (d) 206,450,944; (e) 162,407,524; (f) 1,012,605,342 Line 15: 99.32% Line 16: 99.53% Line 17: 0.47% Line 18: 0.34% 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) 2019


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
Sanford Group Return
 
Employer identification number
45-3791176
Part I
Contributors
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
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
Sanford Group Return
 
Employer identification number

45-3791176
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2019)

Additional Data


Software ID:  
Software Version:  
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on 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.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2019

Schedule C (Form 990 or 990-EZ) 2019
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(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? ...................................................................................................................

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) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
572,506
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
1,572,003
j
Total. Add lines 1c through 1i ....................................................................................................
2,144,509
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
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.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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" on 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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 60,166,967 62,584,497 58,142,005 54,120,507 48,229,852
b Contributions ... 4,233,247 -2,436,209 4,442,491 4,007,618 5,316,297
c Net investment earnings, gains, and losses   18,679   25,086 654,694
d Grants or scholarships ... 751,526       54,813
e Other expenditures for facilities
and programs ...
      6,372 6,949
f Administrative expenses ....       4,834 18,574
g End of year balance ...... 63,648,688 60,166,967 62,584,497 58,142,005 54,120,507
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
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" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   108,520,505 108,520,505
b Buildings ....   1,538,272,323 587,600,500 950,671,823
c Leasehold improvements   76,594,247 45,343,171 31,251,076
d Equipment ....   1,538,836,043 932,904,777 605,931,266
e Other .....   37,187,229 21,997,385 15,189,844
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,711,564,514
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on 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........    
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Non-operating property 68,250,164
(2)Deferred compensation assets held for investment 116,144,069
(3)Other assets 7,077,737
(4)Enhanced Benefits 1,398,765
(5)Interest Receivable 45,291
(6)Cash Value-Insurance Policies 86,062
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 193,002,088
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 200,572,587
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) 2019

Schedule D (Form 990) 2019
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on 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' on 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: Sanford Health Foundation, Sanford Health Foundation North, Sanford Health Foundation Hillsboro, Sanford Health Foundation of Northern Minnesota, Sandford Health Foundation of Thief River Falls and Sanford Health Foundation West hold endowment funds on behalf of the filing organization to be used for assistance in its activities and for providing health care, medical, or educational services.
Part X, Line 2: Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Group did not have a material income tax liability at June 30, 2018; some related organizations have established reserves.
Schedule D (Form 990) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image 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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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" on Form 990, Part IV, line 14b.
1
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? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
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 the region (d) Activities conducted in region (by type) (such as, 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 the region
(f) Total expenditures
for and investments
in the region
East Asia and the Pacific 0 0 Investments Clinic operations, investment of potential additional clinic sites 903,000
Europe (Including Iceland & Greenland) 0 0 Program Services Travel, conferences, and purchased goods and services 38,000
North America 0 0 Program Services Travel, conference, purchased goods and services 14,000
Sub-Saharan Africa 0 0 Investments Clinic operations and investment in potential additional clinic sites 4,466,000
Central America and the Caribbean 0 0 Investments Investigation of potential clinic sites, travel 42,000
East Asia and the Pacific 0 0 Program Services Purchased goods/services, travel 14,000
Europe (Including Iceland & Greenland) 0 0 Investments Clinic operations, hospital, investigation of clinic sites, travel, purch goods, services 12,888,000
Middle East and North Africa 0 0 Program Services Purchased Goods/Services 2,000
North America 0 0 Investments Investigation of potential clinic sites, travel 13,000
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 18,367,000
b Total from continuation sheets to Part I ... 0 0 13,000
c Totals (add lines 3a and 3b) 0 0 18,380,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on 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.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
East Asia and the Pacific Subaward of Gray Foundation Grant 60,983 Bank Transfer     Cost
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 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
1
3 Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on 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
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately 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; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .
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) .
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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 separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
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
Part I, Line 2: Prior to disbursement all grant fund requests are reviewed to ensure the receiving organization and proposed use of funds align with Sanford's mission. Grants are disbursed by the organization only after the expenditure has been made and properly authorized by the organization along with related documentation to ensure the funds are not diverted for non-charitable use.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2019
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
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
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
b
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: . . . . . . . .
3b
Yes
 
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . .
    72,271,034 0 72,271,034 1.900 %
b Medicaid (from Worksheet 3, column a) . . . . .     516,441,336 343,930,325 172,511,011 4.530 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     588,712,370 343,930,325 244,782,045 6.430 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     10,501,695 789,969 9,711,726 0.250 %
f Health professions education (from Worksheet 5) . . .     24,181,248 3,873,734 20,307,514 0.530 %
g Subsidized health services (from Worksheet 6) . . . .     474,169,582 412,809,904 61,359,678 1.610 %
h Research (from Worksheet 7) .     32,802,185 18,701,133 14,101,052 0.370 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     19,912,155   19,912,155 0.520 %
j Total. Other Benefits . .     561,566,865 436,174,740 125,392,125 3.280 %
k Total. Add lines 7d and 7j .     1,150,279,235 780,105,065 370,174,170 9.710 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     155   155 0 %
2 Economic development     3,733   3,733 0 %
3 Community support     31,276 4,418 26,858 0 %
4 Environmental improvements            
5 Leadership development and
training for community members
    1,621   1,621 0 %
6 Coalition building     705,586   705,586 0.020 %
7 Community health improvement advocacy     576,274   576,274 0.020 %
8 Workforce development     31,549   31,549 0 %
9 Other            
10 Total     1,350,194 4,418 1,345,776 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
50,285,952
3
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. ......
3
 
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
881,110,124
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
936,620,572
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-55,510,448
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 %
11 Everist Health
 
Prevention of heart and cardiovascular disease through unique medical tech 22.840 % 15.340 %  
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?25Name, 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)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other 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
5225 23rd Avenue S
Fargo,ND58104
www.sanfordhealth.org
ND 5070
Sanford Medical Center Fargo
450226909
X X X X     X     A
3 Sanford Broadway Medical Center Fargo
801 Broadway North
Fargo,ND58122
www.sanfordhealth.org
ND 5018A
Sanford Medical Center Fargo
450226909
X X X X     X     A
4 Sanford Medical Center South University
1720 South University
Fargo,ND58103
www.sanfordhealth.org
ND 5068A
Sanford Medical Center Fargo
450226909
X X   X           A
5 Sanford Bismarck Medical Center
300 N 7th Street
Bismarck,ND58501
www.sanfordhealth.org
ND 5003A
Sanford Bismarck
450226700
X X   X     X     A
6 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
7 Sanford Medical Center Thief River Falls
3001 Sanford Parkway
Thief River Falls,MN56701
www.sanfordhealth.org
MN 371500
Sanford Health Network North
450409348
X X     X   X   Inpatient Mental Health A
8 Sanford Aberdeen Medical Center
2905 3rd Avenue SE
Aberdeen,SD57401
www.sanfordhealth.org
SD 65089
Sanford Health Network
460388596
X X         X     A
9 Sanford Worthington Medical Center
1018 6th Avenue
Worthington,MN56187
www.sanfordhealth.org
MN 371449
Sanford Health Network
460388596
X X         X     A
10 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
11 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
12 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
13 Sanford Luverne Medical Center
1600 N Kniss Avenue
Luverne,MN56156
www.sanfordhealth.org
MN 371352
Sanford Health Network
460388596
X X     X   X     A
14 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
15 Sanford Jackson Medical Center
1430 N Highway
Jackson,MN56143
www.sanfordhealth.org
MN 371002
Sanford Health Network
460388596
X X     X   X     A
16 Sanford Tracy Medical Center
251 5th Street E
Tracy,MN56175
www.sanfordhealth.org
MN 371440
Sanford Health Network
460388596
X X     X   X     A
17 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
18 Sanford Hillsboro Medical Center
12 3rd Street SE
Hillsboro,ND58045
www.sanfordhealth.org
ND 5026A
Sanford Health Network North
450409348
X X     X   X     A
19 Sanford Medical Center Mayville
42 6th Avenue SE
Mayville,ND58257
www.sanfordhealth.org
ND 5034A
Sanford Health Network North
450409348
X X     X   X     A
20 Sanford Webster Medical Center
1401 W 1st Street
Webster,SD57274
www.sanfordhealth.org
SD 10573
Sanford Health Network
460388596
X X     X   X     A
21 Sanford Medical Center Wheaton
401 12th Street N
Wheaton,MN56296
www.sanfordhealth.org
MN 371390
Sanford Health Network North
450409348
X X     X   X     A
22 Sanford Bagley Medical Center
203 4th Street NW
Bagley,MN56621
www.sanfordhealth.org
MN 371484
Sanford Health of Northern Minnesota
411266009
X X     X   X     A
23 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
24 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
25 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) 2019
Schedule H (Form 990) 2019
Page 4
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.sanfordhealth.org/about/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
see narrative for full url
b
see narrative for full url
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 nonpayment?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 Did the hospital facility or other authorized 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 3: Sanford Broadway Medical Center Fargo, - Facility 4: Sanford Medical Center South University, - Facility 5: Sanford Bismarck Medical Center, - Facility 6: Sanford Bemidji Medical Center, - Facility 7: Sanford Medical Center Thief River Falls, - Facility 8: Sanford Aberdeen Medical Center, - Facility 9: Sanford Worthington Medical Center, - Facility 10: Sanford Sheldon Medical Center, - Facility 11: Sanford Vermillion Medical Center, - Facility 12: Sanford Chamberlain Medical Center, - Facility 13: Sanford Luverne Medical Center, - Facility 14: Sanford Canby Medical Center, - Facility 15: Sanford Jackson Medical Center, - Facility 16: Sanford Tracy Medical Center, - Facility 17: Sanford Rock Rapids Medical Center, - Facility 18: Sanford Hillsboro Medical Center, - Facility 19: Sanford Medical Center Mayville, - Facility 20: Sanford Webster Medical Center, - Facility 21: Sanford Medical Center Wheaton, - Facility 22: Sanford Bagley Medical Center, - Facility 23: Sanford Canton-Inwood Medical Center, - Facility 24: Sanford Clear Lake Medical Center, - Facility 25: Sanford Westbrook Medical Center, - Facility 2: Sanford Medical Center Fargo
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 6a: Sanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Crime/Safety - Pharmaceutical Narcotics in the CommunitySanford USD Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Chronic DiseaseSanford is dedicated to improving health outcomes by monitoring BMI through quality metrics and referring to internal/external services to improve the care of patients with overweight or obesity diagnosis. The Sanford fit Program will be available to all local schools, students and families in the area through the classroom modules and the fit website. Sanford will address diabetes by adopting optimal diabetes care for patients ages 18-75 with diabetes. Sanford will standardize hypertension protocols in all primary care settings, and will adopt standardized protocols for optimal vascular care.Addressing of Significant Needs during Current Year:Priority 1: Crime/Safety- Reduce Pharmaceutical Narcotics in the CommunitySanford developed strategy to reduce narcotic use across the system by providing alternative pain management methods. Policies and procedures to address the prescription of narcotics have been standardized across the healthcare system. The measureable outcome for this implementation strategy is to track narcotic prescriptions and identify areas for improvement. Pain medication prescriptions are continuously tracked and studied to identify areas for improvement. There has been a 28% reduction in the prescription of narcotics since beginning this initiative in 2017.Priority 2: Chronic DiseasePhysical HealthSanford has set strategy to improve the care of patients with overweight or obesity diagnosis. Patients who are overweight will be referred to internal and external services including registered dietitians, exercise physiologists, and RN Health Coaches. The measureable outcome for this implementation strategy is to track the referrals. From 2017 through Q3 of 2018, the referrals for follow-up interventions have increased. The current rate of referral is 46.2%.The Sanford fit initiative, http://sanfordfit.org/, a childhood obesity prevention initiative, continues to grow and mature while refining the offerings and enabling broad replication and meaningful use. Supported by the clinical experts of Sanford, fit educates, empowers and motivates families to live a healthy lifestyle through a comprehensive suite of resources for children, parents, teachers and clinicians. fit is the only initiative focusing equally on the four key contributing factors to childhood obesity: Food (nutrition), Move (activity), Mood (behavioral health), and Recharge (sleep). Sanford's fit initiative has come a long way since its inception in 2010. Through fit, healthy lifestyles are actively being promoted in homes, schools, daycares, clinical settings, and throughout the community by way of technology, engaging programs, and utilizing key role models in a child's life. Since 2017, Sanford has presented the Sanford fit program to live audiences and has reached 5,075 individuals through interactive engagement. Sanford fit is available in classrooms across the Sioux Falls area with 8,179 students currently using the curriculum. The Sanford fit online program is available nationwide and has over 22 million views with 198,000 engagements.DiabetesSanford has set strategy to provide optimal diabetes care and to measure the outcomes for systolic and diastolic blood pressure, LDL cholesterol, hemoglobin A1C, tobacco use and aspirin use. These outcomes are part of the optimal care recommendations for people living with diabetes. The measureable outcomes are systolic blood pressure of <140, diastolic blood pressure of <90, LDL per statin indication, HbA1C < 8, tobacco free, and a daily aspirin if ischemic vascular disease. Currently at Sanford, 49.4% of patients with diabetes are at optimal outcomes.HypertensionSanford has set strategy to address hypertension through standardized protocol, frequent blood pressure monitoring, and referral. Outcomes measures include a blood pressure of less than 140/90 for all ages 18-59, and for age 60+ with diabetes, vascular or renal disease. For patients 60 or older without diabetes, vascular or renal disease the goal is a blood pressure of 150/90. Eighty-eight percent of patients with hypertension are now under control with a blood pressure of <140/90.Ischemic Vascular DiseaseSanford has set strategy to address ischemic vascular disease by standardizing protocols for optimal vascular care. Outcome measures include systolic blood pressure <140, diastolic blood pressure < 90, LDL statin indications, tobacco free recommendations, and a daily use of aspirin. Currently at Sanford 63% have met the outcomes for optimal care.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Child and Youth - Bullying Access to Health Care - Access to affordable health insurance, Access to affordable health, Access to affordable prescription drugs Mental Health - Underage drug use and abuse, Alcohol abuse
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Broadway Medical Center Fargo Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: HypertensionSanford Fargo Medical Center will reduce the number of patients with uncontrolled hypertension. Standardized nursing protocol for blood pressure checks and rechecks is a strategy that has been implemented throughout the medical center.Priority 2: DepressionSanford has prioritized depression as a top priority and has implemented strategy to perform assessments for depression and to improve PHQ-9 scores and the severity for patients with depression.Priority 3: Flu Vaccines Sanford has prioritized flu vaccines and has implemented strategy to increase the number of flu vaccines provided to community members. Sanford will develop consumer education materials, and conduct flu blitz clinics at various locations in the community. Addressing of Significant Needs during Current Year:Priority 1: HypertensionHypertension is a risk factor for cardiovascular disease, and contributes to premature death from heart attack, stroke, diabetes and renal disease. The North Dakota Department of Health reports that 27.7% of the population in Cass County has been told by their provider that they have hypertension.Sanford prioritized hypertension as a top priority for 2017-2019, and has set strategy to standardize nursing protocol for blood pressure checks and rechecks. The goal is to reduce the number of patients with uncontrolled hypertension. The measureable outcome is the number of patients with blood pressure < 140/90. This goal has been reached for 87.8% of patients with hypertension.Priority 2: DepressionDepression is a common but serious illness that can interfere with daily life. Many people with a depressive illness never seek treatment. However, the majority, even those with the most severe depression, can get better with treatment. The North Dakota Department of Health reports that 11.9% of residents in Cass County have reported fair or poor mental health days. County Health Rankings for Clay County indicate that 11% of the residents have fair or poor mental health.Sanford has prioritized depression as a top priority and has set strategy to perform assessments for depression and to improve PHQ-9 scores for patients who are diagnosed with depression. The goal is to improve PHQ-9 scores for patients with depression. The measurable outcome is the percentage of patients with major depression or dysthymia and an initial PHQ-9 score greater than 9 whose 6-month PHQ-9 score is less than 5. This goal has been reached by 10.7% of patients with a depression diagnosis.Priority 3: Flu VaccinesThe CDC states that influenza is a serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently. Even healthy people can get very sick from the flu and spread it to others. The North Dakota Department of Health reports that 33.5% of adults age 65 and older did not receive a flu vaccine in the past year. Respondents to the CHNA generalizable survey report that 26% of children 18 years and younger did not receive a flu vaccine in the past year.Sanford has prioritized flu vaccines as a top priority and has set strategy to increase the number of flu vaccines provided to community members. The goal is to increase the number of flu vaccines provided to community members. The measurable outcomes are the number of flu vaccines given to adults each year and the number of flu vaccines given to the pediatric population each year. The combined number of flu vaccines given in FY 2016 was 2675, in FY 2017, it was 2518 and in FY 2018, the total was 2017.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing, Hunger Aging - Cost of long term care, Availability of memory care, Availability of LTC Children and Youth - Bullying, Cost of quality child care, Cost of quality infant care, Availability of quality child care, Availability of quality infant care, Cost of services for at risk youth Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Crime, Child abuse and neglect, Domestic violence, Presence of gang activity in the community, Sex trafficking Health care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Timely access to substance abuse providers, Cost of affordable dental insurance coverage, Use of emergency room for primary care, Cost of affordable vision insuranceAll assessed needs that are healthcare related are being addressed at Sanford. Sanford is not developing strategies to address the cost of long term care and the availability of long term care and memory care in the Fargo-Moorhead area. Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs. Additional concerns that will not be addressed directly by strategy include bullying among children and youth, the cost of quality child care and the cost of quality infant care. The results of the CHNA have been shared with community leaders, and those who have expertise in the areas that are not being addressed directly by Sanford. Sanford Medical Center Fargo will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Medical Center South University Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: HypertensionSanford Medical Center South University will reduce the number of patients with uncontrolled hypertension. Standardized nursing protocol for blood pressure checks and rechecks is a strategy that has been implemented throughout the medical center.Priority 2: DepressionSanford has prioritized depression as a top priority and has implemented strategy to perform assessments for depression and to improve PHQ-9 scores and the severity for patients with depression. PHQ-9 score is a standardized tool used to assess depression. The goal is to lower the score from the original starting point. Sanford uses the PHQ-9 screening tool in primary care settings across the system.Priority 3: Flu Vaccines Sanford has prioritized flu vaccines and has implemented strategy to increase the number of flu vaccines provided to community members. Sanford will develop consumer education materials, and conduct flu blitz clinics at various locations in the community. Addressing of Significant Needs during Current Year:Priority 1: HypertensionHypertension is a risk factor for cardiovascular disease, and contributes to premature death from heart attack, stroke, diabetes and renal disease. The North Dakota Department of Health reports that 27.7% of the population in Cass County has been told by their provider that they have hypertension.Sanford prioritized hypertension as a top priority for 2017-2019, and has set strategy to standardize nursing protocol for blood pressure checks and rechecks. The goal is to reduce the number of patients with uncontrolled hypertension. The measureable outcome is the number of patients with blood pressure < 140/90. This goal has been reached for 87.8% of patients with hypertension.Priority 2: DepressionDepression is a common but serious illness that can interfere with daily life. Many people with a depressive illness never seek treatment. However, the majority, even those with the most severe depression, can get better with treatment. The North Dakota Department of Health reports that 11.9% of residents in Cass County have reported fair or poor mental health days. County Health Rankings for Clay County indicate that 11% of the residents have fair or poor mental health.Sanford has prioritized depression as a top priority and has set strategy to perform assessments for depression and to improve PHQ-9 scores for patients who are diagnosed with depression. The goal is to improve PHQ-9 scores for patients with depression. The measurable outcome is the percentage of patients with major depression or dysthymia and an initial PHQ-9 score greater than 9 whose 6-month PHQ-9 score is less than 5. This goal has been reached by 10.7% of patients with a depression diagnosis.Priority 3: Flu VaccinesThe CDC states that influenza is a serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently. Even healthy people can get very sick from the flu and spread it to others. The North Dakota Department of Health reports that 33.5% of adults age 65 and older did not receive a flu vaccine in the past year. Respondents to the CHNA generalizable survey report that 26% of children 18 years and younger did not receive a flu vaccine in the past year.Sanford has prioritized flu vaccines as a top priority and has set strategy to increase the number of flu vaccines provided to community members. The goal is to increase the number of flu vaccines provided to community members. The measurable outcomes are the number of flu vaccines given to adults each year and the number of flu vaccines given to the pediatric population each year. The combined number of flu vaccines given in FY 2016 was 2675, in FY 2017, it was 2518 and in FY 2018, the total was 2017.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing, Hunger Aging - Cost of long term care, Availability of memory care, Availability of LTC Children and Youth - Bullying, Cost of quality child care, Cost of quality infant care, Availability of quality child care, Availability of quality infant care, Cost of services for at risk youth Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Crime, Child abuse and neglect, Domestic violence, Presence of gang activity in the community, Sex trafficking Health care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Timely access to substance abuse providers, Cost of affordable dental insurance coverage, Use of emergency room for primary care, Cost of affordable vision insuranceAll assessed needs that are healthcare related are being addressed at Sanford. Sanford is not developing strategies to address the cost of long term care and the availability of long term care and memory care in the Fargo-Moorhead area. Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs. Additional concerns that will not be addressed directly by strategy include bullying among children and youth, the cost of quality child care and the cost of quality infant care. The results of the CHNA have been shared with community leaders, and those who have expertise in the areas that are not being addressed directly by Sanford. Sanford Medical Center South University will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Bismarck Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Access to affordable careSanford Bismarck Medical Center is increasing the percentage of community members accessing preventive and acute care in appropriate settings. Sanford is establishing a Family Wellness Center to provide year-round health and wellness opportunities for community members and is also providing education to make patients aware of the best coverage options through a "no wrong door" policy to help community members secure health coverage and/or financial assistance through the Sanford financial assistance (Community Care) program.Priority 2: Substance abuseSanford will work with community stakeholders to identify gaps in the community's substance abuse continuum of care and to improve access to care. Sanford Bismarck Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Access to Affordable CareTo help uninsured and underinsured patients secure access to care, Sanford integrated full-time, on-site financial advocates help uninsured and underinsured patients apply for health coverage and apply for Sanford's financial assistance program. Sanford worked with local public health officials to help patients in need to access care and prescription medication. Sanford provided support and assistance to underserved and vulnerable populations via community volunteer work, including the Bismarck/Mandan emergency homeless shelter, and provided Medicaid enrollment assistance on site at the Standing Rock Sioux Reservation. Sanford also facilitated MyChart access for Ruth Meiers transitional housing residents.To increase access to services and facilities that foster healthy lifestyles, Sanford completed construction of the Family Wellness Center in 2017, which is a partnership between Sanford and the Missouri Valley Family YMCA. The community facility features more than 70 fitness classes for members of all ages, a gymnasium, indoor track and child watch services. In 2017, more than 2,000 Bismarck-Mandan area individuals and families joined Family Wellness and more than $12,000 in financial assistance was granted to children and families in need.Sanford hosted the Edith Sanford Run/Walk for Breast Cancer, an annual breast cancer awareness event that features a 5K run and walk as well as a comprehensive education fair that includes information regarding prevention, screening, treatment and community support programs.Sanford also established Better Choices, Better Health, a chronic disease self-management program designed to help adults manage the symptoms of diabetes, arthritis, heart disease, stroke, asthma, lung disease, pain, depression and anxiety. The evidence-based program is free to patients with chronic disease and caregivers.Priority 2: Substance AbuseSanford built partnerships with community stakeholders and donated leadership for one year to launch Face It TOGETHER, a community-based approach to addressing addiction in Bismarck-Mandan. Serving as interim director, Sanford leadership focused on increasing community stakeholder awareness of addiction recovery services and securing funding to hire a full-time executive director.Sanford served in a community collaborative to bring Caring for Our Community: Time to Talk Opioids, a six-part opioid education series designed for healthcare providers and community members, to the provider community and to community key stakeholders. Topics include recognizing addiction in the workplace, removing stigma and shame barriers, socioeconomic impact, diversion, strategies to reduce overdose-related deaths, and evidenced-based treatment programs including peer recovery coaching and medication assisted treatment (MAT).During 2016, Sanford executed the Sanford Opioid Stewardship initiative through the Sanford Quality Cabinet to reduce the volume of opioids prescribed to patients experiencing pain while integrating evidence-based, best practice strategies to manage pain effectively. From January 2016 to June 2017 Sanford providers reduced the number of opioid prescriptions by 30%.Sanford also facilitated a community stakeholder project to eliminate barriers to help law enforcement appropriately triage individuals under the influence of drugs or alcohol.Identified needs not directly addressed by this facility include: Aging Population - Cost of long term care, Availability of memory care, Availability of long term care, Availability of resources to help elderly stay in their homes, Availability of resources for family/friends caring/making decisions for elders Children and Youth - Cost of quality child care, Availability of quality child care, Cost of quality infant care, Availability of quality infant care, Bullying, Youth crime Crime/Safety - Presence of street drugs, prescription drugs and alcohol, Crime, Presence of drug dealers in the community, Child abuse and neglect, Sex trafficking, Domestic violence, Presence of gang activity, Elder abuse Economics - Availability of affordable housing, Homelessness, Hunger Physical Health - Chronic disease, Inactivity/lack of exercise, Poor nutrition, Obesity Diversity - Access to translators/bilingual providers Mental Health - Depression, Stress, Suicide, Other psychiatric diagnosis, Dementia and Alzheimer's disease Transportation - Driving habits, Availability of good walking or biking options Environment - Hazardous water, Water quality, Air quality, Home septic systems
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 6 -- Sanford Bemidji Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Behavioral healthSanford Bemidji Medical Center has set strategy to reduce mortality and morbidity from chemical addiction and mental health disease by participating in a community partnership to develop a continuum of care for behavioral health services and to offer psychiatry and psychology services in the ambulatory setting. Sanford will also enhance the level of behavioral health services available in the inpatient setting. Sanford Bemidji Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Children and YouthSanford has set strategy to reduce the number of infants born to mothers who are opioid users by developing a case management system to work with pregnant women and to also coordinate medical assisted therapy options for pregnant women at risk of opioid use. Additionally, Sanford will enhance the level of care available to high risk infants born in Sanford Bemidji Medical Center.Sanford will also provide the Sanford fit program to the local schools and make the program available to families in the area through the fit website.Addressing of Significant Needs during Current Year:Priority 1: Behavioral HealthGoal 1: Participate in the planning for development of a community-based continuum of behavioral health servicesA community collaborative of 15-20 individuals in several community service organizations has been working on a mental health service inventory, a gap analysis, a prioritization of community need's and program start up. Since the inception of this effort in 2016, Sanford has been part of the start-up of an Assertive Community Treatment program for mentally ill adults, the expansion of several other mental health programs, the start-up of a Medication Therapy Program and the associated chemical dependency treatment services, and the development of a residential treatment center and detoxification beds. The plan developed by the collaborative calls for the development of added CD treatment, youth programs and other community-based programs.The ACT program, which now serves over 40 people with serious and persistent mental illness, affected the community by providing a host of supportive services so individuals can live in their own homes, secure jobs, avoid readmission to acute psychiatric medical centers, and stay out of jail and emergency rooms. The individuals served through these services report that their quality of life is much improved.Goal 2: Offer psychiatry and psychology services in the ambulatory settingIn 2017 and 2018, Sanford Bemidji has added three psychiatric nurse practitioners, four psychologists and several other independent licensed therapists. Recruitment of psychiatry remains a high priority and telemedicine psychiatry is available for inpatients and clinic patients on a scheduled basis.Goal 3: Enhance the level of behavioral health services available to patients hospitalized at Sanford Bemidji Medical CenterThe implementation of scheduled tele-psychiatry for inpatients has improved the ability to evaluate and treat inpatients at Sanford Bemidji Medical Center appropriately. With the affiliation with Upper Mississippi Mental Health Center, the access to the mobile crisis team has improved by placement of this staff directly in the medical center, allowing them to respond to behavioral health crises both in the ER and in the inpatient units.Priority 2: Children and YouthGoal 1: Reduce the number of infants born addicted to opioidsWith the support of a grant from PrimeWest, Sanford Bemidji implemented a program entitled First Steps to Healthy Newborns, providing education, prevention, early intervention and support for opioid exposed newborns and mothers. In addition to the development of community educational material, this program includes chemical dependency counseling, case management and medication-assisted therapy for pregnant women using opioids.Although it is early in the program's existence, First Steps to Healthy Newborns saw an impact. For the first time in several years, the number of opioid exposed babies born at Sanford Bemidji Medical Center did not increase but remained flat during 2017. The program is currently expanding to include other adults, not just pregnant women.Goal 2: Enhance the level of care available for high-risk infants born in Sanford Bemidji Medical CenterThe volume of high-risk deliveries in the Sanford Bemidji Medical Center is high in proportion to the number of total deliveries. The population served by Sanford Bemidji has several high-risk factors. The need to assure fast, safe access to caesarian section capabilities and immediate access to a higher level of nursery care for infants were two identified strategies to improve care for infants and mothers.In 2017, a new Level 2 nursery was constructed, offering individual nursery bays, expanded nutritional services and other secondary services to support lower weight infants born in Bemidji.In June of 2018, Sanford Bemidji Medical Center opened a surgical suite on its obstetrics floor, dedicated to performing C-section deliveries and other OB-related procedures. This new OR suite assures faster, safer, more responsive care for babies and for families requiring C-section deliveries.Goal 3: Improve the availability of programs for youth across the communityIn 2017, Sanford affiliated with the Upper Mississippi Mental Health Center to better support the development and growth of mental health programs in the region. This has allowed Sanford to add new staff to better serve children in the local schools by growing the resources in Sanford children's mental health programs.In 2018, Sanford sponsored a program called No Hungry Child, funding meals and underwriting costs for the area schools to provide meals year round to children and, in summer months, their families, so no child goes without food. Sanford also underwrote the expansion of a program called Backpack Buddies to all local schools, where backpacks with healthy meals are sent home on Fridays with students who might otherwise not have food over the weekend.Additionally, Sanford is exploring the feasibility of a community Sports and Wellness Center to offer children and families an environment for healthy physical activities, educational programs on healthy living and cooking, wellness and fitness classes, as well as a recreational sports and swimming venue. This project is still in the evaluation stage and does not have a target completion date.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of public transportation Aging - Cost of long term care, Availability of long term care, Availability of resources for caregivers making decisions, Availability of memory care, Availability of resources to help the elderly stay in their homes, Availability of resources for grandparent caregivers for grandchildren, Understanding of advanced care directives Safety - Child abuse and neglect, Crime, Presence of street drugs, prescription drugs and alcohol, Presence of drug dealers, Domestic violence, Presence of gang activity, Elder abuse, Safe places for outdoor youth activities, Sex trafficking Health care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Cost of affordable dental insurance, Use of emergency services for primary care, Cost of affordable vision insurance, Timely access to mental health/behavioral health providers, Availability of non-traditional hours, Timely access to physician specialists, Coordination of care between providers and services Physical Health - Cancer, Inactivity, Obesity Chronic disease, Poor nutrition Preventive Health - Flu shots
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Thief River Falls Medical Center has set strategy for the Behavioral Health Center to become CMS certified as a free-standing psychiatric hospital. Sanford will also develop a partial hospitalizations program and work to develop partnerships with regional behavioral health organizations.Priority 2: Physical HealthSanford will expand the wellness center and focus on a Kids Unite wellness center. Sanford will Partner with community organizations to plan and develop a self-sustaining community center. Additionally, Sanford will provide Sanford Fit program was introduced to local schools and child care organizations and will continue to enroll patients into the Medical Home. Addressing of Significant Needs during Current Year:Priority 1: Mental Health/Behavioral HealthIn October 2015, Sanford Thief River Falls moved into the newly renovated space for the Sanford Behavioral Health Center, a 16-bed freestanding psychiatric medical center and the only one in the Sanford Enterprise. In order to receive payments from Federal and commercial payors it was necessary to become certified by the Centers for Medicare and Medicaid Services (CMS). The survey was conducted in January 2016 and the center received Federal certification in April 2016. Federal surveyors contracted by CMS rather than the Minnesota Department of Health surveyors performed the survey. The reason for this was because there are so few freestanding psychiatric medical centers in Minnesota that the Department of Health cannot maintain surveyor proficiency and competencies. Obtaining certification was an arduous process but well worth the effort - bringing a higher level of behavioral and mental health services to the region. It has also enabled Sanford to recruit more professionals to the area, improving access and services available to the region that is served.After an extensive analysis of the regulatory requirements, reimbursement systems for the partial hospitalization program and the elements required to provide a quality program of care, it was determined that at this point in time a partial hospitalization program would not be economically feasible. This initiative has been tabled for review in the future.The Sanford Behavioral Health Center has worked very hard since certification to develop partnerships with other local, regional and state programs, and agencies having a role in delivering behavioral and mental health services. The term "partnership" is used rather loosely as it is often more akin to developing relationships that provide additional resources to Sanford's patient population, whether on an inpatient or outpatient basis. Critical or high priority relationships continue to be cultivated with the surrounding county social service agencies, as they most often have reasons to interface with a large proportion of the individuals seeking behavioral or mental healthcare. These relationships are crucial to delivering high quality, high impact services throughout the region.Priority 2: Physical HealthGoal 1: Expanded Wellness CenterSince 2016 Sanford Thief River Falls has expanded the physical footprint of the Wellness Center by 30,000 square feet, making it the largest wellness center in Thief River Falls and within a 60-mile radius as well. The most significant expansion project was the addition of a kid's area, funded entirely through the Sanford Foundation Thief River Falls which contributed nearly $300,000 for this initiative. The Wellness Center now has an area that is the best in this region, specifically focused on children and addressing all levels of fitness, through integrated play systems, instructor-led classes and space for relaxation. Memberships, both family and individual, have also grown significantly (by nearly 33%) since the opening of the kid's fitness area. The Wellness Center currently has over 1,600 members, doubling from 800 members when moving into the current space in September 2014. Growth has been steady.Goal 2: Develop a community centerThis initiative requires the collaboration of many local/regional organizations as well as governmental agencies if Thief River Falls is ever to see a community center developed. Since 2016 interest in developing a community center in Thief River Falls has lost traction among the needed partners and as such has not progressed. This initiative is still very much on the minds of the community; undoubtedly surfacing in the years to come with Sanford Thief River Falls ready to partner with the community when the time comes.Goal 3: Improve the availability for exercise and nutrition education across the communityThe primary impact Sanford has had on this goal has been through the relocation and expansion of the Wellness Center. As noted above, memberships have doubled in four years with no slowing in momentum. The interest in exercise, individual as well as group classes, has exceeded expectations and has required a number of additions to the teaching staff. Sanford has a number of dietetic nutrition counselors in the primary care clinic, working hand in hand with providers, providing nutrition counseling and education for patients and families.Goal 4: Continued growth of Sanford Medical HomeThis is an area where Sanford Thief River Falls has not seen as much growth in as previously predicted. The focus initially has been on patients with chronic conditions. However, with the recent transition to team-based care in the primary clinic there is an opportunity to expand this emphasis to every patient.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of good walking or biking paths Aging - Cost of long term care, Availability of memory care, Availability of resources to help the elderly stay safe in their homes Children and Youth - Availability of quality infant care, Availability of quality child care, Availability of activities for children and youth, Cost of activities for children and youth, Cost of quality infant care, Bullying, Cost of quality child care, Teen pregnancy, Availability of services for at-risk youth Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Domestic violence Health care - Access to affordable health insurance, Access to affordable prescription drugs, Access to affordable health care, Availability of non-traditional hours, Cost of affordable dental insurance coverage, Use of emergency services for primary care Preventive health - Flu shots, Immunizations, Not seeing a health care provider or dentist within the past yearSanford will not directly develop strategy to address the availability of affordable housing, walking and biking paths, the availability and cost of quality infant and child care, the availability and cost of activities for children and youth (except for the Sanford fit Program), bullying, teen pregnancy, services for at-risk youth, the presence of street drugs, drug dealers in the community, and domestic violence. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the findings of the CHNA and the needs with community leaders and public health agencies in the area. Sanford Medical Center Thief River Falls will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health/ObesitySanford Aberdeen Medical Center will provide the Sanford fit Program to all students and families through classroom modules and the fit website.Priority 2: Mental Health/DepressionSanford is committed to improving the care of patients with depression diagnosis and will perform depression assessments, and implement health coaches and primary care staff into the care process.Addressing of Significant Needs during Current Year:Priority 1: Physical Health/ObesitySanford Aberdeen Medical Center focused on the pediatrics population by providing Sanford fit program materials to area schools and childcare centers and promoting health and wellness. Sanford fit is available to all students and families through classroom and/or online through the Sanford fit website.In addition, Sanford continues to offer educational sessions for the community:Cooking classes and nutrition education to student athletesNutrition presentations to groups with cancer and other chronic conditions (breast cancer, COPD, diabetes, etc.)Participation in community health fairsNutrition education for pregnant women and new moms (B4 Baby)Introduction of Solids (nutrition class series) for new parentsParticipation in TV, radio, and newspaper interviews regarding nutrition topics in the newsDiabetes Prevention ProgramCooking with the Cardiologist for community members to attendParticipation in various community youth events through the schools (middle school/high school) promoting good nutritionPriority 2: Mental Health/DepressionSanford developed a depression assessment tool for patients to complete during a clinic visit. Sanford Aberdeen Medical Center also added an Integrated Health Therapist (IHT) to the team as a resource along with RN Health Coaches and a care coordination assistant.The Integrated Health Therapist (IHT) serves as an integral core team member within the patient- centered Medical Home. The IHT works with the physician, advanced practice provider, RN Health Coach, nurses, care coordinator assistant, peer support advocate and community partners, all of whom work collaboratively to provide the best care to patients. The IHT is an important resource for patients and team members for issues related to mental and behavioral health, chemical health, psychosocial aspects of health and disease, and lifestyle management to support optimal patient functioning.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Environment - Good water quality Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Cost of quality infant care Safety - Presence of street drugs and alcohol in the community, Domestic violence, Child abuse Health care - Access to affordable health insuranceSanford will not directly develop strategy to address the availability of affordable housing, good water quality, the cost of long term care and the availability of memory care, the cost of quality infant care, and the presence of street drugs and alcohol in the community. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the results of the CHNA and the unmet needs with community leaders. Sanford Aberdeen Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 9 -- Sanford Worthington Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: AccessSanford Worthington Medical Center has implemented strategy to improve access by helping community members understand the resources and financial assistance that is available through Sanford Health. Sanford will also partner with community entities to increase holistic care and with an employer group to increase education relative to health career services and insurance.Priority 2: Physical HealthSanford will fully implement the Medical Home model, increase provider education of registered dietitian services, improve the availability of exercise and nutrition education across the community, and increase the implementation of preventive health care. Addressing of Significant Needs during Current Year:Priority 1: AccessSanford Worthington initiated a monthly health topic page in the local newspaper. As a result of this campaign, Sanford Worthington also enlisted local employees engaged in care delivery to talk about services offered at the medical center and clinic that corresponded with the monthly health topic. Sanford Worthington contributed 20 health topic articles to the local newspaper and 32 radio talks to improve health literacy about available services in the community. Topics ranging from health promotion through routine screening, as well as recognition of serious medical conditions to seek medical care immediately were presented. Sanford Worthington became recognized as a consistent provider for the community's health needs.Sanford Worthington collaborated with JBS, a local employer, to refer patients to an employee program called JBS Strong. This program provided mentoring and coaching for lifestyle changes to employees with classes located at the workplace. Through collaboration between Sanford Worthington and JBS, 51 patients were referred to the JBS Strong program. Sanford Worthington gave YMCA memberships to six graduates of this program. This incentive was provided to encourage graduates to continue holistic care that was started by JBS. To reach this goal Sanford Worthington also envisioned a partnership with the YMCA to provide a consistent partner for referral of patients under the care of clinic RN Health Coaches. This collaboration began with referrals and will expand to formalize this relationship.Sanford Worthington began a relationship with JBS to improve health literacy among the plant's workforce. A relationship developed with the plant human resources department, union officials, and health plan agents. A need was identified for improved education about health topics. To meet this need, Sanford Worthington and JBS developed a health topic kiosk in employee break areas. This central location was used to deliver a health topic education during break times at the plant. JBS human resources and Sanford Worthington worked together to provide medical information on the kiosk in several languages to bring health education to those who were unable to obtain information from other sources due to a language barrier. Sanford Worthington offered 16 health topic education messages on the kiosk during this assessment cycle. Sanford Worthington clinic staff were on site twice per month at the plant to offer services to employees including educational presentations, assisting plant employee health leaders with employee blood draws, and participating in health fair programming. Sanford Worthington Medical Center assisted with the drawing, processing and distribution of up to 1,000 individual employee's annual health assessment data. This goal will continue as the collaboration with JBS continues which will result in improved access for its employees.Priority 2: Physical Health and Mental HealthSanford Worthington embarked on a journey to revamp its care delivery system for primary care. Sanford Worthington participated as a pilot site for the Medical Home model of care delivery. Primary care physicians and advance practice providers joined with nurses and clinical care assistants, RN Health Coaches and Integrated Health Therapists to provide a comprehensive care model for patients. Sanford Worthington achieved certification as a Medical Home during the 2016 cycle period, and has recently achieved recertification and recognition for the advancement of the care delivery model over the past three years. Patients with the chronic diseases of hypertension and diabetes, as well as patients at risk for developing diabetes, were offered behavior modification programs and personal care management with RN Health Coaches. The comorbid factor of mental health was also addressed for many patients in one setting through the use of the Integrated Health Therapist into the patient's primary care appointment. Evidence of the advantage of this model of care include improved performance in community healthcare measures including colorectal screening. Colorectal screening increased from 65% to 68% during this time frame. A colorectal screening performance improvement project was also undertaken to improve patient scheduling processes to make it more convenient to schedule a screening exam. Sanford Worthington Medical Center also entered into an agreement with the Minnesota Department of Health to be a SAGE Scopes provider for free colorectal screening. Through this grant program community residents who are underinsured and uninsured can access care without a burden of cost.Sanford Worthington hired a Licensed Independent Social Worker to provide integrated care in collaboration with medical providers at the clinic. The objective of this Integrated Health Therapist (IHT) position was to be present and available to physician and patient on an as-needed basis for rapid assessment and collaboration of care. On a daily basis, the IHT maintains a visible presence to all clinic staff and functions as point of contact for any questions/issues related to behavioral/chemical health. They were available for immediate team "handoffs" of patients requiring immediate assessment or intervention. They triaged patients with high-risk behavioral profiles and coordinating services with specialty care resources, performed brief, limited follow-up visits with selected patients using behavioral or problem solving strategies for symptom reduction, and acted as a consultant to the clinic as it relates to universal screening procedures, outcome data management, and fidelity measures.Sanford Worthington offered an intensive behavior therapy program for weight loss to assist patients to overcome poor eating habits and develop better lifelong habits. Providers and RN Health Coaches were able to refer patients to the program with positive outcomes for the patients. During this assessment cycle, 71 intensive behavior therapy sessions were completed for program enrollees.Sanford Worthington introduced the Sanford fit website to local school teachers and childcare centers in the community. School nurses employed by Sanford Worthington created a collaboration to bring healthy habit education to young children when health habits are developing. Sanford Worthington Employee Health and Marketing coordinated an education session in the spring of 2017 to provide education to elementary school nurses and physical education teachers about Sanford fit. This education has the potential to reach over 3,000 students in public and private education in Nobles County.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of public transportation Environment - Water quality Aging - Cost of long term care, Availability of memory care, Availability of long term care, Availability of resources for family friends/ caring for and making decisions for elders, Availability of resources to help the elderly stay safe in their homes Children and Youth - Availability of quality infant care, Availability of quality child care, Bullying, Cost of quality child care, Cost of quality infant care, Availability of activities for children and youth, Teen pregnancy, Cost of activities for children and youth, Availability of services for at risk youth, Teen births Safety - Presence of street drugs and alcohol in the community, Domestic violence, Presence of drug dealers in the community, Child abuse
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 10 -- Sanford Sheldon Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Sheldon Medical Center has developed strategy to reduce mortality and morbidity from chemical addiction and mental health diseases by recruiting a triage therapist, and working to reduce drug and alcohol abuse in the community. Sanford will work with the high school counselor to enhance curriculum to include abuse issues. Sanford Sheldon Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Children and YouthSanford has developed strategy to support the youth in the community by enhancing the community environment through structured after school programming, day care expansion, and education sessions for youth and parents.Addressing of Significant Needs during Current Year:Priority 1: Mental Health/Behavioral HealthSanford Sheldon Medical Center has increased the availability of mental health counseling with the addition of an Integrated Health Therapist. The IHT addresses the immediate need for mental health counseling at Sanford Clinic Sheldon.Priority 2: Children and YouthSanford Sheldon Medical Center provides 75 backpacks to the Shop with a Cop program, which provides children in need with the opportunity to go back to school with new school supplies. Sanford supports the summer lunch program that is facilitated at a local church and provides meals to students in need during the summer months when school is not in session. A farm safety course is taught to all children in the second grade at all Sheldon schools. Sanford invites third grade students from all Sheldon schools and other nearby community schools to tour the medical facility. The tour helps to increase the students' comfort level with the facility and staff. Sanford hosts events such as the Glow Walk that is promoted as a family fun wellness event.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Safety - Presence of street drugs, prescription drugs and alcohol in the community, Child abuse and neglect, Domestic violence Health Care - Use of emergency services for primary health care, Access to affordable health insurance, Timely access to physician specialists, Availability of non-traditional hours, Timely access to doctors, PAs or NPs, Timely access to mental health providers Physical Health - Cancer, Chronic disease, Obesity, Poor nutrition, Inactivity Preventive Health - Flu shots, Immunizations
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 11 -- Sanford Vermillion Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental HealthSanford Vermillion Medical Center has developed strategy to increase mental health services in the Vermillion community through additional mental health counselors and providers as well as offering psychiatry telemedicine services. Sanford Vermillion Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Physical Health Sanford Vermillion has set strategies to reduce obesity, hypertension and high cholesterol and realize an overall improvement in physical health by offering a variety of classes, fitness programs and screenings.Addressing of Significant Needs during Current Year:Priority 1: Mental HealthDepression is a common but serious illness that can interfere with daily life. Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. County Health Rankings for Clay County indicated that 11% of the residents have fair or poor mental health.Sanford has prioritized depression as a top priority and has set strategy to perform assessments for depression and to improve PHQ-9 scores for patients who are diagnosed with depression. The goal was to improve PHQ-9 scores for patients with depression, which has experienced a 4% improvement in this short time with the percentage of patients with major depression or dysthymia who had an initial PHQ-9 score greater than 9 whose 6-month PHQ-9 score was less than 5.The goal of increasing the availability and number of mental health services in the Vermillion community was also set by Sanford Vermillion. Several strategies have been implemented to achieve this goal. The mental health counselor now offers evening appointments in addition to regular daytime appointments. Sanford Vermillion has also hired a psychologist as their Integrated Health Therapist who works full-time offering mental health services to the extended community via face-to-face visits and through telehealth visits.Sanford Vermillion has also continued to provide a Certified Nurse Practitioner who specializes in psychiatry to its monthly outreach services. She provides psychiatric services for patients of all ages from pediatrics to elderly monthly at the Sanford Clinic Vermillion.Sanford Vermillion also credentialed and added to their allied health staff a Licensed Addiction Counselor to assist with patients in need of evaluation and/or rehabilitation services in the clinic, emergency room and inpatient setting.Sanford Vermillion has the equipment and medical staff credentialed to provide psychiatric outreach services via telemedicine services through the facility and Sanford USD Medical Center as another strategy to increase availability of services in the community and also collaborates with USD through the student health contract to offer the USD students counseling services on campus at the USD Counseling Center and the USD Psychological Services Center.Priority 2: Physical HealthFor reducing obesity in the community, several strategies have been established. For children, Sanford Vermillion has been working with the Vermillion School district for several years implementing the Sanford fit initiative. This initiative continues to grow and has reached approximately 750 children this past year in grades kindergarten through fifth grade. It has been very well received in the community. Supported by clinical experts of Sanford, fit is the only initiative focusing equally on the four key contributing factors to childhood obesity: Food/nutrition, Move/activity, Mood/behavioral health and Recharge/sleep. Sanford's fit initiative has come a long way since its inception in 2010. Through Sanford fit, healthy lifestyles are actively being promoted in homes, schools, and throughout the community by way of technology, engaging programs and utilizing key role models in a child's life. For Sanford Vermillion, the athletic trainer is being utilized to implement the program in the schools.Sanford Vermillion also continues to encourage the Vermillion community to engage in all forms of exercise including sponsoring and hosting a number of events throughout the year such as Relay for Life. The annual community Great Strides walking program is hosted every spring for 6 weeks where 200 to 300 community members participate.The RN Health Coach at Sanford Clinic Vermillion also continues to work with the diabetic and hypertension patients proactively to ensure they come in for their health maintenance visits and labs. Sanford has set strategies to provide optimal diabetic care and to measure outcomes for systolic and diastolic blood pressures, LDL cholesterol, hemoglobin A1c, tobacco use, and aspirin use for people living with diabetes.Sanford Vermillion has also set strategies to address hypertension through a standardized protocol, frequent blood pressure monitoring, and referral as appropriate for patients with hypertension.Outcome measures include a blood pressure of less than 140/90 for all ages 18-59 and for age 60+ with diabetes, vascular or renal disease. For patients age 60 or older without diabetes, vascular or renal disease the goal is blood pressure of 150/90 or less. Sanford Vermillion is currently meeting this goal with 92.1% of hypertension patients having blood pressure of less than 140/90.The Sanford Vermillion wellness program also makes over 3,000 community contacts per year through its various health screening and community vaccination events. The annual health fair with free and reduced health screenings and a variety of reduced laboratory tests is available along with a wealth of community educational offerings in which approximately 350 community members attend annually.Educating the community on healthy nutrition was another strategy that Sanford Vermillion implemented by working with the on-site dietitian and a visiting cardiologist.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying Safety - Presence of street drugs and alcohol in the community, Child abuse and neglect Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable health care, Cost of affordable dental insurance coverage
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Chamberlain Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical HealthSanford Chamberlain Medical Center has developed strategy to help the community improve their physical health and chronic health conditions. The Medial Home model will be fully integrated into the clinic setting, and quality measures for patients with diabetes, elevated lipids and asthma will be monitored. A patient advisory council will convene to improve patient and clinic communications. Sanford fit will be offered to the local school districts, and resources will be available to students, families, and leaders. Priority 2: Mental Health/Behavioral HealthSanford will integrate the Medical Home model into the clinic primary care setting and will utilize PHQ-9 assessments to evaluate for depression. Health coaches and a Master's prepared social worker will be dedicated to mental health/behavioral health services. The facilitated support group will be a focus for additional patient engagement.Addressing of Significant Needs during Current Year:Priority 1: Physical HealthSanford Family FIT night was established with the Chamberlain School District. Sanford Chamberlain staff are on site during parent teacher conferences at the elementary school (K-5), where Sanford hosts various booths discussing healthy lifestyle choices, teaching the children and parents the importance of mental health in young people, avoiding drug use, promoting an active lifestyle, and heart health. The community prescription take-back program is also promoted.Camp FUEL, held every summer as a three-day camp, is free of charge and focuses on the importance of healthy eating, healthy lifestyle choices and physical exercise.Priority 2: Mental Health/Behavioral HealthSanford Chamberlain works with Indian Health Services (IHS) and tribal leaders to participate in health fairs, providing hands-on education about substance abuse, mental health, healthy eating, and also conducts blood pressure and cholesterol checks.Identified needs not directly addressed by this facility include: Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Child abuse and neglect Substance Use and Abuse - Drug use and abuse, Underage drug use and abuse, Alcohol use and abuse, Underage drinking, Smoking and tobacco use Children and Youth - Bullying, Youth crime, Availability of quality child care, Availability of quality infant care, High rates of teen births Health Care - Access to affordable health care, Need for medical care, Need for prescription medications, Unmet mental health needsSanford will not develop strategy to address the presence of street drugs and alcohol in the community, the presence of drug dealers, and child abuse. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford shared the findings of the CHNA research and these unmet needs with community leaders and community stakeholders. Sanford Chamberlain Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Mayville Medical CenterSanford 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 Luverne Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical HealthSanford Luverne Medical Center will address chronic disease management and monitor MN community measure scores for improvement. Sanford will engage the community around wellness, healthy eating and dental health.Priority 2: Mental HealthSanford has developed strategy to improve access to mental health and substance abuse resources. PHQ-9 scores will be monitored and referrals to behavioral health triage therapists, care coordinators and chemical dependency staff with be made as determined by assessment.Addressing of Significant Needs during Current Year:Priority 1: Physical HealthSanford Luverne set a strategic goal focused on improving chronic disease management. Throughout the past three years, the core team focused on using Healthy Planet population registries to ensure patients are receiving all recommended preventive care. The team is focusing on asthma, diabetes and mental health/depression. The quality scores in each of these areas have demonstrated improvements.Depression remission scores at 6 months measured 5.6% in July 2015, and as of July 2018, 18.1% patients noted they were in remission at 6 months and 25.1% at 12 months. Optimal diabetes management was reported for 36% of patients in December 2014, and as of July 2018, 53.6% of patients have met the goals for optimal diabetes management. In July 2015, 45.2% of patients had an asthma control test completed. In July 2018, 63.5% of patients had an asthma action plan in place - noting that metrics for measurement changed during this time period.In addition, Sanford Luverne's registered dietician has utilized a variety of platforms to bring forward education on healthy eating options, including the local senior meal site. Sanford Luverne has supported the efforts of the City of Luverne to expand the Luverne LOOP walking trail. Sanford Luverne partnered with the City on a task force looking at wellness within the community, and has sponsored several wellness challenges. Despite this focus (and following national trends), higher obesity rates are prevailing but Sanford's strategies will continue to focus on diet and exercise.Sanford Luverne leadership reached out to bring dental services to the community through mobile services, but the request was denied. A task force is now working to address dental access, such as bringing dental screenings into the school and bringing more access within the community as part of the Blandin poverty initiative.Priority 2: Mental HealthSanford Luverne employs a part-time therapist to assist with treatment and triage of mental health issues for patients. Additionally, a second Integrative Health Therapist has joined the Sanford Luverne staff, providing additional access for Medicare beneficiaries. The Sanford Luverne therapists work closely with local mental health providers. In addition, the facility sponsored mental health first aid training for the community. Sanford's therapist has completed the training to become a Mental Health First Aid trainer. Sanford Luverne was awarded a grant to look at mental health services and care coordination and has developed a release of information form that allows for greater care coordination across all entities. This form was reviewed and approved by all agencies involved. Sanford Luverne has seen an improvement in depression remission scores over the past three years. Sanford Luverne is in the process of implementing tele-psychiatry for improved access. The Sanford Luverne substance use program has actively been involved in Rock, Nobles, Pipestone, and Murray drug courts and is actively engaged in providing community education and serving on various community boards to decrease substance use issues within the county.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Availability of quality infant care, Availability of quality child care Safety - Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance Preventive Health - Flu shots, ImmunizationsSanford will not develop strategy to address the cost of long term care, the availability of memory care, the availability of quality infant and child care and the presence of street drugs in the community. However, Sanford shared the results of the CHNA research with community leaders and agencies with expertise to the identified needs. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford Luverne Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Canby Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health Sanford Canby Medical Center will implement the Together Canby Can initiative to promote healthy lifestyles, and will work with the public schools and parochial schools to bring Sanford fit to school age youth. Sanford will also implement the MN Community Measurement application for blood pressure screening and follow-up.Priority 2: Mental HealthSanford will implement an education program for awareness and prevention and will determine the availability of resources for mental health within the geographical area in partnership with public health. Sanford Canby Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priorities 1 & 2: Physical Health and Mental HealthA goal was set to reduce the negative health effects of obesity and to control hypertension in the community of Canby. The BMI reduction initiative was started in the Sanford Canby Clinic with the aim to identify patients who would benefit from weight loss and commit to a 12-week weight loss program. The initiative began in February 2017 and new class sessions start every six weeks.The Sanford Canby RN Health Coach performed readiness assessments on each participant. The assessment included data collection to record initial weight, BMI, and blood pressure. Each participantset individual smart goals, and throughout the course of the program participants completed a weekly one-on-one check-in with the purpose of reassessing goals and reporting weights. A monthly re-charge session was also conducted. During this session, participants could discuss activity, diet, mood, and share personal stories. The session also provided a platform for sharing healthy recipes and sampling of healthy food choices.Four groups (a total of 26 participants) completed the 2017 sessions. The groups lost a total of 140 pounds collectively. All but one participant lost weight except for two participants who maintained their weight. All but one participant reduced their blood pressure except for two who maintained their blood pressure. Participants noted that one-on-one sessions offered accountability to the program.The electronic medical record (EMR) has been upgraded with the capability to calculate BMI. If the calculation meets or exceeds a BMI of 30 (defined as obese by CDC definition), providers are alerted, allowing them to specifically address lifestyle and other health factors. The EMR allows providers to refer patients to weight loss programs, a dietician, bariatric surgery, an RN Health Coach, behavioral health, and/or pulmonology services. With the added functionality in the EMR, a patient's BMI can be addressed at every patient visit. Additionally, the Together. Canby Can initiative promoting healthy lifestyles within the community continues with 75 community members participating. The strategy of this initiative was to address both mental and physical health. Through this initiative monthly wellness education classes for the general public focus on nutrition, healthy routines, mental health, better balance, etc.The Sanford fit kids program focuses on four areas - Food, Move, Recharge, and Mood. Sanford Canby brought this program to both Canby Public School and St. Peter's Catholic School in the fall and spring of 2016-2017. Kindergarten through sixth grade classes were able to take part in the program. Approximately 350 students participated in this program learning healthy lifestyle and healthy mental health strategies.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth Safety - Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable prescription drugs, Cost of affordable dental insurance coverage
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 15 -- Sanford Jackson Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthSanford Jackson Medical Center will utilize Sanford Fit tools at the Family Fun nights and will bring the curriculum to the area schools. Priority 2: Mental Health Sanford has developed strategy to reduce drug abuse by educating the public on the take back program in the community. Additionally, Sanford will consider the availability of the mobile mental health unit in Jackson County as a collaborative partnership for mental health services.Sanford Jackson Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Children and YouthSanford Jackson Medical Center leadership distributed the Sanford fit program information to the schools and day care centers in the Jackson/Lakefield area. In May of 2016, 2017 and 2018, the Sanford fit program was promoted at the annual Family Fun Night. Over 300 parents and children attended this event each year. The annual Sanford Tri for Health for youth celebrated its 10th year in 2018 with over 120 youth ages 4-14 participating. Sanford Jackson Medical Center continued to support free activities in the community such as Jackson Food 4 Kids, which provides weekly food packs for food insecure children, summer library programs, and the free summer lunch program. With the financial support of Sanford Jackson and Sanford Sioux Falls, Sanford committed to a multi-year pledge in support of building a splash pad in Jackson. The splash pad will provide free admission May-September each year.Priority 2: Mental HealthSanford Jackson Medical Center developed strategies to meet the needs for mental health and substance abuse services. A licensed counselor is now available to provide mental health services. The added service provides for immediate access when a crisis presents.When underage drug use and abuse was identified as a community concern, Sanford Jackson committed to providing education on the topic of the Take Back program. An Ask the Expert column in the local newspaper featured this program.Another successful tactic in relation to mental health collaboration was facility leadership participation in the Integrated Behavioral Health Strategic Planning session with community partners. A community task force was started and meets quarterly. Current accomplishments include a decrease from 47% to 23% for the behavioral health patients discharged from the emergency room to inpatient behavioral health facilities. Additionally, the length of stay in the emergency room for patients with behavioral health primary encounter diagnoses has dropped from 4:38 hours to 2:45 hours.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Aging - Cost of long term care, Availability of memory care, Availability of resources for family/friends caring for and making decisions for elders Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Child abuse and neglect, Domestic violence, Violent crime Health Care - Availability of no-traditional hours, Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Cost of affordable dental insurance coverage Physical Health - Cancer, Inactivity or lack of exercise, Poor nutrition, Obesity, Chronic disease Preventive Health - Flu shots, Not seeing a health care provider or dentist in the past year
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 16 -- Sanford Tracy Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental HealthSanford Tracy Medical Center has developed strategy to improve the access time for patients waiting to be placed for mental health services from the ER. Sanford will also work with community partners to create new recovery program options for community members, and will work with the MN DOH on a pilot project for integrating behavioral health into critical access hospitals.Sanford Tracy Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Physical HealthSanford will address chronic disease through utilization of Medical Home, health coaches, and the Sanford fit Program.Addressing of Significant Needs during Current Year:Priority 1: Mental HealthThe mental health strategy continues to be a top priority and a work in progress for Sanford Tracy. Work continues on implementing a telehealth behavioral health placement program for the Sanford Tracy emergency room. Mental health placement has been and continues to be a major issue throughout the state of Minnesota, especially in rural areas. Although the Minnesota Department of Health project did not come to fruition, Sanford Tracy continues to search for opportunities to develop and grow the behavioral health services in Tracy. Child psychiatric care is provided via telemedicine, and locally through a family nurse practitioner and two LICSW providers. A recruitment plan is in place to seek additional specialists and telemedicine opportunities for Sanford Tracy. Sanford Tracy continues to provide presentations and media coverage to make the public and community partners aware of the services that are available.Priority 2: Physical HealthThe RN Health Coach continues to work closely with providers to reach patients and help them manage their chronic illnesses.Beginning in January of 2016, Sanford Tracy completed a 19-week Sanford fit program with the Tracy Area Elementary School fourth grade classes. The program was a customized version of Sanford fitClub. Two Sanford Tracy staff members met with the Tracy Area Elementary fourth grade physical education classes once a week for 25 minutes each. The students learned all about Sanford fit and about making good, healthy choices regarding their food, move (exercise), mood, and recharge (sleep/rest). In addition, the students had weekly challenge cards they took home to complete during the remainder of the week. By bringing back completed challenge cards, students worked their way towards end-of-year prizes, but also took home activities and exposed their families to fit. The program completed its second year in May of 2018. After a successful pilot year, at the beginning of the 2018 program, the students completed a fitClub "test". The students would take this test again in May after 19 weeks of learning about fit. The students increased their correct answers by more than 24% from the first test to the last. Each week, the Sanford Tracy staff could see the students engaging and absorbing the information through the fun activities. The program received positive feedback by the Tracy Area Elementary School physical education teacher and principal and will continue into the coming years.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Safety - Presence of drug dealers in the community, Presence of street drugs and alcohol in the community Health Care - Cost of affordable dental insurance coverage, Access to affordable health insurance Preventive Health - Flu shots, Immunizations, STDs
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 17 -- Sanford Rock Rapids Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 17 -- Sanford Rock Rapids Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 17 -- 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 17 -- Sanford Rock Rapids Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Rock Rapids Medical Center will enhance access to mental health and substance abuse resources, and access to resources to help the elderly stay in their homes. Behavioral health triage therapists and mental health providers will be added to improve access for mental health and behavioral health. Additionally, Sanford will work with local facilities and pharmacists on discharge to home and home options to ensure independence and safety at home. Sanford Rock Rapids Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Physical Health/Chronic DiseaseSanford will focus on the MN Community Measures Scores, continue the disease registry, and expand beyond diabetes to target evolving needs. Medication management, community education, and the promotion of physical activity in the community will be addressed. Sanford will also work with local dentists and mobile dental services to seek options to increase the availability of dental services that accept Medicaid.Addressing of Significant Needs during Current Year:Priority 1: Enhanced Access to Mental Health and Substance Abuse Resources and Services for SeniorsSanford Rock Rapids is partnering with area mental health services and refers patients to outpatient services. Sanford is also partnering with area providers to bring consulting services to patients who are in a mental health crisis in the emergency room. Sanford Rock Rapids is also in process of moving forward with telehealth mental health services.Sanford Rock Rapids is partnering with area nursing homes and home health services to refer patients who need additional care after discharge. Sanford Rock Rapids provides follow-up phone calls to patients after discharge. Patients are scheduled for follow-up provider visits prior to discharge, either within 7 days or within 14 days, depending on the risk for potential readmission. Readmission scores to this Sanford facility are currently 7.7%, with a goal of under 7%. This number has trended down over the past three years. The Sanford Rock Rapids pharmacist provides medication management and partners with the RN Health Coach and dietician to review high-risk patient cases and implement the best management to prevent a medical center admission.Priority 2: Physical Health/Chronic Disease Sanford Rock Rapids has worked hard to improve quality metrics for chronic conditions over the past three years. In January 2015, 32.5% of diabetic patients had optimal management, and in June of 2018, this grew to 50.6%. Optimal vascular was at 53% in January 2015, and is now at 57.1%. In June of 2015, 84.5% of hypertension patients had optimal management and today the optimal management is at 90.5%. Breast cancer screening was completed on 70.4% of eligible women in January 2015, and this indicator has seen improvements with a current score of 73.3%. Colorectal screening has also increased from 65.4% to 71.8%. Sanford Rock Rapids will continue to focus on obesity and will continue to be a community partner to promote individual and community health.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Aging - Cost of long term care, Availability of memory care, Availability of resources to help the elderly stay safe in their homes Children and Youth - Bullying, Availability of quality infant care, Cost of quality infant care, Availability of quality child care Safety - Presence of street drugs, prescription drugs and alcohol in the community Health Care - Access to affordable health insurance, Access to affordable prescription drugs, Cost of affordable dental insurance, Access to affordable health care, Cost of affordable vision insurance Preventive Health - Flu shots, ImmunizationsSanford will not directly develop strategy to address the availability of affordable housing, bullying among children and youth, and the cost and availability of infant and child care. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford will share the concerns and the results of the CHNA with community leaders who do have expertise in their areas.
Group A-Facility 17 -- Sanford Rock Rapids Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 17 -- Sanford Rock Rapids Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 18 -- Sanford Hillsboro Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 18 -- Sanford Hillsboro Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 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 18 -- Sanford Hillsboro Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical HealthSanford Hillsboro Medical Center will focus on exercise programs for community members, including walking clubs, biking clubs and fitness challenges in partnership with the local wellness center and the medical center's therapy department. Sanford will also provide the Sanford fit program to the local schools and childcare providers.Priority 2: Mental Health ServicesSanford will implement the PHQ-9 assessment to identify patients with depression and develop plans to reduce the severity of depression. Sanford will also distribute a directory of available resources to patients, local groups and entities to create awareness in the community. Sanford Hillsboro Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Physical HealthSanford Hillsboro developed strategy to increase physical activity for the Hillsboro community. Sanford staff presented the Sanford fit program to the three area schools within the Hillsboro service area. Sanford fit is an online curriculum that is available for all students, faculty and community members. Sanford also supports the annual 5/10K run that the Hillsboro Running Club puts on during Hillsboro Days.Priority 2: Mental HealthSanford Hillsboro Medical Center developed strategy to address mental health in the community. The Sanford Hillsboro Clinic has implemented a comprehensive behavioral health screening tool (BHS6) for all new patients and for all patients receiving comprehensive physicals. Sanford Hillsboro Medical Center has added availability of an Integrated Health Therapist through visits by telehealth. This service is available during all clinic hours.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth Safety - Seat belt usage, Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable prescription drugs, Cost of affordable dental insurance coverage Preventive Health - Flu shots, ImmunizationsSanford will not develop strategy to address the cost of long term care and the availability of memory care because the state of North Dakota through the Department of Human Services controls the cost. Memory care cannot be added to the LTC facility. Safety issues such as seat belt usage and the presence of street drugs are issues that the city council and the sheriff's office are issues that the community stakeholders are addressing. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 18 -- Sanford Hillsboro Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 18 -- Sanford Hillsboro Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 19 -- Sanford Medical Center Mayville Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 19 -- Sanford Medical Center Mayville Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford 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 19 -- 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 19 -- Sanford Medical Center Mayville Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health Sanford Mayville Medical Center will improve the availability of nutrition and exercise programs for community members. Additionally, the Sanford fit Program will be available to all students and families through classroom curriculum and through the Sanford Fit website.Priority 2: Mental Health ServicesSanford will implement the PHQ-9 assessment to identify patients with depression and develop plans to reduce the severity of depression. Sanford will also distribute a directory of available resources to patients, local groups and entities to create awareness in the community. Sanford Medical Center Mayville will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Physical HealthSanford Mayville Medical Center staff developed strategies to address physical health in the community. The Sanford fit program was made available to the four area schools within the Sanford Mayville service area. Teachers and school administration have found the fit program to be a very positive addition. Sanford Mayville's dietitian presented mini-seminars on Better Nutrition for Better Living at the Mayville Senior Center.Priority 2: Mental HealthSanford Mayville Medical Center determined that mental health was a top priority for the community. Sanford Mayville Clinic has implemented a comprehensive behavioral health screening tool (BHS6) for all new patients and for patients who are scheduled for comprehensive physicals. Additionally, Integrated Health Therapists are immediately available through telehealth services. Sanford Mayville has a pilot project, Bridging Health and Home, which is a free service to complement clinical services.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth Safety - Seat belt usage, Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable prescription drugs, Cost of affordable dental insurance coverage Preventive Health - Flu shots, ImmunizationsSanford will not directly develop strategy to address the cost of long term care and the availability of memory care because the state of North Dakota through the Department of Human Services controls the cost. Sanford has deferred to the local nursing home which does have an Alzheimer's unit. Safety issues such as seat belt usage and the presence of street drugs are issues that the city council and the sheriff's office are addressing. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 19 -- Sanford Medical Center Mayville Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 19 -- Sanford Medical Center Mayville Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 20 -- Sanford Webster Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 20 -- Sanford Webster Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 20 -- 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 20 -- Sanford Webster Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: SafetySanford Webster Medical Center will address safety by offering MOAB (management of aggressive behavior) training for employees and to local schools, businesses and the public. Sanford will present a DUI drama program to high school juniors and seniors to reduce the number of alcohol and drug related accidents among teens. Sanford will conduct an annual sports power program to discourage drug and alcohol abuse.Priority 2: Physical Health Sanford will offer the use of PT equipment for the public to increase physical health. Sanford will also increase the number of nutrition consults and provide American Cancer Society referral cards for clinic and hospital visitors and patients.Sanford Webster Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: SafetyAccording to the CDC, every day, 28 people in the United States die in motor vehicle accidents in the United States. Sanford Webster Medical Center decided to combat this community concern by working with the local Key Club and giving presentations to this community audience. Sanford's Lola Pollard, PA, who is also the Key Club President, gave presentations and education sessions about the local accident rate and how to combat those situations. Local law enforcement also continues to do DUI checkpoints in the county to help with these statistics and to keep the population safe.As drug use and violence continues to increase in this area, South Dakota and the United States, Sanford's staff took the MOAB training. MOAB training presents principles, techniques, and skills for recognizing, reducing and managing violent and aggressive behavior. As Sanford continues to work in and care for this population, the training has been helpful in many of the situations that are faced on a daily basis.Priority 2: Physical HealthSanford Webster's strategy of opening up the physical therapy equipment to the community has been a definite success. On average there have been around 15-20 community members each week who use the equipment. The Sanford physical therapy staff has also offered Better Balance classes in the community to help people who are struggling with physical health or those who want to maintain their physical status.The Sanford Webster dietician meets with patients and individuals on a referral basis in the clinic. This has been a very successful program for those who need the services. The dietician meets with people who are experiencing chronic conditions, and with patients who need overall healthy lifestyle management and medical nutrition therapy. Medical nutrition therapy is an important service for patients and the Webster community.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Children and Youth - Bullying, Availability of activities for children and youth Health Care - Access to affordable health insurance, Cost of affordable dental insurance, Cost of affordable vision insurance, Access to affordable health care, Access to affordable prescription drugs Mental Health - Underage drug use and abuse, Alcohol use and abuse, Drug use and abuse, Underage drinking, Smoking and tobacco use, Stress, Depression
Group A-Facility 20 -- Sanford Webster Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 20 -- Sanford Webster Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 21 -- Sanford Medical Center Wheaton Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 21 -- Sanford Medical Center Wheaton Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 21 -- 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 21 -- Sanford Medical Center Wheaton Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental HealthSanford Medical Center Wheaton will expand Medical Home patients who have a PHQ-9 assessment indicating depression. Evidence-based guidelines for mental health will be implemented, and Sanford will work with the TRF psychiatry team and the Traverse County mental health providers to increase the number of available appointments for services. Sanford will also promote the early identification of mental health needs through early childhood wellness exams. Sanford will support parents with healthy social and emotional development tools.Priority 2: SafetySanford will work with law enforcement to provide safe collection sites for unused drugs.Priority 3: Children and YouthSanford will increase access to healthy food options to decrease hunger among children in the community, and support the development of local 4-H groups.Sanford Medical Center Wheaton will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Mental HealthWith the increasing need for mental health services, Sanford Wheaton worked with the Sanford Thief River Falls psychiatry team and Traverse County Mental Health providers to increase the number of available appointments for services and decrease ER visits. Telehealth visits were utilized to provide these services so no one had to drive out of town for services and children did not need to miss a large amount of school time. Sanford Wheaton has added another mental health group, Peterson Medical Clinic that will see all ages of patients and has availability for emergency needs. These services are provided by telehealth. Appointments are available weekly and for emergency cases. Psychiatrist services that are readily available have helped the family practice providers with prescription management.Another strategy was to expand the Medical Home and utilization of an RN Health Coach to provide follow-up for those patients who have PHQ-9 scores that indicate depression. Additional screening tools at timed intervals assess the need for follow-up or demonstrates improvement. A panel specialist will utilize the report for those who are not meeting the PHQ-9 goals for improvement or who are due for re-screening. Quality scores for depression have improved from 2.3 to 4.3. The goal is 5.In addition to the PHQ-9 assessment, Sanford Wheaton implemented evidence-based practice guidelines for patients seen for mental health. Early identification of mental health needs is important and has become standard practice within Sanford. To assist in identifying mental health needs Sanford will work to increase the number of wellness exams and to make them more timely. Sports physicals are now considered well exams and have been expanded with the necessary tools for screening and early detection of mental health issues.Parents of at-risk children also need to have extra support in understanding how to work with and develop healthy social and emotional development skills. During well exams, children and parents are presented with an age-appropriate Reach Out and Read book.Priority 2: SafetySanford Wheaton worked with law enforcement agencies and the Drug Enforcement Agency (DEA) to provide safe collection sites in the community for unused drugs. These sites were established and the amounts that are being turned in are much larger than anticipated. Sanford as a system has taken on the task of reducing opioid prescriptions in an attempt to have less drugs in the community, reduce the number of chronic opioid drug users, and reduce the number of drug seekers in the community.Priority 3: Children and YouthSanford Wheaton's third goal was to provide children with access to healthy food when they are not able to have meals at the school. A large majority of children did not have healthy food from Friday at lunch until they came back on Monday morning for breakfast. Increased access to food was needed to decrease the hunger among children as there are many proven studies that enforce the fact that children who are adequately fed improve their success at school both in learning and behavior. Sanford Wheaton started a food backpack program and worked with the school officials to help identify the individuals who needed food and then proceeded to distribute the bags. Sanford was careful to protect the privacy of families. The program started with distribution during the school year but it was found that the program was going to be needed during the summer also. Current distribution numbers are at 60 on a regular basis. A focus is to have presence at the back-to-school events to make sure that all parents and their families are aware of the food program and to provide some samples of the products so they feel comfortable about registering to receive them.Sanford also supports local 4-H groups in their projects for community gardens, education activities, and financial support to encourage participation in the county fair and other community projects. Sanford also discusses drug abuse and the need for healthy food choices and availability of the food backpack program at the wellness exams.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Physical Health - Cancer, Inactivity or lack of exercise, Obesity Preventive Health - Flu shots
Group A-Facility 21 -- Sanford Medical Center Wheaton Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 21 -- Sanford Medical Center Wheaton Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 22 -- Sanford Bagley Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 22 -- Sanford Bagley Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 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 22 -- Sanford Bagley Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthSanford Bagley Medical Center has made children and youth a significant priority and has developed strategies to improve the health of newborns and young children, and to enhance the level of care that is available for high risk infants. Sanford clinic nurses will communicate with providers and other staff members about the services that are available to at-risk youth in the community. Sanford Ambassadors will provide educational materials and Text 4 Life bracelets at community events. Additionally, Sanford Fit is an on-line community health activation initiative created by Sanford Health that provides engaging programs and resources to kids, families, leaders and role models across numerous settings to promote and activate healthy choices.Priority 2: Mental Health Sanford has developed strategies to reduce mortality and morbidity from tobacco use, and has set strategies for suicide prevention.Sanford will not directly develop strategy to address the availability of affordable housing and public transportation. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford will share the formally assessed issues with community leaders who have expertise in these areas.Sanford Bagley Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Children and YouthSanford Bagley Medical Center placed a great deal of emphasis on getting resources and materials to children and their parents to help them to become more aware of health goals and wellness options. The Bagley Ambassadors group holds 4-5 events per year that provide interaction and learning opportunities for youth. These include booths at the county fair and high school events, a Teddy Bear Clinic, Spring Fling, and Haunted Hallway. The goal of these programs is to engage the youth in the community to make wellness a conversation and to make heath care a familiar, non-threatening part of their lives. The information provided at these events reaches hundreds of individuals. This work is ongoing and will continue to be a priority for the community.Priority 2: Mental HealthSanford Bagley Medical Center's goal of adding tobacco cessation services and providing Test4Life bracelets serves as a constant reminder of the importance of seeking mental health services for optimal mental health. These services provide the community with the opportunity to have tobacco cessation services available at the local level. The strategic goals have been met, and Sanford will continue to provide services for the community.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of public transportation Aging - Cost of long term care, Availability of long term care, Availability of resources for caregivers making decisions, Availability of memory care, Availability of resources to help the elderly stay in their homes, Availability of resources for grandparent caregivers for grandchildren, Understanding of advanced care directives Safety - Child abuse and neglect, Crime, Presence of street drugs, prescription drugs and alcohol, Presence of drug dealers, Domestic violence, Presence of gang activity, Elder abuse, Safe places for outdoor youth activities, Sex trafficking Health Care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Cost of affordable dental insurance, Use of emergency services for primary care, Cost of affordable vision insurance, Timely access to mental health/behavioral health providers, Availability of non-traditional hours, Timely access to physician specialists, Coordination of care between providers and services Physical Health - Cancer, Inactivity, Obesity Chronic disease, Poor nutrition Preventive Health - Flu shots
Group A-Facility 22 -- Sanford Bagley Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 22 -- Sanford Bagley Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 23 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 23 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 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 23 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthSanford Canton-Inwood Medical Center will implement the Sanford fit Program curriculum in the local schools and childcare facilities, and will make the program available for families through the website.Priority 2: Physical Health Sanford will develop a wellness challenge, create a community health fair and bike rodeo to increase opportunities to improve physical health in the community. Sanford Canton-Inwood Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Children and YouthWith the growing obesity epidemic, the Sanford Canton-Inwood Medical Center leadership team worked closely with the City of Canton and the Canton School System on strategies to give families more opportunities to be physically fit. Sanford Canton-Inwood Medical Center explored how to enhance youth activities. Work began on improving the summer recreation plan for youth ages 5 to 12 years.The group tailored the 2018 summer recreation program based on the feedback from parents and families. The enrollment for the 2018 recreation program increased to 148 youth participants. Changes were made to incorporate more activities like baseball, ultimate Frisbee, football, kickball and volleyball, but also adding Friday field trips to state parks, museums, and other local attractions. Sanford's community Board of Directors was supportive of this project and provided over $6,000 in funding to help purchase the equipment needed for the new programs and to sponsor some of the field trips for the children and their families.Sanford also worked with the Canton schools to increase activities by providing the Canton Elementary School, which includes approximately 300 students K-5), with a Sanford fit program that help kids understand and manage moods, eat better, enhance their energy, and include physical activity in their healthy lifestyle. The Sanford Canton-Inwood Medical Center Board of Directors invested in funding a strength and conditioning coach for the local schools. The new position started in July 2018 and was geared not only toward student athletes, but also to those students wanting to build confidence and become healthier.Priority 2: Physical HealthThe Sanford Canton-Inwood Medical Center staff and Board of Directors have joined forces with the Canton Chamber of Commerce on a community wellness challenge. The program was developed as a competition and gives points to the individuals on each team for things like eating vegetables, fruits, exercising, attending community events, volunteering, and many other things. Each week the results are tallied and posted for teams to see how they compare to each other. The length of the competition has been anywhere from 6 weeks up to 10 weeks in duration.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of good walking or biking options Aging - Cost of long term care, Availability of memory care, Availability of long term care, Availability of resources to help the elderly stay safe in their homes, Availability of activities for seniors, Availability of resources for family/friends caring for and making decisions for elders, Cost of activities for seniors Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Use of the emergency room services for primary health care Mental Health/Behavioral Health - Underage drug use and abuse, Underage drinking, Depression, Smoking and tobacco use, Stress, Dementia and Alzheimer's disease, Binge drinkingSanford will not develop strategy to address the need for affordable housing or the availability of good walking and biking option. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has convened community leaders to learn of the findings of the formalized assessment and the unmet needs in the community.
Group A-Facility 23 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 23 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 24 -- Sanford Clear Lake Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 24 -- Sanford Clear Lake Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 24 -- 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 24 -- Sanford Clear Lake Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthThrough the Medical Home program, RN Health Coach, and PHQ-9 screening, Sanford offers/refers to mental health services for patients with scores indicative of depression. The goal was to evaluate 100% of Medical Home patients for mental health needs. Sanford has met this goal, and continues to complete the PHQ-9 screening every six months for patients with a depression diagnosis, as well as diabetes diagnosis, and those who are a part of Medical Home. Additionally, screenings occur with well child checks including athletic physicals for children and youth age 12 and older. The Columbia Suicide Screening tool is also used to identify patients at risk for suicide.Sanford has worked to identify patients with mental health needs who do not have a primary care provider (PCP) listed in the EMR. This strategy has been successful and a formal process has been implemented. When patients present for a visit, the registrar discusses the PCP and inquires with the patient if a PCP can be named in the EMR. If the patient agrees, the patient is registered with a provider at Sanford Clear Lake Medical Center allowing us to address preventive health maintenance.With the limited mental health resources available in the Clear Lake community, research was conducted to develop and distribute a Clear Lake Area Resource Directory. This strategy has been successful for addressing both mental and physical health within the population. The directory not only includes resources to address mental and physical health, but also resources such as employment, financial assistance, housing, nutrition, pre-planning, protective services, support groups, education, just to name a few. The resource directory is readily available for patients in the clinic setting when these needs are identified. Additionally, the directory is distributed to each medical center patient upon admission.Priority 2: Physical HealthSanford Clear Lake Medical Center projected a positive impact for the community by increasing compliance with preventive screening recommendations. Sanford's strategy for meeting this goal included describing the various preventive services available to 100% of its patients. Through the use of the EMR, 100% of Sanford's patients with overdue health maintenance screenings are easily identified. The clinic support nurse reviews overdue health maintenance with patients and offers these services at each visit. The nurse prepares orders as patients agree to the services. If a patient refuses, a gap sheet indicating the patient's refusal is given to the provider to use as a tool to educate the patient on the importance of preventive health and encourage the patient to complete the preventive health maintenance. Providers are involved in the improvements and progress made through performance improvement and quality assurance studies and Sanford Clear Lake is helping patients manage their optimal health.Addressing of Significant Needs during Current Year:Priority 1: Mental Health/Behavioral HealthThe medical home patients are reviewed each month and all clinic patients are screened using the PHQ9. The counseling services available in our area are listed in the community resources book. Tele-health is available for counseling. Priority 2: Physical HealthFit test kits for colon cancer screening were provided during influenza vaccine clinics at Sanford Clear Lake. Working with health coach and clinic nursing on preventative health screenings. Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of resources for family/friends caring for and making decisions for elders, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth, Children living in poverty, Children in single parent households Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Cost of affordable dental insurance coverage, Access to affordable prescription drugs, Access to affordable health care, Unmet medical needs, Unmet mental health needs, Need prescription medications Safety - Presence of street drugs and alcohol in the community Substance Use and Abuse - Underage drinking, Underage drug use and abuse, Smoking and tobacco use, Alcohol use and abuse Preventive Health - Flu shots, Immunizations, Not seeing a health care provider or dentist in the past year
Group A-Facility 24 -- Sanford Clear Lake Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 24 -- Sanford Clear Lake Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 25 -- Sanford Westbrook Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 25 -- Sanford Westbrook Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 25 -- 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 25 -- Sanford Westbrook Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Westbrook Medical Center has set strategy to decrease the time for patients who seek mental health services to be in the ER before placement, and to work with community partners to create new recovery program options. Sanford will also work with the Minnesota Department of Health on a pilot for integrating behavioral health into critical access hospitals.Priority 2: Physical Health Sanford has set strategy to improve the care of patients with chronic disease, overweight and obesity diagnosis. Patients will work with registered dietitians, exercise specialists, and Health Coaches. Additionally, Sanford will work with the local school leadership to implement Sanford fit into the schools and community.Sanford Westbrook Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Addressing of Significant Needs during Current Year:Priority 1: Mental Health/Behavioral HealthSanford Westbrook continues to improve access to mental health services and decreasing the time for patients to be in its ER. A goal is to provide telehealth for behavioral health services for the Sanford Westbrook emergency room, which has been a work in progress for a few years. Placement of patients with mental health needs has been and continues to be a major issue throughout the state of Minnesota, and especially in rural areas.Sanford Westbrook Medical Center provides child psychiatric care via telemedicine and through consults with a nurse practitioner and LICSW. Sanford Westbrook has worked hard to make the public and community partners aware of the services available.Priority 2: Physical HealthSanford Westbrook has shown great impact through their RN Health Coach and Sanford fit programs, which is demonstrated by the increase in the patient chronic conditions registry and the Minnesota measurement scores.During January of 2016, Sanford Westbrook completed a 19-week Sanford fit program with the Westbrook Walnut Grove Elementary School fourth grade class. The program was a customized version of Sanford fitClub. Two Sanford Westbrook staff members met with the Westbrook Walnut Grove Elementary fourth grade physical education class once a week for 25 minutes each session. The students learned all about Sanford fit and making good, healthy choices regarding their food, move (exercise), mood and recharge (sleep/rest). In addition, the students had weekly challenge cards they took home to complete during the remainder of the week. The completed challenge cards were placed in a drawing and students worked their way towards end-of-year prizes, but also took home activities and exposed their families' to fit. The program completed its second year in May of 2018. After a successful pilot year, at the beginning of the 2018 program the students completed a fitclub "test and were tested again at the end of the year. The students increased their correct answers by more than 24% from the first test to the last. Each week, the Sanford Westbrook staff could see the students engaging and absorbing the information through the fun activities. The program received positive feedback by the Westbrook Walnut Grove Elementary School physical education teacher and principal and will continue into the coming years.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care, Availability of resources for family/friends caring for and making decisions for elders Children and Youth - Bullying Safety - Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs
Group A-Facility 25 -- Sanford Westbrook Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 25 -- Sanford Westbrook Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
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?193
Name and address Type of Facility (describe)
1 1 - Sanford Clinic Aberdeen
3015 3rd Avenue SE
Aberdeen,SD57401
Medical Clinic
2 2 - Sanford Clinic Aberdeen Surgical Center
3015 3rd Avenue SE
Aberdeen,SD57401
Ambulatory Surgery Center
3 3 - Sanford Health Adrian Clinic
201 Maine Ave
Adrian,SD56110
Rural Health Clinic
4 4 - Sanford Health Broadway Clinic
1527 Broadway Street
Alexandria,MN56308
Medical Clinic
5 5 - Sanford Health Easton Place Clinic
510 - 22nd Avenue E Suite 602
Alexandria,MN56308
Medical Clinic
6 6 - Sanford Bagley Clinic
1656 Central St W
Bagley,MN56621
Rural Health Clinic
7 7 - Sanford Bagley Eye Center & Optical
14 2nd St NE
Bagley,MN56621
Eye Care Center
8 8 - Sanford Tracy Balaton Clinic
551 Highway 14 E
Balaton,MN56115
Medicare Certified Rural Health Clinic
9 9 - Sanford Health Bassett Family Clinic
103 Clark St
Bassett,NE68714
Medical Clinic
10 10 - Sanford Health Baudette Eye Center
103 Main St
Baudette,MN56623
Eye Care Center
11 11 - Baker Park Inc
803 Dewey Avenue
Bemidji,MN56601
Assisted Living Center
12 12 - Edith Sanford Breast Center Bemidji
1233 34th St NW
Bemidji,MN56601
Women's Health
13 13 - Sanford Bemidji 1611 Anne St Clinic
1611 Anne St NW
Bemidji,MN56601
Medical Clinic
14 14 - Sanford Bemidji 1705 Ann St Clinic
1705 Anne St NW
Bemidji,MN56601
Medical Clinic
15 15 - Sanford Bemidji Downtown Eye Center & Op
506 Beltrami Ave NW
Bemidji,MN56601
Eye Care Center
16 16 - Sanford Bemidji Home Care & Hospice
3201 Pine Ridge Ave NW
Bemidji,MN56601
Home Care and Hospice
17 17 - Sanford Bemidji Main Clinic
1233 34th St NW
Bemidji,MN56601
Medical Clinic
18 18 - Sanford Dialysis Bemidji
1300 Anne Street NW
Bemidji,MN56601
Dialysis
19 19 - Sanford Health Neilson Place
1000 Anne St NW
Bemidji,MN56601
Skilled Nursing Facility
20 20 - Sanford Health Trillium
930 Anne Street NW
Bemidji,MN56601
Assisted Living Center
21 21 - Sanford Health Windsong
1010 Anne Street N
Bemidji,MN56601
Assisted Living Center
22 22 - Sanford Joe Lueken Cancer Center
1233 34th St NW
Bemidji,MN56601
Cancer Center
23 23 - Sanford Clinic Beresford
600 W Cedar Street
Beresford,SD57004
Rural Health Clinic
24 24 - Bismarck Cancer Center
500 N 8th Street
Bismarck,ND58501
Cancer Center
25 25 - Sanford Birth Center
300 N 7th Street
Bismarck,ND58501
Birth Center
26 26 - Sanford Cancer Center Bismarck
300 N 7th Street
Bismarck,ND58501
Cancer Center
27 27 - Sanford Tom & Frances Leach Bismarck Dia
209 N 7th Street
Bismarck,ND58501
Dialysis Center
28 28 - Sanford Clinic
222 N 7th Street
Bismarck,ND58501
Medical Clinic
29 29 - Sanford Children's North Clinic
765 W Interstate Ave
Bismarck,ND58503
Children's Clinic
30 30 - Sanford Bemidji Blackduck Clinic
81 1st St NW
Blackduck,MN56630
Medical Clinic
31 31 - Sanford Boyden Clinic
3971 320th St
Boyden,IA51234
Medical Clinic
32 32 - Sanford Brandon Family Medicine Clinic
1105 E Holly Blvd
Brandon,SD57005
Medical Clinic
33 33 - Sanford Health Brookings Clinic
922 - 22nd Avenue S
Brookings,SD57006
Medical Clinic
34 34 - Sanford Canby Clinic
112 St Olaf Avenue
Canby,MN56220
Medicare Certified Rural Health Clinic
35 35 - Sanford Canby Dental Clinic
11 St Olaf Ave S
Canby,MN56220
Dental Clinic
36 36 - Sanford Canby Dialysis Unit
112 St Olaf Avenue S
Canby,MN56220
Medicare Certified End Stage Renal Dialysis
37 37 - Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220
Medicare Certified Home Health Agency
38 38 - Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220
Class F Home Care Provider
39 39 - Sanford Health Canby Sylvan Place
212 St Olaf Avenue S
Canby,MN56220
Housing with Services
40 40 - Sanford Health CanistotaUSD Clinic
320 W Main St
Canistota,SD57012
Rural Health Clinic
41 41 - Sanford Canton Clinic
400 N Hiawatha Drive
Canton,SD57013
Rural Health Clinic
42 42 - Sanford Health Canton Hiawatha Heights
398 N Hiawatha Drive
Canton,SD57013
Assisted Living Center
43 43 - Sanford Bemidji Cass Lake Clinic
219 Grant Utley Ave NW
Cass Lake,MN56633
Medical Clinic
44 44 - Sanford Chamberlain Clinic
300 S Byron Blvd
Chamberlain,SD57325
Rural Health Clinic
45 45 - Sanford Health Chamberlain Care Center
300 S Byron Blvd
Chamberlain,SD57325
Nursing Facility
46 46 - Sanford Home Health & Hospice Chamberlai
110 W Beebe Ave
Chamberlain,SD57325
Home Health Care & Hospice
47 47 - Sanford Health Clark Clinic
211 N Commercial Street
Clark,SD57225
Rural Health Clinic
48 48 - Sanford Clear Lake Clinic
701 3rd Avenue S
Clear Lake,SD57226
Rural Health Clinic
49 49 - Sanford Clear Lake Medical Center
701 3rd Avenue S
Clear Lake,SD57226
Home Health Care
50 50 - Sanford Bagley Clearbrook Clinic
22 Elm Street
Clearbrook,MN56634
Rural Health Clinic
51 51 - Sanford Health Dakota Dunes Clinic
350 Oak Tree Ln
Dakota Dunes,SD57049
Medical Clinic
52 52 - Sanford Health Dell Rapids Orchard Hills
200 W 10th Street
Dell Rapids,SD57022
Assisted Living Center
53 53 - Sanford Dialysis
114 Frazee St E
Detroit Lakes,MN56501
Dialysis Center
54 54 - Sanford Health Detroit Lakes Clinc & Sam
1245 Washington Avenue
Detroit Lakes,MN56501
Ambulatory Surgery Center/Clinic
55 55 - Sanford Health Detroit Lakes Eye Center
1245 Washington Avenue
Detroit Lakes,MN56501
Eye Care Center
56 56 - Sanford Health West Dickinson Clinic
2615 Fairway Street
Dickinson,ND58601
Medical Clinic
57 57 - Sanford Health East Dickinson Clinic
33 9th St W
Dickinson,ND58601
Medical Clinic
58 58 - Sanford Health Hearing Center Dickinson
1531 W Villard St
Dickinson,ND58601
Hearing Center
59 59 - Sanford Health 621 DeMers Ave Clinic
621 DeMers Ave NW
East Grand Forks,MN56721
Medical Clinic
60 60 - Sanford Health 929 Central Ave Clinic
929 Central Ave
East Grand Forks,MN56721
Medical Clinic
61 61 - Sanford Health EGF Dermatology Clinic
625 DeMers Ave NW
East Grand Forks,MN56721
Medical Clinic
62 62 - Sanford Home Care East Grand Forks
404 DeMers Ave
East Grand Forks,MN56721
Home Health Care
63 63 - Sanford Health Edgeley Clinic
506 2nd St
Edgeley,ND58433
Medical Clinic
64 64 - Sanford Luverne Edgerton Clinic
733 Main Ave
Edgerton,MN56128
Rural Health Clinic
65 65 - Sanford Health Ellendale Clinic
141 Main St
Ellendale,ND58436
Rural Health Clinic
66 66 - Sanford Health Enderlin Clinic
201 4th Avenue
Enderlin,ND58027
Rural Health Clinic
67 67 - Sanford Clinic Estelline
305 Hospital Drive
Estelline,SD57234
Rural Health Clinic
68 68 - Edith Sanford Breast Center Fargo
737 Broadway N
Fargo,ND58102
Women's Health
69 69 - Sanford 1711 Medical Building
1711 University Drive S
Fargo,ND58103
Medical Clinic
70 70 - Sanford 1717 Medical Building
1717 Medical Buildingq
Fargo,ND58103
Medical Clinic
71 71 - Sanford Broadway Clinic
801 Broadway N
Fargo,ND58102
Medical Clinic
72 72 - Sanford Children's Broadway Clinic
737 Broadway
Fargo,ND58102
Medical Clinic
73 73 - Sanford Dialysis Fargo
2801 S University Drive
Fargo,ND58122
Dialysis
74 74 - Sanford I-94 Clinic
5225 23rd Avenue South
Fargo,ND58104
Medical Clinic
75 75 - Sanford Home Care Fargo
100 4th Street S
Fargo,ND58103
Home Health Agency
76 76 - Sanford Roger Maris Cancer Center
840 4th Street N
Fargo,ND58102
Cancer Center
77 77 - Sanford South University Eye Center & Op
1717 S University Dr
Fargo,ND58103
Eye Care Center
78 78 - Sanford Children's Southwest Clinic
2701 13th Ave S
Fargo,ND58103
Children's Clinic
79 79 - Sanford Southpointe Eye Center & Optical
2400 32nd Ave S
Fargo,ND58103
Eye Care Center
80 80 - Sanford Health Finley Clinic
407 Washington Ave
Finley,ND58230
Rural Health Clinic
81 81 - Sanford Health Forman Clinic
336 Main St SW
Forman,ND58032
Rural Health Clinic
82 82 - Sanford Dialysis Fort Yates
100 N River Road
Fort Yates,ND58538
Dialysis Center
83 83 - Sanford Health Fosston Eye Center & Opti
111 2nd St NE
Fosston,MN56542
Eye Care Center
84 84 - Sanford Rock Rapids George Clinic
101 N Main
George,IA51237
Rural Health Clinic
85 85 - Sanford Health Gwinner Clinic
69 ND 13
Gwinner,ND58040
Rural Health Clinic
86 86 - Sanford Health Halstad Clinic
445 1st Street E
Halstad,MN56548
Rural Health Clinic
87 87 - Sanford Health Hartford Clinic
905 N Oaks Ave
Hartford,SD57033
Medical Clinic
88 88 - Sanford Sheldon Hartley Clinic
512 3rd St NE
Hartley,IA51346
Medical Clinic
89 89 - Sanford Hawley Clinic
1412 Main St
Hawley,MN56549
Medical Clinic
90 90 - Sanford Health Comstock Corner
12 3rd Street SE
Hillsboro,ND58045
Hospital Based-Nursing Facilities
91 91 - Sanford Health Hillsboro Clinic
315 East Caledonia
Hillsboro,ND58045
Rural Health Clinic
92 92 - Sanford Health Dialysis Hospers
112 Sunrise Drive
Hospers,IA51238
End Stage Renal Dialysis
93 93 - Sanford Health International Falls Eye C
1400 Highway 71
International Falls,MN56649
Eye Care Center
94 94 - Sanford Health Inwood Clinic
303 E Jefferson St
Inwood,IA51240
Medical Clinic
95 95 - Sanford Clinic Ipswich
110 5th Avenue
Ipswich,SD57451
Rural Health Clinic
96 96 - Sanford Jackson Clinic
1430 North Highway
Jackson,MN56143
Medicare Certified Rural Health Clinic
97 97 - Sanford Dialysis Jamestown
300 2nd Avenue NE
Jamestown,ND58401
Dialysis Center
98 98 - Sanford Health Hearing Center Jamestown
904 5th Ave NE
Jamestown,ND58401
Hearing Center
99 99 - Sanford Health Jamestown 2nd Ave Clinic
300 2nd Avenue NE
Jamestown,ND58401
Medical Clinic
100 100 - Sanford Health Jamestown 5th Ave Clinic
904 5th Ave NE
Jamestown,ND58401
Medical Clinic
101 101 - Sanford Health Kelliher Clinic
243 Clark Ave N
Kelliher,MN56650
Medical Clinic
102 102 - Sanford Chamberlain Kimball Clinic
101 S Main St
Kimball,SD57355
Rural Health Clinic
103 103 - Sanford Children's Clinic
3001 Daggett St
Klamath Falls,OR97601
Medical Clinic
104 104 - Sanford Health Lake Norden Clinic
512 Main Ave
Lake Norden,SD57248
Rural Health Clinic
105 105 - Sanford Jackson Lakefield Clinic
209 Main Street
Lakefield,MN56150
Medicare Certified Rural Health Clinic
106 106 - Sanford Health LaMoure Clinic
101 1st Ave SW
LaMoure,ND58458
Rural Health Clinic
107 107 - Sanford Health Lennox Clinic
108 S Main
Lennox,SD57039
Rural Health Clinic
108 108 - Sanford Health Lidgerwood Clinic
21 Wiley Ave S
Lidgerwood,ND58053
Rural Health Clinic
109 109 - Sanford Health Lisbon Clinic
102 10th Ave W
Lisbon,ND58054
Rural Health Clinic
110 110 - Sanford Home Care Lisbon
404 Forest St
Lisbon,ND58054
Home Health Care
111 111 - Sanford Home Health Luverne
304 N McKenzie St
Luverne,MN56156
Home Health Care
112 112 - Sanford Luverne Clinic
1601 Sioux Valley Dr
Luverne,MN56156
Medical Clinic
113 113 - Sanford Luverne Hospice
217 N Oakley St
Luverne,MN56156
Medicare Certified Hospice
114 114 - Sanford Dialysis
323 SW 10th Street
Madison,SD57042
End Stage Renal Dialysis
115 115 - Sanford Hospice Madison
900 2nd Avenue
Madison,MN56256
Hospice (licensed in SD)
116 116 - Sanford Health Mahnomen Clinic
410 W 4th St
Mahnomen,MN56557
Rural Health Clinic
117 117 - Sanford Home Care Mahnomen
414 W Jefferson Ave
Mahnomen,MN56557
Home Health Care
118 118 - Sanford Home Care Bismarck
910 18th Street NW
Mandan,ND58554
Home Health Agency
119 119 - Sanford East Mandan Clinic
102 Mandan Ave
Mandan,ND58554
Medical Clinic
120 120 - Sanford Home Care Mayville
49 7th Ave SE
Mayville,ND58257
Home Health Care
121 121 - Sanford Mayville Clinic
600 1st St SE
Mayville,ND58257
Rural Health Clinic
122 122 - Sanford Health Highway 2 Clinic
801 21st Ave SE
Minot,ND58701
Medical Clinic
123 123 - Sanford Health Northwest Clinic
1500 21st Ave NW
Minot,ND58701
Medica
124 124 - Sanford Health Minneota Clinic
700 N Monroe St
Minneota,MN56264
Rural Health Clinic
125 125 - Sanford Health Mitchell Clinic
2100 Highland Way
Mitchell,SD57301
Medical Clinic
126 126 - Sanford Dialysis Morris
400 1st Street East
Morris,MN56267
Dialysis
127 127 - Sanford Health Mountain Lake Clinic
308 N 8th Street
Mountain Lake,MN56159
Medicare Certified Rural Health Clinic
128 128 - Sanford Health Oakes Clinic
420 7th St S
Oakes,ND58474
Medical Clinic
129 129 - Sanford Children's Clinic
3605 Vista Way
Oceanway,CA92056
Children's Clinic
130 130 - Sanford Health Park Rapids Clinic
110 7th St W
Park Rapids,MN56470
Medical Clinic
131 131 - Sanford Health Parkers Prairie Clinic
115 E Soo Street
Parkers Prairie,MN56361
Rural Health Clinic
132 132 - Sanford Health Pelican Rapids Clinic
211 East Mill Street
Pelican Rapids,MN56572
Rural Health Clinic
133 133 - Sanford Home Care Pelican Rapids
211 East Mill Street
Pelican Rapids,MN56572
Home Health Care
134 134 - Sanford Health Pierre Clinic
521 E Sioux Ave
Pierre,SD57501
Medical Clinic
135 135 - Sanford Dialysis Red Lake
24760 Hospital Drive
Red Lake,MN56671
Dialysis
136 136 - Sanford Rock Rapids Clinic
803 South Green Street
Rock Rapids,IA51246
Rural Health Clinic
137 137 - Sanford Sheldon Sanborn Clinic
321 Main Street
Sanborn,IA51248
Medical Clinic
138 138 - Sanford Health Sheldon Care Center
118 North Seventh Avenue PO Box 250
Sheldon,IA51201
Home Health Agency and Hospice
139 139 - Sanford Senior Care Sheldon
118 North Seventh Avenue PO Box 250
Sheldon,IA51201
Hospital Based-Nursing Facilities
140 140 - Sanford Sheldon Clinic
800 Oak Street
Sheldon,IA51201
Rural Health Clinic
141 141 - Ava's House
1320 W 17th Street
Sioux Falls,SD57104
Nursing Facility
142 142 - Sanford 10th & Phillips Acute Care & Ort
136 S Phillips Ave
Sioux Falls,SD57104
Medical Clinic
143 143 - Sanford 27th & Sycamore Family Medicine
4405 E 26th St
Sioux Falls,SD57103
Medical Clinic
144 144 - Sanford 32nd & Ellis Clinic
2601 S Ellis Road
Sioux Falls,SD57106
Medical Clinic
145 145 - Sanford Family Medicine 34th & Kiwanis
2701 S Kiwanis Ave
Sioux Falls,SD57105
Medical Clinic
146 146 - Sanford 49th & Oxbow Family Medicine
3401 W 49th Street
Sioux Falls,SD57106
Medical Clinic
147 147 - Sanford 4th & Sycamore Family Medicine
600 N Sycamore Ave
Sioux Falls,SD57110
Medical Clinic
148 148 - Sanford Cancer Center
1309 W 17th St
Sioux Falls,SD57104
Cancer Center
149 149 - Sanford Children's MB2 Clinic
1205 S Grange Ave
Sioux Falls,SD57105
Children's Clinic
150 150 - Sanford Children's Residency Clinic
6101 S Louise Ave
Sioux Falls,SD57108
Children's Clinic
151 151 - Sanford Children's Specialty Clinic
1605 W 22nd St
Sioux Falls,SD57117
Children's Clinic
152 152 - Sanford Dialysis Sioux Falls
1321 W 22nd Street
Sioux Falls,SD57117
Dialysis Center
153 153 - Sanford Eye Center & Optical
1621 S Minnesota Ave
Sioux Falls,SD57105
Eye Care Center
154 154 - Sanford Fetal Care Center
1500 W 22nd Street
Sioux Falls,SD57105
Birth Center
155 155 - Sanford Health Midtown Family Planning C
1205 S Grange Ave
Sioux Falls,SD57105
Medical Clinic
156 156 - Sanford Hospice
2710 West 12th Street
Sioux Falls,SD57104
Hospice (licensed in MN and SD)
157 157 - Sanford Imagenetics
1321 W 22nd Street
Sioux Falls,SD57117
Genetics
158 158 - Sanford Home Health Sioux Falls
2710 West 12th Street
Sioux Falls,SD57104
Home Health Care
159 159 - The Birth Place
1305 W 18th Street
Sioux Falls,SD57105
Birth Center
160 160 - Northern Lights Community Residence
324 E 10th St
Thief River Falls,MN56701
Community Residence
161 161 - Pathfinder Children's Treatment Center
921 Atlantic Ave N
Thief River Falls,MN56701
Treatment Center
162 162 - Sanford Behavioral Health Outpatient Cli
120 Labree Avenue S
Thief River Falls,MN56701
Behavioral Health Treatment Center
163 163 - Sanford Dialysis Thief River Falls
120 Labree Avenue S
Thief River Falls,MN56701
Dialysis
164 164 - Sanford Health Thief River Falls Eye Cen
1720 Highway 59 S
Thief River Falls,MN56701
Eye Care Center
165 165 - Sanford Medical Center Thief River Falls
1720 Highway 59 S
Thief River Falls,MN56701
Medical Clinic
166 166 - Sanford Health Tracy O'Brien Court
410 State Street
Tracy,MN56175
Housing with Services
167 167 - Sanford Tracy Clinic
249 Fifth Street E
Tracy,MN56175
Medicare Certified Rural Health Clinic
168 168 - Shetek Medical Services
251 5th St E
Tracy,MN56175
Medical Clinic
169 169 - Sanford Health Twin Valley Clinic
501 2nd St NW
Twin Valley,MN56584
Rural Health Clinic
170 170 - Sanford Health Ulen Clinic
108 Viking Avenue W
Ulen,MN56585
Rural Health Clinic
171 171 - Sanford Health Valley City Clinic
520 Chautauqua Blvd
Valley City,ND58072
Medical Clinic
172 172 - Sanford Health Vermillion Clinic
20 S Plum Street
Vermillion,SD56069
Medical Clinic
173 173 - Sanford Health Vermillion Dakota Gerdens
126 S Plum Street
Vermillion,SD57069
Residential Living Center
174 174 - Sanford Hospice
848 East Cherry Street
Vermillion,SD57069
Hospice
175 175 - Sanford Vermillion Care Center
20 S Plum Street
Vermillion,SD57069
Nursing Facility
176 176 - Sanford Dialysis
111 Washington Ave NW
Wagner,SD57380
Dialysis Center
177 177 - Sanford Clinic Wahpeton
332 2nd Ave N
Wahpeton,ND58075
Medical Clinic
178 178 - Sanford Health Wahpeton Eye Center & Opt
332 2nd Ave N
Wahpeton,ND58075
Eye Care Center
179 179 - Sanford Health Walker Clinic
614 Michigan Avenue
Walker,MN56484
Rural Health Clinic
180 180 - Sanford Tracy Walnut Grove Clinic
810 8th St
Walnut Grove,MN56180
Medicare Certified Rural Health Clinic
181 181 - Sanford Health Watertown Clinic
901 4th Street NW
Watertown,SD57201
Medical Clinic
182 182 - Sanford Webster Clinic
101 Peabody Drive
Webster,SD57274
Rural Health Clinic
183 183 - Sanford Health Westrook Peterson Estates
1012 9th Street
Westbrook,MN56183
Housing with Services
184 184 - Sanford Westbrook Clinic
920 Bell Avenue
Westbrook,MN56183
Medicare Certified Rural Health Clinic
185 185 - Sanford Home Care Wheaton
405 12th St N
Wheaton,MN56926
Home Health Care
186 186 - Sanford Wheaton Clinic
401 12th St N
Wheaton,MN56926
Medical Clinic
187 187 - Sanford Clinic Windom
591 2nd Avenue N
Windom,MN56101
Medicare Certified Rural Health Clinic
188 188 - Sanford Hospice Winner
745 E 8th Street
Winner,SD57580
Hospice
189 189 - Sanford Dialysis
1018 Sixth Avenue
Worthington,MN56187
Dialysis Center
190 190 - Sanford Health Cancer Center
1018 Sixth Avenue
Worthington,MN56187
Cancer Center
191 191 - Sanford Hospice
1151 Ryans Road Suite 100
Worthington,MN56187
Hospice (licensed in SD)
192 192 - Sanford Worthington Clinic
1680 Diagonal Road
Worthington,MN56187
Medical Clinic
193 193 - Sanford Worthington Medical Center
1018 Sixth Avenue
Worthington,MN56187
Medicare Certified End Stage Renal Dialysis
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
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.The Amount Generally Billed (AGB) discount percentage is the least amount Sanford can discount for any patient qualifying under the Sanford Financial Assistance Policy. It is the percentage used for the lowest level of assistance granted for those qualifying under the Sanford Financial Assistance Policy as listed on Appendix 1 - Sliding Discount Schedule for Assistance. Anyone else qualifying for assistance at greater levels will receive discount amounts greater than the Sanford AGB discount amount. Part I, Line 5b: Sanford as a whole did exceed its financial assistance budget for FY 2018, 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's 2017 Community Benefit Annual Report is posted annually on the Sanford website at:http://www.sanfordhealth.org/about/community-benefit
Part I, Line 7: The Amount Generally Billed (AGB) discount percentage is the least amount Sanford can discount for any patient qualifying under the Sanford Financial Assistance Policy. It is the percentage used for the lowest level of assistance granted for those qualifying under the Sanford Financial Assistance Policy as listed on Appendix 1 - Sliding Discount Schedule for Assistance. Anyone else qualifying for assistance at greater levels will receive discount amounts greater than the Sanford AGB discount amount. Cost to Charge Ratios are used to calculate the amounts on Line 7a - 7c (Financial Assistance, Medicaid Shortfall, and Other Means-Tested Government Programs) and also Line 7g (Subsidized Health Services) for each of the subsidiaries included in the return. All other amounts for Lines 7e, 7f, 7h and 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio, or similar cost accounting methodology. These costs still represent the costs to provide benefits.
Part I, Line 7g: Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. 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 2018, subsidized health services provided through these physician practices generated losses of $51,308,768.
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 $246,321,201. Sanford believes this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if it was not provided by Sanford.
Part III, Line 9b: Sanford will provide services at no cost or reduced cost to patients who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guideline will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commercial insurance, or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges. Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle.Sanford has zero tolerance for abusive, harassing, oppressive, false, deceptive, or misleading language of collections conduct. This zero tolerance applies to internal Sanford staff and third party collection vendors and attorneys.Neither Sanford nor any of its third party collection vendors will take any extraordinary collection efforts until Sanford and the third party collection vendor have made reasonable efforts to determine if a patient is eligible for financial assistance under the Financial Assistance Policy.
Part VI, Line 2: Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area -Cass County, North Dakota and Clay County, Minnesota, the Bemidji area - Beltrami County in MN, the Bismarck area - Burleigh and Morton counties in ND, and the Sioux Falls area - Minnehaha, Lincoln, Turner and McCook counties in SD. A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included. A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity.Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University -Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Part VI, Line 3: Sanford employs a variety of strategies to make certain that the organization is transparent in the communication of financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities display signage in registration areas advising patients of their ability to request financial assistance. The signage was made available in English and Spanish. Financial Assistance applications were 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:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policyfinancial-assistance-policy
Part VI, Line 4: Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics in nine states and three countries. Sanford Health's approximately 33,000 employees, including 1,400 physicians, make it the largest employer in the Dakotas. Sanford USD Medical Center - Sioux Falls, South DakotaSioux Falls is the largest city in the state of South Dakota and is the County seat of Minnehaha County. Sioux Falls also extends into Lincoln County. The 2017 U.S. Census Bureau estimates a total population of 176,888 for Sioux Falls. According to the 2017 County Health Rankings, the population of Minnehaha County is 84.0% white, 4.5% African American, 2.8% American Indian, 2.0% Asian and 4.9% Hispanic. Sioux Falls is a significant regional health care center. Only 2% of the population is reported to be not proficient in English. The median household income in Sioux Falls is $55,600.Sanford Medical Center Fargo - Fargo, North DakotaFargo is the largest city in North Dakota, accounting for 15% of the state's population. Fargo is also the county seat of Cass County. The 2017 United States Census estimates the population of Fargo was 122,359. According to the 2017 County Health Rankings, the population of Cass County is 87.5% white, 4.0% African American, 1.4% American Indian, 2.8% Asian and 2.6% Hispanic. Only 1% of the population is reported to be not proficient in English. The median household income is $55,900. Sanford Bemidji Medical Center - Bemidji, MinnesotaBemidji is located in Beltrami County, Minnesota. Bemidji houses many Native American Services, including the Indian Health Service. The city is the central hub of the Red Lake Indian Reservation, White Earth Indian Reservation, and the Leech Lake Indian Reservation. According to the 2017 United States Census estimates, the population of Bemidji is 15,366. According to the 2017 County Health Rankings, the population of Beltrami County is 73.1% white, 0.8% African American, 21.2% American Indian, 0.7% Asian and 2.0% Hispanic. 0% of the population is reported to be not proficient in English. The median household Income is $46,000.Sanford Bismarck Medical Center - Bismarck, North DakotaBismarck is a city located in Burleigh County in central North Dakota. Bismarck is experiencing fast-paced growth as a direct result of oil development throughout the western part of the state. Bismarck is the state capital and is the second largest city in the state of North Dakota with a population 72,865. According to the 2017 County Health Rankings, the population of Burleigh County is 90.1% white, 1.4% African American, 4.2% American Indian, 0.7% Asian and 2.1% Hispanic. 0% of the population is reported to be not proficient in English. The median household income is $66,100.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 14 members at the end of the fiscal year, including 9 volunteer community members, 4 physicians and the CEO. Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve patients and communities.
Part VI, Line 6: Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics in nine states and three countries. Sanford Health's 27,000 employees, including 1,400 physicians, make it the largest employer in the Dakotas.Sanford Health provides services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area and a network of children's primary care clinic locations across the country and world. Sanford Health operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford Health financially supports health and wellness, education and community development activities to improve the quality of life and strenghten communities throughout the region. Each facility promotes health and healing that responds to the unique needs of the patients in the community, ensuring access to comprehensive and specialized services. Part VI, Line 7: Community benefit reporting is not required and therefore not filed in North Dakota, South Dakota, Nebraska or Iowa. Filing in Minnesota is voluntary.
Schedule H (Form 990) 2019
Additional Data


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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," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part I
General Information on Grants and Assistance
1
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? ........................
2
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" on 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 (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) ABERDEEN CATHOLIC SCHOOL
1400 N Dakota Street
Aberdeen,SD57401
46-0334005 501(c)(3) 27,850       GENERAL SUPPORT
(2) ABERDEEN DEVELOPMENT CORP
416 Production St N
Aberdeen,SD57401
46-6011831 501(c)(6) 8,500       GENERAL SUPPORT
(3) ABERDEEN FAMILY YMCA
5 South State Street
Aberdeen,SD57401
46-0255779 501(c)(3) 20,500       PLEDGE
(4) ABERDEEN PUBLIC SCHOOLS FOUNDATION
1224 3rd St South
Aberdeen,SD57401
46-0423109 501(c)(3) 40,000       GENERAL SUPPORT
(5) ABERDEEN SCHOOL DISTRICT
1224 3rd St South
Aberdeen,SD57401
46-6000912 115 5,300       KNIGHT FOR A PRINCESS DONATIO
(6) ALEXANDER MITCHELL PUBLIC LIBRARY
519 S Kline Street
Aberdeen,SD57401
46-0428183 501(c)(3) 10,000       GENERAL SUPPORT
(7) ALZHEIMERS ASSOCATION
1000 N West Avenue Ste 250
Sioux Falls,SD57104
13-3039601 501(c)(3) 9,000       GENERAL SUPPORT
(8) AMERICAN FOUNDATION FOR SUICIDE
1040 N Main Ave Unit D
Tea,SD57064
13-3393329 501(c)(3) 7,000       GENERAL SUPPORT
(9) AMERICAN HEART ASSOCIATION INC
7272 Greenville Ave
Dallas,TX75231
13-5613797 501(c)(3) 124,000       GENERAL SUPPORT
(10) AMERICAN LEGION
1701 W Legion Dr
Sioux Falls,SD57104
38-6902131 501(c)(3) 6,620       GENERAL SUPPORT
(11) AMERICAN RED CROSS
808 West Ave
Sioux Falls,SD57104
53-0196605 501(c)(3) 30,000       GENERAL SUPPORT
(12) AMERICAN CANCER SOCIETY
4904 S Technopolis Dr
Sioux Falls,SD57106
41-0724036 501(c)(3) 294,400       SUPPORT ACS EVENTS
(13) AMERICAN GOLD GYMNASTICS
2001 17th Ave S
Fargo,ND58103
45-0333196 501(c)(3) 22,250       GOLF SCRAMBLE TEE BOX SPONSOR
(14) ARTHRITIS FOUNDATION - UPPER MIDWEST REGION
PO Box 1208
Fargo,ND58107
39-0860526 501(c)(3) 30,500       GENERAL SUPPORT
(15) ARTS PARTNERSHIP
1104 2nd Ave S Suite 315
Fargo,ND58103
23-7108936 501(c)(3) 25,500       CREATING GOOD DONATION
(16) AUGSBURG COLLEGE
2211 Riverside Ave
Minneapolis,MN55454
41-0694721 501(c)(3) 7,500       ADVANCEMENT PEACE ACTION SPON
(17) AUGUSTANA UNIVERSITY
2001 S Summit Ave
Sioux Falls,SD57197
46-0224588 501(c)(3) 1,515,818       DONATION
(18) BEMIDJI BLUE OX MARATHON
PO Box 633
Bemidji,MN56619
46-1700357 501(c)(3) 15,000       DONATION
(19) BEMIDJI STATE UNIVERSITY
1500 Birchmont Dr NE
Bemidji,MN56601
23-7044156 501(c)(3) 74,625       GENERAL SUPPORT
(20) BEMIDJI YOUTH LEAGUE INC
PO Box 1677
Bemidji,MN56619
41-1763981 501(c)(3) 5,500       DONATION
(21) BIG BROTHERS BIG SISTERS OF AMERICA
2502 n Rocky Point Dr
Tampa,FL33607
23-1365190 501(c)(3) 10,000       GENERAL SUPPORT
(22) BISMARCK EVENT CENTER
315 S 5th St
Bismarck,ND58504
45-6002036 115 5,804       SANFORD CLASSIC TOURNEY
(23) BISMARCK RECREATION COUNCIL
400 E Front Ave
Bismarck,ND58504
45-0384442 501(C)(3) 10,000       ICE EXPANSION -BRC
(24) BISMARCK PUBLIC SCHOOLS
806 N Washington St
Bismarck,ND58501
45-0442960 501(c)(3) 104,000       GENERAL SUPPORT
(25) BISMARCK STATE COLLEGE FOUNDATION
PO Box 5587
Bismarck,ND58506
45-0358929 501(c)(3) 523,718       GENERAL SUPPORT
(26) BOYS & GIRLS CLUB
824 E 14th St
Sioux Falls,SD57104
46-0399482 501(c)(3) 41,334       GENERAL SUPPORT
(27) BRANDON VALLEY BASEBALL ASSOC
PO Box 605
Brandon,SD57005
46-0401362 501(c)(3) 28,000       LEGENDS 2017 GRANT FENCING
(28) BRANDON VALLEY BOOSTER CLUB
PO Box 572
Brandon,SD57005
46-6002577 501(c)(6) 10,500       DONATION SCOREBOARD 2
(29) BRANDON VALLEY FOOTBALL
301 S Splitrock Blvd
Brandon,SD57005
46-6002577 501(c)(6) 5,015       2017 LEGENDS FB GRANT
(30) BRANDON VALLEY SCHOOL
PO Box 572
Brandon,SD57005
46-6002577 501(c)(6) 14,800       YEARLY DONATION
(31) BROOKINGS HEALTH SYSTEM FOUNDATION
300 22nd Ave
Brookings,SD57006
27-1785343 501(c)(3) 20,000       GENERAL SUPPORT
(32) CANTON INWOOD AREA HEALTH
PO Box 292
Canton,SD57013
46-0210400 501(c)(3) 5,500       GENERAL SUPPORT
(33) CATHOLIC COMMUNITY FOUNDATION
523 N Duluth Ave
Sioux Falls,SD57104
46-6068924 501(C)(3) 10,000       GENERAL SUPPORT
(34) 45CENTRAL CASS PUBLIC SCHOOLS
802 5th St N
Casselton,ND58012
45-6000306 115 20,000       WELLNESS CTR DONATION
(35) CENTRAL LYON SCHOOL DISTRICT
104 Riverview Dr
Rock Rapids,IA51246
42-1515405 501(c)(3) 15,500       DIGITAL BOARD SPONSORSHIP
(36) CHAD GREENWAY FOUNDATION
59 Cavalier Blvd Ste 310
Florence,KY41042
26-1782419 501(c)(3) 18,400       SPONSOSHIP-CELEB WAITER/FOOTB
(37) CHAMBER OF COMMERCE
200 N Phillips Ave Sute 200
Sioux Falls,SD57104
46-0189300 501(c)(6) 35,755       DONATION
(38) CHAMBER OF COMMERCE BIS-MAN
PO Box 1675
Bismarck,ND58502
45-0116753 501(c)(6) 5,935       2018 TRC CAMPAIGN SPONSOR
(39) CHAMBER OF COMMERCE FMWF
PO Box 2443
Fargo,ND58108
45-0448041 501(c)(6) 47,755       105 HOMETOWN HERO SPONSOR
(40) CHARIS MINISTRY PARTNERS
1300 E 10th Street
Sioux Falls,SD57103
38-3775128 501(c)(3) 7,000       DONATION TO HEALTHY RIDES MIN
(41) CHILDREN OF THE NATIONS
PO Box 3970
Silverdale,WA98383
91-1702551 501(c)(3) 12,500       DONATION
(42) CHILDRENS HOME SOCIETY OF SD
801 N Sycamore Ave
Sioux Falls,SD57110
46-0224542 501(c)(3) 12,500       GENERAL SUPPORT
(43) CHILDRENS HOSPITAL LOS ANGELES
4650 Sunset Blvd
Los Angeles,CA90027
95-1690977 501(c)(3) 212,500       CONSORTIUM COLLABORATION FUND
(44) CHILDRENS WORLD
1221 E 6th St
Sheldon,IA51201
42-1036015 501(c)(3) 6,000       GENERAL SUPPORT
(45) CITY OF FARGO
PO Box 1607
Fargo,ND58107
45-6002069 115 10,000       GENERAL SUPPORT
(46) CITY OF SHELDON
416 9th Street PO Box 276
Sheldon,IA51201
42-6005194 115 50,000       DONATION PLEDGE PAYMENT
(47) COMMUNITIES FOUNDATION OF OKLAHOMA
PO Box 21210
Oklahoma City,OK73156
73-1396320 115 10,000       GENERAL SUPPORT
(48) COMMUNITY INDOOR TENNIS CENTER
4210 N Bobhalla Dr
Sioux Falls,SD57107
45-2784394 501(c)(3) 25,000       GENERAL SUPPORT
(49) COMMUNITY MEMORIAL HOSPITAL
PO Box 319
Burke,SD57523
46-0219795 501(c)(3) 25,000       GENERAL SUPPORT
(50) CONCORDIA COLLEGE
901 8th St
Moorhead,MN56560
41-0693977 501(c)(3) 1,388,100       TED HEIMARCK PROFESSOR PLEDGE
(51) CYSTIC FIBROSIS FOUNDATION
8011 34th Ave S Ste 116
Bloomington,MN55425
13-1930701 501(c)(3) 36,750       SUPPORT: CORKS & KEGS DONATION
(52) DAKOTA ALLIANCE SOCCER CLUB
401 W 39th Street
Sioux Falls,SD57105
46-0359817 501(c)(3) 61,000       CONTRACT DONATION
(53) DAKOTA BOYS AND GIRLS RANCH
PO Box 5007
Minot,ND58702
45-0333670 501(c)(3) 15,000       DONATION
(54) DAKOTA MEDICAL FOUNDATION
4141 28th Ave S
Fargo,ND58104
45-6012318 501(c)(3) 25,000       DONATION SUPPORT
(55) DAKOTA SCHOOLERS
1809 W Oak Street
Sioux Falls,SD57105
20-3452350 501(c)(3) 37,500       DONATION CONTRACT PAYMENT
(56) DAKOTA STATE UNIVERSITY
820 N Washington Ave
Madison,SD57042
46-6000364 501(c)(3) 6,000       GALA 2018 SUPPORT
(57) DETROIT MOUNTAIN
Po Box 1039
Detroit Lakes,MN56502
27-2089583 501(c)(3) 10,000       GENERAL SUPPORT
(58) DICKINSON STATE UNIVERSITY
PO Box 19
Dickinson,ND58602
47-5378716 501(c)(3) 10,000       MULTIPURPOSE RM NAMING RIGHTS
(59) DILWORTH GLYNDON FELTON PUBLIC SCHOOLS
513 Parke Ave
Glyndon,MN56547
06-1400159 115 5,050       NEW SCOREBOARD DONATION
(60) DOW RUMMEL
1321 West Dow Rummel St
Sioux Falls,SD57104
46-0271277 501(c)(3) 25,000       DONATION
(61) DUNCAN REGIONAL HEALTH (OK)
1407 Whisenant Dr
Duncan,OK73533
20-2772056 501(c)(3)   2,234,776 FMV CLINIC BUILDING DONATION OF CLINIC
(62) Edith Sanford Breast Cancer Foundation
P O Box 5039 Rte 5218
Sioux Falls,SD571175039
45-0404126 501(c)(3) 8,382       GENERAL SUPPORT
(63) EL RIAD SHRINERS
510 S Phillips Ave PO Box 1203
Sioux Falls,SD571011203
46-0129703 501(c)(3) 8,300       DONATION
(64) EMBE
300 West 11th Street
Sioux Falls,SD571046306
46-0234998 501(c)(3) 15,250       GENERAL SUPPORT
(65) EMERGING PRAIRIE
4141 28th Ave S
Fargo,ND58104
20-0520386 501(c)(3) 30,000       TEDX 2017 SPONSORSHIP
(66) FACE IT TOGETHER
231 S Phillips Ave No 201
Sioux Falls,SD57104
27-2501220 501(c)(3) 25,000       GENERAL SUPPORT
(67) FAMILY ADVOCACY CENTER OF NORTHERN MINNESOTA
800 Bemidji Ave N Ste 4
Bemidji,MN56601
20-2102302 501(C)(3) 32,000       GENERAL SUPPORT
(68) FAMILY HEALTHCARE CENTER
301 NP Avenue
Fargo,ND58102
45-0430628 501(c)(3) 10,130       GENERAL SUPPORT
(69) FARGO MARATHON
405 W Main Ave No 1D
West Fargo,ND58078
43-2043293 501(c)(3) 92,500       EDITH BRANDING DONATION
(70) FARGO PARK DISTRICT FOUNDATION
701 Main Ave
Fargo,ND58103
47-1248968 501(c)(3) 8,143       LEAGUE TEAM FEE DONATION
(71) FARGO SCHOOLS
415 4th St N
Fargo,ND57192
45-6012318 501(c)(3) 11,000       SIGN SPONSORSHIP
(72) FARGO HOCKEY ASSOCIATION
831 17TH Ave N
Fargo,ND58102
36-3548649 501(C)(3) 12,250       HOCKEY NIGHT IN FARGO 2018
(73) FEEDING SOUTH DAKOTA
3511 N 1st Avenue
Sioux Falls,SD57104
36-3293534 501(c)(3) 10,000       DONATION
(74) FELLOWSHIP OF CHRISTIAN ATHLETES
8701 Leeds Rd
Kansas City,MO64129
44-0610626 501(c)(3) 7,500       GENERAL SUPPORT
(75) FIRST TEE OF SOUTH DAKOTA
4809 W 41st St Suite 202
Sioux Falls,SD57106
46-0449824 501(c)(3) 90,000       DONATION
(76) FM SYMPHONY
808 3rd Ave S Ste 300
Fargo,ND58103
45-0275135 501(c)(3) 20,000       2017-2018 SPONSORSHIP
(77) FORWARD SIOUX FALLS
PO Box 907
Sioux Falls,SD57101
46-0396647 501(c)(6) 350,000       GENERAL SUPPORT
(78) FRIENDS OF THE ND GOVERNORS RESIDENCE
PO Box 2024
Bismarck,ND58502
36-3646958 501(c)(3) 150,000       GENERAL SUPPORT
(79) FRIENDS OF THE UNIV OF STELLENBOSCH FOUNDATION
1000 N West St Suite 1200
Wilmington,DE19801
13-4091453 501(c)(3) 100,000       GENERAL SUPPORT
(80) GIRL SCOUTS
1101 S Marion Road
Sioux Falls,SD57106
46-0250744 501(c)(3) 11,500       DONATION
(81) GIRLS ON THE RUN
300 West 11th Street
Sioux Falls,SD571046306
46-0234998 501(c)(3) 6,000       GENERAL SUPPORT
(82) GLOBAL HEALTH CORPS INC
1 Penn Plaza Suite 6271
New York,NY10119
80-0512336 501(c)(3) 1,000,000       GENERAL SUPPORT
(83) GOOD SAMARITAN CENTER (SOCIETY)
401 W 2nd St
Sioux Falls,SD57104
46-0349951 501(c)(3) 26,500       ANNL CONFERENCE
(84) GOVERNORS OFFICE OF ECONOMIC DEVELOPMENT
711 E Wells Ave
Pierre,SD57501
46-6000364 115 15,000       GENERAL SUPPORT
(85) GREAT PLAINS FOOD BANK
1720 3rd Ave N
Fargo,ND58102
45-0226421 501(c)(3) 25,000       FEED THE FUTURE
(86) GREAT PLAINS ZOO
805 S Kiwanis Ave
Sioux Falls,SD57104
46-6015015 501(c)(3) 195,317       DONATION
(87) GREAT RIDES FARGO
425 Broadway N
Fargo,ND58102
46-1849025 501(c)(3) 15,000       GENERAL SUPPORT
(88) Greater Fargo Moorhead Economic Development Corporation
51 Broadway Suite 500
Fargo,ND58102
45-6011769 501(c)(6) 40,000       GENERAL SUPPORT
(89) GROUND WORKS
201 N Weber Ste 201
Sioux Falls,SD57103
45-2767053 501(c)(3) 17,500       TEACHING GARDEN EXPANS DONATE
(90) HEALING HOPE MINISTRIES
30185 475th Ave
Alcester,SD57001
81-2069424 501(c)(3) 27,500       DONATION OPERATING EXPENSES
(91) HELPLINE CENTER INC
1000 N West Ave Suite 310
Sioux Falls,SD57104
23-7424387 501(c)(3) 21,000       2018 CORPORATE CONTRIBUTION
(92) HILLSBORO PUBLIC SCHOOLS
128 4th St NE PO Box 579
Hillsboro,ND58045
45-6001736 501(c)(3) 6,250       SPORTS COMPLEX SPONS
(93) HOPE HAVEN INC
PO Box 70
Rock Valley,IA51247
42-0890017 501(c)(3) 7,500       DESSERT AUCTION & GOLF BNFT
(94) HOSPICE OF MURRAY COUNTY
36 Park Dr
Slayton,MN56172
41-1593410 501(c)(3) 8,000       GENERAL SUPPORT
(95) HUNGRY HEARTS
4701 E 54TH ST
SIOUX FALLS,SD57110
47-4744673 501(c)(3) 10,000       DONATION SF SCHOOL LUNCH
(96) ICE SPORTS ASSOCIATION
108 S Dakota Ave
Sioux Falls,SD57104
27-1234271 501(c)(3) 155,600       1984 ZAMBONI ICE RESURFACER
(97) IMPACT FOUNDATION
4141 28th Ave S
Fargo,ND58104
20-0520386 501(c)(3) 12,500       DONATION
(98) INDEPENDENT SCHOOL DISTRICT FARGO
415 N 4th Street
Fargo,ND58102
45-6000294 115 15,000       VETERANS MEM CTR
(99) JAMESTOWN PARK & RECREATION FOUNDATION
1002 2ND Ave SE
Jamestown,ND58401
75-1597713 501(C)(3) 5,700       TWO RIVERS ACTIVITY CENTER
(100) JDRF
2301 East 60th St North
Sioux Falls,SD57104
23-1907729 501(c)(3) 25,000       GENERAL SUPPORT
(101) JEREMIAH PROGRAM
615 1st Ave NE No 210
Minneapolis,MN55413
41-1801834 501(c)(3) 5,500       JOURNEY FOR HOPE DONATION
(102) JUNIOR ACHIEVEMENT
1000 N West Ave No 110
Sioux Falls,SD57104
46-0306352 501(c)(3) 37,950       DONATION MATCHING GIFTS
(103) KIDS CHANCE OF SOUTH DAKOTA
300 S Main Ave
Sioux Falls,SD57104
47-4439997 501(c)(3) 8,000       DONATION SCHOLARSHIP FUNDING
(104) LEADERSHIP SOUTH DAKOTA
PO Box 675
Platte,SD57369
46-0398115 501(c)(3) 10,000       GENERAL SUPPORT
(105) Legends Of Gold Inc
Box 287
Beresford,SD57004
27-3794971 501(c)(3) 21,425       GENERAL SUPPORT
(106) LEWIS & CLARK FORT MANDAN FDTN
PO Box 607
Washburn,ND58577
36-4012431 501(c)(3) 6,500       DONATION
(107) HI-LINE HEALTH FOUNDATION INCLIBERTY MEDICAL CENTER
PO Box 705
Chester,MT59522
81-0453568 501(c)(3) 9,000       GENERAL SUPPORT
(108) LIFESCAPE
2501 W 26th St
Sioux Falls,SD57105
46-5151247 501(c)(3) 51,000       GENERAL SUPPORT
(109) LIFESOURCE
2225 West River Road N
Minneapolis,MN55411
36-3584029 501(c)(3) 15,000       GENERAL SUPPORT: DONATION
(110) LINCOLN HIGH SCHOOL
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 34,960       ANNL CONTRIBUTION
(111) LUTHERAN SCHOOLS
308 W 37th St
Sioux Falls,SD57105
46-0343381 501(c)(3) 3,000,000       GENERAL SUPPORT
(112) LUTHERAN SOCIAL SERVICES
705 East 41st Street Ste 200
Sioux Falls,SD571056048
46-0224731 501(c)(3) 15,250       DONATION
(113) MAKE A WISH
1400 W 17th St
Sioux Falls,SD57104
46-0375953 501(c)(3) 25,280       DONATION
(114) MANDAN PUBLIC SCHOOLS
901 Division St NW
Mandan,ND58554
45-6001098 115 15,000       ATHLETIC DONATION
(115) MAYVILLE STATE UNIVERSITY
330 3rd St NE
Mayville,ND58257
45-6002485 501(c)(3) 10,000       CORP AD PROGRAM
(116) MCCROSSAN BOYS RANCH
47135 260th Street
Sioux Falls,SD57107
46-0311913 501(c)(3) 11,000       BANQUET AUCTION DONATION
(117) MCKENZIE COUNTY HEALTHCARE SYS
516 N Main
Watford City,ND58854
77-0637498 501(c)(3) 100,000       CONTRIBUTION CONTRACT PAYMENT
(118) Metro Area Tournament Committee
415 4th St N
Fargo,ND58102
45-0458883 501(c)(3) 14,000       GENERAL SUPPORT
(119) MHCH Foundation (Matson Halverson Christiansen Hamilton)
201 S Main Street PO Box 84
Kimball,SD57355
46-0461691 501(c)(3) 15,000       GENERAL SUPPORT
(120) MIKE MILLER FOUNDATION
2107 Quiett Lane
Mitchell,SD57301
30-0015773 501(c)(3) 10,000       MIKE MILLER CLASSIC DONATION
(121) MN STATE UNIVERSITY MANKATO FOUNDATION
236 Wigley Administration Center
Mankato,MN56001
41-6033423 501(c)(3) 250,000       GENERAL SUPPORT
(122) MOORHEAD BUSINESS ASSOC
PO Box 612
Moorhead,MN56560
27-4254782 501(c)(6) 5,750       OHS AND AHS 4TH OF JULY EVENT
(123) MOORHEAD PUBLIC SCHOOLS
2300 4th Ave S
Moorhead,MN56560
26-2502312 501(c)(3) 5,555       GAME DAY PROGRAM AD
(124) MSUM
1104 7th Ave S
Moorhead,MN56563
23-7106061 501(c)(3) 205,200       FY18 PLEDGE
(125) MUSCULAR DYSTROPHY ASSOC
7401 Metro Blvd 325
Edina,MN55439
13-1665552 501(c)(3) 7,500       GENERAL SUPPORT DONATION
(126) NAMI SD
PO Box 88808
Sioux Falls,SD57109
36-3593027 501(c)(3) 6,000       DONATION DANCING W/STARS
(127) NATL KIDNEY FOUNDATION
30 E 33rd St
New York,NY10016
13-1673104 501(c)(3) 28,250       DONATION PAY PLEDGE
(128) NATL MS SOCIETY
733 3rd Ave
New York,NY10017
13-5661935 501(c)(3) 25,000       2017-18 DONATION PLEDGE PYMNT
(129) NAVY LEAGUE OF THE US SD COUNC
201 S Phillips Ave Ste 790
Sioux Falls,SD57104
81-3858674 501(c)(3) 25,000       USS SD SSN 790 COMSG COMTE
(130) ND HOSPITAL ASSOC
PO Box 7340
Bismarck,ND58507
45-0274165 501(c)(6) 10,000       2017 CONV SPONSOR DIAMOND LVL
(131) ND SAFETY COUNCIL
1710 Canary Ave Suite A
Bismarck,ND58501
45-0353009 501(c)(3) 15,000       GENERAL SUPPORT
(132) NDSCS FOUNDATION
800 6TH ST NO
Wahpeton,ND58076
45-0407617 501(c)(3) 24,300       GENERAL SUPPORT
(133) NDSU
PO Box 6050 NDSU Dept 1200
Fargo,ND58108
45-6014085 501(c)(3) 1,459,600       SUSTAINING PARTNER
(134) NICKLAUS CHILDRENS HOSPITAL FOUNDATION
3100 SW 62nd Ave
Miami,FL33155
59-0638499 501(c)(3) 1,000,000       GENERAL SUPPORT
(135) NICKLAUS CHILDRENS HEALTH CARE FOUNDATION
11770 US Highway 1 No 308
North Palm Beach,FL33408
57-1154352 501(c)(3) 250,000       GENERAL SUPPORT
(136) NORTHERN STATE UNIVERSITY FOUNDATION
620 15th Ave SE
Aberdeen,SD57401
23-7002314 501(c)(3) 558,000       GENERAL SUPPORT
(137) Northland Comm & Tech College Foundation
1101 Highway One East
Thief River Falls,MN56701
41-1287038 501(c)(3) 10,000       GENERAL SUPPORT
(138) NORTHWESTERN COLLEGE
101 7th Street SW
Orange City,IA51041
42-0698196 501(c)(3) 50,000       DONATION
(139) NSIC
2999 County Rd 42 West Suite 136
Burnsville,MN55306
41-1783486 501(c)(3) 240,000       GENERAL SUPPORT
(140) OAK GROVE LUTHERAN SCHOOL
124 North Terrace
Fargo,ND58102
45-0226473 501(c)(3) 11,250       GENERAL SUPPORT
(141) OUTDOOR ADVENTURE FOUNDATION
415 38th St S Suite E
Fargo,ND58103
27-0192316 501(c)(3) 12,500       DREAMAKERS DONATION SUPPORT
(142) PEACEMAKER RESOURCES
2301 Johanneson Dr NW Suite 106
Bemidji,MN56601
45-0507287 501(c)(3) 16,750       GENERAL SUPPORT
(143) PHEASANTS FOREVER
1783 Buerkle Cir
St Paul,MN55110
41-1429149 501(c)(3) 41,500       GENERAL SPRT DONATION 2017
(144) PHILANTHROPY PROMOTIONS INC
2601 W 60th Street North
Sioux Falls,SD57107
87-0695596 501(c)(3) 20,000       DONATION HOT HARLEY NIGHTS
(145) PLAINS ART MUSEUM
PO Box 2338
Fargo,ND58108
41-1260780 501(c)(3) 22,500       PLAINSART4ALL PLEDGE
(146) PRESIDENTS BOWL
201 East 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 10,000       DONATION
(147) PROJECT PREP OLYMPIC DEVELOP PROGRAM
PO Box 385970 6101 Old Shakopee Rd
Bloomington,MN55438
04-3644163 501(c)(3) 12,500       GENERAL SUPPORT
(148) PROJECT SCHOOL SAFE ASSOC
43407 218th St
De Smet,SD57231
47-3199527 501(c)(3) 24,000       PROJECT STAND UP DONATION
(149) RADY CHILDRENS HOSPITAL FOUNDA
3020 Childrens Way MC 5001
San Diego,CA92123
33-0170626 501(c)(3) 287,500       CONSORTIUM COLLABORATION FUND
(150) REACH
629 S Minnesota Ave
Sioux Falls,SD57104
46-0396579 501(c)(3) 6,000       DONATION BREWHAHA FUNDRAISING
(151) REALTORS FOR KIDS
2415 W 57th St
Sioux Falls,SD57108
26-2681308 501(c)(3) 6,000       DONATION AUCTION FUNDRAISER
(152) RED RIVER CHILDRENS ADVOCACY
100 S 4th St No 302
Fargo,ND58103
20-1095721 501(c)(3) 25,000       DONATION
(153) RED RIVER ZOOLOGICAL SOCIETY
4255 23rd Avenue S
Fargo,ND58104
36-3938878 501(c)(3) 25,000       SANTA CLAUS 2017 SPONSORSHIP
(154) REINBOWS INC
43341 480th Avenue
Windom,MN56101
20-8775427 501(c)(3) 6,000       GENERAL Support
(155) ROCK RAPIDS KIDS CLUB
309 North Story Street
Rock Rapids,IA51246
20-5156803 501(c)(3) 10,080       DONATION
(156) ROGER MARIS CELEBRITY GOLF
Po Box 3202
Fargo,ND58108
45-0425333 501(c)(3) 10,000       MAJOR SPONSORSHIP
(157) RONALD MCDONALD HOUSE
825 S Lake Ave
Sioux Falls,SD57104
46-0371152 501(c)(3) 140,000       DONATION PLEDGE PAYMENT
(158) ROOSEVELT HIGH SCHOOL
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 51,457       DONATION
(159) SAMARITANS FEET INTERNATIONAL
PO Box 78992
Charlotte,NC28271
14-1880905 501(c)(3) 6,500       HURRICANE HARVEY RELIEF DONAT
(160) SANFORD HEALTH FOUNDATION NORTH
P O Box 5039 Rte 5218
Sioux Falls,SD571175039
45-0398104 501(c)(3) 15,200       MAYVILLE COUPLES GOLF TOURN
(161) SD BASKETBALL COACHES ASSOC
1404 Yosemite Ln
Brookings,SD57706
81-1379554 501(c)(3) 7,500       DONATION
(162) SD BIOTECH ASSOC
2329 N Career Ave Ste 115
Sioux Falls,SD57107
37-1518658 501(c)(6) 9,500       DONATION 2018 MEMBER DUES
(163) SD CATTLEMANS ASSOC
215 E Prospect PO Box 29
Pierre,SD57501
46-2773322 501(c)(3) 15,000       DONATION
(164) SD CHORALE
300 S Minnesota Avenue
Sioux Falls,SD57104
45-2709374 501(c)(3) 25,000       3RD/FINAL PAYMENT CONTRACT
(165) SD CORN GROWERS ASSOCIATION
4712 S Technopolis Dr
Sioux Falls,SD57106
46-0392991 501(c)(5) 6,000       DONTATION
(166) SD GOLF ASSOCIATION
4809 W 41st St Suite 202
Sioux Falls,SD57106
46-0310847 501(c)(4) 11,500       DONATION 1ST TEE OF SD
(167) SD HALL OF FAME
1480 S Main Ave
Chamberlain,SD57325
46-0324210 501(c)(3) 50,000       PLEDGE PAY #1 OF 5 SUPPORT
(168) SD HIGH SCHOOL ACTIVITIES
PO Box 1217 804 North Euclid Ave
Ste 102
Pierre,SD575011217
46-0226882 501(c)(3) 125,000       ATTN: DR DAN SWARTOS -SUPPORT
(169) SD HIGH SCHOOL COACHES ASSOC
801 W Eagle Ridge St
Sioux Falls,SD57108
23-7297479 501(c)(3) 10,000       DONATION
(170) SD LAW ENFORCEMENT CHARITIES
5214 Sweetbriar Court
Sioux Falls,SD57108
46-0440378 501(c)(3) 10,000       SUPPORT CHARITY FUNDRAISING
(171) SD PARKS & WILDLIFE FOUNDATION
523 E Capitol Ave
Pierre,SD57501
46-0387968 501(c)(3) 10,000       BLOOD RUN
(172) SD STATE UNIVERSITY
815 Medary Ave PO Box 525
Brookings,SD57007
46-0273801 501(c)(3) 2,619,990       DONATION 11112017
(173) SD SYMPHONY ORCHESTRA
300 North Dakota Ave Ste 116
Sioux Falls,SD57104
46-6017026 501(c)(3) 57,400       DONATION
(174) SD SYNOD
2001 S Summit Ave
Sioux Falls,SD57197
36-3512774 501(c)(3) 265,000       DONATION
(175) SF AREA COMMUNITY FOUNDATION
200 N Cherapa Place
Sioux Falls,SD57103
31-1748533 501(c)(3) 57,000       DONATION
(176) SF CHRISTIAN HIGH SCHOOL
6120 Charger Circle
Sioux Falls,SD571091110
46-0340024 501(c)(3) 18,500       PLEDGE AGEREMENT
(177) SF CYCLONES
PO Box 361
Sioux Falls,SD57101
27-4705069 501(c)(3) 31,727       LEGENDS GOLF BAG ASSISTANCE
(178) SF JAZZ & BLUES SOCIETY
123 S Main Ave Ste 204
Sioux Falls,SD57104
46-0418356 501(c)(3) 15,000       CHILDRENS JAZZ QUEST DONATION
(179) SF Jr Stampede (Hat Trick Hockey Corp)
3213 Nicann Ct
Sioux Falls,SD57103
47-1795011 501(c)(3) 15,000       GENERAL SUPPORT
(180) SF LITTLE LEAGUE JUNIOR DIV
PO Box 91921
Sioux Falls,SD57109
35-2590301 501(c)(3) 7,000       GENERAL SUPPORT DONATION
(181) SF SWIM TEAM INC
PO Box 2736
Sioux Falls,SD571012736
46-0452453 501(c)(3) 25,000       DONATION
(182) SF YOUTH HOCKEY ASSOC
4235 West Mesa Pass
Sioux Falls,SD57106
46-0427805 501(c)(3) 27,000       SUPPORT
(183) SHEYENNE VALLEY COMMUNITY FOUNDATION
250 West Main ST
Valley City,ND58072
46-4371645 501(c)(3) 6,000       GENERAL SUPPORT
(184) SHILOH CHRISTIAN SCHOOL
1915 Shiloh Dr
Bismarck,ND58503
45-0348120 501(c)(3) 72,000       GENERAL SUPPORT
(185) Sioux Council Boy Scouts Of America Inc
800 N West Avenue
Sioux Falls,SD57104
46-0224599 501(c)(3) 5,500       GENERAL SUPPORT
(186) SIOUX EMPIRE ARTS COUNCIL
PO Box 1165
Sioux Falls,SD57101
20-8535871 501(c)(3) 10,000       2017 GENERAL DONATION PLEDGE
(187) SIOUX EMPIRE YOUTH WRESTLING
3509 S Genevieve Ave
Sioux Falls,SD57103
82-2705107 501(c)(3) 35,000       DONATION
(188) SIOUX FALLS CATHOLIC SCHOOLS
3100 W 41st St
Sioux Falls,SD57105
46-0413591 501(c)(3) 65,500       DONATION
(189) FamilyFest LLC
P O Box 90646
Sioux Falls,SD57109
20-3789203 501(c)(3) 10,000       GENERAL SUPPORT
(190) SIOUX FALLS AREA CASA PROGRAM
300 N Dakota Ave Suite 609
Sioux Falls,SD57104
46-0430647 501(c)(3) 10,000       DONATION
(191) SIOUX FALLS FIREFIGHTERS
PO Box 340
Sioux Falls,SD57101
68-0589701 501(c)(3) 7,500       STEP UP FOR HEROES 0917
(192) SIOUX FALLS SCHOOL DISTRICT
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 83,275       GENERAL SUPPORT
(193) SIOUX FALLS SPORTS AUTHORITY
200 N Phillips Ave No 304
Sioux Falls,SD57104
20-5850491 501(c)(3) 2,453,000       GOLF TOURNAMENT AND MARATHON
(194) SIOUX FALLS WOMEN RUN LLC
5235 S Sweetbriar Ct
Sioux Falls,SD57108
81-3518734 501(c)(6) 10,000       DONATION
(195) SOUTHEAST EDUCATION COOP
1305 9th Ave S
Fargo,ND58103
47-5548763 501(c)(3) 15,000       DONATION
(196) SOUTHEAST TECHNICAL INSTITUTE
2320 N Career Ave
Sioux Falls,SD57107
36-4112897 501(c)(3) 10,000       DONATION
(197) SPECIAL OLYMPICS
305 W 39th St
Sioux Falls,SD57105
46-0359776 501(c)(3) 19,750       DONATION
(198) SPECIAL OLYMPICS SOUTH DAKOTA
800 E I-90 Lane
Sioux Falls,SD57104
46-0359776 501(c)(3) 6,500       LEGENDS GRANT EQUIPMENT
(199) ST MARYS FOUNDATION
1027 Washington Ave
Detroit Lakes,MN56501
27-1984704 501(c)(3) 25,000       DETROIT LAKES HELIPAD
(200) STEM FOR LIFE FOUNDATION
420 Lexington Ave Sute 350
New York,NY10170
26-1150435 501(c)(3) 500,000       stem for life contribution
(201) STOCKYARDS AG EXPERIENCE
PO Box 2042
Sioux Falls,SD57101
46-5391991 501(c)(3) 25,000       SUPPORT CHAMBER APPEALS 1OF3
(202) SUSAN G KOMEN BREAST CANCER
5005 LBJ Freeway Suite 526
Dallas,TX75244
75-1835298 501(c)(3) 35,000       RACE FOR CURE SPONSORSHIP
(203) THE BANQUET
900 E 8th St
Sioux Falls,SD57103
46-0387495 501(c)(3) 5,260       RUN FOR FOOD
(204) THEODORE ROOSEVELT PRESIDENTIAL LIBRARY AND MUSEUM
PO Box 700
Dickinson,ND58602
47-1324043 501(c)(3) 100,000       GENERAL SUPPORT
(205) TNT KIDS FITNESS
2800 Main Ave
Fargo,ND58103
20-3459549 501(c)(3) 21,500       BREAK BARRIERS PARTNER SPONS
(206) TRI CITY STORM SOCCER CLUB
1323 23rd St S Ste A
Fargo,ND58103
36-3346894 501(c)(3) 10,000       2017-2018 SPONSORSHIP
(207) TUITION4TECHSTUDENTS
101 N Main Ave Ste 321
Sioux Falls,SD57104
82-2410074 501(c)(3) 25,000       DONATION INITIATED MEASURE
(208) UCODEGIRL
325 5th St N
Fargo,ND58102
81-2623993 501(c)(3) 6,000       DONATION
(209) UNITED WAY
1000 North West Ave 120
Sioux Falls,SD571041314
46-0233701 501(c)(3) 278,600       DONATION
(210) UNIV OF ND FOUNDATION
3501 University Ave
Grand Forks,ND58202
45-0348296 501(c)(3) 100,100       GENERAL SUPPORT
(211) UNIV OF SD FOUNDATION
1110 N Dakota Po Box 5555
Vermillion,SD57069
46-6018891 501(c)(3) 500,000       GENERAL SUPPORT
(212) UNIV OF SIOUX FALLS
1101 W 22nd St
Sioux Falls,SD57105
46-0224600 501(c)(3) 10,000       HYVEE/SANFORD LEGENDS SCHOLAR
(213) University Of South Dakota FoundationUniversity of South Dakota
414 E Clark
Vermillion,SD57069
46-6018891 501(c)(3) 186,753       GENERAL SUPPORT
(214) University Of Wisconsin Foundation
600 Highland Ave K4/646
Madison,WI53792
39-0743975 501(c)(3) 154,100       GENERAL SUPPORT
(215) UNIVERSITY OF JAMESTOWN
6088 College Lane
Jamestown,ND58405
45-0231180 501(c)(3) 15,000       GENERAL SUPPORT
(216) UNIVERSITY OF MARY
7500 University Dr
Bismarck,ND58504
45-0273403 501(c)(3) 10,000       HYVEE/SANFORD LEGENDS
(217) UP AQUATICS INC
3740 Aspyn Ln N
Fargo,ND58102
27-1181382 501(c)(3) 30,000       2018 PLEDGE 3RD YR
(218) USD SCHOOL OF MEDICINE
1400 W 22nd Street
Sioux Falls,SD57105
46-0418678 501(c)(3) 55,796       Dr. Freeman Neuro Ed Service
(219) VALLEY CITY STATE UNIVERSITY FOUNDATION
101 College St SW
Valley City,ND58072
23-7178785 501(c)(3) 5,500       GENERAL SUPPORT
(220) VILLAGE FAMILY SERVICE CENTER
PO Box 9859
Fargo,ND58106
45-0226423 501(c)(3) 101,000       BOBCAT OPEN HOLE SIGN SPONSOR
(221) VOLUNTEERS OF AMERICA DAKOTAS
1309 W 51st St
Sioux Falls,SD57105
23-7353508 501(c)(3) 20,500       GENERAL SUPPORT DONATION
(222) WAHPETON SCHOOLS
1021 N 11th St
Wahpeton,ND58074
45-6001462 115 5,350       SPONSORSHIP 2017-2018
(223) WASHINGTON HIGH SCHOOL
501 N Sycamore Ave
Sioux Falls,SD57110
46-6002586 501(c)(3) 6,005       HEATHER WALKER - DONATION
(224) WASHINGTON PAVILION
301 S Main Ave PO Box 984
Sioux Falls,SD57101
46-0435791 501(c)(3) 79,272       GENERAL SUPPORT
(225) WATERTOWN COMMUNITY FOUNDATION
PO Box 116
Watertown,SD57201
46-0350319 501(c)(3) 20,000       GENERAL SUPPORT
(226) WATERTOWN DEVELOPMENT COMPANY
PO Box 332
Watertown,SD57201
47-0813269 501(c)(3) 15,000       GENERAL SUPPORT
(227) WAVE
513 Main St
Webster,SD57274
20-1307620 501(c)(3) 15,000       PLEDGE
(228) WEST CENTRAL BASEBALL ASSOC
904 Nordic Cir
Hartford,SD57033
46-4596999 501(c)(3) 5,160       LEGENDS SCOREBOARD
(229) WEST FARGO SCHOOLS
801 9th St E
West Fargo,ND58078
45-6000298 115 7,200       7TH GR TEAM ZEN DONATION
(230) WESTERN GOVERNORS FOUNDATION
1600 Broadway Suite 1700
Denver,CO80202
74-2368923 501(c)(3) 15,000       WORKSHOP
(231) WESTERN ND AREA HEALTH EDUC
P O Box 615
Hettinger,ND58639
45-6002485 501(c)(3) 12,000       FUTURE HEALTH PROFESSIONALS
(232) WHEATON AREA SCHOOLS
1700 3rd Ave S
Wheaton,MN56296
41-6004390 501(c)(3) 10,050       TRACK DONATION
(233) WINDOM YOUTH HOCKEY
PO Box 41
Windom,MN56101
41-1290460 501(c)(3) 8,333       GENERAL SUPPORT
(234) WINNER REGIONAL HEALTHCARE CTR
745 E 8th St
Winner,SD57580
46-0274380 501(c)(3) 101,000       DONATION
(235) WOUNDED WARRIOR PROJECT
4899 Belfort Road Suite 300
Jacksonville,FL32256
20-2370934 501(c)(3) 8,500       DONATION
(236) YELLOW JACKET FOUNDATION
1200 University St No 9506
Spearfish,SD57799
51-0151319 501(c)(3) 50,000       PLEDGE PAYMENT
(237) YMCA SIOUX FALLS REGION
230 S Minnesota Ave
Sioux Falls,SD57104
46-0225021 501(c)(3) 35,500       PLEDGE
(238) YOUTH VILLAGESJANIES FUND
3320 Brother Blvd
Memphis,TN38133
62-1652079 501(c)(3) 205,000       DONATION-STEVEN TYLER FUNDRAISER
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
223
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
15
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) Donation to parent for child receiving treatment 2 25,000      
(2) Donation - State Powerlifting Championships 1 10,000      
(3) Donation - Dakota United Rugby Club 1 8,613 0    
(3)
(4)
(5)
(6)
(7)
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: Prior to disbursement all grant fund requests are reviewed to ensure the receiving organization and proposed use of funds align with Sanford's mission.
Schedule I (Form 990) 2019



Additional Data


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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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on 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 .........
1b
Yes
 
2
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 on Line 1a? ..
2
Yes
 
3
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.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
Yes
 
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.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
Yes
 
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on 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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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 on 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 on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Maria Bell MD
Trustee/Research Administrator
(i)

(ii)
775,124
-------------
0
10,000
-------------
0
3,909
-------------
0
0
-------------
0
29,050
-------------
0
818,083
-------------
0
0
-------------
0
2Mark Lundeen MD
Trustee/Orthopedics Services Chair
(i)

(ii)
725,227
-------------
0
0
-------------
0
1,392
-------------
0
0
-------------
0
29,050
-------------
0
755,669
-------------
0
0
-------------
0
3Mark Paulson MD
Chair/Physician Regional Chair
(i)

(ii)
268,457
-------------
0
0
-------------
0
-2,091
-------------
0
0
-------------
0
26,202
-------------
0
292,568
-------------
0
0
-------------
0
4Michael LeBeau MD
Trustee/Senior VP - Bismarck Clinic
(i)

(ii)
1,342,178
-------------
0
3,000
-------------
0
69,454
-------------
0
0
-------------
0
29,050
-------------
0
1,443,682
-------------
0
0
-------------
0
5Kelby K Krabbenhoft
Sanford President & CEO
(i)

(ii)
1,644,254
-------------
0
542,500
-------------
0
89,431
-------------
0
0
-------------
0
12,726
-------------
0
2,288,911
-------------
0
0
-------------
0
6Kelby K Krabbenhoft Def Comp
Sanford President & CEO
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
0
877,405
-------------
0
0
-------------
0
877,405
-------------
0
0
-------------
0
7JoAnn L Kunkel
Chief Financial Officer
(i)

(ii)
703,270
-------------
0
202,500
-------------
0
114,571
-------------
0
21,375
-------------
0
21,813
-------------
0
1,063,529
-------------
0
0
-------------
0
8Randy Bury
Chief Administrative Officer
(i)

(ii)
724,232
-------------
0
225,000
-------------
0
123,522
-------------
0
21,375
-------------
0
6,882
-------------
0
1,101,011
-------------
0
0
-------------
0
9Randy Bury Deferred Comp
Chief Administrative Officer
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
0
15,683
-------------
0
0
-------------
0
15,683
-------------
0
0
-------------
0
10Bill Gassen
Chief Human Resources Officer
(i)

(ii)
458,075
-------------
0
130,500
-------------
0
74,469
-------------
0
13,275
-------------
0
14,970
-------------
0
691,289
-------------
0
0
-------------
0
11Kim Patrick
Chief Legal Officer (through 12/17)
(i)

(ii)
510,765
-------------
0
150,083
-------------
0
99,321
-------------
0
14,175
-------------
0
26,226
-------------
0
800,570
-------------
0
0
-------------
0
12Jennifer Grennan
Chief Legal Officer
(i)

(ii)
306,150
-------------
0
72,500
-------------
0
34,346
-------------
0
8,475
-------------
0
26,226
-------------
0
447,697
-------------
0
0
-------------
0
13Allison Wierda-Suttle MD
Sr. VP, Chief Med Officer
(i)

(ii)
617,672
-------------
0
150,000
-------------
0
77,217
-------------
0
18,405
-------------
0
16,777
-------------
0
880,071
-------------
0
0
-------------
0
14Bill Marlette
Treasurer
(i)

(ii)
621,534
-------------
0
180,000
-------------
0
139,810
-------------
0
0
-------------
0
1,470
-------------
0
942,814
-------------
0
0
-------------
0
15Bill Marlette Def Comp
Treasurer
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
0
211,820
-------------
0
0
-------------
0
211,820
-------------
0
0
-------------
0
16Micah Aberson
Chief Global Brand Officer
(i)

(ii)
395,781
-------------
0
86,250
-------------
0
57,355
-------------
0
13,275
-------------
0
26,226
-------------
0
578,887
-------------
0
0
-------------
0
17Bryan Nermoe
President, Bemidji
(i)

(ii)
457,008
-------------
0
112,500
-------------
0
74,553
-------------
0
12,255
-------------
0
26,226
-------------
0
682,542
-------------
0
0
-------------
0
18Craig Lambrecht
President, Bismarck
(i)

(ii)
658,075
-------------
0
162,500
-------------
0
102,349
-------------
0
18,375
-------------
0
22,028
-------------
0
963,327
-------------
0
0
-------------
0
19Nate White
COO, President Fargo
(i)

(ii)
861,156
-------------
0
363,500
-------------
0
208,067
-------------
0
25,125
-------------
0
26,226
-------------
0
1,484,074
-------------
0
0
-------------
0
20Michelle Micka
Sr. VP Finance, Corporate Controller
(i)

(ii)
347,118
-------------
0
83,750
-------------
0
35,599
-------------
0
9,375
-------------
0
26,226
-------------
0
502,068
-------------
0
0
-------------
0
21Michelle Bruhn
Sr. VP Finance, Health Services
(i)

(ii)
456,739
-------------
0
112,500
-------------
0
61,501
-------------
0
12,225
-------------
0
14,970
-------------
0
657,935
-------------
0
0
-------------
0
22Paul Hanson
President, Sioux Falls
(i)

(ii)
650,764
-------------
0
160,000
-------------
0
105,046
-------------
0
18,375
-------------
0
26,226
-------------
0
960,411
-------------
0
64,318
-------------
0
23Paul Richard
Exec VP Fargo
(i)

(ii)
650,764
-------------
0
160,000
-------------
0
120,739
-------------
0
0
-------------
0
26,226
-------------
0
957,729
-------------
0
0
-------------
0
24Richard Adcock
Chief Innovation Officer
(i)

(ii)
425,765
-------------
0
184,500
-------------
0
65,234
-------------
0
0
-------------
0
19,916
-------------
0
695,415
-------------
0
0
-------------
0
25William Brunner
Physician
(i)

(ii)
2,671,215
-------------
0
0
-------------
0
-2,228
-------------
0
0
-------------
0
29,050
-------------
0
2,698,037
-------------
0
0
-------------
0
26Larry Burris
Physician
(i)

(ii)
2,270,657
-------------
0
0
-------------
0
-1,397
-------------
0
0
-------------
0
29,050
-------------
0
2,298,310
-------------
0
0
-------------
0
27Scott Pham
Physician
(i)

(ii)
2,899,659
-------------
0
0
-------------
0
-2,261
-------------
0
0
-------------
0
29,050
-------------
0
2,926,448
-------------
0
0
-------------
0
28Adam Stys
Physician
(i)

(ii)
2,470,741
-------------
0
0
-------------
0
4,662
-------------
0
0
-------------
0
29,050
-------------
0
2,504,453
-------------
0
0
-------------
0
29Tomasz Stys
Physician
(i)

(ii)
2,656,360
-------------
0
0
-------------
0
1,232
-------------
0
0
-------------
0
29,050
-------------
0
2,686,642
-------------
0
0
-------------
0
30Daniel Olson
Former Exec VP Bemidji
(i)

(ii)
285,238
-------------
0
300
-------------
0
31,904
-------------
0
0
-------------
0
26,226
-------------
0
343,668
-------------
0
0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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 2018.
Part I, Lines 4b-c Part I, Line 4b: Certain executives participate in a defined contribution SERP Plan. Part I, Line 4c: Certain executives participate in a KEYSOP Plan.
Part I, Line 6 Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production.
Part I, Line 7 Certain employees are eligible for a discretionary incentive bonus. Bonuses are paid based on the achievement of financial and other goals.
Schedule J (Form 990) 2019

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part
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
Yes No Yes No Yes No
A South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VHY3 09-14-2004 70,073,989 2004: New construction of healthcare facilities   X   X   X
B South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VNZ3 09-29-2009 71,015,042 2009: New construction and remodeling of healthcare facilities   X   X   X
C City of Fargo
 
45-6002069 307479CK9 02-09-2011 134,069,821 2011: Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002   X   X   X
D South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VVM3 11-01-2012 128,733,641 2012E: New construction and remodeling of healthcare facilities   X   X   X
City of Chamberlain
 
46-0000094 000000000 12-30-2010 4,000,000 2010 Chamb: New construction of long-term care facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 03-29-2012 66,185,000 2012AB: Refunding bonds issued 9/12/2001 and 10/15/2002   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 06-14-2012 45,000,000 2012D:Refinance taxable indebtedness used to construct healthcare facility   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VWA8 08-05-2014 52,083,720 2014A: 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 2014B: New construction and remodeling of healthcare facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VZW7 10-21-2015 192,641,206 2015:New construction & advanced refunding of bonds issued 4/19/07, 5/22/07   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 10-28-2016 50,000,000 2016: New Construction, equipment and improvements   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 55,565,000 6,545,000 37,020,000  
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 71,393,241 134,069,821 129,135,779
4 Gross proceeds in reserve funds ............. 237,887 543 1,389 616
5 Capitalized interest from proceeds ............. 31,874      
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 997,167 150,032 1,470,647
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 70,396,074 45,000,000 127,665,132
11 Other spent proceeds .............   66,160,644 134,069,821 52,083,720
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2012 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
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
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) 2019

Schedule K (Form 990) 2019
Page 2
Part
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 ....SchKMediumBullet 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 ......... SchKMediumBullet 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
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 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) 2019

Schedule K (Form 990) 2019
Page 3
Part
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
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
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: 09/29/2012 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 03/29/2013
Schedule K, Part I, Bond Issues Entity 3, Bond Issue A, (c) CUSIP #: 83755VXF6 and 83755VXE9 Entity 1, Bond Issue A, (c) CUSIP #: 83755VHY3 and 83755VHZ0
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.
Part III Part III has not been completed for the 2013 City of Fargo bonds or for the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6 With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield- restricted advance refunding escrow financed with proceeds of bonds.
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part
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
Yes No Yes No Yes No
A South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VHY3 09-14-2004 70,073,989 2004: New construction of healthcare facilities   X   X   X
B South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VNZ3 09-29-2009 71,015,042 2009: New construction and remodeling of healthcare facilities   X   X   X
C City of Fargo
 
45-6002069 307479CK9 02-09-2011 134,069,821 2011: Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002   X   X   X
D South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VVM3 11-01-2012 128,733,641 2012E: New construction and remodeling of healthcare facilities   X   X   X
City of Chamberlain
 
46-0000094 000000000 12-30-2010 4,000,000 2010 Chamb: New construction of long-term care facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 03-29-2012 66,185,000 2012AB: Refunding bonds issued 9/12/2001 and 10/15/2002   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 06-14-2012 45,000,000 2012D:Refinance taxable indebtedness used to construct healthcare facility   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VWA8 08-05-2014 52,083,720 2014A: 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 2014B: New construction and remodeling of healthcare facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VZW7 10-21-2015 192,641,206 2015:New construction & advanced refunding of bonds issued 4/19/07, 5/22/07   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 10-28-2016 50,000,000 2016: New Construction, equipment and improvements   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 55,565,000 6,545,000 37,020,000  
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 71,393,241 134,069,821 129,135,779
4 Gross proceeds in reserve funds ............. 237,887 543 1,389 616
5 Capitalized interest from proceeds ............. 31,874      
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 997,167 150,032 1,470,647
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 70,396,074 45,000,000 127,665,132
11 Other spent proceeds .............   66,160,644 134,069,821 52,083,720
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2012 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
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
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) 2019

Schedule K (Form 990) 2019
Page 2
Part
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 ....SchKMediumBullet 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 ......... SchKMediumBullet 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
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 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) 2019

Schedule K (Form 990) 2019
Page 3
Part
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
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
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: 09/29/2012 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 03/29/2013
Schedule K, Part I, Bond Issues Entity 3, Bond Issue A, (c) CUSIP #: 83755VXF6 and 83755VXE9 Entity 1, Bond Issue A, (c) CUSIP #: 83755VHY3 and 83755VHZ0
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.
Part III Part III has not been completed for the 2013 City of Fargo bonds or for the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6 With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield- restricted advance refunding escrow financed with proceeds of bonds.
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part
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
Yes No Yes No Yes No
A South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VHY3 09-14-2004 70,073,989 2004: New construction of healthcare facilities   X   X   X
B South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VNZ3 09-29-2009 71,015,042 2009: New construction and remodeling of healthcare facilities   X   X   X
C City of Fargo
 
45-6002069 307479CK9 02-09-2011 134,069,821 2011: Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002   X   X   X
D South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VVM3 11-01-2012 128,733,641 2012E: New construction and remodeling of healthcare facilities   X   X   X
City of Chamberlain
 
46-0000094 000000000 12-30-2010 4,000,000 2010 Chamb: New construction of long-term care facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 03-29-2012 66,185,000 2012AB: Refunding bonds issued 9/12/2001 and 10/15/2002   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 06-14-2012 45,000,000 2012D:Refinance taxable indebtedness used to construct healthcare facility   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VWA8 08-05-2014 52,083,720 2014A: 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 2014B: New construction and remodeling of healthcare facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VZW7 10-21-2015 192,641,206 2015:New construction & advanced refunding of bonds issued 4/19/07, 5/22/07   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 10-28-2016 50,000,000 2016: New Construction, equipment and improvements   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 55,565,000 6,545,000 37,020,000  
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 71,393,241 134,069,821 129,135,779
4 Gross proceeds in reserve funds ............. 237,887 543 1,389 616
5 Capitalized interest from proceeds ............. 31,874      
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 997,167 150,032 1,470,647
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 70,396,074 45,000,000 127,665,132
11 Other spent proceeds .............   66,160,644 134,069,821 52,083,720
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2012 2013
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
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
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) 2019

Schedule K (Form 990) 2019
Page 2
Part
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 ....SchKMediumBullet 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 ......... SchKMediumBullet 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
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 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) 2019

Schedule K (Form 990) 2019
Page 3
Part
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
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
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: 09/29/2012 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 03/29/2013
Schedule K, Part I, Bond Issues Entity 3, Bond Issue A, (c) CUSIP #: 83755VXF6 and 83755VXE9 Entity 1, Bond Issue A, (c) CUSIP #: 83755VHY3 and 83755VHZ0
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.
Part III Part III has not been completed for the 2013 City of Fargo bonds or for the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6 With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield- restricted advance refunding escrow financed with proceeds of bonds.
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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 section 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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2019
Schedule L (Form 990 or 990-EZ) 2019
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?
Yes No
(1) Kathryn Nermoe B Nermoe - family relationship 93,220 Compensation   No
(2) Annette White N White - family relationship 428,392 Compensation   No
(3) Paige Campbell P Richard - family relationship 53,520 Compensation   No
(4) Melinda Anderson M Paulson - family relationship 68,310 Compensation   No
(5) Michael Kunkel J Kunkel - family relationship 115,801 Compensation   No
(6) John Durick P Durick - family relationship 105,195 Compensation   No
(7) Louis Krabbenhoft K Krabbenhoft - family relationship 93,174 Compensation   No
(8) Megan Hemmelgarn M Paulson - family relationship 37,935 Compensation   No
(9) Barb Everist Joint Venture in Everist Health 6,000,000 Sanford contributed $4M into Everist Health during the previous fiscal year. During the current fiscal year, Sanford contributed an additional $2M. As a result, Sanford and Barb Everist both owned more than a 10% interest in this company.   No
(10) Andy North Business Relationship-Consultant for business and relationship development 120,000 Independent Contractor   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) 2019


Additional Data


Software ID:  
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SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods .......
     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial .. X 2 5,112,030 FMV
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image ( )
27 Other Right pointing arrow large image ( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2019)
Schedule M (Form 990) (2019)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Part I, Column (b): The organization is reporting the number of contributions.
Part I, Line 32b: The organization uses third parties for real estate transactions, for appraisals, title work, closings in the normal course of business.
Schedule M (Form 990) (2019)

Additional Data


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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet Attach to Form 990 or 990-EZ.
bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36. Part I can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
Sanford Medical Center Thief River Falls 41-0709579 - Cash 02-01-2018 -7,864 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Thief River Falls 41-0709579 - ST Investments 02-01-2018 543,353 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Fals,SD571175039
501(c)(3)
Sanford Medical Center Thief River Falls 41-0709579 - Accounts Receivable (Net) 02-01-2018 9,217,782 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Thief River Falls 41-0709579 - Inventory 02-01-2018 656,103 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Thief River Falls 41-0709579 - Prepaid Expenses 02-01-2018 240,631 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Thief River Falls 41-0709579 - Property & Equipment 02-01-2018 67,882,316 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Thief River Falls 41-0709579 - Other Assets 02-01-2018 8,520,620 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - Cash 02-01-2018 13,109 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - ST Investments 02-01-2018 153,474 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - Accounts Receivable (Net) 02-01-2018 868,701 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - Inventory 02-01-2018 96,322 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - Prepaid Expenses 02-01-2018 4,668 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - Assets Whose Use is Limited BDI 02-01-2018 16 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Mayville 45-0228899 - Property & Equipment 02-01-2018 2,368,266 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Cash 02-01-2018 273,644 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center WheatonSanford Medical Center Wheaton 27-2042143 - ST Investments 02-01-2018 9,045 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Accounts Receivable (Net) 02-01-2018 847,502 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Inventory 02-01-2018 115,894 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Prepaid Expenses 02-01-2018 20,896 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Assets Whose Use is Limited BDI 02-01-2018 1 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Propery & Equipment 02-01-2018 2,099,889 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Medical Center Wheaton 27-2042143 - Other Assets 02-01-2018 251,376 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Hillsboro 45-0230400 - Cash 02-01-2018 1,264,765 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Hillsboro 45-0230400 - Accounts Receivable (Net) 02-01-2018 1,323,567 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Hillsboro 45-0230400 - Inventory 02-01-2018 38,211 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Hillsboro 45-0230400 - Prepaid Expenses 02-01-2018 20,456 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Sanford Hillsboro 45-0230400 - Property & Equipemnt 02-01-2018 6,485,604 Book Value 45-0409348 Sanford Health Network North
 
PO Box 5039 Rte 5218
Sioux Falls,SD571175039
501(c)(3)
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? .........................
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? .....................
2b
Yes
 
c
Become a direct or indirect owner of a successor or transferee organization? .....................
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's significant disposition of assets? ........
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2019)

Schedule N (Form 990 or 990-EZ) (2019)
Page 2
Part I
Liquidation, Termination, or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III .............
3
Yes
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? ......
4a
Yes
 
b
If "Yes," did the organization provide such notice? .....................
4b
Yes
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? .....................
5
Yes
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? .....................
6a
 
No
b
If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?
6b
 
 
c
If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.

Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? .........................
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? .....................
2b
Yes
 
c
Become a direct or indirect owner of a successor or transferee organization? .....................
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? ........
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2019)

Schedule N (Form 990 or 990-EZ) (2019)
Page 3
Part III
Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule N, Part I, line 2e The following Trustees, and Officers are Trustees, and Officers of Sanford Health Network North (the successor organization): Barb Everist, Trustee Andy North, Trustee Brent Teiken, Vice Chair David Beito, Past Chair Don Jacobs, Treasurer James Cain, Secretary Maria Bell, MD, Trustee Mark Lundeen, MD, Trustee Mark Paulson, MD, Trustee Melissa Hinton, Trustee Michael LeBeau, MD, Trustee Patrick Durick, Trustee Thomas Hruby, Trustee Kelby Krabbenhoft, Sanford President & CEO, Officer JoAnn Kunkel, Chief Financial Officer, Officer
Schedule N (Form 990 or 990-EZ) (2019)



Additional Data


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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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
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 Clinic and Sanford Bismarck have unrelated business gross income over $1,000.
Part V, Line 4a: Sanford World Clinics has an interest in financial accounts in the foreign countries of Ghana, China and Germany.
Form 990, Part VI, Section A, line 2 The following officers, board members, and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Allison Wierda-Suttle, Bill Gassen, Bill Marlette, Bryan Nermoe, Craig Lambrecht, Jennifer Grennan, JoAnn Kunkel, Kelby Krabbenhoft, Maria Bell, Mark Lundeen, Mark Paulson, Micah Aberson, Michael LeBeau, Michelle Bruhn, Michelle Micka, Nate White, Paul Hanson, Randy Bury.
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 11b 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 2018. 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 A The Sanford Board of Trustees has ultimate goverance 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 VII, Section B Amounts listed as compensation for the five highest compensated independent contractors include payments for both materials and services.
Form 990, Part XI, line 9: Net payroll and other expenses paid on behalf of parent/affiliates -35,020,517. Transfer of Sanford House to Sanford Health 9,781,329. Transfer of restricted funds raised for Sanford House 2,324,421. Liquidation of SAS into Sanford West 1,913,776. Transfer of Restricted Funds for Ava's House 2,939,681. Net Assets released from restrictions for acquisition of property and equip 5,797,290. Pension Plan related changes other than net periodic plan expense 16,441,716. Swap Valuation Change 377,125. Change in Net Assets due to Acquisition 684,250.
Form 990 Elections Form 990, Page 1, Line H(a) - Listing of Subordinate Organizations: Names, Addresses, and EINs Sanford Health 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 31-1527032 Sanford USD Medical Center 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0227855 Sanford Home Health 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0282134 Sanford Health Network 1305 W 18th Street Sioux Falls, SD 57105 EIN: 46-0388596 Sanford Clinic 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0447693 Sanford Research 2301 E 60th Street N Sioux Falls, SD 57104 EIN: 46-0450378 Sanford World Clinics 1305 W 18th Street Sioux Falls, SD 57105 EIN: 26-2707628 Sanford North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0385890 Sanford Clinic North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 91-1770748 Sanford Medical Center Fargo 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0226909 Sanford Health Network North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0409348 Sanford Medical Center Thief River Falls 3001 Sanford Parkway Thief River Falls, MN 56701 EIN: 41-0709579 Sanford Medical Center Mayville 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0228899 Sanford Medical Center Wheaton 401 12th Street N Wheaton, MN 56296 EIN: 27-2042143 Sanford Hillsboro 12 3rd Street SE, PO Box 609 Hillsboro, ND 58045 EIN: 45-0230400 Sanford Health of Northern Minnesota 1300 Anne Street NW Bemidji, MN 56601 EIN: 41-1266009 Baker Park, Inc. 803 Dewey Avenue NW Bemidji, MN 56601 EIN: 41-1372480 Sanford West 300 N 7th Street Bismarck, ND 58501 EIN: 45-0397195 Sanford Bismarck 300 N 7th Street Bismarck, ND 58501 EIN: 45-0226700 Sanford Living Centers 1000 18th Street NW, Suite 1 Mandan, ND 58554 EIN: 45-0416454
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
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 0 586,468 Sanford Health
 
(2) PPK Family Trust
100 S Phillips Ave
Sioux Falls,SD57104
20-7317570
Rental Real Estate SD 23,732 2,367,386 Sanford Health
 
(3) Lynx Trust
PO Box 5186
Sioux Falls,SD57117
26-6167201
Investment SD 0 1 Sanford Health
 
(4) National Student Housing Trust-SD
PO Box 5186
Sioux Falls,SD57117
20-6831968
Investment SD 0 737 Sanford Health
 
(5) Sanford HealthCare Accessories LLC
3223 32nd Ave SW
Fargo,ND58103
20-2404179
Sales of Durable Medical Equip ND 31,243,055 13,277,787 Sanford North
 
(6) Healthcare Environmental Services LLC
PO Box 2010
Fargo,ND58122
20-5236701
Retail Enterprises ND 1,965,664 5,545,056 Sanford North
 
(7) North Country Senior Living LLC
1000 Anne St NW
Bemidji,MN56601
26-3862586
Senior Housing CO 3,373,136 7,481,083 Sanford Health of Northern Minnesota
 
(8) 1527 Broadway LLC
1527 Broadway
Alexandria,MN56308
41-1336392
Real Estate MN 554,268 6,584,557 Sanford Clinic North
 
(9) Medequip One LLC
626 N 6th Street
Bismarck,ND58501
45-0452639
Durable medical equipment, products, and services ND 0 0 Sanford West
 
(10) Shetek Medical Services LLC
251 5th Street E
Tracy,MN56175
41-2004685
Home Health Services MN 433,111 168,133 Sanford Health Network
 
(11) Sanford Health Mobile Med LLC
2603 E Broadway Avenue
Bismarck,ND58501
47-1209528
Mobile Healthcare ND 0 644,118 Sanford Health
 
(12) Southwest MN Radiation Center LLC
1018 6th Avenue
Worthington,MN56187
46-0447693
Radiation Services MN 1,093,670 76,896 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?
Yes No
(1)Sanford
P O Box 5039 Rte 5218

Sioux Falls,ND58122
27-1218956
Supporting Organization ND 501(c)(3) 12-II  
 
No
(2)Sanford Health Foundation
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
36-3297853
Foundation SD 501(c)(3) 12-II Sanford Health
 
Yes
 
(3)Edith Sanford Breast Cancer Foundation
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0404126
Foundation ND 501(c)(3) 12-II Sanford Health
 
Yes
 
(4)F-M Ambulance Service Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0344371
EMT ND 501(c)(4)   Sanford North
 
Yes
 
(5)Sanford Health Foundation North
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0398104
Foundation ND 501(c)(3) 7 Sanford North
 
Yes
 
(6)Sanford Health Foundation Hillsboro
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
36-3542187
Foundation ND 501(c)(3) 7 Sanford Hillsboro
 
Yes
 
(7)Sanford Health Foundation of Northern Minnesota
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
41-1389317
Foundation MN 501(c)(3) 12-II Sanford Health of Northern Minnesota
 
Yes
 
(8)Sanford Health Foundation West
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0397196
Foundation ND 501(c)(3) 7 Sanford Bismarck
 
Yes
 
(9)Medcenter One Inc Auxiliary
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
23-7293043
Supporting Organization ND 501(c)(3) 12-II Sanford Bismarck
 
Yes
 
(10)Sanford Heart of America Health Plan
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0346132
Insurance ND 501(c)(4)   Sanford Health Plan
 
Yes
 
(11)Sanford Health Foundation Thief River Falls
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
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) 2019
Schedule R (Form 990) 2019
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


Yes No Yes No
(1) National Student Housing-South Dakota LLC

100 S Phillips Ave
Sioux Falls,SD57104
20-2129839
Investment SD Sanford Health
 
Related -2,656 3,919,813   No     No 99.990 %
(2) RAC Rentals LLC

100 S Phillips Ave
Sioux Falls,SD57104
26-1961077
Investment SD Sanford Health
 
Related -18,872 3,895,099   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?
Yes No
(1) Sanford Home Medical Equipment Inc

2710 W 12th Street
Sioux Falls,SD57105
46-0388597
Healthcare Equipment SD Sanford Health
 
C 2,847,331 17,612,055 100.000 % Yes  
(2) Sanford Health Plan

300 Cherapa Place
Sioux Falls,SD57103
91-1842494
Insurance SD Sanford Health
 
C 11,876,501 268,175,876 100.000 % Yes  
(3) Sanford Health Plan of MN

300 Cherapa Place
Sioux Falls,SD57103
46-0445852
Insurance MN Sanford Health
 
C -76,275 2,340,884 100.000 % Yes  
(4) Sanford Frontiers

1305 W 18th Street PO Box 5039
Sioux Falls,SD571175039
45-5436599
Weight Loss Management SD Sanford Health
 
C -10,929,316 92,863,190 100.000 % 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 -5,884   100.000 % Yes  
(7) Sanford World Clinics - Ghana

Sarbah Road Tantri Lorry Station
Cape Coast    
GH
Healthcare GH Sanford World Clinics
 
C -2,496,643 4,635,496 100.000 % Yes  
(8) Shanghai Sanford Healthcare Management Consulting Co Ltd

188 Yesheng Road Room A-862 Guoma
Shanghai    
CH
Healthcare CH Sanford World Clinics
 
C -322,053 515,952 100.000 % Yes  
(9) Sanford International - Munich GmbH

Nymphenburger Strasse 3
Munich    
GM
Healthcare GM Sanford World Clinics
 
C -531,206 11,906,793 100.000 % Yes  
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
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 38,512,577 Cash Basis
(2) Sanford Health Foundation North

C 2,954,631 Cash Basis
(3) Sanford Health Foundation West

C 375,062 Cash Basis
(4) Edith Sanford Breast Cancer Foundation

C 258,630 Cash Basis
(5) Sanford Health Foundation Hillsboro

C 177,262 Cash Basis
(6) Sanford Health Foundation Thief River Falls

C 536,832 Cash Basis
(7) Sanford Health Foundation of Northern Minnesota

C 77,733 Cash Basis
(8) Sanford Heart of America Health Plan

P 495,788 Cash Basis
(9) Sanford Heart of America Health Plan

Q 430,357 Cash Basis
(10) Sanford Health Foundation

R 7,325,611 Cost
(11) Sanford Health Foundation North

R 1,706,594 Cost
(12) Sanford Health Foundation Thief River Falls

R 419,094 Cost
(13) Sanford Health Foundation of Northern Minnesota

R 498,956 Cost
(14) Sanford Health Foundation Hillsboro

R 102,030 Cost
(15) Sanford Health Plan

R 8,500,000 Cost
(16) SOB Inc

R 67,622 Cash Basis
(17) F-M Ambulance Service Inc

S 4,336,222 Cost
(18) Sanford Frontiers

S 26,775,345 Cash Basis
(19) Sanford Health Foundation Thief River Falls

S 535,909 Cost
(20) Edith Sanford Breast Cancer Foundation

B 799,493 Cost
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 2019

Additional Data


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