Form990
Click to see list of attachments
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 01-01-2019 , and ending 12-31-2019
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 $ 4,427,626,494
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 sharing God's love through the work of health, healing and comfort."
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 2,855
6 Total number of volunteers (estimate if necessary) ............. 6 1,994
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 82,045,367
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 2,206,149
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 37,218,413 75,717,791
9 Program service revenue (Part VIII, line 2g) ......... 2,061,780,166 4,340,390,961
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -480,542 1,264,847
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,444,680 967,825
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 2,099,962,717 4,418,341,424
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 23,246,082 32,126,097
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 1,183,284,205 2,485,262,586
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).... 783,394,688 1,697,083,177
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,989,924,975 4,214,471,860
19 Revenue less expenses. Subtract line 18 from line 12....... 110,037,742 203,869,564
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,880,075,474 2,975,394,335
21 Total liabilities (Part X, line 26)............. 1,471,704,281 1,409,187,225
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,408,371,193 1,566,207,110
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 $ 3,887,131,247 including grants of $ 32,125,097 ) (Revenue $ 4,331,651,670 )
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 $ 225,333,978 including grants of $ 0 ) (Revenue $ 3,715,078 )
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 $ 34,899,651 including grants of $ 1,000 ) (Revenue $ 5,024,213 )
Sanford Research and Sanford Research North are both non-profit health research organizations. Combined, both entities have 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; Neurosciences, focused on the area of eating disorders, obesity and bariatric surgery outcomes as well as physiological aspects of eating and addiction 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 and Sanford Research North offer 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 expensesMediumBullet4,147,364,876
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
Yes
 
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
Yes
 
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
 
No
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
Yes
 
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
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
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
 
No
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
3,289
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
2,855
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCH , GH , GM
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
 
No
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
 
No
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
12
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
5
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
Yes
 
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:
MediumBulletBill Marlette Treasurer2301 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           0 0 0
(2) Andy North......................................................................
Trustee
7.90
.................
1.70
X           258,864 0 0
(3) Brent Teiken......................................................................
Vice Chair
3.90
.................
1.70
X   X       0 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) James Cain......................................................................
Secretary
3.90
.................
1.70
X   X       0 0 0
(7) Maria Bell MD......................................................................
Trustee/Research Administrator
58.30
.................
1.70
X           891,333 0 30,986
(8) Mark Lundeen MD......................................................................
Trustee/Orthopedics Service Chair
58.40
.................
1.60
X           682,389 0 28,250
(9) Mark Paulson MD......................................................................
Chair/Physician Regional Chair
58.30
.................
1.70
X   X       281,890 0 28,771
(10) Melissa Hinton......................................................................
Trustee (Thru 8/19)
3.90
.................
1.70
X           0 0 0
(11) Neil Gulsvig......................................................................
Trustee
3.90
.................
1.70
X           0 0 0
(12) Patrick Durick......................................................................
Trustee
3.90
.................
1.70
X           491 0 0
(13) Thomas Hruby......................................................................
Trustee (Thru 11/19)
3.90
.................
1.70
X           1,010 0 0
(14) Kelby K Krabbenhoft......................................................................
Sanford President & CEO
46.10
.................
13.90
X   X       0 3,088,308 14,171
(15) Kelby K Krabbenhoft Def Comp......................................................................
Sanford President & CEO
46.10
.................
13.90
X   X       0 0 1,081,296
(16) JoAnn L Kunkel......................................................................
Chief Financial Officer
46.10
.................
13.90
    X       0 1,333,149 135,506
(17) Bill Gassen III......................................................................
Chief Human Resources Officer
55.00
.................
5.00
      X     0 1,036,106 99,475
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) Jennifer Grennan........................................................................
Chief Legal Officer
55.00
.......................5.00
      X     0 809,984 86,491
(19) Allison Wierda-Suttle MD........................................................................
Sr VP, Chief Medical Officer
60.00
.......................0.00
      X     0 1,089,314 119,803
(20) Bill Marlette........................................................................
Treasurer
55.00
.......................5.00
      X     0 1,391,177 1,355
(21) Bill Marlette Def Comp........................................................................
Treasurer
55.00
.......................5.00
      X     0 0 221,323
(22) Micah Aberson........................................................................
Executive VP, Sanford
10.00
.......................50.00
      X     0 1,075,157 112,291
(23) Bryan Nermoe........................................................................
President, Bemidji/President, Fargo
60.00
.......................0.00
      X     0 1,009,343 81,571
(24) Craig Lambrecht........................................................................
President, Bismarck (Thru 3/19)
60.00
.......................0.00
      X     0 265,501 12,022
(25) Michael LeBeau MD........................................................................
President, Bismarck
60.00
.......................0.00
      X     0 1,502,524 96,346
(26) Nate White........................................................................
COO, President Fargo (Thru 9/19)
55.00
.......................5.00
      X     0 1,532,070 137,491
(27) Michelle Micka........................................................................
Sr VP Finance, Health Service
55.00
.......................5.00
      X     0 630,680 72,421
(28) Michelle Bruhn........................................................................
Sr VP Finance, Health Svc(Thru 3/19)
55.00
.......................5.00
      X     0 844,000 105,241
(29) Nicholas Olson........................................................................
VP Finance
55.00
.......................5.00
      X     0 357,931 28,171
(30) Paul Hanson........................................................................
President, Sioux Falls
60.00
.......................0.00
      X     0 1,490,907 107,755
(31) Matt Hocks........................................................................
Chief Operating Officer
60.00
.......................0.00
      X     0 1,143,171 108,760
(32) Susan Jarvis........................................................................
President, Bemidji
60.00
.......................0.00
      X     0 664,414 34,617
(33) Eric Belanger........................................................................
Physician
60.00
.......................0.00
        X   3,093,253 0 30,986
(34) William Brunner........................................................................
Physician
60.00
.......................0.00
        X   2,626,708 0 30,986
(35) Adam Stys........................................................................
Physician
60.00
.......................0.00
        X   2,993,769 0 30,986
(36) Tomasz Stys........................................................................
Physician
60.00
.......................0.00
        X   3,031,201 0 28,250
(37) Corey Teigen........................................................................
Physician
60.00
.......................0.00
        X   2,614,225 0 27,962
(38) Daniel Olson........................................................................
Former Exec VP Bemidji
0.00
.......................0.00
          X 0 357,931 28,171
(39) Kim Patrick........................................................................
Former Chief Legal Officer
55.00
.......................5.00
          X 0 865,967 28,171
(40) Randy Bury........................................................................
Former Chief Administrative Officer
0.00
.......................60.00
          X 0 1,145,407 110,405
(41) Randy Bury Deferred Comp........................................................................
Former Chief Administrative Officer
0.00
.......................60.00
          X 0 0 22,929
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 16,475,133 21,633,041 3,082,959
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 MediumBullet3,422
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 83,614,336
Medtronic USA

710 Medtronic Parkway
Minneapolis,MN55432
Medical Services 44,354,253
GE Healthcare

1053 W Grand Ave
Chicago,IL60642
Medical Services 31,493,601
Henry Carlson Construction

1205 Russell Street
Sioux Falls,SD57104
Construction 21,116,768
Epic Systems Corp

1979 Milky Way
Verona,WI53593
Computer Services 9,870,202
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1,221
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 47,201,284
e Government grants (contributions)1e 23,009,536
f All other contributions, gifts, grants, and similar amounts not included above1f 5,506,971
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 75,717,791
 Program Service RevenueAmt Business Code
2a Patient Services 621110 2,951,292,454 2,951,292,454    
b Medicare/Medicaid 621400 815,363,677 815,363,677    
c 340B Revenue 621300 328,832,222 328,832,222    
d Retail Sales 446199 81,089,964 74,863,520 6,226,444  
e Support Services 541900 51,304,560   50,767,534 537,026
f All other program service revenue. 112,508,084 78,419,015 25,051,389 9,037,680
g Total. Add lines 2a–2f .....MediumBullet 4,340,390,961
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 3,741,772     3,741,772
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 16,383     16,383
(ii) Personal (i) Real
6a Gross rents   3,397,948 6a
b Less: rental expenses   2,446,506 6b
c Rental income or (loss)   951,442 6c
d Net rental income or (loss).......MediumBullet 951,442     951,442
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 4,361,639   7a
b Less: cost or other basis and sales expenses 6,838,564   7b
c Gain or (loss) -2,476,925   7c
d Net gain or (loss).........MediumBullet -2,476,925     -2,476,925
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 4,418,341,424 4,248,770,888 82,045,367 11,807,378
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 .... 31,645,635 31,645,635
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 480,462 480,462
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 24,124,100 22,524,323 1,599,777  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 2,358,982   2,358,982  
7 Other salaries and wages........ 2,050,192,476 1,916,437,600 133,754,876  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 88,804,799 80,823,806 7,980,993  
9 Other employee benefits ....... 194,126,125 174,913,890 19,212,235  
10 Payroll taxes ........... 125,656,104 116,916,617 8,739,487  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 4,218,293 884,163 3,334,130  
c Accounting ........... 1,128,090 175,498 952,592  
d Lobbying ........... 535,123   535,123  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 63,524 63,524    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 211,428,900 174,653,079 36,775,821  
12 Advertising and promotion .... 22,945,209 11,904,425 11,040,784  
13 Office expenses ....... 47,423,853 34,216,979 13,206,874  
14 Information technology ...... 75,626,258 39,035,983 36,590,275  
15 Royalties ..        
16 Occupancy ........... 96,686,621 85,193,290 11,493,331  
17 Travel ............ 20,398,067 17,524,453 2,873,614  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 7,468,201 4,076,072 3,392,129  
20 Interest ........... 37,136,853 36,191,718 945,135  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 161,153,573 137,997,310 23,156,263  
23 Insurance ... 14,778,344 14,676,074 102,270  
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 946,407,980 943,431,691 2,976,289  
b Other Taxes 12,760,141 10,744,176 2,015,965  
c Settlement 10,255,611   10,255,611  
d Cert/Licenses/Subscript 9,573,803 7,455,279 2,118,524  
e All other expenses 17,094,733 285,398,829 -268,304,096  
25 Total functional expenses. Add lines 1 through 24e 4,214,471,860 4,147,364,876 67,106,984 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 ........ 31,589,448 1 21,434,357
2 Savings and temporary cash investments ......... 59,215,248 2 81,092,458
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 568,730,465 4 582,590,074
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) ...
  6 105,504
7 Notes and loans receivable, net ........... 51,669,528 7 52,089,499
8 Inventories for sale or use ............ 91,235,305 8 90,430,284
9 Prepaid expenses and deferred charges ...... 42,544,722 9 49,922,293
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,415,520,622
b Less: accumulated depreciation 10b 1,732,577,417 1,711,062,541 10c 1,682,943,205
11 Investments—publicly traded securities . 1,966,009 11 1,778,446
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .. 53,873,388 13 42,214,085
14 Intangible assets ............... 53,914,128 14 51,961,717
15 Other assets. See Part IV, line 11 ........... 214,274,692 15 318,832,413
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,880,075,474 16 2,975,394,335
Liabilities 17 Accounts payable and accrued expenses ..... 344,956,193 17 308,796,732
18 Grants payable ... 1,177,930 18 9
19 Deferred revenue ......... 2,463,220 19 3,313,175
20 Tax-exempt bond liabilities ......... 867,258,682 20 770,491,636
21 Escrow or custodial account liability. Complete Part IV of Schedule D 227,385 21 226,251
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 .. 52,425,127 23 30,892,029
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 203,195,744 25 295,467,393
26 Total liabilities. Add lines 17 through 25.. 1,471,704,281 26 1,409,187,225
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 .......... 1,408,360,003 27 1,565,644,729
28 Net assets with donor restrictions ........... 11,190 28 562,381
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 ........... 1,408,371,193 32 1,566,207,110
33 Total liabilities and net assets/fund balances ........ 2,880,075,474 33 2,975,394,335
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
4,418,341,424
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
4,214,471,860
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
203,869,564
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,408,371,193
5
Net unrealized gains (losses) on investments ...............
5
-292,755
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
-45,740,892
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,566,207,110
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 ...............................  
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
 
   
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 Research North 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 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) $38,213,150 Line 12, Column: (i) Sanford Clinic; (ii) 46-0447693; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $4,267,709 Line 12, Column: (i) Sanford Research; (ii) 46-0450378; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $714,957 Line 12, Column: (i) Sanford Research North; (ii) 45-0274828; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $92,373 Line 12, Column: (i) Sanford Home Health; (ii) 46-0282134; (iii) 509(a)(2); (iv) Yes; (v) $298,821 Line 12, Column: (i) Sanford Health Network; (ii) 46-0388596; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $10,149,617 Line 12, Column: (i) Sanford Clinic North; (ii) 91-1770748; (iii) 509(a)(2); (iv) Yes; (v) $5,367,174 Line 12, Column: (i) Sanford Medical Center Fargo; (ii) 45-0226909; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $46,253,601 Line 12, Column: (i) Sanford World Clinics; (ii) 26-2707628; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $358,157 Line 12, Column: (i) Sanford Health of Northern Minnesota; (ii) 41-1266009; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $10,781,642 Line 12, Column: (i) Baker Park, Inc.; (ii) 41-1372480; (iii) 509(a)(2); (iv) Yes; (v) $22,999 Line 12, Column: (i) Sanford Health Foundation North; (ii) 45-0398104; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) $256,939 Line 12, Column: (i) Sanford Bismarck; (ii) 45-0226700; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $20,711,293 Line 12, Column: (i) Sanford Living Centers; (ii) 45-0416454; (iii) 509(a)(2); (iv) Yes; (v) $4,715 Line 12, Column: (i) Sanford Health Foundation West; (ii) 45-0397196; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) $88,916
Schedule A, Part III Line 1 - column: (a) 221,829; (b) 159,929; (c) 279,310; (d) 133,275; (e) 429,804; (f) 1,224,147 Line 2 - column: (a) 229,728,673; (b) 205,167,015; (c) 159,680,023; (d) 81,522,328; (e) 172,911,271; (f) 849,009,310 Line 6 - column: (a) 229,950,502; (b) 205,326,944; (c) 159,959,333; (d) 81,655,603; (e) 173,341,075; (f) 850,233,457 Line 8 - column: (f) 850,233,457 Line 9 - column: (a) 229,950,502; (b) 205,326,944; (c) 159,959,333; (d) 81,655,603; (e) 173,341,075; (f) 850,233,457 Line 10a - column: (a) 718,153; (b) 713,259; (c) 1,664,637; (d) 1,127,888; (e) 1,216,540; (f) 5,440,477 Line 10c - column: (a) 718,153; (b) 713,259; (c) 1,664,637; (d) 1,127,888; (e) 1,216,540; (f) 5,440,477 Line 11 - column: (a) 274,195; (b) 410,742; (c) 783,554; (d) 718,178; (e) ; (f) Line 13 - column: (a) 230,942,850; (b) 206,450,945; (c) 162,407,524; (d) 83,501,669; (e) ; (f) Line 15: 99.02% Line 16: 99.17% Line 17: 0.63% Line 18: 0.54% Line 19a: X Line 19b: X Part IV, Section A Line 1: Yes Line 2: No Line 3a: No Line 4a: No Line 5a: Yes Line 5b: No Line 5c: 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
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(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


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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
 
655,276
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
1,357,964
j
Total. Add lines 1c through 1i ....................................................................................................
2,013,240
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 .... 84,843,272 63,648,688 60,166,967 62,584,497 58,142,005
b Contributions ... 4,372,894 21,194,584 4,233,247 -2,436,209 4,442,491
c Net investment earnings, gains, and losses       18,679  
d Grants or scholarships ...     751,526    
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ...... 89,216,166 84,843,272 63,648,688 60,166,967 62,584,497
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 .....   115,887,324 115,887,324
b Buildings ....   1,609,346,334 661,431,587 947,914,747
c Leasehold improvements   73,140,610 47,498,716 25,641,894
d Equipment ....   1,574,622,774 997,889,159 576,733,615
e Other .....   42,523,580 25,757,955 16,765,625
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,682,943,205
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 82,110,970
(2)Deferred compensation assets held for investment 143,797,635
(3)Other assets 18,448,350
(4)Enhanced Benefits 116,504
(5)Interest Receivable 94,313
(6)Right of Use Asset 74,264,641
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 318,832,413
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 295,467,393
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 December 31, 2019; 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 Program Services Clinic operations (China), Investigation of potential additional clinic sites (New Zealand, Australia, Vietnam, Japan) 318,000
Sub-Saharan Africa 0 0 Program Services Clinic operations (Ghana) 3,474,000
Central America and the Caribbean 0 1 Program Services Investigation and support of new clinic site (Costa Rica) 590,000
Europe (Including Iceland & Greenland) 0 0 Program Services Clinic operations (Germany), Investigation of potential clinic sites (Ireland, Norway) 382,000
Middle East and North Africa 0 0 Program Services Travel, purchased goods and services 2,000
North America - Canada and Mexico 0 0 Program Services Investigation of potential clinic site (Mexico), purchased goods and services 109,000
South Asia 0 0 Program Services Purchased services 2,000
East Asia and the Pacific 0 0 Investments China investments, beginning in 2014 831,000
Europe (Including Iceland & Greenland) 0 0 Investments Germany investments beginning in 2015 11,928,000
Sub-Saharan Africa 0 0 Investments Ghana investments, beginning in 2012 3,716,000
Central America and the Caribbean 0 0 Investments Costa Rica investments, beginning in 2019 8,000,000
North America - Canada and Mexico 0 0 Investments Mexico investments, beginning in 2019 500,000
East Asia and the Pacific 0 0 Investments New Zealand investments, beginning in 2019 400,000
Middle East and North Africa 0 0 Investments Israel investments, beginning in 2018 1,300,000
           
           
           
3a Sub-total .... 0 1 5,708,000
b Total from continuation sheets to Part I ... 0 0 25,844,000
c Totals (add lines 3a and 3b) 0 1 31,552,000
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 89,096 Bank Transfer 0   Cost
Europe (Including Iceland & Greenland) General Support 150,000 Bank Transfer 0   Cost
East Asia and the Pacific General Support 241,366 Bank Transfer 0   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
3
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.
Part III Accounting Method:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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
 
No
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
 
 
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) . . .
    86,790,075 0 86,790,075 2.060 %
b Medicaid (from Worksheet 3, column a) . . . . .     583,664,105 445,789,477 137,874,628 3.270 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     670,454,180 445,789,477 224,664,703 5.330 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     13,033,949 637,546 12,396,403 0.290 %
f Health professions education (from Worksheet 5) . . .     25,333,978 3,715,078 21,618,900 0.510 %
g Subsidized health services (from Worksheet 6) . . . .     587,333,435 491,415,959 95,917,476 2.280 %
h Research (from Worksheet 7) .     38,871,713 21,327,405 17,544,308 0.420 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     32,126,097 0 32,126,097 0.760 %
j Total. Other Benefits . .     696,699,172 517,095,988 179,603,184 4.260 %
k Total. Add lines 7d and 7j .     1,367,153,352 962,885,465 404,267,887 9.590 %
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     0      
2 Economic development     3,005   3,005 0 %
3 Community support     22,504 3,340 19,164 0 %
4 Environmental improvements     0 0    
5 Leadership development and
training for community members
    2,228 0 2,228 0 %
6 Coalition building     55,933 1,049 54,884 0 %
7 Community health improvement advocacy     65,933 0 65,933 0 %
8 Workforce development     64,304 0 64,304 0 %
9 Other     0 0    
10 Total     213,907 4,389 209,518 0 %
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
58,554,846
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
0
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
882,928,319
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
932,073,757
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-49,145,438
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 18
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 18
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Economic Well-Being - Skilled Labor ForceThe Council on Social Work Education reports that economic well-being may be achieved by individuals, families, and communities through public policies that ensure the ability to build financial knowledge and skills, access to safe and affordable financial products and economic resources, and opportunities for generating income and asset building. It occurs within a context of economic justice within which labor markets provide opportunities for secure full employment with adequate compensation and benefits for all. Sanford has made economic well-being a significant priority and has developed a strategic plan to provide workforce and skilled labor opportunities in the Sioux Falls area and across the system. Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health, behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current Year: Priority 1: Economic Well-Being: Workforce DevelopmentSanford USD Medical Center is committed to the economic well-being of the Sioux Falls community. To this end, we are continually working to recruit, support, and develop a skilled workforce through partnerships with higher education organizations for internships, LPN sponsorships, scholarships, residencies, and fellowships. In addition to the medical residencies and scholarships, we have created scholarships for licensed practical nurses (LPNs) and medical assistants (MAs) to help meet the patient care demands in our ambulatory locations. These scholarships give individuals an opportunity to have all or a majority of their education paid for by entering one of these in-demand healthcare fields. For calendar year 2019, we had 80 LPN's and 10 MA's individuals on scholarships.The Sanford Sons and Daughters program has 226 individuals in physician education on scholarship. The Heart of Tomorrow program provided scholarships of $1,000 each to 100 high school or college aged children of Sanford employees. In addition, Sanford continues to solely support residency education in pediatrics and general surgery and fellowship education in cardiology and interventional cardiology. We partner with other health care facilities to support residencies in the following: internal medicine, pathology, transitional year and family medicine. All such programs are in good standing and are at capacity. Priority 2: Behavioral Health and Mental Health AccessAs demand for behavioral and mental health services continues to grow, Sanford USD Medical Center aims to ensure availability of necessary services for patients and community members. This work will include embedding Integrated Health Therapists (IHT) in primary care centers, formalizing a recruitment plan for behavioral health specialty services, reducing depression through PHQ-9 screening, and collaborating on a community triage program. Integrative Health Therapists continue to be embedded in each primary care clinic. In the past year, we have added an additional psychiatrist, one additional psychologist, three psychiatric advanced practice clinicians, and four therapists. Our goal is to recruit two additional psychologists. We also continue to provide PHQ-9 depression remission performance exceeding the national benchmark - ensuring consistent screening for depression across the patient population.Sanford has also collaborated with the City of Sioux Falls, Minnehaha County, and Avera Health to create the Community Triage Center (CTC). The (CTC) will be a voluntary and involuntary commitment (IVC) mid-level care alternative for those with substance/alcohol abuse with potential mental illness co-morbidities who are not violent in their behavior. The target population is individuals in a co-morbid mental health and/or substance use disorder crisis, regardless of socio-economic background. The partnership collaborative, led by Minnehaha County, the City of Sioux Falls, Avera Health, and Sanford Health, aims to create a front-line service for a population that needs immediate care delivered with respect, dignity, and understanding. The CTC project has been investigated since 2014. Strategic community partners collaborated to determine if a triage center would be appropriate for Minnehaha and Lincoln Counties. In order to inform the conceptual plan, data was collected and analyzed to determine need, a sequential intercept model mapping was conducted to determine interventions, and model community sites visited to identify operational best practices. The report Community Triage Center Conceptual Plan issued in June 2018 summarized the work completed during the planning phase. Currently, individuals who are experiencing a mental health or substance use crisis arrive at the emergency room department and Detox Facility and Sobering Center at the Minnehaha County jail. Once the CTC is operational, the Minnehaha County jail will cease operations of the Detox Facility and Sobering Center. When the CTC is operational, individuals in crisis will be routed to the CTC through self-referral, law enforcement, and other agencies (jail, ER, behavioral health, medical-surgical units, and SUD providers). The CTC staff will complete the intake information and decide whether to send the individual to the CTC's Observation, Detox, or Stabilization service, make a referral and a warm hand-off to a partner agency, or send to the hospital. If stabilized, the individual may be sent home. The CTC purpose is not to duplicate services but act as an intermediary to bridge individuals to long-term care providers.Identified needs not directly addressed by this facility include: Economic - Need for affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and concern for homelessnessTransportation - Need for door-to-door transportation for community members who do not drive, and the availability of public transportationAging - Cost of long term care and memory careChild and Youth - Substance abuse by youth, childhood obesity, availability of services for at-risk youth, bullying, crime committed by youth, and teen suicideSafety - Abuse of prescription drugsAccess to Health Care - Availability of behavioral health providers, availability of mental health providers, access to affordable prescription drugs, and access to affordable healthcare
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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. 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: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointments.Priority 2: Mental Health/Behavioral Health and Substance AbuseSanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current Year: Priority 1: Healthcare AccessIncrease availability of mental health/behavioral health providers Sanford Health improved access to behavioral health services in 2019 through a series of initiatives and targeted recruiting. A recruitment plan is in place to add behavioral health care providers in the Fargo setting.In 2019, Sanford Health's Fargo Region successfully implemented a long-term post-doctoral candidate training program in adult psychology. This "grow our own" program brought in the first candidate in 2019 and is expanding in 2020. Promote role expansion of Advanced Practice Providers to improve accessSanford added primary care walk-in services with Advanced Practice Providers to all of the neighborhood primary care clinics to accommodate growing patient needs. Advanced Practice Providers have designated pre-op clinics to improve access to care for patient's needing surgery. Same day access/walk-in services were added at the five primary care clinic locations. Improve access to mental health services for children in rural school districts.Sanford Health began collaborating with Fargo Public Schools and Moorhead Public Schools to research and develop a tele-behavioral health program.Improve access through primary care, emergency department and walk-in urgent care clinics.Designated nurse practitioners and physicians assistants are located in four of the seven family medicine clinics to cover walk-in urgent care services. Sanford expanded our West Fargo clinic and opened Veterans Clinic to improve primary care access. Provide non-traditional hours in primary care and walk-in urgent care clinics.Instituted Saturday hours for walk-in care at West Fargo clinic. Offer extended hours on Mondays at Veteran's Square Clinic and Tuesday at Southpointe Clinic. Walk in care in all primary care neighborhood clinics Monday through Friday 8:00 a.m. to 5:00 p.m. Three locations available for urgent care 7 days per week. Decrease the use of emergency services for primary health care.Sanford Health expanded the Community Paramedic (CP) Program in 2020 by 1.0 FTE. 2.0 FTE currently allocated to seeing patients who are at high-risk for readmission. Monitor ED usage to determine acuity and admit percentage for appropriateness of utilization.Because of targeted education, support of new social and healthcare programs, and improved pre-hospital partnerships, progress continued towards making sure the most appropriate patients are seeking care in the emergency department (ED). Educate patients (decision path) on primary care and walk-in urgent care clinic options.Signage posted indicating where to go for severity of symptoms in all exam rooms, elevators as well main corridors. Scheduling and triage nurses provide real-time education for patients as to where to receive care at most appropriate setting. Provide care coordination/care plan development and referral to internal/external services.We provide longitudinal care plans and assignment of nurse care managers to all high risk patients as outlined by outpatient risk stratification tool. Priority 2: Mental Health and Substance Abuse Reduce the opportunity for drug use and abuse.In September 2019, Sanford Health implemented the use of a substance abuse and chemical dependency screening tool for pediatric trauma patients called SBIRT (Screening, Brief Intervention. Screening). Beginning September 1, 2019, the outcome goal for SBIRT completion on pediatric trauma patients of 80% has been met every month.Continue prescription stewardship initiative to reduce opioid/narcotic prescriptions.Discharge order sets - our pharmacy and provider teams worked to standardize (and default) minimum quantity and day supply of opioids. Prescribing decision support and documentation support - Implemented acute pain opiate script system defaults to follow the rules of less than 50 MME per day, less than 100 MME per script. Prevention of unnecessary opioid dispensing - We removed daisy chain orders for opiates to follow newer rules of dispensing. Over 2019, total opioid tablet count prescribed remained at 50% less in the Fargo region versus 2016. Explore medication assisted treatment by increasing the number of certified providers.Four family medicine physicians and one Internal Medicine physician have waivers to prescribe suboxone. This program was launched in early 2020. Patients with alcohol use and abuse receive services through internal or external services. Sanford Health began collaborating with a Fargo-based peer-to-peer substance abuse support program provider, F5, in 2019. The program will be offered to inpatients who are detoxing.IHT services are provided in all Sanford primary care settings.Integrated health therapist's (IHT) are located in all primary care clinics. All IHT's have immediate, same day access available for our patients. Reduce the severity of depression for patients with a PHQ-9 score greater than 9.PHQ's are deployed by the panel assistant. Primary care physician receives elevated PHQ and places appropriate referrals to IHT for intervention. Patient's assessment is in place to determine the patients' risk of suicide. PHQ is given to patient based on outlined criteria. If positive, Columbia Suicide Severity Rating Scale is administered by nursing. Results are elevated to physician/APP for disposition of treatment interventions. The Columbia Suicide Severity Rating Scale is executed across primary care clinics in the Fargo market. Education provided to all clinical staff in primary care regarding the Columbia Suicide Severity Rating Scale. Mental Health First Aid Training.Education provided to clinical and non-clinical staff. Goal is to provide the knowledge and skill set that healthcare professionals can use to intervene in the event of a mental health crisis.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, hunger, homelessness, and need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violenceTransportation - Need for door-to-door transportation for community members.Aging - Cost of long-term care and memory care, cost of in-home services, availability of resources for family and friends caring for elders, availability of resources to help the elderly stay safe in their homesChildren and Youth - Availability and cost of services for at-risk youth, cost and availability of quality childcare, substance abuse by youth, teen suicide, childhood obesity, and bullyingSafety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, child abuse and neglect, sex trafficking, and presence of street drugsSanford is not developing strategies to address the cost 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. The results of the CHNA have been shared with community leaders, and those who have expertise in the areas.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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. 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: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointments.Priority 2: Mental Health/Behavioral Health and Substance AbuseSanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current Year: Priority 1: Healthcare AccessIncrease availability of mental health/behavioral health providers Sanford Health improved access to behavioral health services in 2019 through a series of initiatives and targeted recruiting. A recruitment plan is in place to add behavioral health care providers in the Fargo setting.In 2019, Sanford Health's Fargo Region successfully implemented a long-term post-doctoral candidate training program in adult psychology. This "grow our own" program brought in the first candidate in 2019 and is expanding in 2020. Promote role expansion of Advanced Practice Providers to improve accessSanford added primary care walk-in services with Advanced Practice Providers to all of the neighborhood primary care clinics to accommodate growing patient needs. Advanced Practice Providers have designated pre-op clinics to improve access to care for patient's needing surgery. Same day access/walk-in services were added at the five primary care clinic locations. Improve access to mental health services for children in rural school districts.Sanford Health began collaborating with Fargo Public Schools and Moorhead Public Schools to research and develop a tele-behavioral health program.Improve access through primary care, emergency department and walk-in urgent care clinics.Designated nurse practitioners and physicians assistants are located in four of the seven family medicine clinics to cover walk-in urgent care services. Sanford expanded our West Fargo clinic and opened Veterans Clinic to improve primary care access. Provide non-traditional hours in primary care and walk-in urgent care clinics.Instituted Saturday hours for walk-in care at West Fargo clinic. Offer extended hours on Mondays at Veteran's Square Clinic and Tuesday at Southpointe Clinic. Walk in care in all primary care neighborhood clinics Monday through Friday 8:00 a.m. to 5:00 p.m. Three locations available for urgent care 7 days per week. Decrease the use of emergency services for primary health care.Sanford Health expanded the Community Paramedic (CP) Program in 2020 by 1.0 FTE. 2.0 FTE currently allocated to seeing patients who are at high-risk for readmission. Monitor ED usage to determine acuity and admit percentage for appropriateness of utilization.Because of targeted education, support of new social and healthcare programs, and improved pre-hospital partnerships, progress continued towards making sure the most appropriate patients are seeking care in the emergency department (ED). Educate patients (decision path) on primary care and walk-in urgent care clinic options.Signage posted indicating where to go for severity of symptoms in all exam rooms, elevators as well main corridors. Scheduling and triage nurses provide real-time education for patients as to where to receive care at most appropriate setting. Provide care coordination/care plan development and referral to internal/external services.We provide longitudinal care plans and assignment of nurse care managers to all high risk patients as outlined by outpatient risk stratification tool. Priority 2: Mental Health and Substance Abuse Reduce the opportunity for drug use and abuse.In September 2019, Sanford Health implemented the use of a substance abuse and chemical dependency screening tool for pediatric trauma patients called SBIRT (Screening, Brief Intervention. Screening). Beginning September 1, 2019, the outcome goal for SBIRT completion on pediatric trauma patients of 80% has been met every month.Continue prescription stewardship initiative to reduce opioid/narcotic prescriptions.Discharge order sets - our pharmacy and provider teams worked to standardize (and default) minimum quantity and day supply of opioids. Prescribing decision support and documentation support - Implemented acute pain opiate script system defaults to follow the rules of less than 50 MME per day, less than 100 MME per script. Prevention of unnecessary opioid dispensing - We removed daisy chain orders for opiates to follow newer rules of dispensing. Over 2019, total opioid tablet count prescribed remained at 50% less in the Fargo region versus 2016. Explore medication assisted treatment by increasing the number of certified providers.Four family medicine physicians and one Internal Medicine physician have waivers to prescribe suboxone. This program was launched in early 2020. Patients with alcohol use and abuse receive services through internal or external services. Sanford Health began collaborating with a Fargo-based peer-to-peer substance abuse support program provider, F5, in 2019. The program will be offered to inpatients who are detoxing.IHT services are provided in all Sanford primary care settings.Integrated health therapist's (IHT) are located in all primary care clinics. All IHT's have immediate, same day access available for our patients. Reduce the severity of depression for patients with a PHQ-9 score greater than 9.PHQ's are deployed by the panel assistant. Primary care physician receives elevated PHQ and places appropriate referrals to IHT for intervention. Patient's assessment is in place to determine the patients' risk of suicide. PHQ is given to patient based on outlined criteria. If positive, Columbia Suicide Severity Rating Scale is administered by nursing. Results are elevated to physician/APP for disposition of treatment interventions. The Columbia Suicide Severity Rating Scale is executed across primary care clinics in the Fargo market. Education provided to all clinical staff in primary care regarding the Columbia Suicide Severity Rating Scale. Mental Health First Aid Training.Education provided to clinical and non-clinical staff. Goal is to provide the knowledge and skill set that healthcare professionals can use to intervene in the event of a mental health crisis.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, hunger, homelessness, and need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violenceTransportation - Need for door-to-door transportation for community members.Aging - Cost of long-term care and memory care, cost of in-home services, availability of resources for family and friends caring for elders, availability of resources to help the elderly stay safe in their homesChildren and Youth - Availability and cost of services for at-risk youth, cost and availability of quality childcare, substance abuse by youth, teen suicide, childhood obesity, and bullyingSafety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, child abuse and neglect, sex trafficking, and presence of street drugsSanford is not developing strategies to address the cost 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. The results of the CHNA have been shared with community leaders, and those who have expertise in the areas.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that barriers to accessing health insurance coverage is reduced.Priority 2: Behavioral Health and Substance AbuseThe Substance Abuse and Mental Health Services Administration reports that "Mental and substance use disorders can have a powerful effect on the health of individuals, their families, and their communities. In 2014, an estimated 22.5 million Americans age 12 and older self-reported needing treatment for alcohol or illicit drug use, and 11.8 million adults self-reported needing mental health treatment or counseling in the past year."Sanford has made behavioral health a significant priority and has developed strategies to reduce mortality and morbidity from behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by substance abuse. Addressing of Significant Needs during Current Year Priority 1: Access to Affordable CareTo help community members who are uninsured and underinsured secure access to healthcare services, Sanford Health has integrated fulltime, onsite financial advocates who specialize in healthcare coverage enrollment. They help Sanford patients as well as community referrals. Individuals unable to secure healthcare coverage and facing medical bills they cannot afford are referred to Sanford's financial assistance program. FAP works with patients and their families to reduce medical bills by eliminating some or all charges for services. We wrote off $31 million dollars in 2019. To help homeless individuals access healthcare services and prescription medications, Sanford works with shelter residents to apply for and secure healthcare coverage through the state's Medicaid program.Through partnerships with Mandan Public Health, Bismarck/Burleigh Public Health, United Way and the local homeless shelter coalition, we have helped at-risk community members secure healthcare coverage, healthcare services and prescription medications.Often, patients who do not qualify for public assistance do not make enough money to afford the prescriptions they need to get well and stay well. In these circumstances, we have helped patients enroll in Marketplace health plans and provided financial assistance to help cover income gaps. As an example, we helped a newly employed young man recently released from incarceration who could not afford his medications for a chronic heart condition. He needed to get his first paychecks before he could pay for health insurance and his medications. He is now working fulltime and has private health insurance.We have helped more than 900 individuals secure healthcare coverage. Sanford's patient assistance program donated services that totaled more than $31 million to patients and their families who could not afford the services. Services were donated to 9,867 patient encounters.When a patient temporarily is unable to afford the medications, they need due to extenuating circumstances, e.g. sudden loss of employment, Sanford's Foundation established a fund to help community members. Established internal workflow processes to help individuals unable to afford prescriptions receive the medication free of charge.Sanford helped 742 patients get the prescription medicine they needed but could not afford. Perhaps more importantly, Sanford helped these individuals connect to vital community services necessary to regain their health, wellbeing and financial independence. Also provided meal vouchers, lodging, gas cards and transportation for 232 patients. Through our partnership with Great Plains Food Bank, we screen expecting and new moms for access to food. We are able to continue to help with emergency food during their pregnancy as well as connecting them to resources in the community. For moms at-risk for food scarcity, sent an additional 18 packages of five meals (90) meals home plus connectivity to sustainable food sources.Priority 2: Behavioral Health and Substance Use Disorder Continuum of CarePartnered with the Reducing Pharmaceutical Narcotics Task Force to increase use of naloxone and reduce overdose-related deaths. We also partnered with Bismarck/Burleigh County behavioral health task force, a stakeholder group established to identify and address gaps in the community's substance abuse and behavioral health continuum of care.Partnered with Face It Together, a community-based approach to helping those suffering with the disease of addiction get well and stay well. Face It Together offers coaching services to clients to help address all social determinants of health, an approach proving successful with a growing number of community members. Coaches help clients secure employment, housing, food, and other supports. Sanford provides in-kind support including grant writing, meeting space, access to healthcare and employment supports.Established a drug takeback location in main campus pharmacy.Collaborated with Heartview, an addiction service provider, to support certified Medication-Assisted Treatment programs in central and western North Dakota.Partnered with Bismarck Public Schools to provide behavioral health service onsite. A pilot program launched in the Fall of 2019 entails a Sanford psychologist seeing patients in person at Simle Middle School. The goal of the project is to establish a program scalable to additional schools via telemedicine.To reduce the number of opioid prescriptions, improved ease of access to the N.D. Prescription Drug Monitoring Program and worked with providers treating chronic pain to incorporate best practice guidelines.Successfully helped 133 community members suffering from the disease of addiction secure coaching support to get well and stay well.Successfully helped 10 expectant moms suffering from substance use disorder participate in medication-assisted treatment programming. Provided 60 behavioral health visit for at-risk middle school students. Reduced the number of opioid tablets prescribed by 25 percent. Provided four grand round education presentations to increase provider awareness on opioid prescribing best practice and CMS guidelines.Identified needs not directly addressed by this facility include:Economic - Homelessness, need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, affordable housing and hunger Aging Population - Cost of long term care, cost of memory care, and the cost of in-home servicesChildren and Youth - Cost and availability of quality childcare, substance abuse by youth, childhood obesity, teen suicide, availability and cost of services for at-risk youth, bullying, and teen tobacco use Crime/Safety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, presence of street drugs, child abuse and neglect, sex trafficking, and criminal activity
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Economic Well-BeingThe Robert Wood Johnson Foundation's Commission to Build a Healthier America reports that good physical and mental health depends on having homes that are safe and free from physical hazards. Adequate housing should protect individuals and families from harmful exposures and provides them with a sense of privacy, security, stability and control, and can make important contributions to health. In contrast, poor quality and inadequate housing contributes to health problems such as infectious and chronic diseases, injuries, and poor childhood development. Sanford Health has made economic well-being a significant priority and has developed a strategic plan to work with community leaders to collaborate on housing and support services development.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPriority 1: Economic Well-BeingWork with community collaborative on housing and support service development.Leaders from our emergency department and case management met with board members from the local homeless shelters to discuss safe & proper discharge planning for those who are homeless. Working through the Collaborative, an additional 32 unit subsidized housing complex will open soon called Conifer Estates, owned by the Headwaters Regional Development Corporation, a local non-profit serving the region. This facility is housing for people with low income that includes coordination of other services for residents. The coordination professional (case manager) can help residents identify resources and navigate systems.Every year Sanford provides donations and sponsorship to area groups, including - but not limited to Evergreen Youth & Family Services, Boys & Girl's Club, Bemidji Food Shelf, Habitat for Humanity, Battered Women's Shelter, Blue Ox Marathon, Headwater Science Center, Bemidji State University, Bemidji Independent School District, Area Arts Endowment, American Indian Resource Center, American Red Cross, Dragon Boars, Bemidji Symphony, Boys and Girl Scouts, Family Advocacy Center, United Way, Northwest Technical College, St. Philips, Youth Soccer, Youth Baseball, Bemidji Lumberjack Athletics, Peacemakers, Paul Bunyan Playhouse, Bemidji Community Theater, Youth Hockey, and many other organizations.Assure children and youth have access to healthy food.Continued to develop the Sanford Health Kids Initiative to address programmatic opportunities and partnerships for at-risk youth.No Hungry Kids: While we are blessed to live in wonderful communities surrounded by beautiful natural resources, a staggering one in five local children do not get enough to eat. Sanford Health, Bemidji Independent School District 31 and United Way of Bemidji took steps to change that. The three organizations worked together through a public-private partnership to create a new program called No Hungry Kids. As part this program Sanford Health made a $405,000 commitment over the next five years to the program to ensure that no student goes hungry. In addition, as a result of our partnership the United Way was able to expand the program to all elementary schools in the district, coordinate a summer program with the Boys & Girls Club and initiate a "pantry" program at the Bemidji High School. Through this project we also developed supporting strategies to support youth - they include: Reach Out & Read: Through the Sanford Healthy Kids Initiative, the organization also launched a program in their Children's Clinic called Reach Out and Read to specifically address literacy. Social Emotional Learning: Partnering with Peacemaker Resources, Bemidji Area Service Collaborative (BASK) and Bemidji Area Schools. Sanford Health was able to help in the expansion of SEL skills, ensuring that all ISD 31 Kindergarten and first grade teachers and classes received both training and classroom time for the 2018-2019 school year.Work collaboratively with community resources on economic development opportunities for the region.Over the past year we have played an active role in positioning the Bemidji community for enhanced economic growth and development. We have strategically been part of partnerships to align Greater Bemidji, the Bemidji Chamber of Commerce, Downtown Business Alliance and Visit Bemidji and played a role in sponsoring the Bemidji 2030 visioning process. We have met with entrepreneurs and business developers who have an interest in relocating to Bemidji to discuss how Sanford Health can help- whether it is providing land or space for a building or simply to just welcome them to Bemidji while they are on a community site visit.Sanford Health was also recently the local title sponsor of Hockey Day in Minnesota, Bemidji, which was televised throughout the state and nationally. Priority 2: Mental Health and Substance AbuseOpened residential crisis center for the provision of mental health and detoxification treatment.Sanford - through a partnership with Beltrami County, the sheriff's department and Prime West Health opened a residential support center, offering detox and residential treatment services for those in crisis in our community. In July remodeling was completed and the 6,800 square-foot, 14-bed center opened - this includes: 5 beds for crisis residential stabilization providing short-term individualized mental health services for patients who would otherwise be at risk of hospitalization if they did not receive these services. 5 beds for intensive residential treatment services (IRTS) assisting patients in need of more focused structure.In 2018 alone, more than 300 patients were transferred out of our facilities here in Bemidji across and even out of the state to receive services they needed that were not available here.Expand Medication Assisted Therapy and associated chemical dependency treatment programs to serve adults.The medication assisted therapy (MAT) program expanded to include adult men and women needing ongoing medication as an alternative to illegal substance abuse. This program continues to grow the number of participants. A Licensed Alcohol and Drug Counselor (LADC) has been co-located with the MAT Clinic. Outpatient treatment in both individual and group modalities are being provided for existing and new MAT patients. One Psychiatrist and three Advanced Practice Nurses are currently certified to provide MAT. Recruit additional behavioral health treatment practitioners, including psychiatry, psychology and psychiatric nurse practitionerIn 2017, Sanford Health and Upper Mississippi Mental Health Center, Inc. (UMMHC) completed the final steps necessary to move forward with merging. They also completed acquisition of an independent psychology practice to add capacity to the therapy services and recruited several mental health therapy providers.Since then we have been able to recruit nine new behavioral health providers, develop an adult MAT clinic and build programs and services that provide critical services to our community.Identified needs not directly addressed by this facility include:Children and Youth - substance abuse by youth, and teen suicideAging - Cost of long term care, and availability of memory careSafety - Abuse of prescription drugs, child abuse and neglect, presence of street drugs, presence of drug dealers, criminal activity, and domestic violenceHealth care - Availability of mental health providers, availability of behavioral health (substance abuse) providers, and use of emergency room services.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthThe U.S. Census Bureau estimates that in 2014, 74% of Minnesota households with children under age 6 had all parents in the workforce. This is the third highest state in the nation for working parents, falling behind Iowa and South Dakota at 75%.According to a report by Child Care Aware of America, states face various challenges in exploring childcare supply and demand and directing precious resources to ensure accessibility to quality child care. Child Care Aware describes quality childcare as "the emotional and academic support children need to be school-ready by the time they enter Kindergarten. Quality childcare should be culturally and linguistically responsive and should be provided by engaged and caring child care providers. Quality childcare incorporates physical activity time and developmental screening practices, and follows food safety guidelines. In addition, quality child care should be easily accessible for all families, regardless of location or socioeconomic status." Sanford has made quality childcare a significant priority and has developed strategies to work in collaboration with community leaders to improve the availability of quality childcare in the community. The intent of the strategies is to create more opportunities for quality childcare in the community and to support childcare providers with educational program opportunities. Addressing of Significant Needs during Current YearPriority 1: Mental Health and Substance AbuseThief River Falls (TRF) leadership developed a new service line proposal, to include an ROI analysis for presentation to Sanford leadership. After considerable review, TRF received approval to move forward with development and implementation of a SUDS (substance use disorder) program.The SUDS program is currently under development in preparation for opening in the Fall 2020.Currently the home that will house the program is being renovated and license applications with the MN Department of Human Services are being prepared for submission.The BHS-6 behavioral health screening tool is one of several depression screening tools available to providers to assess a patient's mental health relative to depression. Currently only Sanford One Care Clinics are using the BHS-6 screening tool and all other Sanford clinics are using the PHQ-9 patient health screening tool. TRF is using the PHQ-9 which has been incorporated into the EMR medical record as a screening prompt for providers on an annual basis for all primary care patients.In CY19 TRF's primary care provider teams achieved an overall administration percentage rate in excess of 90% for the PHQ-9; well above the target of 80%. Upon completion of the PHQ-9 screening and based on the individuals score, the provider may recommend additional screenings and further clinical follow-up with a mental health professional. Sanford has an algorithm that outlines each step in the process.Priority 2: Children and YouthTRF behavioral health staff make themselves available and participate with law enforcement educating school age children regarding the Drug Abuse Resistance Education (DARE) program every year. Children's Therapeutic Support Services (CTSS) is a flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention. This program is provided in all TRF schools and will address the dangers of drugs in addition to other mental health issues.TRF has expanded the CTSS program from one school to all three this past year; providing behavioral health professionals in each school five days a week.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, household budgeting and money management, need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic abuse, and a skilled labor workforce Aging - Cost of long-term care and the cost and availability of memory care, cost of in-home care, and the availability of resources for grandparents caring for their grandchildrenChildren and Youth - Childhood obesity, substance abuse by youth, availability and cost of services for at-risk youth, teen tobacco use, bullying, crime committed by youth, and opportunities for youth-adult mentoring Safety - Abuse of prescription drugs, presence of drug dealers, presence of street drugs, child abuse and neglect, criminal activity, and domestic violenceHealth care - access to affordable health insurance coverage, access to affordable healthcare, access to affordable prescription drugs, use of emergency room services for primary health care, availability of specialist physicians, availability of non-traditional hours, availability of behavioral health (substance abuse) providers, access to affordable dental coverage, and availability of mental health providersSanford 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.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointmentsPriority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPriority 1: Health Care AccessSanford Aberdeen Medical Center (SAMC) is committed to helping community members understand their health care insurance options. Our goal is that no one in our service area is denied necessary health care services due to lack of coverage and/or insufficient coverage. In 2019, SAMC staff utilized Sanford Health Plan's website and related information and resources to provide relevant insurance information for individuals and companies as needed. This information on coverage options allows consumers to compare Sanford Health Plan's options to see what is right for them. In addition, our staff has been working more closely with both Sanford Health Plan representatives as well as various local insurance agents regarding access to a range of insurance products and services for anyone in need. Priority 2: Mental Health and Substance AbuseSAMC seeks to ensure that mental health services are available in Aberdeen and the surrounding area. Additionally, we aim to achieve a reduction in opioid prescriptions. To this end, Sanford Aberdeen Clinic is offering telemedicine options for psychiatry services to increase overall access to mental health care. SAMC is also currently evaluating outreach opportunities for these services for broader reach across the service area. To identify need and ensure access to appropriate care, PCP visits include a questionnaire assessment tool that is aligned with Sanford Health enterprise protocols for screening. To approach are in a more holistic manner, we have embedded an Integrated Health Therapist (IHT) in our primary care clinics. Our IHT also offers ongoing education on services offered through primary care. In 2019, our Integrated Health Therapist saw a total of 284 patients (note: IHT was on leave a portion of the year so this number is expected to increase for 2020). Finally, our staff and providers are routinely given updates to Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically. Identified needs not directly addressed by this facility include:Economics - Need for a skilled labor forceChildren and Youth - Childhood obesity, and substance abuse by youthAging - Cost of long term care, cost of memory careSafety - abuse of prescription drugsSanford 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.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring healthcare are successful in securing timely appointments.Priority 2: WellnessThe Centers for Disease Control and Prevention reports that Americans use preventive services at about half the recommended rate. Chronic diseases account for 7 of 10 deaths among Americans annually and for 75% of U.S. health spend. These diseases are largely preventable through close partnership with a healthcare team, or can be detected through appropriate screenings, when treatment works best.Eating healthy, exercising regularly, avoiding tobacco, and receiving preventive services such as cancer screenings, preventive visits and vaccinations help people stay healthy. The right preventive care at every stage of life helps individuals to avoid or delay the onset of disease, keep diseases they have from becoming worse or debilitating, lead productive lives, and reduce cost.Sanford has made wellness and chronic disease prevention a significant priority and has developed strategies to promote and improve cancer and chronic disease screening in the community. Addressing of Significant Needs during Current YearPriority 1: Healthcare AccessSanford Worthington intends to develop a community task force to improve dental care access for children. Progress thus far includes collaboration with Nobles County Community Services as a joint agency goal. We will continue collaboration through the next assessment period. Sanford Worthington hired Christine Bullerman in December 2018 as Lead Community Specialist to be a liaison for Sanford with the community. We formed a small task force with representation from Nobles County Community Services and Sanford Worthington. Ann March, Public Health Assessment Planner from the Center for Public Health Practice from the Minnesota Department of Health, was consulted to assist development of collaborative strategies to address this goal. Christine established a list of community members who were contacted to inform them of the small work group to assess solutions to this issue. In October 2019, we began to form the Dental Coalition. Sanford Worthington and Nobles County Community Services, with guidance from Ann March, began to engage the community. Ann introduced the results-based accountability planning model to engage the community stakeholder group to identify priority areas. The following month, Sanford Worthington hosted the first stakeholder session with 35 Nobles County attendees. The scope of the problem was presented specifically in relation to Nobles County. A representative from MN DOH reviewed successful programs from across the state that address similar concerns. A summary document of ideas was created listing factors helping/hurting this goal in the community. These were combined into 15 key tactics for discussion at the next meeting to develop action items. In January 2020, the stakeholder group conducted the 2nd results-based accountability session to identify 3-4 priority strategies.Our second initiative focused on the use of the emergency department (ED) for primary care to reduce patient recidivism. Sanford Worthington collaborated with Sanford Enterprise Value Improvement Program, Sanford Health Population Health leaders, and JBS to decrease the use of the ED among Nobles County residents. JBS is a local business for which Sanford Worthington Medical Center is their 4000 employees' (and families) preferred provider and narrow network insurance plan. In 2019 metrics were established regarding the rate of ED usage per 1000 health plan members for the JBS narrow network participants. These metrics are a shared goal with JBS and Sanford Worthington. We developed a local Care Management group consisting of our Clinic RN Care Manager, Hospital Discharge Planner, Quality Manager, and Director of Nursing and Clinical Services. The group meets monthly to review and develop strategies to impact this issue including: Clinic RN Care manager receives ED Discharge data through a system report. The report is reviewed daily to identify individuals showing trends for increased ED usage for non-emergent concerns. These individuals are contacted for follow-up to assess barriers or social determinant of health causing ED overuse. They are invited to participate in an integrative care plan to assist with their health care access and care needs. 12 longitudinal care plans were completed by the Clinic RN Care Manager for patients with complex social/medical needs for improvement of health access and management.Sanford Worthington has begun to examine the impact of ED recidivism locally to prepare a proposal for additional Social Services care management resources within the hospital allowing for better collaboration with the Clinic RN Care Manager.Sanford Health has begun collaboration with a telehealth crisis intervention service to complement local crisis intervention services for early intervention for individuals presenting with mental health concerns in the ED. Additional telehealth mental health practitioners have been credentialed through this collaboration pilot for increased access for patients with mental health medication maintenance needs. Priority 2: WellnessSanford Worthington aims to improve cancer and chronic disease screening in the community. We set a goal to develop a lung cancer screening program for the community. In 2019 Sanford Worthington invested in and installed a new CT scanner that will provide up-to-date technology for this screening program. Program development meetings began with Sanford Cancer Center and Sanford Pulmonology. Three meetings occurred in 2019 to explore implementation of a lung cancer screening service. We also aim to collaborate with a large community employer to assess and evaluate disease prevention measure outcomes among health plan benefit members. Sanford Health collaborated with Sanford Health Plan population health team to develop health screening metrics specific to a population in the community at risk for health disparities. Sanford Worthington Clinic focused on colorectal screening access in 2019. This increased colorectal screenings completed from 68% to 73% of eligible population in our clinic, and an additional 70 screening colonoscopies over 2018 total at Sanford Worthington Medical Center.Sanford Worthington partnered with MNRAAA to bring Living Well With Chronic Conditions: Better Choices Better Health classes in both English and Spanish to our community. Staff completed layperson educator training for classes to begin in 2020. Identified needs not directly addressed by this facility include:Economics - Availability of affordable housingTransportation - Availability of public transportationAging - Cost of long term care, availability of memory care, and the cost of in-home servicesChildren and Youth - Availability and cost of quality childcare, availability of services for at-risk youth, teen pregnancy, childhood obesity, bullying, substance abuse by youth and the availability of activities for children and youthMental Health - drug use and abuse, depression, stress, and alcohol use and abuseSanford will not develop strategy to address the availability of affordable housing, the availability of public transportation, the cost and availability of long-term care, memory care. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the assessed needs with community leaders that have expertise in the various needs of the community.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Children and YouthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Substance abuse is another high raking concern for community members. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Protective factors include: Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford has made children and youth a significant priority and has developed strategies to offer support programs that provide children and youth with safe and healthy environments.Priority 2: Mental Health and Substance Abuse Mental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearPriority 1: Children and YouthAt Sanford Sheldon we take great pride in supporting the youth of the community in various events. We provide 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. We order 75 backpacks. We support the summer lunch program, which is facilitated at a local church, which provides meals to students in need during the summer months when school is not in session. We teach farm safety to all children in the 2nd grade of all Sheldon school, with approximately 97 children participating. We invited 3rd grade students of all Sheldon schools and other nearby community schools to tour our facility. This increases their comfort level with the facility and staff that work here. The tours were given to 240 children.Priority 2: Mental Health and Substance AbuseSanford Sheldon Medical Center is strongly committed to meeting the mental health and substance abuse needs of our patients and all community residents. We have expanded access to mental health counseling available with the addition Dr. Matthew Eggers, Psychiatrist, via telemedicine video visits as well as with Mark Daniels, integrated health specialist, via telemedicine video visits. Having access to Dr. Eggers and Mr. Daniels has helped us to address immediate needs for mental health counseling at Sanford Clinic Sheldon. Identified needs not directly addressed by this facility include:Economic - Need for skilled labor force, affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and household budgeting and money managementAging - Cost of long term care, cost of memory care, and the cost of in-home services Safety - Abuse of prescription drugsHealth Care - Availability of mental health providers, availability of behavioral health providers, access to affordable health insurance coverage, access to affordable health care, access to affordable prescription drugs, and access to affordable vision insurance
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Economic Well Being Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Sanford Vermillion has made affordable housing and economic well-being a significant priority and has developed strategies to work with community partners and community leaders to improve the availability of affordable housing in the community.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPriority 1: Economic Well-Being - Availability of Affordable Housing and FoodThe intent of this implementation strategy is that our community would see at least an increase in the awareness of the availability of affordable housing units in Vermillion. To achieve this aim, Sanford Vermillion will request and participate in a housing inventory, encourage collaboration in housing development, and request an inventory and subsequently increase awareness of food assistance programs.Sanford Vermillion has requested a Housing Inventory to include the number of reduced income units currently available in Vermillion. Vermillion saw one of the largest increases in additional housing units added to the community during 2019 including permits for a multi-family dwelling, twin homes, single-family dwelling permits and two large apartment complexes that were completed. In 2019, the City of Vermillion issued permits for:o 1 multi-family dwellingo 4 single family attached dwellings (twin homes at Bliss Pointe)o The Quarters at Vermillion apartment complex - 74 units providing 235 bedroomso The Heights apartment complex - 169 units providing 496 bedroomsSanford Vermillion has also continued to collaborate with the Vermillion Chamber & Development Company for the second phase of housing development at Bliss Pointe development as well as their NOW 3 campaign for Vermillion. Sanford Vermillion provided a major investor in the NOW 3 Campaign to assist towards its goal of raising $1.75 million for 2019 for the purpose of funding changes and improvements in the infrastructure of Vermillion. The Vermillion NOW 3 Campaign raised $2.01 million by October 2019 exceeding their goal for infrastructure improvements in the Vermillion Community.Sanford Vermillion has requested an inventory of the food assistance programs available in the community which includes programs such as the Vermillion Food Pantry, Welcome Table weekly free meal, Vermillion Weekend Backpack Program, Tanager Take Out program, Dakota Senior Meals, SNAP and WIC available through the Department of Social Services and participating with Feeding SD Food Giveaway programs. The Community Connection Center also opened in 2019 to house the United Way, Welcome Table, Vermillion Food Pantry, Weekend Backpack Program and Salvation Army services all under one roof in downtown Vermillion for a one-stop shop for their clients. The Community Connection Center works with the Clay County Poverty Task force to identify community needs and awareness of their programs.Priority 2: Mental Health - Substance Abuse and Binge Drinking By increasing mental health services in the community and working with its community partners,Sanford Vermillion intends to have a positive impact on the percentage of its community that report abusing alcohol and drugs. In particular, Sanford Vermillion will increase the number of mental health services available in the community.Sanford Vermillion was able to increase Mental Health services offered to the Vermillion Community adding a full-time Integrated Behavioral Therapist/Psychologist in April 2018 to work at our clinic. We also continue to provide a monthly Psychiatric specialty outreach clinic and a Mental Health counselor who is on site two days per week. The number of completed Mental Health visits at Sanford Vermillion increased by 422 visits in 2019 as compared to 2018. This was a total of 1349 completed visits for 2019 showing a 31% increase from 2018.In the community, a private counselor is available as well. Additionally, Lewis & Clark Behavioral Health purchased a building in Vermillion where local counselors including a licensed alcohol and addiction counselor is housed for serving the Vermillion Community.Identified needs not directly addressed by this facility include:Aging - Cost of long term care, cost of memory care, and cost of in-home servicesChildren and Youth - Substance abuse by youth, and childhood obesitySafety - Culture of excessive drinkingHealth Care - Access to affordable health insurance, access to affordable health care, and cost of affordable prescription drugs
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Substance abuse is another high raking concern for community members. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Protective factors include: Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford has made children and youth a significant priority and has developed strategies to offer support programs that provide children and youth resources for healthy living.Addressing of Significant Needs during Current YearPriority 1: Mental Health/Behavioral Health and Substance AbuseTo increase community safety and decrease substance abuse, Sanford Chamberlain Medical Center (SCMC) is training community members on Mental Health First Aid. In 2019, three Mental Health First Aid sessions were offered in Chamberlain, training a total of 34 community members. SCMC also provides education on substance abuse prevention and behavioral health for students and parents of local schools. Sanford Chamberlain has engaged in work with the Chamberlain school district, embedding a licensed mental health counselor in the high school/middle school and elementary school one day per week. Additionally, we are working with the Chamberlain middle school in supporting a curriculum around social/emotional well-being. The curriculum is live in classrooms. In 2019, Sanford Chamberlain also helped to sponsor wellness support grab bags for all Chamberlain Middle school students. Priority 2: Children and YouthSanford Chamberlain intends to make the Sanford fit wellness program available to local schools as well as parents of students. SCMC hosted Sanford FIT night in conjunction with parent teacher conferences at the Chamberlain elementary school. Approximately 200 people attended the event. Expanding this opportunity to other districts is currently under consideration.Camp FUEL is a summer camp for area youth where healthy eating, exercise, and health outcomes are explored. The camp took place in summer 2019 and plans are underway to hold a Camp FUEL again in 2020. The 2020 camp strategy will include reaching out to St. Joseph's Indian School as well.Identified needs not directly addressed by this facility include:Economic - Need for a skilled labor forceAging - Cost of long-term care, and the cost of memory care Safety - presence of drug dealers, presence of street drugs, and abuse of prescription drugs Health Care - Access to affordable health care, and access to affordable health insurance coverageSanford 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.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Mayville Medical CenterSanford 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: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointments.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPriority 1: Improving Health Care AccessSanford Luverne set three primary goals around improving access to care in our community. The first is improved access to primary care providers through recruitment, telemedicine, and outreach. The second goal focuses on improved price transparency through pricing estimates and help with affordable drug coverage. Finally, we aim to enhance access to dental health for area residents. Primary care access - with the retirement of a primary care provider, a new primary care provider was recruited to the practice (began in August 2019) and a second physician has signed to join the practice in two years (starting 2022). In addition, we have promoted e visits and video visits as appropriate for patients. Our Lead RN has championed the use of telehealth to area nursing homes, but support thus far is minimal. Expanding hours at satellite clinics has been limited due to access to primary care providers. We plan to revisit this when fully staffed with providers.Price transparency - our Finance department has continued to focus on price transparency. We continue to share our phone number for pricing estimates for services. Our health coach continues to work one-on-one with patients as needed on assistance for drug coverage. The top 25 codes used in the clinic are posted for clinic patients, as required per the Minnesota State Legislature. Additionally, the current hospital charge master is posted on the website.Dental care access - Sanford Luverne clinic providers and nursing staff continue to focus on applying dental varnish. Sanford has supported a mobile dental clinic that has begun coming to Luverne for lower income residents through sponsorship support; we also provide breakfast and lunch for the staff. The mobile dental clinic is a partnership between Luv1LuvAll community initiative, Southwest Health and Human Services, and Delta Dental. Mobile dental clinics are 100% full each month. From Sept 2019 - March 2020 the dental clinic has serviced 74 patients during six dates of service in Luverne. Of the 74 patients, 70 were children and four were adults.Priority 2: Improving the Mental Health of the CommunitySanford Luverne aims to improve mental health in our community through enhanced access to services as well as decreasing depression and anxiety scores through regular screening for depression and anxiety with preventative medicine visits. Improved access - Sanford Luverne has two integrative therapists assisting more one-on-one with patients. The Luverne site is second highest utilizer for telehealth psych services within the clinic and ER setting. Our Lead RN has accepted a role to support tele psychology services. Integrative health therapists are involved with the Luv1LuvAll community group working on mental health and evening educational series. Our facility has sponsored several presenters including integrative health therapist, physician, and substance use supervisor. We continue to stress importance of utilizing the county crisis response team in the ER or accessing tele psych services to assist with mental health triage and holds. We had 148 completed tele psychiatry visits in 2019, plus additional 24 no show visits scheduled for patients within the clinic setting. Since go-live date of Feb 28, 2019, Sanford Luverne has had 23 emergent tele psychiatry visits from the emergency room. Finally, we co-sponsor a monthly brain health series whereby 20-25 individuals have attended each session.Decreased depression and anxiety scores - our clinic continues to focus on assessment of depression and anxiety with preventative medicine visits. Our Care Coordinator assistant focuses on scores and recalling patients who have scored high to ensure reassessment is completed and diagnosis is properly controlled. Our RN Care Manager assists with resource and medication management, referrals to telehealth psychology services, and other local behavioral health providers. Our RN Care manager also works closely with physicians and patients to fill gaps in care. As of Dec 31, 2019, Sanford Luverne clinic depression quality measure at six months was 17% at the end of 2018, and achieved 24.1% ( goal is 11%) optimal care at the end of 2019. In addition, the 12 month quality measure was 14.6% at the end of 2018, and achieved 16.2% (goal is 11%). This is a measure of depression management related to patient perceived depression indicators. Identified needs not directly addressed by this facility include:Economic - Need for a skilled labor force, affordable housing, and employment optionsAging - Cost of long term care, availability of memory care, and cost of in-home servicesChildren and Youth - availability and cost of quality childcare, availability and cost of services for at-risk youth, substance abuse by youth, bullying, and teen suicide.Sanford will not develop strategy to address the cost of long term care, the availability of memory care, the availability and cost of quality child care. 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.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 According the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Canby has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Mental Health Mental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPriority 1: Physical HealthTo improve physical health for the greater Canby, Minnesota community, Sanford Canby Medical Center (SCMC) is working to reduce the negative health outcomes associated with obesity. SCMC has provided sponsorship support to various activities and events in the community. Donation requests are reviewed at administrative council meetings; events/activities aligning with the promotion of healthy living are given strong consideration. In 2019, approximately $5,600 was donated to events/organizations of the Canby community including the Canby Golf Course, Canby 4 Kids, and Canby YAMS among others.SCMC also continues to sustain the Sanford fit Kids program with school-age youth throughout the community. In March and April 2019, Sanford Canby staff brought the fit Kids program to both St. Peter's Elementary School and Canby Public Elementary School. Grades K-6th were able to take part with approximately 350 kids impacted by the program. On August 6, 2019, SCMC sponsored a fit Kids pool noodle obstacle course at the National Night Out event at Sylvan Lake Park area. Approximately 85 kids ages 2-12 completed the obstacle course.We continue to promote healthy living with our valued employees at SCMC. In April 2019, Sanford Profile presented a demonstration on their weight loss/nutrition program to Sanford Canby staff. Employee Health staff also routinely sends informational emails and resources to our staff on various physical health topics such as self-care.Priority 2: Mental HealthBecause of the close relationship between physical and mental health, especially for those with chronic illness, Sanford Canby Medical Center aims to increase awareness of resources for mental health care. The Sanford Canby Pathways Support Group offers support, resources, and routes to thrive and better manage life with chronic conditions. This group provides strategies, solutions, and resources to aid members along an empowered pathway in living life after diagnosis of a chronic disease. The group is open to anyone with, or caregiving for, a person with, a chronic medical condition including Parkinson's, memory loss, vision loss, cancer, heart disease, mental health, grief/loss, or pain. Sanford Canby hosted the Pathways support group quarterly in 2019 on 02/28/2019, 04/25/2019, 8/22/19, and 10/24/19.To expand identification of patients in need of mental health services, SCMC utilizes the PHQ-9 screening tool within the electronic medical record. Through the medical home program, RN care manager, and PHQ-9 screening, we can offer and refer mental health services to those with scores indicative of depression. In January 2019, 13.7% of patients recorded remission in six months and 0% of patients recorded remission in 12 months. In January 2020, 9.5% of patients recorded remission in six months and 11% recorded remission in 12 months. Identified needs not directly addressed by this facility include:Economic - Employment options, and skilled labor forceAging - Cost of long term care and memory care, and cost of in-home servicesChildren and Youth - Bullying, and availability of quality childcareHealth Care - Access to affordable health insurance, cost of affordable vision insurance, access to affordable prescription drugs, cost of affordable dental insurance coverage, and access to affordable healthcare
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Youth According to the Centers for Disease Control, obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion. Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer. Sanford Jackson has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity. Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearPriority 1: Children and YouthSanford Jackson Medical Center is working to create awareness of health behaviors for children and parents in our community through a number of initiatives. Tri for Health Sponsorship - our Marketing Specialist continues to strengthen relationships with community members specifically for Jackson's annual Kids Tri for Health. Our Marketing Specialist attended five meetings related to planning and set up for the June 2019 event. Sanford Jackson was again the title sponsor for Tri for Health in June 2019 - an event that served 100 youth from the community. All attendees received Sanford Fit Kids curriculum information in athletic bags. Our next Tri for Health will take place mid-June, 2020. Fit Kids in the Community - we utilize the Sanford Fit Kids curriculum at various community events, speaking engagements, and in the resource bags for participants in Tri for Health. Supporting Families in the Community - in 2019, we sponsored organizations such as Jackson County Libraries, Jackson County Food 4 Kids, the new Jackson City Splash Pad, and Kirby's closet (a newer nonprofit that served over 200 during the 2019 Christmas season). In September 2019, we hosted trivia and educational resources for families at JCC's Community Resource Fair, at which over 250 parents and children attended. In July, our RN Care Manger gave a presentation to the community at the Jackson County Fair. JCC Middle School hosted an event in December where we spoke with students about healthcare career paths. Priority 2: Mental Health and Substance AbuseMental and behavioral health care continues to be a pressing need for our community. Our goal at Sanford Jackson Medical Center is to decrease patients presenting to the emergency room with mental and behavioral health issues as well as to decrease substance abuse within the community. Sanford Jackson Medical Center is working internally and also with community partners to decrease substance abuse in the area via several projects.Jackson County Sheriff Education - we were unable to coordinate Jackson County Sheriff Education with providers in 2019. However, we plan to offer an education session in quarter three or four of 2020. We maintain a strong partnership with Jackson County Sheriff's Department. Education to Providers & Care Team - our RN Health Coach specializes in customized care plans for patients needing support in weight loss initiatives, diabetes management, smoking cessation, or assistance in navigating primary care. A key voice in our community, she has provided education resources at the 2019 Jackson Farm and Home Show, Jackson County Fair, and AGCO Health Fair. She also attended six monthly meetings in 2019 for the facilitation of the Weight Loss Support Group. She also coordinated this group for patients, for which there has been one participant in the latter months of 2019. In 2019, she attended a workshop in Worthington for the American Lung Association's Freedom from Smoking class. She has incorporated information from this training into her one-on-one meetings with patients, many of whom are referred to her for smoking cessation. She plans to offer classes as interest increases. Her meetings with patients involve helping them create an individualized quit plan. We often refer them to Quit Plan or MN Quit Fax Referral. In October 2019, we had one "Ask the Expert" newspaper column on "Is Vaping Safe?" featuring expertise from Martha Johnson, PA.Our providers discuss tobacco use rates and the impact on care for people with diabetes and vascular disease specifically. Our Performance Improvement team monitors these measurements quarterly and updates action plans for all members involved in patient care. The Sanford Health Network occasionally sends updates on best practices for care teams working with patients dealing with tobacco use or chronic disease. Opioid Prescribing Best Practices - our staff and providers are routinely given updates to Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically. Minnesota Prescription Monitoring Program - at Sanford Jackson, all controlled substances that are sent home with the patient from the hospital are automatically reported to the Minnesota Hospital Prescription Monitoring Program (PMP) electronically via information entered on the Medication Administration Record (MAR). The provider enters the order, nurses chart on the MAR, and then that information is sent to the MN PMP electronically. Our Senior Pharmacist receives daily emailed reports of what has been sent to the MN PMP and also verifies that data with the paper copy of the prescriptions that were sent home with the patient. Overall, there have been changes within the state and also federal government in that prescribers are limited in the quantity of controlled substances that they can prescribe. A new feature in EPIC became available for the providers to choose acute or chronic pain. This is update is now a requirement in MN but not all states. Identified needs not directly addressed by this facility include:Children and Youth - Availability and cost of quality childcare, bullying, availability and cost of services for at-risk youth, substance abuse by youth, teen tobacco use, and opportunities for mentoringAging - Cost of long term care, availability and cost of memory careHealth Care - Availability of non-traditional hours, access to affordable health insurance, access to affordable health care, access to affordable prescription drugs, cost of affordable dental insurance coverage
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: WellnessAccording the Center for Disease Control, obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Tracy has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Health Care AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made health care access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to health care are successful in securing timely appointments.Addressing of Significant Needs during Current YearPriority 1: WellnessSanford Tracy Medical Center seeks to improve physical and chronic health and overall wellness of Tracy community members through dietician and RN health coach services, providing needed medical supplies to low income patients, and expanding Sanford fit programming.Dietician services - both Dietician and RN Health Coach services continued to be offered and referred to in 2019. Dietician services are now available via telemedicine, making access quicker and easier. Our Dietician had 11 visits in 2019 (9 in 2018). Our RN Health Coach had 182 visits in 2019.Medical supply availability - Sanford Tracy completed the grant period by providing pill caddies, digital thermometers, blood pressure monitors, glucometer test strips, medication spoons, scales and wellness center vouchers to in-need patients (with need determined by nurses/Health Coach/providers). The majority of our supplies were exhausted in 2019. In total, we provided medical supplies to 55 in-need patients in 2019 (some patients may have received more than one item). WE are currently discussing ways to continue project into 2020 and beyond. Sanford fit programming - staff continued the Sanford fit program, which focuses on health lifestyle choices to decrease childhood obesity, from January 2019 - May 2019. Staff also shared Sanford fit online resources with local school administration and teachers. Tracy Area Elementary School 4th grade students took a pre-test on first day of fitClub and a post-test on the final day. Students increased their test scores by more than 21% from the pre-test to the post-test.Priority 2: Health Care AccessOur staff is committed to improving access to health care through education and awareness. Specifically, additional awareness of mental health services is needed along with additional outreach services and medical supplies for low-income and in-need patients. Mental health awareness - to increase overall awareness of telemedicine services and local behavioral health services, Sanford Tracy developed marketing and social media campaigns in 2019. Also, referrals for behavioral health providers continued as needed in 2019. PCP providers were reminded of services available on site at the regularly scheduled provider meetings. Behavioral Health providers in Tracy saw 119 new referrals in 2019 and a grand total of 1181 visits for the year.Specialty outreach - work began in 2019 to obtain a Sanford orthopedic outreach provider as well as a dermatology outreach provider. Expected start date for these outreach services is spring 2020. Wound Care telemedicine services were added in 2019. Hospital outpatient dressing changes/wound care visits were 468 in 2019 (up from 151 in 2018). Outreach Clinic wound care telemedicine visits were five in 2019 (as a brand new service). Medical supply availability - grant period was completed by providing pill caddies, digital thermometers, blood pressure monitors, glucometer test strips, medication spoons, scales and wellness center vouchers to in-need patients (with need determined by nurses/Health Coach/providers). The majority of the supplies were exhausted in 2019. Sanford Tracy provided medical supplies to 55 in-need patients in 2019 (some patients may have received more than one item). Our staff is currently discussing ways to continue the project into 2020 and beyond.Identified needs not directly addressed by this facility include:Economic - Need for employment options, and availability of a skilled labor forceChildren and Youth - Availability of quality childcareAging - Cost of long term care, availability and cost of memory careMental Health and Substance Abuse - Depression, stress, dementia and Alzheimer's
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 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: ObesityAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford has made obesity reduction a significant priority and has developed strategies to offer support programs that can reduce obesity rates and improve overall health. Priority 2: Chronic DiseaseSanford has made chronic disease a significant priority and has developed strategies to reduce mortality and morbidity from chronic disease. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by chronic diseases.Addressing of Significant Needs during Current YearNOTE: Sanford no longer operates this facility as of 4/30/19. As such, the demonstrating impact narrative is pursuant only to the period from January 1, 2019 to April 30, 2019.Priority 1: ObesityTo promote health and wellness in the community, Sanford Rock Rapids worked on several strategies including promoting fitness center utilization and programs focusing on weight management. Our wellness committee promoted walking competitions and conducted lunch-and-learn events for employees to enhance physical and mental health. Additionally, our staff participated in the Glynlyon Health Fair and the Home & Farm show to take blood pressures, promote our wellness services, offer care and referrals, and share information about the wellness center. Priority 2: Chronic DiseaseOur initiative around improved community health focused on decreasing chronic health conditions. Strategies implemented include offering RN care management services to assist with education, care coordination, and resources. We also help patients in need of financial assistance with filling out the required paperwork; this keeps them coming in to see their provider regularly to talk about their chronic diseases, which ultimately enhances outcomes. Sanford Rock Rapids also offers monthly education and data sharing for our providers and nurses related to how well they care for our patients with diabetes, high BMI, and depression.We participated in several community partnership efforts including:Collaborate with Atlas to provide needed resources for food, housing, utilitiesCollaborate with Safenet RX to provide free medications to patients with limited incomes, high insurance copays, or no insuranceCollaborate with Lewis drug to offer cash paying patients less expensive medication for chronic disease by discounting with their primary pharmacistFinally, in light of the strong connection between physical and mental health, our staff met with public health, school nurses, and Area 4 to promote the availability of psychiatry and psychology services with Dr. Eggers and Dr. Daniels through telemedicine at our clinic.Identified needs not directly addressed by this facility include:Economics - Presence of food insecurityChildren and Youth - Use of seat belts and car seats for childrenHealth Care - Cost of affordable dental insurance, access to affordable health careMental Health and Substance Abuse - Presence of anxiety, depression and binge drinkingSanford will not directly develop strategy to address the unmet needs. 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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Hillsboro has made transportation a significant priority and has developed a strategy to work in collaboration with city and county leadership and the department of human services to explore options for the local community and county members.Addressing of Significant Needs during Current YearPriority 1: Mental Health Services We are using the PHQ-9 patient health questionnaire on initial and certain follow-up appointments and appropriate patients to ensure that we are able to identify and treat those in need of mental health services. Also, our panel management team is completing follow-up for new depression diagnosis. We have seen an increase in our local patient population and with the use of the PHQ-9 tool, expect that we will see a positive movement in depression management outcomes.Both Sanford Mayville and Sanford Hillsboro have implemented IHT (integrated health therapist) into the Clinics, mostly by tele-health. 1-3 patients per day are being seen by telehealth from each Clinic. Patients and Providers feel it is going well and it is used quite frequently. Sanford Hillsboro has contracted Senior Life Solutions to bring their outpatient group geriatric psych service to Traill County. Priority 2: TransportationBoth Sanford Hillsboro and Sanford Mayville worked with Traill County to provide public directory of transportation options. The directory is now available throughout the county.We worked with the City of Hillsboro as they submitted a grant to secure an autonomous bus to transport people throughout Hillsboro. The county does have a bus/van available for use.Go Live for Senior Life Solutions outpatient group therapy program is Summer of 2020 with an estimated 4-10 patients per day by end of 2020 year.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, and employment optionsAging - Cost of long term care and memory care, availability of resources for family and friends caring for elders the cost of in-home services, cost of in-home services, and help making out a will or healthcare directiveChildren and Youth - Availability of quality childcare, childhood obesity, cost of quality childcare, the availability of services for at-risk youth, bullying, substance abuse by youth, cost of activities, cost of services for at-risk youth, opportunities for youth-adult mentoring, and teen tobaccos useSafety - Culture of excessive drinking, and abuse of prescription drugsHealth Care - Access to affordable health insurance, access to affordable healthcare, access to affordable prescription drugs, access to affordable dental insurance, and access to affordable vision insurance Sanford will not develop strategy to address the cost of long term care and 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 the culture of excessive drinking, and abuse of prescription 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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford 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: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Mayville has made transportation a significant priority and has developed a strategy to work in collaboration with city and county leadership and the department of human services to explore options for the local community and county members. Addressing of Significant Needs during Current YearPriority 1: Mental Health Services We are using the PHQ-9 patient health questionnaire on initial and certain follow-up appointments and appropriate patients to ensure that we are able to identify and treat those in need of mental health services. Also, our panel management team is completing follow-up for new depression diagnosis. We have seen an increase in our local patient population and with the use of the PHQ-9 tool, expect that we will see a positive movement in depression management outcomes.Both Sanford Mayville and Sanford Hillsboro have implemented IHT (integrated health therapist) into the Clinics, mostly by tele-health. 1-3 patients per day are being seen by telehealth from each Clinic. Patients and Providers feel it is going well and it is used quite frequently. Sanford Hillsboro has contracted Senior Life Solutions to bring their outpatient group geriatric psych service to Traill County. Priority 2: TransportationBoth Sanford Hillsboro and Sanford Mayville worked with Traill County to provide public directory of transportation options. The directory is now available throughout the county.We worked with the City of Hillsboro as they submitted a grant to secure an autonomous bus to transport people throughout Hillsboro. The county does have a bus/van available for use.Go Live for Senior Life Solutions outpatient group therapy program is Summer of 2020 with an estimated 4-10 patients per day by end of 2020 year.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, and employment optionsAging - Cost of long term care and memory care, availability of resources for family and friends caring for elders, cost of in-home services, and help making out a will or healthcare directiveChildren and Youth - Bullying, availability and cost of quality childcare, childhood obesity, cost of activities for children and youth, availability and cost of services for at-risk youth, substance abuse by youth, opportunities for youth-adult mentoring, and teen tobacco useSafety - Concerned about the culture of excessive drinking, and abuse of prescription drugsHealth Care - Access to affordable health insurance, cost of affordable vision insurance, access to affordable prescription drugs, cost of affordable dental insurance coverage, and access to affordable healthcareSanford will not directly develop strategy to address the cost of long term care and 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. 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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Aging ServicesAccording to the Administration for Community Living, families are the major provider of long-term care for older adults and people with disabilities in the U.S. Research indicates that caregiving also exacts a significant emotional, physical, and financial toll. With nearly half of all caregivers older than age 50, many are vulnerable to a decline in their own health. Studies have shown that coordinated support services can reduce caregiver depression, anxiety, and stress, and enable them to provide care longer, which avoids or delays the need for costly institutional care.Sanford has made the aging population a significant priority and has developed strategies to support caregivers through community services. The creation of collaborative partners will provide the necessary support to make a positive impact on caregivers and to provide the tools to support their work.Addressing of Significant Needs during Current YearPriority 1: Mental HealthAs need continues to increase, we aim to ensure that access to mental health services are available for the community of Webster. We will achieve this through improved access for mental health specialty care, psychiatry outreach services, and the Bridging Health and Home program. Bridging Health and Home is offered to support older adults in our rural areas. Bridging Health and Home services are free for adults age 55 and older and offers compassion and care to those wishing to remain at home as long as possible.Sanford Webster is currently offering telehealth psychology services. Dr. Mark Daniels who is a psychologist and integrated health therapist out of Vermillion, SD has been offering his services to the community. He is seeing an average of 10 patients per month via telehealth in the clinic. Additionally, Dr. Nuss is a licensed psychiatrist and credentialed to offer services to our community. Dr. Eggers who is also a licensed psychiatrist is being utilized for telehealth services as well. Dr. Nuss and Dr. Eggers are seeing an average of 15 patients per month via telehealth at the clinic.Finally, Dr. Daniels has been involved in the interdisciplinary team to make sure we are offering a physical and mental health approach with our patients. Dr. Daniels has been involved in offering an integrated approach to metal health services for 223 patients in the Bridging Health and Home program. Priority 2: Aging PopulationSanford Webster is committed to supporting caregivers through community service providers. We have collaborated with our local caregiver support group to offer resources and education. Vanessa Bloom and Lori Reetz have been actively involved with providing these resources. In 2019, supportive services were offered to 59 local caregivers. Our staff has also started the Better Balance program to prevent falls in the community. Kyle Hubsch led the first sessions to get the program underway. Now, the program is facilitated by community volunteers, with Sanford Webster coordinating the locations and volunteer schedule. In 2019, approximately 300 local residents have participated in Better Balance training.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, need to maintain energy efficient homes, household budgeting and money management skills, and skilled labor forceChildren and Youth - Bullying, availability of activities for children and youth, childhood obesity, substance abuse by youth, availability and cost of services for at-risk youth, opportunities for adult-youth mentoring, teen tobacco use, and education about birth controlSafety - Presence of street drugs, culture of excessive drinking, presence of drug dealers, abuse of prescription drugs, domestic violence, crime, and child abuse and neglectHealth Care - Access to affordable health insurance, access to affordable vision insurance, access to affordable health care, and access to affordable prescription drugs
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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 Health Mental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and depression. All patients in the primary care setting will have a Patient Health Questionnaire (PHQ-9) completed at each visit. The PHQ-9 is an assessment tool used for screening, diagnosing, measuring, and monitoring the severity of depression. Patients are evaluated to determine if there is a need to provide additional services. Sanford is providing on-site mental health services and has implemented telehealth services to improve access to psychiatry services. Priority 2: Economic Well BeingFood security means access by all people at all times to enough food for an active, healthy life. Food insecurity describes a household's inability to provide enough food for every person to live an active, healthy life. According to United States Department of Agriculture, an estimated 12.3 percent of American households were food insecure at least some time during the year in 2016, meaning they lacked access to enough food for an active, healthy life for all household members. That is essentially unchanged from 12.7 percent in 2015. The prevalence of very low food security also essentially unchanged, at 4.9 percent in 2016 and 5.0 percent in 2015. Sanford has made economic well-being specific to food security a significant priority and has developed a strategic plan to sustain the backpack program and food distribution for students in the community.Addressing of Significant Needs during the Current YearPriority 1: Mental HealthImproved PHQ patient health questionnaire scores in 2018 starting with a score of 2.3% ending with a score of 9.3% and continuation of improvement through 2019. January 2019 started with 12.9% and ended with 16.1%. The enterprise goal for depression score is 11%. The panel specialist and RN health coach review the charts and complete follow up to ensure these are being met when able.All patients that are currently under the care of the telehealth psychiatrist receive a PHQ 9 on each visit. The remainder of patients are screened when deemed necessary by the provider, after med changes and to fall into the measured goal need to be done at 4-6 month and 11-13 months. The RN health coach helps patients in navigating the system, assisting with referrals, appointments and follow up.We have added a psychologist and additional psychiatrist, so access is no longer much of an issue. This is a large population of non-compliant patients that don't always present to their appointments.We have improved access and encourage patients to keep appointments. Priority 2: Economic Well-BeingOur Backpack Program is sustained with the partnership between Sanford Wheaton, Bethlehem Covenant, North Country food bank and Wheaton area schools.We currently have 43 children signed up receiving and 4 pounds bag of snacks and entrees every other week.We also collect food for the local food bank. In 2019, 40 pounds of food has been collected during the year for local food bank.Identified needs not directly addressed by this facility include:Children and Youth - opportunities for youth-adult mentoring, bullying, availability of activities for children and youth, childhood obesity, and teen tobacco use Aging - Cost of long term care, availability of memory care, cost of in-home services, and the availability of activities for seniors.Safety - Abuse of prescription drugs, presence of drug dealers and street drugs, child abuse and neglect, crime, culture of excessive and binge drinking, and domestic violenceHealth Care - Access to affordable health insurance coverage, availability of mental health and substance abuse providers, access to affordable health care, availability of specialist physicians, access to affordable prescription drugs, use of emergency room services for primary health care, access to affordable vision insurance coverage, availability of doctors, physician assistants or nurse practitioners, and availability of non-traditional hours.
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthAccording the U.S. Department of Drug Enforcement Administration (DEA), nationally almost 20 percent of students surveyed admit to using marijuana at least once during the last 30 days, and 13 percent of students surveyed admitted driving when they used marijuana within the last 30 days.Researchers have identified risk factors that can increase a person's chances for misuse, and protective factors that can reduce the risk. However, many people with risk factors do not abuse substances. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Youth may also be more likely to try drugs because of circumstances or events called risk factors. Examples of risk factors include: Poor grades in school Engaging in alcohol or drug use at a young age Friends and peers who engage in alcohol or drug use Persistent, progressive, and generalized substance use, misuse, and use disorders by family members Conflict between parents or between parents and children, including abuse or neglect BullyingProtective factors include:Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford Health Bagley has made children and youth a significant priority and has developed strategies to expand education for healthy lifestyle choices, provide opportunities for local employment and careers, and provide outreach for teen and adolescent behavioral health services.Addressing of Significant Needs during Current YearPriority 1: Mental Health and Substance AbuseAs Identified on our community needs assessment, Mental Health care is a gap in our community that we have addressed. We selected a current Family Medicine Nurse Practitioner and sent them back to school for Psychiatric Nurse Practitioner Certification. This allows us to have an expert in Psychiatric Medication Management in our local community. The Psychiatric Nurse Practitioner is done with his clinical rotations and is now able to see Psychiatric patients. The Psychiatric Nurse Practitioner has both family medicine and psychiatric certification, so they are now able to see patients for both medical concerns and mental health concerns. In addition to providing this service to the Bagley Community, we are having this individual do outreach to Walker, Park Rapids, Blackduck, and Cass Lake regional clinics to provide the same service to the other rural communities in our area. Pharma providers are now using Sanford Prescribing algorithms for opioid prescribing. This allows for a standard approach to opioid prescribing to patients - eliminating the patient trying different doctors to get different answers. Contracts are being used with patients as part of the opioid prescription process, having the patient and provider sign an agreement on how to safely utilize the prescribed medication. In the event we feel a provider is prescribing opioids outside of the guidelines we can audit each providers prescriptions.Crisis services are reporting in person for crisis visits. The crisis services team is a group out of Sanford Bemidji that can assist our providers in the event they have a patient in the middle of a mental health crisis. The crisis team can help determine the most appropriate next service. For example: a patient comes into the Emergency Department saying they are suicidal. Our provider can have the crisis team help determine next steps - inpatient vs. outpatient vs. other treatment. Priority 2: Children and YouthWe are making volunteer opportunities available to Bagley High School students and have participated in regional "Career Fairs" at high schools. SHNM has hired a teen/adolescence psychiatric nurse practitioner and a full-time licensed psychologist was hired and onboarded in September 2019. Sanford Bagley continues to be involved in community events, including health fairs. An RN health coach is available to the public for patient educationIdentified needs not directly addressed by this facility include:Economics - Availability of affordable housing, concern for homelessness, food insecurity, and a need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic abuseAging - Cost of long term care, and availability of memory careSafety - Child abuse and neglect, crime, presence of street drugs, abuse of prescription drugs, presence of drug dealers, and domestic violenceHealth Care - Use of emergency services for primary care, and access to mental health/behavioral health providers
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: Economic Well-Being - Affordable HousingResources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Priority 2: Behavioral Health and Mental Health Access - Substance Abuse by YouthMental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearPriority 1: Economic Well-Being - Availability of Affordable HousingThe Canton area is in need of more affordable housing units to increase the well-being of community members. Sanford Canton-Inwood Medical Center (SCIMC) is collaborating with the Canton Economic Development Committee to expand options for local residents. The Senior Director of SCIMC is also the Board President of the Canton Economic Development Committee (CEDC), and this strategy is a priority for the committee. To date the CEDC has provided a grant to Canton Housing for $8,000. They are also applying with the State to develop a 15-unit building for low-income housing.CEDC has also updated their Housing Study, which indicated the need for additional affordable housing. CEDC entered into an agreement with ISG out of Sioux Falls, SD who created a housing development project on two different land options. CEDC is currently exploring a TIF within the county to help develop the infrastructure that will attract contractors to assist in development of this housing project, including affordable housing units. Outcomes completed to date include a housing plan and completed housing development drawing to be utilized for presentations and requesting TIF funds for infrastructure.Priority 2: Behavioral Health and Mental Health Access - Youth Substance Abuse The Sanford Canton-Inwood Medical Center staff aims to raise awareness of drug use impact to help reduce substance abuse by area youth. Working in conjunction with local law enforcement, schools, and treatment facilities, SCIMC offers various educational and screening opportunities for the community and our staff. In 2019, we facilitated presentations by Sanford Health in Canton on Behavioral Health and Suicide to 16 of our staff, including providers.Additionally, Cari Folkens, CNP, participated in a Vaping Education Webinar on December 16, 2019 and will provide an update to our providers and staff. Cari was also a guest speaker along with the School Counselors regarding substance abuse, particularly as it relates to Vaping. SCIMC held a screening day at the hospital on October 1, 2019. We had a booth on the dangers of vaping as well as different vaping devices that are used and a description of how vaping affects the body. Approximately 30-50 people attended the event.Identified needs not directly addressed by this facility include:Economic - Employment options, a skilled labor force, household budgeting and money management, and maintaining livable and energy efficient homesTransportation - Availability of good walking or biking options, and driving habits related to speed and road rageAging - Cost of long term care and memory care, cost of in-home services, availability of memory care, availability of resources to help the elderly stay safe in their homes, and availability of resources for caregiversSafety - Abuse of prescription drugs in the community, presence of drug dealers in the communityHealth Care - Access to affordable health insurance, access to affordable vision insurance, availability of health care services for Native American people, access to affordable dental insurance, availability of non-traditional hours, availability of prevention programs, and availability of specialist physicians Children and Youth - Cost and availability of activities for children, cost and availability of quality childcare, cost and availability of services for at-risk youth, bullying, childhood obesity, teen tobacco use, teen suicide, and opportunities for youth mentoringMental Health and Substance Abuse - Depression, stress, dementia and Alzheimer's disease, drug use and abuse, smoking and tobacco use, alcohol use and abuse, and exposure to second hand smoke
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Clear Lake has made transportation a significant priority and has developed a strategy to work in collaboration with community organizations to explore options for the local community and county members. Priority 2: Physical HealthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Clear Lake has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Addressing of Significant Needs during Current YearPriority 1: TransportationThrough enhanced availability of transportation options for community members, Sanford Clear Lake Medical Center (SCLMC) aims to address an existing access gap. Some patients are unable to keep appointments due to lack of personal transportation. While working to build a list of volunteer drivers in our community, we learned of a transit service that was looking to expand services to Deuel County. We received an invitation to complete a stakeholder survey and participated in a stakeholder meeting on July 11, 2019. Stakeholders at this meeting included community members, local business owners, and two of our Sanford Clear Lake staff. Stakeholders proposed that a community survey be conducted in our county to determine viability of a transit service. A survey was developed and circulated in the fall of 2019 via social media and newsprint. Surveys were available at area businesses as well. SCLMC also served as a collection site for the surveys. Paper surveys collected at our facility were entered into the online survey site by Sanford Clear Lake staff. The transit company has analyzed all survey data, and the next step will be a public meeting in the spring of 2020. The agenda will include a proposed plan, hours of operation, days of operation, the public survey and breaking down the wants and needs, developing a rough draft of a budget and more. A rough draft budget was created based on a project of similar size and operating details. In February 2014, Sanford Clear Lake staff and community stakeholders were introduced to a program sponsored by Wellmark. "Healthy Hometown" is a program that assists communities in implementing changes that promote healthy living by focusing on three areas - move more, eat well, and feel better. A component of this program analyzes walkability in the community and assists in facilitating people and resources in order to improve walkability. Healthy Hometown committee members meet routinely and report progress on individual projects/goals. A walking audit is scheduled for spring 2020.Priority 2: Physical Health Sanford Clear Lake Medical Center is committed to improving the physical health of the Clear Lake community with a particular focus on reducing negative health effects from obesity. Our wellness center sponsored a weight loss challenge in spring 2019. Teams reported initial weights and reported weight loss progress on a weekly basis. At the close of the challenge, teams reported final weights and were able to win prizes based on ranking of percentage of weight lost. Seven two-person teams participated in the weight loss challenge. Approximately 166lbs were lost, with the winning team losing 23.5% of their initial weight. In summer 2019, the wellness center underwent a significant facelift that aided in modernizing the facility. The facility also enrolled in the Silver Sneakers program allowing Medicare-aged seniors in our community access to the facility at no cost to them. In 2019, 13 members enrolled in Silver Sneakers.SCLMC staff and community stakeholders were introduced to a program sponsored by Wellmark. "Healthy Hometown" is a program that assists communities in implementing changes that promote healthy living by focusing on three areas - move more, eat well, and feel better. A component of this program provides tools and resources necessary to implement healthy options at concession stands in the community and improve access to drinking water in the community. Sanford Clear Lake staff continue to attend routinely scheduled meetings working towards improving the health of the community. Sanford Clear Lake provides meeting space for this project. In Fall/Winter 2019, our staff met with Deuel School administration to propose the addition of healthy items to concession stand offerings at Deuel athletic sporting events. Fresh fruit, string cheese, veggie straws, and trail mix were healthier options added to concessions at Deuel School. The CHNA planning team meets monthly and reviews sponsorship requests for community events. 1n 2019, approximately $2,300 was donated to events and organizations including a Good Samaritan Society Fun Run/Walk, Clear Lake Baseball Association, New Hope Walk for Cancer to name a few. Identified needs not directly addressed by this facility include:Economic Well-Being - Employment options, skilled labor force, availability of affordable housing and the need for budgeting and money management.Children and Youth - Childhood obesity and bullying Aging - Cost of long term care, availability of resources and cost of services to help the elderly stay in the homes, availability of activities for seniors, and availability and cost of memory careSafety - Abuse of prescription drugsHealth Care - Access to affordable health insurance, access to affordable health care, and availability of behavioral and mental health providersMental Health and Substance Abuse - Depression, stress and tobacco use
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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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 Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford 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: WellnessAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Westbrook has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Mental Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPriority 1: WellnessSanford Westbrook aims to help our community improve physical and chronic health as well as general wellness. To do so, we are leveraging dietician and RN Health Coach services, the Sanford fit program, and community education opportunities. Dietician and health coach services - these continued to be offered/referred as needed. Dietician services are now available via telemedicine, making access quicker and easier. Dietician use five on-site visits (up from two in 2018) and no telemed visits in 2019. Our RN Health Coach had 125 visits in 2019.Community education - staff attended local HS basketball games in February 2019 to share heart health information with the community. A free diabetes lunch-and-learn event was held for community members in June 2019. We also work with A.C.E. to provide a Bone Builders class two times a week and a Matter of Balance class periodically for area seniors at Peterson Estates (senior living facility attached to Sanford Westbrook).-Heart Health event - shared heart healthy information with over 30 people at booth.-Diabetes Lunch & Learn - 20 community members in attendance.Sanford fit program - staff continued the Sanford fit program, which focuses on healthy lifestyle choices to prevent childhood obesity, from January 2019 - May 2019. They also shared Sanford fit online resources with local school administration and teachers. Local 4th grade students took a pre-test on the first day of fitClub and a post-test on the final day. Students increased their test scores by more than 25% from the pre-test to the post-test.Priority 2: Mental Health and Substance AbuseThis initiative focuses on enhanced access and awareness of community resources for mental health and substance abuse. This includes working with community partners to create new and promote current recovery program options, promoting telemedicine options for behavioral health, and providing community education. Awareness of mental health telemedicine services and local behavioral health providers began with development of marketing and social media campaigns in 2019. Referrals for behavioral health providers continued in 2019. Primary care providers were reminded of services available on site at their regular provider meetings. A total of 619 patients were seen by our behavioral health providers in calendar year 2019. Identified needs not directly addressed by this facility include:Economic Well-Being - Need for employment options, household budgeting, money management and the availability of a skilled labor force Transportation - Availability of public transportationChildren and Youth - Availability and cost of quality childcare, childhood obesity, and teen tobacco useAging - Cost of long term care, and cost of memory careSafety - Abuse of prescription drugs Health Care - Access to affordable health insurance and access to affordable health care
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 Building
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 not exceed its financial assistance budget for CY 2019, however, if they would have exceeded their budget it would not impact their ability to serve any patients and no patients would be disallowed services. The organization provided free or discounted services to patients who were eligible for free or discounted care.Part I, Line 6: Sanford Health's Community Benefit Annual Report is posted annually on the Sanford website at:http://www.sanfordhealth.org/about/community-benefit
Part I, Line 7: Cost to Charge Ratios are used to calculate the amounts on Line 7a - 7c (Financial Assistance, Medicaid Shortfall, and Other Means-Tested Government Programs) and also Line 7g (Subsidized Health Services) for each of the subsidiaries included in the return. All other amounts for Lines 7e, 7f, 7h and 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio, or similar cost accounting methodology. These costs still represent the costs to provide benefits.
Part I, Line 7g: Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. 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 CY 2019, subsidized health services provided through clinic physician practices generated losses of $86,596,523.
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 $349,905,908. 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 (CHNA) during 2018 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 2018 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 in North Dakota and Clay County in 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 economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. 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 2019-2021. 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 responses 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. Alternate languages were included on the signage that basically stated, if you need interpreter services, please inquire at the registration desk. Financial Assistance applications were available in English, Spanish, Chinese, German, Hindi, Korean, Laotian and Vietnamese upon request or on the Sanford website. All healthcare workers who identify patients with financial need are encouraged to provide patients or their designees a financial application. This may include, but not be limited to the following areas: Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial Counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services.Sanford'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 25 hospitals and nearly 448 clinics in 158 locations in nine states and three countries. Sanford Health's approximately 34,000 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 2019 U.S. Census Bureau estimates a total population of 183,793 for Sioux Falls. According to the 2019 County Health Rankings, the population of Minnehaha County is 82.8% white, 5.6% African American, 2.8% American Indian, 2.2% Asian and 4.8% 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 $61,200.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 2019 United States Census estimates the population of Fargo was 124,662. According to the 2019 County Health Rankings, the population of Cass County is 85.4% white, 5.6% African American, 1.4% American Indian, 3.3% Asian and 2.7% Hispanic. Only 1% of the population is reported to be not proficient in English. The median household income is $64,400. 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 2019 United States Census estimates, the population of Bemidji is 15,434. According to the 2019 County Health Rankings, the population of Beltrami County is 72.2% white, 0.7% African American, 21.9% American Indian, 0.7% Asian and 2.3% Hispanic. 0% of the population is reported to be not proficient in English. The median household Income is $47,300.Sanford Bismarck Medical Center - Bismarck, North DakotaBismarck is a city located in Burleigh County in central North Dakota. Bismarck is experiencing fast-paced growth as a direct result of oil development throughout the western part of the state. Bismarck is the state capital and is the second largest city in the state of North Dakota with an estimated population of 73,529. According to the 2018 County Health Rankings, the population of Burleigh County is 88.9% white, 2.2% African American, 4.1% American Indian, 0.8% Asian and 2.6% Hispanic. 0% of the population is reported to be not proficient in English. The median household income is $70,100.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 12 members at the end of the calendar year, including 8 volunteer community members, 3 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 25 hospitals and nearly 450 clinics in nine states and three countries. Sanford Health's 34,000 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 SYSTEM
1400 N Dakota Street
Aberdeen,SD57401
46-0334005 501(c)(3) 26,450       Capital Campaign for Revitalizing Roncalli High School to include building renovations with a new geothermal heating and cooling system, new windows new spinkler and fire alarm system, new lights and ceilings, adding new boys & girls bathrooms to each wing and new faculty bathrooms; new carpeting in m ost classrooms and upgraded central offices.
(2) ABERDEEN FAMILY YMCA
5 South State Street
Aberdeen,SD57401
46-0255779 501(c)(3) 15,200       Capital Campaign for their Youth Development Center
(3) ABERDEEN PUBLIC SCHOOLS FOUNDATION
1224 3rd St South
Aberdeen,SD57401
46-0423109 501(c)(3) 40,625       Foundation donation contribution $20k; Scholarship fund contribution $10k; Student activity contribution $10k
(4) ABERDEEN SCHOOL DISTRICT
1224 3rd St South
Aberdeen,SD57401
46-6000912 115 6,000       Donations toward support of sports events at the Aberdeen School District via scoreboard contract
(5) ACTIVE GENERATIONS
2300 W 46th St
Sioux Falls,SD57105
46-0305500 501(c)(3) 15,200       Rich Greeno Memorial Fund $10k; Lunar Fest $1k; Volunteer Banquet $1k; Gourmet Guys fundraiser $3,200
(6) ALEXANDER MITCHELL PUBLIC LIBRARY
519 S Kline Street
Aberdeen,SD57401
46-0428183 501(c)(3) 10,000       Library Foundation Building Fund / Payment 4 of 5 of commitment
(7) ALEXANDRIA SCHOOLS
1410 South McKay Ave
Alexandria,MN56308
41-6000893 115 8,000       CAN Course Donation, Scholarship donations
(8) ALL STARS BOOSTER CLUB
3009 S Phillips Ave
Sioux Falls,SD57105
36-3897227 501(c)(3) 13,000       Donation toward the state gymnastics meet &10k; Yearly booster club donation payment #4 of #4
(9) ALLIANCE FOR CELL THERAPY NOW
611 Pennsylvania Ave SE 267
Washington,DC20003
47-5183080 501(c)(6) 88,000       Donation to advance national cell therapy registry
(10) ALZHEIMERS ASSOCIATION
225 N Michigan Ave 17th Floor
Chicago,IL606017633
13-3039601 501(c)(3) 8,500       Walk to End Alzheimer's
(11) AMERICAN CANCER SOCIETY
4904 S Technopolis Dr
Sioux Falls,SD57106
41-0724036 501(c)(3) 557,500       Coaches vs Cancer (pymt 2 of 5) $500k; and Relay for Life & Gala events in Sioux Falls and Fargo
(12) AMERICAN FOUNDATION FOR SUICIDE PREVENTION
120 Wall Street FL 29
New York,NY10005
13-3393329 501(c)(3) 11,000       Out of Darkness Walk
(13) AMERICAN GOLD GYMNASTICS INC
2001 17th Avenue South
Fargo,ND58103
45-0333196 501(c)(3) 40,000       Annual donation pledge for support and sports medicine
(14) AMERICAN HEART ASSOCIATION INC
7272 Greenville Ave
Dallas,TX75231
13-5613797 501(c)(3) 122,000       Go Red For Women Event and walks in the following areas: Sioux Falls, Fargo, Detroit Lakes and Bismarck.
(15) ARTHRITIS FOUNDATION
PO Box 1208
Fargo,ND58107
39-0860526 501(c)(3) 29,000       Jingle Bell Run, Zombie Run, and Family Fun Events
(16) AUGUSTANA UNIVERSITY
2001 S Summit Ave
Sioux Falls,SD57197
46-0224588 501(c)(3) 2,024,809       Horizon 2030 Gift; General Support; Scholarships; PS Professorship
(17) BEMIDJI AREA SCHOOLS
502 Minnesota Ave
Bemidji,MN56619
41-6000181 115 75,000       Angel Fund Donation
(18) BEMIDJI BLUE OX MARATHON
PO Box 633
Bemidji,MN56619
46-1700357 501(c)(3) 15,000       General Support
(19) BEMIDJI JAYCEES
PO Box 293
Bemidji,MN56619
41-1383120 501(c)(4) 5,500       General Support
(20) BEMIDJI STATE UNIVERSITY
1500 Birchmont Drive NE
Bemidji,MN56601
41-1687554 115 77,500       General Support
(21) BIO GIRLS
556 Lizzie Place East
West Fargo,ND58078
81-0792142 501(c)(3) 10,931       Donation to self-esteem programming for girls 7-12
(22) BISHOP O'GORMAN CATHOLIC SCHOOL
3100 W 41st St
Sioux Falls,SD571054222
46-0413591 501(c)(3) 6,250       Donation to Teacher's Salary Inititive, Dakota Bowl and Charity Tournament
(23) BISMARCK CANCER CENTER
500 N 8th Street
Bismarck,ND58501
45-0454363 501(c)(3) 8,500       General Support
(24) BISMARCK EVENT CENTER
315 S 5th St
Bismarck,ND58504
45-6002036 115 6,322       Sanford Classic-venue rental fee host ESBC Clasic basketball games
(25) BISMARCK LARKS BASEBALL TEAM
300 N 4th StSuite 103
Bismarck,ND58501
81-3163412   36,026       2019 Sponsorship in relation to Sports Med coverage contract
(26) BISMARCK PARKS & REC DISTRICT
400 E Front Ave
Bismarck,ND58504
45-0409352 501(c)(3) 10,250       Schaumberg Ice Expansion $10k; $250 Babe Ruth World Series Donation
(27) BISMARCK PUBLIC SCHOOLS
806 N Washington St
Bismarck,ND58501
45-0442960 501(c)(3) 117,654       Sports Complex, Academic Donation and Athletics Donations
(28) BISMARCK STATE COLLEGE
PO Box 5587
Bismarck,ND58506
45-0343498 115 94,022       BSC Med Lab Tech Program Coordinator
(29) BISMARCK STATE COLLEGE FOUNDATION
PO Box 5587
Bismarck,ND585065587
45-0358929 501(c)(3) 20,000       BSC Mystics Scoreboards Project
(30) BISMARCK YOUTH BASEBALL INCORPORATED
PO Box 176
Bismarck,ND58501
45-0420820 501(c)(3) 6,000       Pebble Creek Recreation Area -Permanent Field Naming Rights
(31) BLACK HILLS STATE UNIVERSITY FOUNDATION
1200 University St Unit 9506
Spearfish,SD57799
23-7428348 501(c)(3) 6,000       Legends Grant $5k; Women's Business Conference $1k
(32) BOYS & GIRLS CLUB
824 E 14th St
Sioux Falls,SD57104
46-0399482 501(c)(3) 64,200       Winter Carnival Fundraising Event, General Campaign Pledge, Ice Rink and Stem Room Donation $15k
(33) BRANDON VALLEY BASEBALL ASSOC
PO Box 605
Brandon,SD57005
46-0401362 501(c)(3) 27,500       Field of Dreams Project
(34) BRANDON VALLEY BOOSTER CLUB
PO Box 572
Brandon,SD57005
46-6002577 501(c)(6) 50,500       Scoreboards $10,500; Video board donation $40k
(35) BRANDON VALLEY SCHOOL
PO Box 572
Brandon,SD57005
46-6002577 501(c)(6) 26,625       Academics & athletics, Power Program, OSM logo wear and State Championship donations
(36) BROOKINGS HEALTH SYSTEM FOUNDATION
300 22nd Ave
Brookings,SD57006
27-1785343 501(c)(3) 20,750       Progress Lives Here capital campaign donation $20k; Aiming to Inspire Health fundraising event $750
(37) CANTON SCHOOLS
800 N Main Street
Canton,SD57103
46-6002143 115 16,655       Strength Coach, Training Rights & Concussion Screening license donation $10,665; C-Hawk Advantage Scholarships $6k
(38) CAPITAL VOLLEYBALL CLUB
607 Weyburn Dr
Bismarck,ND58503
81-1302972 501(c)(3) 7,500       2019-2020 CVC Season Donation
(39) CARSON WENTZ A01 FOUNDATION
2605 Nicholson Road Suite 5140
Sewickley,PA15143
04-3367888 501(c)(3) 15,332       Foundation donation contribution
(40) CENTURY HIGH SCHOOL
1000 E Century Ave
Bismarck,ND58503
47-3905804 115 6,885       Athletic Seating - Sideline Chairs
(41) CHAD GREENWAY FOUNDATION
59 Cavalier Blvd Suite 310
Florence,KY41042
26-1782419 501(c)(3) 20,000       Foundation donation contribution
(42) CHAMBER OF COMMERCE ABERDEEN AREA
516 S Main St PO Box 1179
Aberdeen,SD574021179
46-0103710 501(c)(6) 7,600       Big Idea Competition fundraiser $6,500; Day of Distinction event donation $500; Night in a Car for a Journey event donation $500; New faculty luncheon donation $100;
(43) CHAMBER OF COMMERCE FMWF
PO Box 2443
Fargo,ND58108
45-0448041 501(c)(6) 181,120       Donation to various programs put on by the chamber for the community including Eggs & Issues, Women Connects, Voices of Vision, etc.
(44) CHAMBER OF COMMERCE SIOUX FALLS
200 N Phillips Ave Suite 200
Sioux Falls,SD571046058
46-0189300 501(c)(6) 15,480       YPN Crossroads Summit donation $10k; DC Fly In event donation $1,500; Mayors Roundup donation $2,180; Day at the Legislature $1,200; SE Livestock event donation $350; Ag Appreciation $250;
(45) CHAMBER OF COMMERCE VERMILLION
2 East Main Street Suite 101
Vermillion,SD57069
46-0284795 501(c)(6) 15,000       Vermillion Chamber NOW! Fundraising event $15k
(46) CHARIS MINISTRY PARTNERS
5509 S 41st Street
Sioux Falls,SD57106
23-7003936 501(c)(6) 7,000       Health Rides Ministry - providing rides to health related appts at no cost $7k
(47) CHILDREN OF THE NATIONS
PO Box 3970
Silverdale,WA98383
91-1702551 501(c)(6) 12,000       Medical Mission Trip to the Dominican Republic for medical services per Dr. Kirk Wheeler $12k
(48) CHILDRENS HOME SOCIETY
801 N Sycamore Ave
Sioux Falls,SD57110
46-0224542 501(c)(3) 32,950       Drive Out Domestic Violence fundraiser $3k; Media One Fund Ski fundraiser $4k; Sanford International gift $25k
(49) CITY OF BEMIDJI
317 4th Street NW
Bemidji,MN56601
41-6004972 115 186,047       General Support
(50) CITY OF BISMARCK
211 N 5th Street
Bismarck,ND58501
45-6002036 115 35,000       Bismarck Event Center Annual Advertising (1st of 3)
(51) CITY OF FARGO
225 4th St North
Fargo,ND58102
45-6002069 115 10,000       Annual use of Suite at Newman Outdoor Field for employee and community engagement
(52) CITY OF JACKSON
80 W Ashley Street
Jackson,MN56143
41-6005262 115 10,000       Splash Pad donation pymt 3 of 5
(53) CITY OF SHELDON
416 9th Street PO Box 276
Sheldon,IA51201
42-6005194 115 50,000       Sheldon Events Center donation pymt 3 of 5
(54) CITY OF SIOUX FALLS
224 West Ninth Street
Sioux Falls,SD571046407
46-6000425 115 50,000       General Support
(55) CITY OF WEBSTER
PO Box 539
Webster,SD57274
13-1830701 115 7,143       Webster Active Living Trail donation pymt 1 of 7
(56) COLLISION
3815 S Western Ave
Sioux Falls,SD57105
26-3765706   12,000       Donation - Youth empowering non-profit organization. Pymt 1 of 3
(57) COMMUNITY MEMORIAL HOSPITAL
PO Box 319
Burke,SD57523
46-0219795 501(c)(3) 25,000       Building Project Capital Campaign donation payment 3 of 10
(58) CONCORDIA COLLEGE
901 8th St
Moorhead,MN56560
41-0693977 501(c)(3) 892,000       Annual Contribution per donation agreements in support of various programs such as nursing and sports medicine
(59) CURA FOUNDATION
PO Box 5298
New York,NY10185
26-1150435 501(c)(3) 1,250,000       Vatican Foundation
(60) CYSTIC FIBROSIS FOUNDATION
4550 Montgomery Ave Suite 1100 N
Bethesda,MD20814
13-1830701 501(c)(3) 35,500       Support to seven events throughout the region for Cystic Fibrosis fundraisers to include Great Strides walks in Fargo, SF, Brookings, Bismarck, Rapid City; a golf tournament and Corks & Kegs event in SF. ($5,000 for each event) Battle for Brooks team in SF for $500.
(61) DAKOTA ALLIANCE SOCCER CLUB
401 W 39th Street
Sioux Falls,SD57105
46-0359817 501(c)(3) 74,750       Yearly donation of $60k; donation of black competitive jerseys $11,250; Legends grant $3500
(62) DAKOTA MEDICAL FOUNDATION
4141 28th Ave S
Fargo,ND58104
45-6012318 501(c)(3) 25,000       Donation for Recovery Reinvented - North Dakota's First lady conference in regards to addiction
(63) DAKOTA STATE UNIVERSITY
820 N Washington Ave
Madison,SD57042
46-6000364 115 519,195       Ortho Sports Med Contract
(64) DAKOTA WEST ARTS COUNCIL INC
400 E Front Ave
Bismarck,ND58504
45-0358000 501(c)(3) 15,500       Capital City Christmas $10k
(65) DETROIT LAKES PUBLIC SCHOOLS
702 Lake Ave
Detroit Lakes,MN56501
41-0971772 115 20,100       Annual Contribution per donation agreement for sports medicine program
(66) DICKINSON STATE UNIVERSITY
PO Box 19
Dickinson,ND58602
47-5378716 115 84,750       Future Projects Payment (Sports Complex) $75k; Athletic scholarship donation $6,750; Nursing Scholarship $3k
(67) DOW RUMMEL
1321 West Dow Rummel St
Sioux Falls,SD57104
46-0271277 501(c)(3) 25,000       Capital campaign fund development donation pymt 4 of 6
(68) DOWNTOWN SIOUX FALLS INC
230 S Phillips Ave Suite 306
Sioux Falls,SD57104
36-3627217 501(c)(3) 8,500       Support donation to Downtown SF $5k; Donation to Riverfest event $3,500
(69) DUNCAN REGIONAL HOSPITAL
1407 Whisenant Dr
Duncan,OK73533
20-2772056 501(c)(3) 75,000       General Support
(70) ELEVATE RAPID CITY
525 University Loop Suite 102
Rapid City,SD57701
46-0118545 501(c)(6) 50,000       General Support
(71) EMBE
300 W 11th Street
Sioux Falls,SD57104
46-0234998 501(c)(3) 15,500       Donation to events: In Her Shoes $5k; Tribute to Women $2,500; Women's Day of Service $1k; First Lego League $1,500; Let Me Run $1,500; Girls on the Run $1,500; Women's Leadership Program $2,500
(72) EMERGING PRAIRIE
4141 28th Ave S
Fargo,ND58104
20-0520386 501(c)(3) 25,000       Tedx19 donation - $15,000; Annual Partnership donation of $10,000
(73) EPILEPSY FOUNDATION OF MINNESOTA INC
1600 University Ave West 300
St Paul,MN551043800
41-0874541 501(c)(3) 5,179       SF: Walk t-shirts $179.32; FGO - $5K - Seizures Walk
(74) FAMILY ADVOCACY CNTR OF NORTH
800 Bemidji Ave N Ste 4
Bemidji,MN56601
20-2102302 501(C)(3) 19,500       General Support
(75) FAMILY FEST
PO Box 90646
Sioux Falls,SD57109
81-2254064 501(c)(3) 10,000       Yearly donation to large family and child oriented event highlighting Sanford's Children Hospital
(76) FAMILY VISITATION CENTER SF
311 E 14th Street
Sioux Falls,SD571045022
26-3654937 501(c)(3) 7,500       Yearly donation to organization that provides safe supervised visits and exchanges for children and their families
(77) FARGO AIRSHO INC
2822 27th Street South
Fargo,ND58103
45-0440151 501(c)(4) 10,000       Sanford Rest Station / Tents donation for Airsho
(78) FARGO MARATHON
405 W Main Ave No 1D
West Fargo,ND58078
43-2043293 501(c)(3) 92,500       Donation for Title Sponsorship and $5K for Edith Branded mini-marathon
(79) FARGO MOORHEAD SYMPHONY ORCHESTRA
808 3rd Ave S 300
Fargo,ND58103
45-0275135 501(c)(3) 40,000       Donation for the FM Symphony's Masterworks Concert Series
(80) FARGO PARK DISTRICT
701 Main Ave
Fargo,ND58103
45-6002070 115 5,190       Donations for Scholarship programs for those unable to pay to attend park programs
(81) FARGO SCHOOLS
415 4th St N
Fargo,ND57192
45-6012318 115 70,600       Annual Contribution per donation agreement for sports medicine progra - $60K, $10.6K - Donations to scholarships, health tech trades, lunch fund
(82) FARGO YOUTH BASEBALL
1892 17th Ave S
Fargo,ND58103
45-0370089 501(c)(3) 23,000       Donations for various Baseball teams, 10K for the Babe Ruth & 12U Little League championships, Scoreboard
(83) FARGO YOUTH HOCKEY ASSOC
831 17TH Ave N
Fargo,ND58102
36-3548649 501(c)(3) 15,000       Donation to the annual FYHA Squirt International Hockey Tournaments and Hockey night in Fargo
(84) FIRST DAKOTA NATIONAL BANK
101 N Main Ave Suite 201
Sioux Falls,SD57104
46-0208038 N/A 50,000       Donation to fundraising event for children nonprofit organizations
(85) FIRST TEE OF SOUTH DAKOTA
4809 W 41st St Suite 202
Sioux Falls,SD57106
46-0449824 501(c)(3) 50,000       Yearly donation $30k; Golf fundraising event $5k; Sanford International donation $15k
(86) FIRSTLINK
4357 13th Ave S 107L
Fargo,ND581070047
45-0419491 501(c)(3) 26,000       $25K donation to Community Addiction Navigator program, $1K - Annual Breakfast/Giving Tree
(87) F-M REDHAWKS
1515 15th Avenue North
Fargo,ND58102
41-1820982   23,270       Donation for Training Room upgrades at Newman Outdoor field
(88) FOLDS OF HONOR KANSAS CITY INC
PO Box 8246
Prairie Village,KS662080246
45-2803323 501(c)(3) 30,000       Legends Grant
(89) FORWARD SIOUX FALLS
PO Box 907
Sioux Falls,SD57101
46-0396647 501(c)(6) 350,000       Yearly donation support for SF business development
(90) FRIENDS OF LEVITT SHELL SF
200 N Cherapa Place
Sioux Falls,SD57103
61-1699910 501(c)(3) 62,000       AKA: Levitt at the Falls - Inaugural donation $50k; Chamber Appeals donation $12k
(91) GIRL SCOUTS
1101 S Marion Road
Sioux Falls,SD57106
46-0250744 501(c)(3) 12,500       Yearly donation to cover several fundraising events: Cookies Corks & Brew $1k; Amplify your Adventure $5k; S'more Brews Please $1k; The BIG Event $5k
(92) GLOBAL HEALTH CORPS INC
1 Penn Plaza Suite 6271
New York,NY10119
80-0512336 501(c)(3) 1,000,000       General Support
(93) GOV OFFICE OF ECON DEVELOP SD
711 E Wells Ave
Pierre,SD57501
46-6000364 115 15,000       Yearly donation support for the Governor's Office fundraising which include the Buffalo Roundup and Pheasant Hunt events
(94) ND DEPARTMENT OF HUMAN SERVICES
600 E Blvd Ave Dept 325
Bismarck,ND58505
45-0309764 115 9,438       Governor's Summit on Behavorial Health
(95) GRAY ACADEMY
5757 W Century Blvd Ste 410
Los Angeles,CA90045
83-1590154 501(c)(3) 25,000       Donation to cure Batten Disease
(96) GREAT BEAR RECREATION
2401 W 49th St
Sioux Falls,SD57105
46-0417880   7,740       Donation in purchasing 200 rental ski/snowboard helmets $6,240; Donation to purchase medical supplies $1500
(97) GREAT BEAR TUBING HILL RENOVATION CAMPAIGN
2401 W 49th St
Sioux Falls,SD57105
46-0417881   30,000       Chamber appeals donation for business renovation - approved thru the SF Area Chamber
(98) GREAT NORTH POLE
675 13th Ave E Ste 101
West Fargo,ND58078
82-1969429 501(c)(3) 10,000       Donation on giving hearts day for organization that uses funds to purchase winter coats/pants/etc for families in need
(99) GREAT PLAINS FOOD BANK
1720 3rd Ave N
Fargo,ND58102
45-0226421 501(c)(3) 25,000       $20K - Fargo, $5K - Bismarck for Food programs in the state of North Dakota
(100) GREAT PLAINS ZOO
805 S Kiwanis Ave
Sioux Falls,SD57104
46-6015015 501(c)(3) 65,000       Yearly donation support for the Great Plains Zoo
(101) GREATER BEMIDJI
102 1st Street West Suite 101
Bemidji,MN56601
36-3367707 501(c)(3) 25,000       General Support
(102) GREATLIFE CARES FOUNDATION
4600 S Tennis Lane
Sioux Falls,SD57106
47-2447820 501(c)(3) 11,000       Yearly donation $1k; Symetra Tour donation $10k
(103) GROUND WORKS
201 N Weber Ste 201
Sioux Falls,SD57103
45-2767053 501(c)(3) 32,500       Yearly SD Ag in the classroom program donation
(104) HARRISBURG SCHOOL DISTRICT
200 Willow Street
Harrisburg,SD57032
46-6002218 115 138,538       Ortho Sports Med Contract
(105) HATTON ELELSON PUBLIC SCHOOL
503 4th Street
Hatton,ND58240
45-6001733 115 5,050       Donation towards the new training room for the school
(106) HEALING HOPE MINISTRIES
30185 475th Ave
Alcester,SD57001
81-2069424 501(c)(3) 30,000       New non-profit donation for group that helps families work through grieving with hope and healing
(107) HELPLINE CENTER INC
1000 N West Ave Suite 310
Sioux Falls,SD57104
23-7424387 501(c)(3) 56,000       Yearly donation $10k; Volunteer donation $3,500; High school texting support program $35k; Camp Capacity donation $7,500
(108) HEMOPHILIA FOUNDATION
750 South Plaza Drive Suite 2017
Mendota Heights,MN55120
41-6032276 501(c)(3) 6,000       Donation for Step out for Bleeding disorders and of bottles of water
(109) HERO
5012 53rd St S Suite C
Fargo,ND58104
45-0457109   28,100       Donations to the Healthcare Equipment Recycling Organization
(110) HIBBING COMMUNITY COLLEGE
1515 E 25th Street
Hibbing,MN55746
41-1687554 115 6,000       General Support
(111) HILLSBORO PUBLIC SCHOOLS
128 4th St NE PO Box 579
Hillsboro,ND58045
45-6001736 501(c)(3) 7,250       Donation per commitment to track & field and to the Hillsboro Running club
(112) HOPE HAVEN INC
PO Box 70
Rock Valley,IA51247
42-0890017 501(c)(3) 16,250       General Support
(113) HOPE INC
810 4th Ave S Suite 140
Moorhead,MN56560
45-0425106 501(c)(3) 6,000       Donation to group that provides sports/health to children that are disabled along with their families
(114) HUETHER FAMILY MATCH POINTE
4210 N Bobhalla Drive
Sioux Falls,SD57107
45-2784394 501(c)(3) 13,000       General Support
(115) IMAGINE THRIVING
3334 14th Ave S
Fargo,ND58103
46-3828944 501(c)(3) 11,050       Donation of support for SWF research study/Not Alone Education program for Mental Health
(116) JAMESTOWN PARK & RECREATION FOUNDATION
1002 2ND Ave SE
Jamestown,ND58401
75-1597713 501(c)(3) 10,700       Donation per commitment to the Two Rivers Activity Center and for Dasherboards
(117) JDRF MN CHAPTER DAKOTA
2301 East 60th St North
Sioux Falls,SD57104
23-1907729 501(c)(3) 50,000       Donation yearly commitment $30k plus remainder of 2019 event commitment of $20k to get us all square with calendar year billing
(118) JEREMIAH PROGRAM
615 1st Ave NE No 210
Minneapolis,MN55413
41-1801834 501(c)(3) 10,500       Donation for Journey for Hope and Generations Building.
(119) JUNIOR ACHIEVEMENT
1000 N West Ave No 110
Sioux Falls,SD57104
46-0306352 501(c)(3) 41,175       Yearly donation pledge and statewide expansion annual drive
(120) KEN DUKE & FRIENDS INC
25 Island Road
Stuart,FL34906
81-3748516 501(c)(3) 12,000       Pro-Am fundraising event to benefit Folds of Honor, First Tee, Treasure Coast and Place of Hope non-profit organizations
(121) LAKE AGASSIZ HABITAT FOR HUMANITY
210 11th Street N PO Box 1022
Moorhead,MN56561
41-1690131 501(c)(3) 22,550       $500 donation to Habitat for Humanity bike race and the rest was catering donation for their big three house build
(122) LEADERSHIP SOUTH DAKOTA
PO Box 675
Platte,SD57369
46-0398115 501(c)(3) 20,000       Yearly donation commitment
(123) LEGENDS OF GOLD
PO Box 287
Beresford,SD57004
27-3794971 501(c)(3) 44,800       Donation to training center for youth athletes to quality for the Olympics - yearly donation $40k; Legends grant $4,800
(124) LEOSTRENGTH LLC
PO BOX 91333
Sioux Falls,SD57109
46-4168160   10,000       Donation to USA Powerlifting training center $10k
(125) LIFESCAPE
2501 W 26th St
Sioux Falls,SD57105
46-5151247 501(c)(3) 41,156       Donation to foundation for handicapped children's care $40k; Legends grant $1,156
(126) LINCOLN HIGH SCHOOL
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 36,461       Ortho Sports Med Contract paid
(127) LIRA DANCE THEATRE COMPANY LLC
402 E 20th Street
Sioux Falls,SD57105
82-0987880   25,000       Dance scholarships donation payment 3 of 3
(128) LUCAS MOORMANN
421 W Brandon Dr
Bismarck,ND58503
50-2061309   15,403       ECI Basketball - Split Bismarck & Fargo
(129) LUTHERAN SOCIAL SERVICES
705 East 41st Street Ste 200
Sioux Falls,SD571056048
46-0224731 501(c)(3) 5,250       Taste of Cultures & Mentor Appreciation Breakfast donations $5k; Aberdeen annual fundraising event $250
(130) LUVERNE PUBLIC SCHOOLS
709 North Kniss
Luverne,MN56156
41-1784004 115 10,000       Donation toward Wellness & Weight room for school system - pymt 2 of 5
(131) MAKE A WISH
1400 W 17th St
Sioux Falls,SD57104
46-0375953 501(c)(3) 50,000       Sanford International donation $25k; Yearly donation support $15k; no documentation for additional $10k indicated
(132) MANDAN PARK DISTRICT
2600 46th Ave SE
Mandan,ND58554
45-6002119 115 10,000       New Headset System
(133) MANDAN PUBLIC SCHOOLS
901 Division St NW
Mandan,ND58554
45-6001098 115 12,500       New Headset System - Memorial Ballpark Pledge
(134) MANKATO AREA PUBLIC SCHOOLS
10 Civic Center Plaza Ste One
Mankato,MN56002
41-6000310 115 5,325       Legends grant
(135) MAYVILLE STATE UNIVERSITY
330 3rd St NE
Mayville,ND58257
45-6002485 115 22,600       Annual Contribution per donation agreement for sports medicine program, training room and scholarships
(136) MCCROSSAN BOYS RANCH
47135 260th Street
Sioux Falls,SD57107
46-0311913 501(c)(3) 12,500       Banquest fundraising event $2,500; Use of horses contract $5k; Rodeo fundraising event $2,500; Legends grant $2,500
(137) MCKENZIE COUNTY HEALTHCARE SYS
516 N Main
Watford City,ND58854
77-0637498 501(c)(3) 100,000       Annual pymnt on $1 million pledge
(138) MERCY HOSPITAL FOUNDATION
144 State Street
Portland,ME04101
01-0211534 501(c)(3) 10,000       Donation via fundraising event $10k
(139) METRO AREA TOURNAMENT COMM
415 4th St N
Fargo,ND58102
45-0458883 501(c)(3) 14,000       Donation to committee for region and state tournaments that take place throughout the year in the metro area
(140) METRO SELECT SPORTS LLC
27203 Regal Court
Sioux Falls,SD57108
50-3067346   5,500       Yearly donation agreement pymt 2 of 3 $5k; misc donation request $500
(141) MICHAEL J ENTRINGER BB CLASSIC 2019
47088 230th St
Colman,SD57017
46-0454541 501(c)(3) 5,176       Donation of t-shirts for youth basketball event at the Pentagon $5,176
(142) MISSOURI SLOPE AREAWIDE UNITED WAY
PO Box 2111
Bismarck,ND58502
46-0387741 501(c)(3) 32,000       Premiere Sponsorship Co-Branding with UW $5k; Backpack Program $2k; Corporate Donation $25k
(143) MN STATE UNIVERSITY MANKATO
236 Wigley Administration Center
Mankato,MN56001
41-6033423 115 300,000       Ortho Sports Med Contract
(144) MNDAKSPAN
PO Box 277
Crosby,MN56441
41-1293243 501(c)(3) 11,200       Donation for the peri-anesthesia conference held in Fargo
(145) MOORHEAD BUSINESS ASSOC
PO Box 612
Moorhead,MN56560
27-4254782 501(c)(6) 5,200       Donation for Fireworks and hole for summer golf
(146) MOORHEAD PUBLIC SCHOOLS
2300 4th Ave S
Moorhead,MN56560
26-2502312 115 45,255       Annual Contribution per donation agreement for sports medicine program and scholarships
(147) MOORHEAD YOUTH HOCKEY ASSOCIATION
707 SE Main Avenue
Moorhead,MN56560
23-7221429 501(c)(3) 100,000       Cullen Hockey Center Donation
(148) MSUM
1104 7th Ave S
Moorhead,MN56563
23-7106061 501(c)(3) 308,450       Annual Contribution per donation agreement for sports medicine program, nursing program and scholarships
(149) NAMI SD
PO Box 88808
Sioux Falls,SD57109
36-3593027 501(c)(3) 13,000       Dancing with the SF Stars fundraising event $9k; Annual conference donation $4k
(150) NATL KIDNEY FOUNDATION
30 E 33rd St
New York,NY10016
13-1673104 501(c)(3) 15,000       Yearly donation pledge payment $15k
(151) NATL MULTIPLE SCLEROSIS SOCIET
733 3rd Ave
New York,NY10017
13-5661935 501(c)(3) 25,000       Yearly donation pledge payment $25k
(152) ND HOSPITAL ASSOC
PO Box 7340
Bismarck,ND58507
45-0274165 501(c)(6) 10,000       Diamond level donation for annual conference
(153) ND SAFETY COUNCIL
1710 Canary Ave Suite A
Bismarck,ND58501
45-0353009 501(c)(3) 20,000       General Support
(154) ND STATE FAIR ASSOCIATION
2005 E Burdick Expy E
Minot,ND58701
45-6013410 115 7,500       Fargo Bismarck donation to state fair for HR to have booth, etc
(155) NDSCS
800 6th St North
Wahpeton,ND58076
45-0407617 501(c)(3) 18,500       Annual Contribution per donation agreement for workforce affairs, wildcat golf tournament and scholarships
(156) NDSU
PO Box 6050 NDSU Dept 1200
Fargo,ND58108
45-6014085 501(c)(3) 2,941,667       Annual Contribution per donation agreement for sports medicine program, nursing program and scholarships
(157) NICKLAUS CHILDRENS HEALTH CARE FOUNDATION
11770 US Highway 1 No 308
North Palm Beach,FL33408
57-1154352 501(c)(3) 500,000       General Support
(158) NORTHERN DENTAL ACCESS CENTER
1405 Anne St
Bemidji,MN56601
84-1711812 501(c)(3) 20,000       General Support
(159) NORTHERN STATE UNIVERSITY
620 15th Ave SE
Aberdeen,SD57401
23-7002314 115 583,512       Ortho Sports Med Contract
(160) NORTHERN SUN INTERCOLLEGIATE
2999 County Rd 42 West Suite 136
Burnsville,MN55306
41-1783486 501(c)(3) 370,000       Ortho Sports Med Contract
(161) NORTHWESTERN COLLEGE
101 7th Street SW
Orange City,IA51041
42-0698196 501(c)(3) 50,000       Donation commitment pymt 4 of 5; Science capital project building
(162) OAK GROVE LUTHERAN SCHOOL
124 North Terrace
Fargo,ND58102
45-0226473 501(c)(3) 32,500       Annual Contribution per donation agreement for sports medicine, spring gala, various sports camps and scholarships
(163) OUR SAVIORS LUTHERAN CHURCH
909 W 33rd St
Sioux Falls,SD57105
46-0229996 501(c)(3) 5,060       AED Donation
(164) OUTDOOR ADVENTURE FOUNDATION
415 38th St S Suite E
Fargo,ND58103
27-0192316 501(c)(3) 12,500       Project Lead the Way; Summer camps; annual business partner
(165) PARKER SCHOOL DIST 60-4
Box 517
Parker,SD57053
46-6003129 115 6,200       Donation pledge scoreboard pymt 1 of 5 $5k; Elementary Science Day $1,200
(166) PATH NORTH DAKOTA INC
1202Westrac Drive S
Fargo,ND58103
91-2159746 501(c)(3) 6,000       Bismarck/Fargo - donation to Nexus Foundation in support of PATH for AED donations
(167) PEACEMAKER RESOURCES
2301 Johanneson Dr NW Suite 106
Bemidji,MN56601
45-0507287 501(c)(3) 15,750       General Support
(168) PETIT KICKS SOCCER
8920 Briardale Dr
Bismarck,ND58504
47-3418017   10,000       Soccer Academy-Athletic Donation
(169) PHILANTHROPY PROMOTIONS INC
2601 W 60th Street North
Sioux Falls,SD57107
87-0695596 501(c)(3) 20,000       Hot Harley Nights fundraising event with all proceeds to go to Make-A-Wish $20k
(170) PLAINS ART MUSEUM
PO Box 2338
Fargo,ND58108
41-1260780 501(c)(3) 12,500       Annual donation to Gala and Art4All programing
(171) POST 320 BASEBALL
PO Box 601
Rapid City,SD57709
46-0447908 501(c)(3) 5,500       Donation to baseball team
(172) PRESIDENTS BOWL
201 East 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 10,000       Donation to support the local high schools activities/events $10k
(173) PROJECT PREP OLYMPIC DEVELOP
PO Box 385970 6101 Old Shakopee Rd
Bloomington,MN55438
04-3644163 501(c)(3) 12,500       Donation in support of the Upper Midwest High School Elite League for Olympic Development
(174) RAPID CITY CLUB FOR BOYS INC
320 N 4th St
Rapid City,SD57701
46-0277778 501(c)(3) 10,000       Club for Boys Capital Campaign donation
(175) REALTORS FOR KIDS
2415 W 57th St
Sioux Falls,SD57108
26-2681308 501(c)(3) 6,000       Fundraising event to benefit children's health needs $6k
(176) RED RIVER CHILDRENS ADVOCACY
100 S 4th St No 302
Fargo,ND58103
20-1095721 501(c)(3) 26,000       Donation of Support for services for abused children and donation for their annual gala
(177) REINBOWS INC
43341 480th Avenue
Windom,MN56101
20-8775427 501(c)(3) 11,000       Equine assisted therapy for disabled children
(178) RESEARCH AMERICA
241 18th St S Suite 501
Arlington,VA22202
52-1609875 501(c)(3) 10,000       Awards dinner donation
(179) ROGER MARIS CELEBRITY GOLF
Po Box 3202
Fargo,ND58108
45-0425333 501(c)(3) 14,500       Donation for Celebrity Golf Tournament - $10K and $4.5K for 3 teams golfing
(180) RONALD MCDONALD HOUSE CHARITIES OF THE RED RIVER VALLEY
4757 Agassiz Xing S
Fargo,ND58104
45-0365598 501(c)(3) 105,000       $100K - Annual Contribution per donation agreement towards their building and $5K donation for Annual Sweetheart Ball
(181) RONALD MCDONALD HOUSE CHARITIES OF SD
825 S Lake Ave
Sioux Falls,SD57104
46-0371152 501(c)(3) 56,000       General donation support $40k; Restore and Renovate project $15k
(182) ROOSEVELT HIGH SCHOOL
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 51,188       Ortho Sports Med Contract paid
(183) ROTARY CLUB OF FARGO
PO Box 1653
Fargo,ND58107
20-3453808 501(c)(6) 5,175       Donation for Group Prenatal care Training for Indigenious Women
(184) SAMARITANS FEET INTERNATIONAL
PO Box 78992
Charlotte,NC28271
14-1880905 501(c)(3) 101,108       Yearly donation agreement payment $100k
(185) SD BASKETBALL COACHES ASSOC
801 W Eagle Ridge St
Sioux Falls,SD57108
23-7297479 501(c)(3) 7,500       Scholarship program donation $7500
(186) SD BEEF INDUSTRY COUNCIL INC
316 Coteau Street
Pierre,SD57501
46-0342595 501(c)(6) 19,000       Collegiate Build Your Base with Beef , sports nutrition and training program with beef as a primary protein. Collaboration between SD Beef and Sanford Sports Science $19k
(187) SD BIOTECH ASSOC
2329 N Career Ave Ste 115
Sioux Falls,SD57107
37-1518658 501(c)(6) 9,500       General Support for Research
(188) SD CATTLEMANS ASSOC
215 E Prospect PO Box 29
Pierre,SD57501
46-2773322 501(c)(6) 15,000       Donation to fundraising event for Feeding SD $15k
(189) SD COMMUNITY FOUNDATION
PO BOX 296
Pierre,SD57501
46-0398115 501(c)(3) 10,000       Donation to the SD Veterans Cemetery - pymt 1 of 5 $10k
(190) SD CORN GROWERS ASSOCIATION
4712 S Technopolis Dr
Sioux Falls,SD57106
46-0392991 501(c)(5) 6,000       Yearly donation pledge $2,500; Annual Education Seminar donation $2,500; Corn Cob Open fundraising event $1k
(191) SD EMERGENCY MEDICAL SERVICES ASSOCIATION INC
7117 w 57TH St Apt 62
Sioux Falls,SD57105
46-0352015 501(c)(6) 7,000       Annual conference donation for EMT's $7k
(192) SD GOLF ASSOCIATION
4809 W 41st St Suite 202
Sioux Falls,SD57106
46-0310847 501(c)(4) 25,000       SDGA Junior Tour presened by Sanford International $15k; SDGA Golf series yearly donation $10k
(193) SD GUARDIANSHIP PROGRAM INC
PO BOX 794
Pierre,SD57501
46-0366602 501(c)(3) 10,000       Donation for court appointed guardianship for adults who cannot afford assistance - yearly commitment $10k
(194) SD HALL OF FAME
1480 S Main Ave
Chamberlain,SD57325
46-0324210 501(c)(3) 50,000       Yearly annual commitment donation $50k
(195) SD HIGH SCHOOL ACTIVITIES
PO Box 1217 804 North Euclid Ave
Ste 102
Pierre,SD575011217
46-0226882 501(c)(3) 125,000       Yearly donation agreement in support of high school athletics across the state $125k
(196) SD JUNIOR FOOTBALL
PO Box 19934
Sioux Falls,SD571098801
46-6037091 501(c)(3) 10,000       Yearly donation agreement pymt $5k; Legends grant $5k
(197) SD LAW ENFORCEMENT CHARITIES
5214 Sweetbriar Court
Sioux Falls,SD57108
46-0440378 501(c)(3) 20,000       Yearly donation commitment to children's fundraising charity event $20k
(198) SD STATE SOCCER ASSOC
2127 S Minnesota Ave Suite 201
Sioux Falls,SD57105
23-7183054 501(c)(3) 20,000       AKA: SD Youth Soccer Assn / Yearly donation pledge payment 2 of 5 $20k
(199) SD STATE UNIV
815 Medary Ave PO Box 525
Brookings,SD57007
46-0273801 501(c)(3) 1,036,687       Ortho Sports Med Contract paid
(200) SD SYMPHONY ORCHESTRA
300 North Dakota Ave Ste 116
Sioux Falls,SD57104
46-6017026 501(c)(3) 65,000       Yearly support donation $65k
(201) SD SYNOD
2001 S Summit Ave
Sioux Falls,SD57197
36-3512774 501(c)(3) 35,000       Capital campaign for their Woyatan Retreat Center renovations donation $20k
(202) SF AREA COMMUNITY FOUNDATION
200 N Cherapa Place
Sioux Falls,SD57103
31-1748533 501(c)(3) 5,500       Donation toward SD Salutes fundraising event $5k; Youth advisory council donation $500
(203) SF CHRISTIAN HIGH SCHOOL
6120 Charger Circle
Sioux Falls,SD571091110
46-0340024 501(c)(3) 78,720       Ortho Sports Med Contract paid
(204) SF CYCLONES
PO Box 361
Sioux Falls,SD57101
27-4705069 501(c)(3) 31,845       Yearly donation support $20k; Family night donation for food $8,727; Legends grant $1,368
(205) SF JAZZ & BLUES SOCIETY
123 S Main Ave Ste 204
Sioux Falls,SD57104
46-0418356 501(c)(3) 15,000       Yearly donation support of JazzFest $15k
(206) SF SWIM TEAM INC
PO Box 758
Sioux Falls,SD571012736
46-0343732 501(c)(3) 28,000       Yearly donation commitment $25k; State A Meet donation $3k
(207) SF YOUTH HOCKEY ASSOC
4235 West Mesa Pass
Sioux Falls,SD57106
46-0427805 501(c)(3) 27,250       Yearly donation commitment $25k; Legends grant $1,500; Individual team requests $750
(208) SHEYENNE VALLEY COMMUNITY FOUNDATION
250 West Main Street
Valley City,ND58702
46-4371645 501(c)(3) 6,000       Annual Contribution per donation agreement for Wellness Center
(209) SHILOH CHRISTIAN SCHOOL
1915 Shiloh Dr
Bismarck,ND58503
45-0348120 501(c)(3) 72,000       Vision 2015 Pledge: Building Contribution: Phase II; Academic & Athletic Donation
(210) SIMMONS CENTER FOUNDATION
800 Chisholm Trail Parkway
Duncan,OK73534
73-1344774 501(c)(3) 10,000       Final donation payment to the Heritage Trails in Duncan, OK
(211) SIOUX COUNCIL BOY SCOUTS
800 N West Avenue
Sioux Falls,SD57104
46-0224599 501(c)(3) 6,300       Yearly donation $5,500; Shootout fundraiser $800
(212) SIOUX EMPIRE ARTS COUNCIL
PO Box 1165
Sioux Falls,SD57101
20-8535871 501(c)(3) 10,000       Yearly donation in support of the local arts and sculpture walk in SF
(213) SIOUX EMPIRE UNITED WAY
1000 N West Ave 120
Sioux Falls,SD571041314
46-0233701 501(c)(3) 135,400       Yearly pledge donation support
(214) SIOUX FALLS AREA CASA PROGRAM
300 N Dakota Ave Suite 609
Sioux Falls,SD57101
46-0430647 501(c)(3) 15,000       Yearly fundraising events to include the Bakker Crossing Charity Pro Am $10k; and the Red Cape Event $5k
(215) SIOUX FALLS CATHOLIC SCHOOLS
3100 W 41st St
Sioux Falls,SD57105
46-0413591 501(c)(3) 60,000       Donation to Teacher Salaries Initiative $60k
(216) SIOUX FALLS FIREFIGHTERS
PO Box 340
Sioux Falls,SD57101
68-0589701 501(c)(3) 7,500       Donation to Step Up For Heroes fundraiser $7,500
(217) SIOUX FALLS HOPE COALITION
2211 W Cherrywood Circle
Sioux Falls,SD57108
82-2097994 501(c)(3) 25,000       Donation in support of every child having access to attend preschool - $25k
(218) SIOUX FALLS LUTHERAN SCHOOL
308 West 37th Street
Sioux Falls,SD57105
46-0343381 501(c)(3) 1,001,000       Ortho Sports Med Contract
(219) SIOUX FALLS POWER HOCKEY
3213 S Nicann Court
Sioux Falls,SD57103
47-1795011 501(c)(3) 40,000       Donation in support of youth hockey and our sports medicine program
(220) SIOUX FALLS SCHOOL DISTRICT
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 116,375       Donations for multiple commitments: Scoreboards $60k; Angel Fund $1k; CTE Health Careers Camp $4k; Project Lead the Way $10k; Workforce Development HOSA $2,400; State Tournament event $25k; Ortho Sports Med
(221) SIOUX FALLS SPORTS AUTHORITY
200 N Phillips Ave No 304
Sioux Falls,SD57104
20-5850491 501(c)(3) 3,808,250       Ortho Sports Med Contract paid
(222) SIOUX FALLS TENNIS ASSOCIATION
PO Box 89512
Sioux Falls,SD57109
36-3916958 501(c)(3) 7,000       Donation commitment $5k/year; Legends Grant $2k
(223) SIOUX FALLS WOMEN RUN LLC
5235 S Sweetbriar Court
Sioux Falls,SD57108
81-3518734 501(c)(7) 15,000       Donation to women's running event fundraiser $15k
(224) SME INC OF SIOUX FALLS
PO Box 90310
Sioux Falls,SD871090310
46-6012934 501(c)(6) 12,800       Leadership Summit $12,500; Women in Business $300
(225) SOUTH EAST EDUCATION COOPERATIVE
1305 9th Ave S
Fargo,ND58103
47-5548763 115 15,000       Donation to Schools Alive, SEEC
(226) SPECIAL OLYMPICS IOWA
551 SE Dovetail Rd PO Box 620
Grimes,IA50111
51-0176029 501(c)(3) 10,000       General Support
(227) SPECIAL OLYMPICS SOUTH DAKOTA
305 W 39th St
Sioux Falls,SD57105
46-0359776 501(c)(3) 19,365       Yearly commitment $10k; Plane Pull fundraising event $5k; Legends Grant $2k
(228) ST JOHN PAUL II CATHOLIC SCHOOLS NETWORK
5600 25th Street South
Fargo,ND58104
45-0403317 501(c)(3) 25,000       Annual Contribution per donation agreement for sports medicine and as a Gold Partner to the schools for support
(229) STOCKYARDS AG EXPERIENCE
PO Box 2042
Sioux Falls,SD57101
46-5391991 501(c)(3) 26,500       Final commitment payment thru Chamber Appeals $25k; Experience Barn July Admissions donation $1,500
(230) STRAWBALE WINERY
47215 257th St
Renner,SD57055
68-0525735   10,000       Yearly donation to Folk-Off fundraising event $10k
(231) SUMMIT LEAGUE
101 W 69th Street Suite 201
Sioux Falls,SD57108
39-1417116 501(c)(3) 1,577,674       Ortho Sports Med Contract paid
(232) SUSAN G KOMEN BREAST CANCER
5005 LBJ Freeway Suite 526
Dallas,TX75244
75-1835298 501(c)(3) 27,500       Yearly donation to fundraising event $27,500
(233) SUTTON BAY GOLF LLC
28950 Sutton Bay Trail
Agar,SD57520
47-0844234   25,276       Gift Certificates given out to misc fundraising events as an auction item, usually given to SDSU, USD, MSU, NDSU, NSU, Make-A-Wish, Children's Home Society, etc., gala foundation events
(234) TEA AREA SCHOOL DISTRICT
PO Box 488
Tea,SD57064
50-0005151 115 12,000       Ortho Sports Med Donation contract
(235) TEDDY BEAR DEN
500 S Main Ave
Sioux Falls,SD57104
31-1802800 501(c)(3) 8,700       Celebrity Night Out fundraising event
(236) THE ARTS PARTNERSHIP OF THE RED RIVER VALLEY
1104 2nd Ave S Suite 315
Fargo,ND58103
23-7108936 501(c)(3) 27,500       Donation for support of all the arts in the metro area coordinated by the Arts Partnership
(237) THE BANQUET
900 E 8th St
Sioux Falls,SD57103
46-0387495 501(c)(3) 30,000       Donation commitment pymt 1 of 3 $25k for yearly support; Run for Food fundraising event at Thanksgiving $5k
(238) THEODORE ROOSEVELT PRESIDENTIAL LIBRARY FOUNDATION
PO Box 338
Medora,ND586450338
47-1324043 501(c)(3) 100,000       Donation Commitment pymt 2 of 3 $100k
(239) THIEF RIVER FALLS NORSKIES
3001 Sanford Parkway
Thief River Falls,MN56701
81-2982246   8,310       Donation for Ice Logo, Dasher Boards, Programs, jerseys, tickets
(240) THIELEN FOUNDATION LLC
314 1st Ave N 200
Minneapolis,MN55401
82-5085997 501(c)(3) 37,500       Yearly donation to Adam Thielen's foundation per Ortho Sports Med contract
(241) TRACY AREA PUBLIC SCHOOLS
934 Pine Street
Tracy,MN56175
90-0501338 115 30,000       $15k to the Tracy Independent School District for their Veterans Memorial Center Revitalization Project. Pymt 4 of 5.; General Support
(242) TRI CITY STORM SOCCER CLUB
1323 23rd St S Ste A
Fargo,ND58103
36-3346894 501(c)(3) 10,000       Annual Contribution per Donation Agreement to support soccer programs for the youth
(243) UCODEGIRL
325 5th St N
Fargo,ND58102
81-2623993 501(c)(3) 6,000       Donation for "Crack the Code" learning event/tech camp for girls
(244) UNITED WAY OF BEMIDJI AREA
PO BOX 27
Bemidji,MN56619
41-1567744 501(c)(3) 67,180       General Support
(245) UNITED WAY OF CASS-CLAY
219 7th Street
Fargo,ND58103
41-0810008 501(c)(3) 98,650       Annual Corporate donation for Fargo area programs
(246) UNITED WAY OF NORTHEASTERN SOUTH DAKOTA
PO Box 1065
Aberdeen,SD57401
23-7086355 501(c)(3) 10,450       Yearly commitment payment $10k; Stamp Out Hunder Food Drive $450
(247) UNIV OF MARY
7500 University Drive
Bismarck,ND58504
45-0273403 501(c)(3) 25,000       Candlelight Gala-Primary Sponsor; Fundraiser for Umary premier School of Health Sciences
(248) UNIV OF NORTH DAKOTA
3501 University Ave
Grand Forks,ND58202
45-0348296 501(c)(3) 100,950       Ortho Sports Med contracts
(249) UNIV OF SOUTH DAKOTA
1110 N Dakota PO Box 5555
Vermillion,SD57069
46-6018891 501(c)(3) 1,509,022       Ortho Sports Med contracts
(250) UNIVERSITY OF JAMESTOWN
6088 College Lane
Jamestown,ND58405
45-0231180 115 26,000       Annual Contribution per donation agreements for Dine & Bid, Scoreboard, Arts, Gator Donation
(251) UP AQUATICS INC
3740 Aspyn Lane N
Fargo,ND58102
27-1181382 501(c)(3) 30,000       Annual Contribution per donation agreement for new building/pool for area
(252) USD SCHOOL OF MEDICINE
1400 W 22nd Street
Sioux Falls,SD57105
46-0418678 501(c)(3) 51,504       General Support
(253) VALLEY CHRISTIAN COUNSELING CENTER
509 25th Ave N
Fargo,ND58102
45-0419100 501(c)(3) 25,000       Donation to Proclaiming Freedom capital campaign
(254) VALLEY CITY PARKS & REC DIST
PO Box 422
Valley City,ND58072
45-0375502 115 5,275       Donation to Wellness Center
(255) VALLEY CITY STATE UNIVERSITY
101 College St SW
Valley City,ND58072
23-7178785 115 10,500       Annual Contribution per donation agreement for sports medicine
(256) VILLAGE FAMILY SERVICE CENTER
PO Box 9859
Fargo,ND58106
45-0226423 501(c)(3) 101,250       $100K - Annual Contribution per donation agreement towards programming, the rest is donation for hole at Bobcat Open, Wine & Dining table, Big Brother Big Sister bowling
(257) VILLAGE NORTHWEST UNLIMITED
330 Village Circle
Sheldon,IA51201
42-1044017   54,000       Donation pledge payment 1 of 5 $50k; Golf benefit fundraiser $1500; Run, Rock & Roll fundraiser $2500
(258) VOLUNTEERS OF AMERICA DAKOTAS
1309 West 51st St PO Box 89306
Sioux Falls,SD57109
23-7353508 501(c)(3) 50,500       HomePlace Capital Campaign (1 of 3) $40k; Rise & Shine Breakfast fundraiser $10k; RC Soup for a Cause $500
(259) VOTE YES FOR RC SCHOOLS
PO Box 9554
Rapid City,SD57709
84-3516362 Political Org 10,000       Vote Yes for Rapid City Schools donation $10k gift
(260) WASHINGTON PAVILION
301 S Main Ave PO Box 984
Sioux Falls,SD57101
46-0435791 501(c)(3) 90,000       Yearly Pilar Partnership donation agreement to include the Kirby Science Discovery Center Fit Zone & Health Quest area
(261) WATERTOWN COMMUNITY FOUNDATION
211 E Kemp Ave
Watertown,SD57201
46-0350319 501(c)(3) 20,000       City of Watertown softball complex - pymt 2 of 5
(262) WATERTOWN DEVELOPMENT COMPANY
PO Box 332
Watertown,SD57201
47-0813269 501(c)(3) 15,000       Grow Watertown Campaign - pymt 1 of 5
(263) WAVE
513 Main St
Webster,SD57274
20-1307620 501(c)(3) 15,000       Webster 2020 Inc - pymt 9 of 10 ( $150k total commitment) - split with Webster
(264) WEST FARGO PARKS & REC
P O Box 762
West Fargo,ND58078
56-2520352 115 8,605       Donations to Programming and scholarships for kids to attend
(265) WESTERN ILLINOIS UNIVERSITY FOUNDATION
1 University Circle Sherman Hall
303
Macomb,IL61455
37-6046814 501(c)(3) 250,000       Kevin Lampe Sanford Basketball Endowment
(266) WESTERN ND AREA HEALTH EDUC
PO Box 615
Hettinger,ND58639
45-6002485 501(c)(3) 12,000       Fargo $12k; ND HOSA - Future Health Professionals program
(267) WHEATON AREA SCHOOLS
1700 3rd Ave S
Wheaton,MN56296
41-6004390 501(c)(3) 5,050       Annual Contribution per donation agreement for bleachers at the school
(268) WINDOM AREA HEALTH
2150 Hospital Drive PO Box 339
Windon,MN56101
23-7159870 501(c)(3) 5,500       Wellness Path & Outdoor Gym - pymt 3 of 4 $4k; Riverfest fundraiser $500; Breast Health Walk fundraiser $1k
(269) WINDOM YOUTH HOCKEY
P O Box 339
Windom,MN56101
72-1543872 501(c)(3) 8,333       Youth Hockey final commitment payment $8,333
(270) WINGS OF VALOR INC
45618 278th Street
Parker,SD57053
84-3711088 501(c)(3) 50,000       Lease property & fund operations donation for a hunting lodge to serve disabled veterans $50k
(271) WINNER REGIONAL FOUNDATION
745 E 8th Street
Winner,SD57580
46-0274380 501(c)(3) 100,500       Pledge payment 3 of 10 $100k; Golf tournament fundraiser $500
(272) XYZ CORP
905 W 14th St
Yankton,SD57078
26-0801357 501(c)(3) 10,000       City of Yankton - Dive in Yankton aquatics center fundraising campaign - pymt 1 of 5 $10k
(273) YELLOW JACKET FOUNDATION
1200 University St Unit 9506
Spearfish,SD57799
51-0151319 501(c)(3) 29,000       Black Hills State University donation pledge payment 2 of 5 $25k; Scholarships $4k
(274) YMCA OF CASS & CLAY COUNTIES
400 First Ave South
Fargo,ND58103
45-0232096 501(c)(3) 18,000       Donations for Livestrong, Partner of Youth and Nurse station for camp
(275) YMCA SIOUX FALLS REGION
230 S Minnesota Ave
Sioux Falls,SD57104
46-0225021 501(c)(3) 77,500       Capital Campaign pymt 1 of 3 ($50k, $100k, $100k); yearly donation agreement $5k; Tri-State tournament $2,500; donation pledge payment 5 of 5 of previous capital campaign $20k;
(276) YOUTH ATHLETIC FOUNDATION
PO Box 770445
Memphis,TN38177
26-4744698 501(c)(3) 10,000       Hoop City Classic event at Pentagon $10k - yearly event donation
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
235
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
41
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)
(2)
(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


Software ID:  
Software Version:  


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
Yes
 
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
1Andy North
Trustee
(i)

(ii)
258,864
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
258,864
-------------
0
0
-------------
0
2Maria Bell MD
Trustee/Research Administrator
(i)

(ii)
832,401
-------------
0
38,167
-------------
0
20,765
-------------
0
0
-------------
0
30,986
-------------
0
922,319
-------------
0
0
-------------
0
3Mark Lundeen MD
Trustee/Orthopedics Service Chair
(i)

(ii)
682,389
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
28,250
-------------
0
710,639
-------------
0
0
-------------
0
4Mark Paulson MD
Chair/Physician Regional Chair
(i)

(ii)
241,710
-------------
0
40,000
-------------
0
180
-------------
0
0
-------------
0
28,771
-------------
0
310,661
-------------
0
0
-------------
0
5Kelby K Krabbenhoft
Sanford President & CEO
(i)

(ii)
0
-------------
2,606,133
0
-------------
402,500
0
-------------
79,675
0
-------------
0
0
-------------
14,171
0
-------------
3,102,479
0
-------------
0
6Kelby K Krabbenhoft Def Comp
Sanford President & CEO
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
1,081,296
0
-------------
0
0
-------------
1,081,296
0
-------------
0
7JoAnn L Kunkel
Chief Financial Officer
(i)

(ii)
0
-------------
1,018,824
0
-------------
145,204
0
-------------
169,121
0
-------------
111,720
0
-------------
23,786
0
-------------
1,468,655
0
-------------
0
8Bill Gassen III
Chief Human Resources Officer
(i)

(ii)
0
-------------
792,150
0
-------------
116,477
0
-------------
127,479
0
-------------
84,120
0
-------------
15,355
0
-------------
1,135,581
0
-------------
0
9Jennifer Grennan
Chief Legal Officer
(i)

(ii)
0
-------------
624,641
0
-------------
87,600
0
-------------
97,743
0
-------------
58,320
0
-------------
28,171
0
-------------
896,475
0
-------------
0
10Allison Wierda-Suttle MD
Sr VP, Chief Medical Officer
(i)

(ii)
0
-------------
844,677
0
-------------
105,122
0
-------------
139,515
0
-------------
91,440
0
-------------
28,363
0
-------------
1,209,117
0
-------------
0
11Bill Marlette
Treasurer
(i)

(ii)
0
-------------
1,019,856
0
-------------
172,511
0
-------------
198,810
0
-------------
0
0
-------------
1,355
0
-------------
1,392,532
0
-------------
0
12Bill Marlette Def Comp
Treasurer
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
221,323
0
-------------
0
0
-------------
221,323
0
-------------
0
13Micah Aberson
Executive VP, Sanford
(i)

(ii)
0
-------------
792,150
0
-------------
156,944
0
-------------
126,063
0
-------------
84,120
0
-------------
28,171
0
-------------
1,187,448
0
-------------
0
14Bryan Nermoe
President, Bemidji/President, Fargo
(i)

(ii)
0
-------------
566,095
0
-------------
316,804
0
-------------
126,444
0
-------------
53,400
0
-------------
28,171
0
-------------
1,090,914
0
-------------
0
15Craig Lambrecht
President, Bismarck (Thru 3/19)
(i)

(ii)
0
-------------
141,716
0
-------------
91,800
0
-------------
31,985
0
-------------
0
0
-------------
12,022
0
-------------
277,523
0
-------------
0
16Michael LeBeau MD
President, Bismarck
(i)

(ii)
0
-------------
1,107,683
0
-------------
300,000
0
-------------
94,841
0
-------------
66,500
0
-------------
29,846
0
-------------
1,598,870
0
-------------
0
17Nate White
COO, President Fargo (Thru 9/19)
(i)

(ii)
0
-------------
994,860
0
-------------
149,000
0
-------------
388,210
0
-------------
109,320
0
-------------
28,171
0
-------------
1,669,561
0
-------------
0
18Michelle Micka
Sr VP Finance, Health Service
(i)

(ii)
0
-------------
505,254
0
-------------
60,000
0
-------------
65,426
0
-------------
44,250
0
-------------
28,171
0
-------------
703,101
0
-------------
0
19Michelle Bruhn
Sr VP Finance, Health Svc(Thru 3/19)
(i)

(ii)
0
-------------
680,791
0
-------------
73,600
0
-------------
89,609
0
-------------
72,120
0
-------------
33,121
0
-------------
949,241
0
-------------
0
20Nicholas Olson
VP Finance
(i)

(ii)
0
-------------
311,363
0
-------------
300
0
-------------
46,268
0
-------------
0
0
-------------
28,171
0
-------------
386,102
0
-------------
0
21Paul Hanson
President, Sioux Falls
(i)

(ii)
0
-------------
767,763
0
-------------
594,400
0
-------------
128,744
0
-------------
82,320
0
-------------
25,435
0
-------------
1,598,662
0
-------------
0
22Matt Hocks
Chief Operating Officer
(i)

(ii)
0
-------------
886,794
0
-------------
113,667
0
-------------
142,710
0
-------------
91,320
0
-------------
17,440
0
-------------
1,251,931
0
-------------
0
23Susan Jarvis
President, Bemidji
(i)

(ii)
0
-------------
456,819
0
-------------
132,300
0
-------------
75,295
0
-------------
6,446
0
-------------
28,171
0
-------------
699,031
0
-------------
0
24Eric Belanger
Physician
(i)

(ii)
3,047,536
-------------
0
0
-------------
0
45,717
-------------
0
0
-------------
0
30,986
-------------
0
3,124,239
-------------
0
0
-------------
0
25William Brunner
Physician
(i)

(ii)
2,623,321
-------------
0
0
-------------
0
3,387
-------------
0
0
-------------
0
30,986
-------------
0
2,657,694
-------------
0
0
-------------
0
26Adam Stys
Physician
(i)

(ii)
2,978,149
-------------
0
0
-------------
0
15,620
-------------
0
0
-------------
0
30,986
-------------
0
3,024,755
-------------
0
0
-------------
0
27Tomasz Stys
Physician
(i)

(ii)
2,953,888
-------------
0
0
-------------
0
77,313
-------------
0
0
-------------
0
28,250
-------------
0
3,059,451
-------------
0
0
-------------
0
28Corey Teigen
Physician
(i)

(ii)
1,887,694
-------------
0
0
-------------
0
726,531
-------------
0
0
-------------
0
27,962
-------------
0
2,642,187
-------------
0
0
-------------
0
29Daniel Olson
Former Exec VP Bemidji
(i)

(ii)
0
-------------
311,363
0
-------------
300
0
-------------
46,268
0
-------------
0
0
-------------
28,171
0
-------------
386,102
0
-------------
0
30Kim Patrick
Former Chief Legal Officer
(i)

(ii)
0
-------------
642,208
0
-------------
96,300
0
-------------
127,459
0
-------------
0
0
-------------
28,171
0
-------------
894,138
0
-------------
0
31Randy Bury
Former Chief Administrative Officer
(i)

(ii)
0
-------------
857,021
0
-------------
128,500
0
-------------
159,886
0
-------------
103,080
0
-------------
7,325
0
-------------
1,255,812
0
-------------
0
32Randy Bury Deferred Comp
Former Chief Administrative Officer
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
22,929
0
-------------
0
0
-------------
22,929
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 2019.
Part I, Lines 4a-c Part I, Line 4a: The following individual participated in a severance arrangement and received payments during the year: Corey Teigen $550,309 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

Additional Data


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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 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
C 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
D 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 .................. 56,290,000 50,605,000   2,057,855
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 134,069,821 129,135,779 4,000,000
4 Gross proceeds in reserve funds ............. 41,026 2,188 910 2,390
5 Capitalized interest from proceeds .............       31,874
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 150,032 1,470,647 1,906,127
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 45,000,000 127,665,132 4,000,000
11 Other spent proceeds ............. 66,160,644 134,069,821 52,083,720  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2013 2010
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)? ........
  X X     X   X
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)? ........
  X X     X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
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: 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 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 10/30/2019
Schedule K, Part I, Bond Issues Bonds issued 10/28/2014, column(c) CUSIP #: 83755VXF6 and 83755VXE9 Bonds issued 9/14/2004, column(c) CUSIP #: 83755VHY3 and 83755VHZ0
Part I, Column e and Part II, Line 3 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 2011 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 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
C 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
D 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 .................. 56,290,000 50,605,000   2,057,855
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 134,069,821 129,135,779 4,000,000
4 Gross proceeds in reserve funds ............. 41,026 2,188 910 2,390
5 Capitalized interest from proceeds .............       31,874
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 150,032 1,470,647 1,906,127
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 45,000,000 127,665,132 4,000,000
11 Other spent proceeds ............. 66,160,644 134,069,821 52,083,720  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2013 2010
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)? ........
  X X     X   X
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)? ........
  X X     X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
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: 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 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 10/30/2019
Schedule K, Part I, Bond Issues Bonds issued 10/28/2014, column(c) CUSIP #: 83755VXF6 and 83755VXE9 Bonds issued 9/14/2004, column(c) CUSIP #: 83755VHY3 and 83755VHZ0
Part I, Column e and Part II, Line 3 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 2011 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 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
C 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
D 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 .................. 56,290,000 50,605,000   2,057,855
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 134,069,821 129,135,779 4,000,000
4 Gross proceeds in reserve funds ............. 41,026 2,188 910 2,390
5 Capitalized interest from proceeds .............       31,874
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 150,032 1,470,647 1,906,127
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 45,000,000 127,665,132 4,000,000
11 Other spent proceeds ............. 66,160,644 134,069,821 52,083,720  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2013 2010
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)? ........
  X X     X   X
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)? ........
  X X     X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
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: 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 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 10/30/2019
Schedule K, Part I, Bond Issues Bonds issued 10/28/2014, column(c) CUSIP #: 83755VXF6 and 83755VXE9 Bonds issued 9/14/2004, column(c) CUSIP #: 83755VHY3 and 83755VHZ0
Part I, Column e and Part II, Line 3 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 2011 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
(1) Christina Olson Family member of - N Olson Education/Student Loans   X 103,598 20,787   No Yes   Yes  
(2) Ryan Patrick Family member of - K Patrick Education/Student Loans   X 80,000 84,717   No Yes   Yes  
Total ...............Small Bullet $ 105,504
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 106,704 Compensation   No
(2) Annette White N White - family relationship 634,690 Compensation   No
(3) Melinda Anderson M Paulson - family relationship 106,591 Compensation   No
(4) John Durick P Durick - family relationship 141,076 Compensation   No
(5) Louis Krabbenhoft K Krabbenhoft - family relationship 203,028 Compensation   No
(6) Megan Hemmelgarn M Paulson - family relationship 43,261 Compensation   No
(7) Julie Paulson M Paulson - family relationship 52,998 Compensation   No
(8) Daniel Aberson M Aberson - family relationship 178,589 Compensation   No
(9) Christina Olson N Olson - family relationship 256,635 Compensation   No
(10) Barb Everist Joint Venture in Everist Health 6,000,000 Sanford contributed $6M into Everist Health during the previous years. As a result, Sanford and Barb Everist both owned more than a 10% interest in this company.   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:  
Software Version:  




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, Kim Patrick, Matt Hocks, Nicholas Olson, Susan Jarvis.
Form 990, Part VI, Section A, line 4 On January 1, 2019, numerous companies changed fiscal year to calendar year in operating agreement/bylaws. Sanford amended bylaws incorporating Good Samaritan Society to appoint members to the Board of Trustees. Also, changed from fiscal year to calendar year.
Form 990, Part VI, Section A, line 6 Sanford is governed by a Board of Trustees (BOT) that has ultimate strategic and decision making authority. The BOT delegates certain activities and responsibilities to Boards of each of Sanford's primary operating subsidiaries. The unique nature and complexity of the subsidiaries requires each to have a delegated Board with a singular entity focus. Such bodies, referred to as Boards of Directors and Boards of Governors, address matters such as credentialing, accreditation standards, developing budgets, programs and facilities on an entity-specific basis, and generally consist of individuals distinct from the BOT. These Boards function much like committees in a traditional corporate structure. The BOT then acts as a holding company Board, synthesizing and reconciling each entity's programs and budgets into a system-wide strategic plan. This structure of governance produces a significant number of trustees, governors and directors. Subsidiaries included within this group tax return consist of Sanford Health, Sanford North, Sanford Medical Center, Sanford Medical Center Fargo, Sanford Clinic, Sanford Clinic North, Sanford Health Network, Sanford Health Network North, Sanford Home Health, Sanford Research, Sanford Research North, Sanford World Clinics, Sanford Health of Northern Minnesota, Baker Park, Inc., Sanford West, Sanford Bismarck 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 the Tax Department and reviewed by executive management. An external accounting firm reviews the return. The Tax Departmemt 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 2019. 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 We are reporting one group of top five employees and independent contractors for the entire group. Amounts listed as compensation for the five highest compensated independent contractors include payments for both materials and services.
Form 990, Part XI, line 9: Net payroll and other expenses paid on behalf of parent/affiliates -45,740,892.
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 Research North 120 8th Street South Fargo, ND 58103 EIN: 45-0274828 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 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 0 Sanford Health
 
(2) PPK Family Trust
100 S Phillips Ave
Sioux Falls,SD57104
20-7317570
Rental Real Estate SD 14,563 2,299,182 Sanford Health
 
(3) Lynx Trust
PO Box 5186
Sioux Falls,SD57117
26-6167201
Investment SD 1 2,705 Sanford Health
 
(4) National Student Housing Trust-SD
PO Box 5186
Sioux Falls,SD57117
20-6831968
Investment SD 34 382 Sanford Health
 
(5) Sanford HealthCare Accessories LLC
3223 32nd Ave SW
Fargo,ND58103
20-2404179
Sales of Durable Medical Equip ND 24,272,533 17,686,614 Sanford North
 
(6) Healthcare Environmental Services LLC
PO Box 2010
Fargo,ND58122
20-5236701
Retail Enterprises ND 958,076 4,960,515 Sanford North
 
(7) North Country Senior Living LLC
1000 Anne St NW
Bemidji,MN56601
26-3862586
Senior Housing CO 3,703,272 8,080,138 Sanford Health of Northern Minnesota
 
(8) 1527 Broadway LLC
1527 Broadway
Alexandria,MN56308
41-1336392
Real Estate MN -1,698,118 3,849,426 Sanford Clinic North
 
(9) Shetek Medical Services LLC
251 5th Street E
Tracy,MN56175
41-2004685
Home Health Services MN 457,331 303,835 Sanford Health Network
 
(10) Sanford Health Mobile Med LLC
2603 E Broadway Avenue
Bismarck,ND58501
47-1209528
Mobile Healthcare ND 0 252,904 Sanford Health
 
(11) Southwest MN Radiation Center LLC
1018 6th Avenue
Worthington,MN56187
46-0447693
Radiation Services MN 1,354,238 261,027 Sanford Health Network
 
(12) B&K Properties LLC
PO Box 5039 Rte 5218
Sioux Falls,SD571175030
83-0614887
Real Estate SD 14,551 20,844,005 Sanford Health
 
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,SD571175039
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)F-M Ambulance Service Inc
P O Box 5039 Rte 5218

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

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

Sioux Falls,SD571175039
36-3542187
Foundation ND 501(c)(3) 7 Sanford Health Network North
 
Yes
 
(6)Sanford Health Foundation West
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0397196
Foundation ND 501(c)(3) 7 Sanford Bismarck
 
Yes
 
(7)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
 
(8)Sanford Health Foundation Thief River Falls
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
41-1761135
Foundation MN 501(c)(3) 7 Sanford Health Network North
 
Yes
 
(9)Sanford Health Foundation of Northern Minnesota
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
41-1389317
Foundation MN 501(c)(3) 7 Sanford Health of Northern Minnesota
 
Yes
 
(10)Sanford-Good Samaritan Community Health Services LLC
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
37-1834045
Long-term care, senior living, and post-acute facilities ND 501(c)(3) 12-II The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(11)Adams County Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-1495572
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(12)Alliance Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
20-4714573
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(13)Arlington Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
37-1805492
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(14)Boise Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
36-3370371
Provide low income housing to seniors and other eligible populations SD 501(c)(3) PF The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(15)Brookings Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0439509
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(16)Collister Drive Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
30-0872973
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) PF The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(17)El Paso Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
27-2876627
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(18)Good Samaritan Holdings LLC
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
75-2979560
Development of senior housing and assisted living services SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(19)Good Samaritan Society Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0349951
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(20)Grants Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0439511
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(21)Greeley Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0456087
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(22)Hastings Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0434693
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(23)Hastings Village Gardens Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
27-1212446
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(24)Howard Lake Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
36-4885253
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(25)Indianola County Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-1328052
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(26)Inver Grove Heights Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
76-0789504
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(27)Jasonville Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0396355
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(28)Jeffersontown Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
91-1751137
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(29)Kearney Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0421846
Provide low income housing to seniors and other eligible populations SD 501(c)(3) PF The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(30)Lea County Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-3946645
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(31)LeMars Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
20-4714415
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(32)Lilac Way Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-5740381
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(33)Lovington Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0392944
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(34)Millard Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0396332
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(35)Northport Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
38-3993597
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(36)Olathe Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0396398
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(37)Prescott Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
27-5114421
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(38)Prophetstown Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0392943
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(39)Rapid City Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-1579750
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(40)Sioux Falls 57 Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
20-4714647
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(41)Sioux Falls Downtown Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-2473519
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(42)Sioux Falls Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0385187
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(43)South Daytona Beach Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0461264
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(44)The Evangelical Lutheran Good Samaritan Foundation
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0422866
Foundation MN 501(c)(3) 12-II The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(45)The Evangelical Lutheran Good Samaritan Society
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
45-0228055
Long-term care, senior housing & home and community based services ND 501(c)(3) 12-I Sanford
 
Yes
 
(46)Valentine Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
91-1751139
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(47)Weld County Good Samaritan Housing GP Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-1591360
Low income housing to seniors and other eligible populations as GP SD 501(c)(3) 12-I The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(48)Winfield Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
20-1115155
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
(49)Wisconsin Good Samaritan Housing Inc
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
46-0447338
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
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 N/A
                 
(2) RAC Rentals LLC

100 S Phillips Ave
Sioux Falls,SD57104
26-1961077
Investment SD N/A
                 
(3) Ada County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
36-4799439
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(4) Adams County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
38-3896526
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(5) Belington Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
32-0493132
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(6) Collister Drive Housing LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
61-1752929
Low-income housing to seniors and other eligible populations as GP SD N/A
                 
(7) Colorado Good Samaritan Housing GP LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
30-1164681
Low-income housing to seniors and other eligible populations as GP SD N/A
                 
(8) Fargo Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
30-1141316
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(9) Good Samaritan Insurance Plan of North Dakota

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-5020633
Insurance ND N/A
                 
(10) Good Samaritan Insurance Plan LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-5051671
Insurance DE N/A
                 
(11) Hastings Village Gardens Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
27-1212511
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(12) HMS Heritage Management Services LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
90-0915850
Provide Home Health Services TX N/A
                 
(13) Indianola Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
30-0755780
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(14) Lilac Way Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
36-4786577
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(15) Millard Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
27-1212324
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(16) Olathe Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
20-5297369
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(17) Olds Hall Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
35-2626242
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(18) Pennington County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
38-4060178
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(19) Prescott Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
27-5115281
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(20) Rapid City Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
35-2466169
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(21) Roseville Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(22) Ruth Street Good Samaritan Housing LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
61-1748321
Low-income housing to seniors and other eligible populations as GP SD N/A
                 
(23) Sioux Falls Downtown Good Samaritan LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
32-0377442
Provide low-income housing to seniors and other eligible populations SD N/A
                 
(24) Texas Good Samaritan Housing LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
37-1774574
Low-income housing to seniors and other eligible populations as GP SD N/A
                 
(25) Weld County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
32-0584614
Provide low-income housing to seniors and other eligible populations SD N/A
                 
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 3,686,810 26,498,606 100.000 % Yes  
(2) Sanford Health Plan

300 Cherapa Place
Sioux Falls,SD57103
91-1842494
Insurance SD Sanford Health
 
C -6,930,018 284,764,768 100.000 % Yes  
(3) Sanford Health Plan of MN

300 Cherapa Place
Sioux Falls,SD57103
46-0445852
Insurance MN Sanford Health
 
C -1,215,175 3,403,441 100.000 % Yes  
(4) Sanford Frontiers

1305 W 18th Street PO Box 5039
Sioux Falls,SD571175039
45-5436599
Weight Loss/Fitness SD Sanford Health
 
C -8,076,356 162,396,987 100.000 % Yes  
(5) SOB Inc

2701 S Minnesota Avenue Suite 2
Sioux Falls,SD57105
46-0442628
Air Transportation SD Sanford Health Foundation
 
C -348,527 30,000 100.000 % Yes  
(6) Sanford World Clinics - Ghana

Sarbah Road Tantri Lorry Station
Cape Coast    
GH
Healthcare GH Sanford World Clinics
 
C   4,318,704 100.000 % Yes  
(7) Shanghai Sanford Healthcare Management Consulting Co Ltd

188 Yesheng Road Room A-862 Guoma
Shanghai    
CH
Healthcare CH Sanford World Clinics
 
C   830,847 100.000 % Yes  
(8) Sanford International - Munich GmbH

Nymphenburger Strasse 3
Munich    
GM
Healthcare GM Sanford World Clinics
 
C   11,927,668 100.000 % Yes  
(9) Angels in Waiting Hospice LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
03-0597309
Provide home and community based services TX N/A
S       Yes  
(10) Good Samaritan Humanitarian Service Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
20-5533741
Management and unbundled services; unrelated business activities SD N/A
C       Yes  
(11) Good Samaritan Insurance Plan of Nebraska Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-5037667
Insurance NE N/A
C       Yes  
(12) Good Samaritan Insurance Plan of North Dakota Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-5020633
Insurance ND N/A
C       Yes  
(13) Good Samaritan Insurance Plan of South Dakota Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-4989242
Insurance SD N/A
C       Yes  
(14) Good Samaritan Society Insurance Ltd

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
98-0379099
Insurance CJ N/A
C       Yes  
(15) Heritage Healthcare of Northern New Mexico Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
90-0491537
Provide home and community based services NM N/A
S       Yes  
(16) Heritage Healthcare Services Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
85-0418562
Provide home and community based services NM N/A
S       Yes  
(17) Heritage Home Healthcare & Hospice Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
85-0463468
Provide home and community based services NM N/A
S       Yes  
(18) Heritage Home Healthcare of Arizona Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
20-4243949
Provide home and community based services NM N/A
S       Yes  
(19) Heritage Home Healthcare Services Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
85-0463469
Provide home and community based services NM N/A
S       Yes  
(20) JJEA LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
77-0713538
Provide home and community based services TX N/A
S       Yes  
(21) Olds Hall Good Samaritan Housing GP Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
61-1861635
Low-income housing to seniors and other eligible populations as GP SD N/A
C       Yes  
(22) Roseville Good Samaritan Housing GP Inc

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
Low-income housing to seniors and other eligible populations as GP SD N/A
C       Yes  
(23) Always Above and Beyond Home Health Care Services LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
26-3456679
Provide home and community based services TX N/A
S       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 34,877,588 Cost
(2) Sanford Health Foundation

B 100,182 Cost
(3) Sanford Health Foundation

R 4,950,987 Cost
(4) Sanford Health Foundation North

C 4,634,587 Cost
(5) Sanford Health Foundation North

R 3,439,848 Cost
(6) Sanford World Clinic Ghana

B 1,459,125 Cost
(7) Sanford Health Foundation West

P 1,133,084 Cost
(8) Sanford Health Foundation of Northern Minnesota

C 973,117 Cash Basis
(9) Sanford Health Foundation of Northern Minnesota

R 544,277 Cost
(10) F-M Ambulance Service Inc

S 4,636,685 Cost
(11) The Evangelical Lutheran Good Samaritan Society

S 5,719,657 Cost
(12) Sanford

S 79,892,584 Cost
(13) Sanford

C 61,112,915 Cost
(14) Sanford Frontiers

B 55,142,438 Cost
(15) Sanford Health Plan

B 4,250,000 Cost
(16) Sanford Health Plan of Minnesota

B 2,300,000 Cost
(17) Heart of America

B 750,000 Cost
(18) SOB Inc

B 237,277 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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