TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JAMES HEREFORD...................................................................... PRESIDENT/CE	40.00 ................. 0.00	X	X				3,290,078	0	266,908
(2) MICHAEL CAMPOLI M D...................................................................... SURGEON	40.00 ................. 0.00				X		1,903,402	0	58,138
(3) ROHANN LALL MD...................................................................... SURGEON	40.00 ................. 0.00				X		1,551,764	0	58,152
(4) DANIEL M FROMM...................................................................... CHIEF FINANC	40.00 ................. 0.00		X				1,359,854	0	233,344
(5) JOHN DOHERTY...................................................................... SR. OPERATIN	40.00 ................. 0.00		X				1,094,991	0	228,887
(6) LAURA REED RN...................................................................... CHIEF NURSIN	40.00 ................. 0.00		X				1,145,199	0	141,287
(7) ROBERT BEACHER...................................................................... CHIEF OF SHA	40.00 ................. 0.00			X			974,284	0	190,781
(8) MARK WELTON MD...................................................................... CHIEF MEDICA	40.00 ................. 0.00		X				952,981	0	155,632
(9) TRUDI TRYSLA...................................................................... CHIEF LEGAL	40.00 .................		X				805,364	0	149,933
(10) CAROLYN JACOBSON...................................................................... CHIEF HR OFF	40.00 ................. 0.00		X				664,285	0	160,144
(11) WILLIAM OMILE MD...................................................................... SURGEON	40.00 ................. 0.00				X		731,392	0	70,505
(12) DAVID CROSBY...................................................................... CHIEF VALUE	0.00 ................. 40.00		X				0	737,454	35,495
(13) JAMES LORGE MD...................................................................... SURGEON	40.00 ................. 0.00				X		690,510	0	58,955
(14) BRADLEY PIERCE MD...................................................................... PHYSICIAN	40.00 ................. 0.00				X		676,191	0	61,275
(15) JOHN BATSON...................................................................... CHEIF FINANC	40.00 ................. 0.00		X				628,312	0	46,793
(16) ALISTAIR JACQUES...................................................................... FORMER CIO	0.00 ................. 0.00					X	616,429	0	0
(17) SAMEER BADLANI...................................................................... CHF INFORMAT	40.00 ................. 0.00		X				494,552	0	35,701

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) SCOTT WEBER........................................................................ CHF MRKTG CO	40.00 .......................0.00		X		370,844	35,937
(19) PATRICK BELLAND........................................................................ FORMER PRES-	0.00 .......................0.00			X	392,143	0
(20) SRIJOY MAHAPATRA........................................................................ CHF STRATEGY	40.00 .......................0.00		X		364,255	19,511
(21) MICHAEL J YOUSO........................................................................ PRES-GICH EN	40.00 .......................0.00		X		188,455	84,895
(22) JOHN HERMAN........................................................................ FORMER PRES	0.00 .......................0.00			X	262,139	0
(23) PATRICK ADAMS........................................................................ CHF OF STAFF	40.00 .......................0.00		X		165,070	49,022
(24) MARK THOMAS........................................................................ FORMER PRES	0.00 .......................0.00			X	114,412	0
(25) RICHARD OSTLUND........................................................................ CHAIR	2.00 .......................0.00	X	X		35,000	0
(26) KAREN GRABOW........................................................................ SECRETARY	2.00 .......................0.00	X			25,000	0
(27) JOHN HEINMILLER........................................................................ DIRECTOR	2.00 .......................0.00	X			25,000	0
(28) ANN HENGEL........................................................................ DIRECTOR, EN	2.00 .......................0.00	X			25,000	0
(29) ANN LOWRY MD........................................................................ VICE CHAIR	2.00 .......................0.00	X			25,000	0
(30) CAROL LEY MD........................................................................ DIRECTOR	2.00 .......................0.00	X			25,000	0
(31) BRADFORD WALLIN........................................................................ DIRECTOR	2.00 .......................0.00	X			25,000	0
(32) JULIE CAUSEY........................................................................ DIRECTOR	2.00 .......................0.00	X			20,000	0
(33) MICHAEL CONNLY........................................................................ DIRECTOR	2.00 .......................0.00	X			20,000	0
(34) RICH THOMPSON MD........................................................................ DIRECTOR	2.00 .......................0.00	X			20,000	0
(35) TIMOTHY MARX........................................................................ DIRECTOR	2.00 .......................0.00	X			20,000	0
(36) KENNETH ROERING........................................................................ DIRECTOR	2.00 .......................0.00	X			20,000	0
(37) BETSY WERGIN........................................................................ DIRECTOR	2.00 .......................0.00	X			20,000	0
(38) JODI RICHARD........................................................................ DIRECTOR, NE	2.00 .......................0.00	X			15,000	0
(39) KEVIN ROBERG........................................................................ DIRECTOR, EN	2.00 .......................0.00	X			10,000	0
(40) BARCLAY BERDAN........................................................................ DIRECTOR, NE	2.00 .......................0.00	X			2,500	0
(41) BRIAN BURNETT........................................................................ DIRECTOR	2.00 .......................0.00	X			0	0
(42) JAKUB TOLAR MD........................................................................ VICE CHAIR	2.00 .......................0.00	X			0	0
(43) MELISSA GELLER MD........................................................................ DIRECTOR, NE	2.00 .......................0.00	X			0	0
(44) SOPHIA VINOGRADOV........................................................................ DIRECTOR, EN	2.00 .......................0.00	X			0	0

(A) Name and business address	(B) Description of services	(C) Compensation
UNIVERSITY OF MINNESOTA PHYSICIANS 420 DELAWARE ST NE MINNEAPOLIS,MN55455	MEDICAL/PHYSICI	510,229,657
UNIVERSITY OF MINNESOA REGENTS 420 DELAWARE ST NE MINNEAPOLIS,MN55455	EDUCAITON	100,551,768
CUSHMAN & WAKEFIELD OF MN INC 3500 AMERICAN BLVD W SUITE 200 BLOOMINGTON,MN554311096	MGMT SERVICES	32,007,045
RIGHTSOURCING INC 999 STEWART AVE STE 100 BETHANY,NY11714	STAFFING	27,887,232
LIFESOURCE 2550 UNIVERSITY AVE W ST PAUL,MN55114	STAFFING	17,041,114
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 185

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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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

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

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.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

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)		(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)		(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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 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

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

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

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

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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

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

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

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

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.

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) .

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).

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

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

Did a disqualified person (as defined in line 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.

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

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

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

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

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

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

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

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 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

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

Caution: An organization that 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 FAIRVIEW HEALTH SERVICES

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization FAIRVIEW HEALTH SERVICES		Employer identification number 41-0991680

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 FAIRVIEW HEALTH SERVICES			Employer identification number 41-0991680
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go 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

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Part I-A

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

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

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

Yes

784,678

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

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

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

784,678

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1	DURING 2019 FAIRVIEW HEALTH SERVICES (FAIRVIEW) OFFICIALS HAD MEETINGS AND CONTACTS WITH BOTH FEDERAL AND STATE GOVERNMENT OFFICIALS, CONGRESSIONAL STAFF AND REPRESENTATIVES TO DISCUSS VARIOUS HEALTH CARE REFORM AND MEDICARE PROPOSALS AND PROPOSED LEGISLATION. FAIRVIEW HAS CORRESPONDED WITH REPRESENTATIVES, STAFF AND GOVERNMENT OFFICIALS OUTLINING CONCERNS AND RECOMMENDATIONS REGARDING HEALTH CARE REFORM AND OTHER HEALTH CARE RELATED TOPICS. MANY OF THESE ACTIVITIES WERE CONDUCTED BY EMPLOYEES OF FAIRVIEW AND THE EXPENDITURES FOR THIS ACTIVITY TOTALED APPROXIMATELY 147,801. ADDITIONALLY, FAIRVIEW PAID APPROXIMATELY 636,877 TO OUTSIDE LOBBYISTS IN 2019. THIS AMOUNT INCLUDES AN AMOUNT OF MINNESOTA HOSPITAL ASSOCIATION DUES THAT WAS DETERMINED TO BE USED FOR LOBBYING ACTIVITIES. FAIRVIEW ALSO PROVIDED INFORMATION AND/OR EXPRESSED ITS CONCERN TO LEGISLATIVE BODIES AND GOVERNMENT OFFICIALS ON MATTERS DIRECTLY RELATED TO HEALTH, THE DELIVERY OF HEALTH CARE AND MEDICAL EDUCATION AND/OR RESEARCH. SUCH ACTIVITY IS NORMALLY AT THE REQUEST OF A LEGISLATIVE BODY, COMMITTEE OR MEMBER. IN 2019, FAIRVIEW REPRESENTATIVES HAD MEETINGS WITH MEMBERS OF THE LEGISLATIVE/EXECUTIVE BRANCHES OF GOVERNMENT TO DISCUSS ISSUES RELATING TO HEALTH CARE AND HEALTH CARE REFORM. FAIRVIEW MAY ALSO MEET WITH MEMBERS OF GOVERNMENT TO DISCUSS ISSUES DEALING WITH FAIRVIEW'S TAX EXEMPT STATUS AND HEALTH CARE ISSUES INCLUDING SALES TAX EXEMPTION, STATE HEALTH CARE REFORM, REAL ESTATE TAX ISSUES, MEDICAID, PHYSICIAN LICENSING, ETC. FAIRVIEW BELIEVES THESE INFORMATIONAL MEETINGS ARE ESSENTIAL TO SUPPORT OUR CHARITABLE PURPOSE AND DO NOT CONSTITUTE ATTEMPTS TO INFLUENCE SPECIFIC LEGISLATION.

Return Reference

Explanation

SCHEDULE C, PART II-B, LINE 1

DURING 2019 FAIRVIEW HEALTH SERVICES (FAIRVIEW) OFFICIALS HAD MEETINGS AND CONTACTS WITH BOTH FEDERAL AND STATE GOVERNMENT OFFICIALS, CONGRESSIONAL STAFF AND REPRESENTATIVES TO DISCUSS VARIOUS HEALTH CARE REFORM AND MEDICARE PROPOSALS AND PROPOSED LEGISLATION. FAIRVIEW HAS CORRESPONDED WITH REPRESENTATIVES, STAFF AND GOVERNMENT OFFICIALS OUTLINING CONCERNS AND RECOMMENDATIONS REGARDING HEALTH CARE REFORM AND OTHER HEALTH CARE RELATED TOPICS. MANY OF THESE ACTIVITIES WERE CONDUCTED BY EMPLOYEES OF FAIRVIEW AND THE EXPENDITURES FOR THIS ACTIVITY TOTALED APPROXIMATELY 147,801. ADDITIONALLY, FAIRVIEW PAID APPROXIMATELY 636,877 TO OUTSIDE LOBBYISTS IN 2019. THIS AMOUNT INCLUDES AN AMOUNT OF MINNESOTA HOSPITAL ASSOCIATION DUES THAT WAS DETERMINED TO BE USED FOR LOBBYING ACTIVITIES. FAIRVIEW ALSO PROVIDED INFORMATION AND/OR EXPRESSED ITS CONCERN TO LEGISLATIVE BODIES AND GOVERNMENT OFFICIALS ON MATTERS DIRECTLY RELATED TO HEALTH, THE DELIVERY OF HEALTH CARE AND MEDICAL EDUCATION AND/OR RESEARCH. SUCH ACTIVITY IS NORMALLY AT THE REQUEST OF A LEGISLATIVE BODY, COMMITTEE OR MEMBER. IN 2019, FAIRVIEW REPRESENTATIVES HAD MEETINGS WITH MEMBERS OF THE LEGISLATIVE/EXECUTIVE BRANCHES OF GOVERNMENT TO DISCUSS ISSUES RELATING TO HEALTH CARE AND HEALTH CARE REFORM. FAIRVIEW MAY ALSO MEET WITH MEMBERS OF GOVERNMENT TO DISCUSS ISSUES DEALING WITH FAIRVIEW'S TAX EXEMPT STATUS AND HEALTH CARE ISSUES INCLUDING SALES TAX EXEMPTION, STATE HEALTH CARE REFORM, REAL ESTATE TAX ISSUES, MEDICAID, PHYSICIAN LICENSING, ETC. FAIRVIEW BELIEVES THESE INFORMATIONAL MEETINGS ARE ESSENTIAL TO SUPPORT OUR CHARITABLE PURPOSE AND DO NOT CONSTITUTE ATTEMPTS TO INFLUENCE SPECIFIC LEGISLATION.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," 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

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

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 ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

Endowment Funds.
Complete if the organization answered "Yes" 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 ....	5,757,124	6,178,465	1,512,011	1,459,459	1,456,099
b	Contributions ...	148,110	38,521	52,144	52,743	19,523
c	Net investment earnings, gains, and losses		-461,060	12,253	408	-15,640
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	-40,158	1,198	-579	-598	-523
g	End of year balance ......	5,865,076	5,757,124	1,575,829	1,512,011	1,459,459

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

30.020 %

Term endowment SchDMd Bullet

69.980 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

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

Yes

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....	25,701,194		25,701,194
b	Buildings ....	1,270,915,105	682,165,180	588,749,925
c	Leasehold improvements	45,298,006	30,446,838	14,851,168
d	Equipment ....	680,710,787	548,166,003	132,544,784
e	Other .....	217,223,614	60,420,003	156,803,611
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				918,650,682

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther 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.)

Part VIII

InvestmentsProgram 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.)

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)INVESTMENT IN AFFILIATES				557,309,472
(2)DEFERRED PREMIUMS & INS. RECOVERIES				21,297,153
(3)INVESTMENTS HELD BY INS SUB				16,441,149
(4)OTHER LONG TERM				2,377,732
(5)DEBT SERVICE RESERVE FUND				65,943
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				597,491,449

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
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	824,237,399
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

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
SCHEDULE D, PAGE 2, PART V, LINE 4	THE INTENDED USES FOR THE ENDOWMENT FUNDS IS FOR EDUCATIONAL GRANTS AND AWARDS THAT ARE GIVEN THROUGH THE FAIRVIEW FOUNDATION.
SCHEDULE D, PAGE 3, PART X	FAIRVIEW RECOGNIZES ALL TAX POSITIONS, INCLUDING THOSE POSITIONS IN A PREVIOUSLY FILED TAX RETURN OR A POSITION EXPECTED TO BE TAKEN IN A FUTURE TAX FILING THAT IS REFLECTED IN MEASURING CURRENT OR DEFERRED INCOME TAX ASSETS AND LIABILITIES, WHEN IT IS MORE LIKELY THAN NOT (LIKELIHOOD OF GREATER THAN 50%) THAT, BASED ON TECHNICAL MERITS, THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THERE ARE NO UNCERTAIN TAX POSITIONS RECORDED IN THE CONSOLIDATED BALANCE SHEETS AS OF DECEMBER 31, 2019 OR 2018. FAIRVIEW HAS MADE REASONABLE ESTIMATES OF THE PROVISION FOR INCOME TAXES AND ON EXISTING DEFERRED TAX BALANCES BASED ON ACCOUNTING GUIDANCE INCLUDED IN ASC 740, INCOME TAXES. FAIRVIEW DOES NOT EXPECT THAT THERE WILL BE A SIGNIFICANT CHANGE IN THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS WITHIN THE NEXT 12 MONTHS.
SCHEDULE D, PAGE 4, PART XIII	SCHEDULE D, PART V: ON AUGUST 31, 2018, HEALTHEAST FOUNDATION WAS MERGED INTO FAIRVIEW FOUNDATION. THE AMOUNT ON SCHEDULE D, PART V, LINE 1A, COLUMNS A AND B INCLUDE THE BALANCES THAT WERE TRANSFERRED INTO FAIRVIEW FOUNDATION ON SEPTEMBER 1, 2018 FROM HEALTHEAST FOUNDATION AND ARE NOW PART OF FAIRVIEW FOUNDATION. COLUMNS C, D AND E REFLECT THE AMOUNTS FOR FAIRVIEW FOUNDATION ONLY.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right pointing arrow large image

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
FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Part I

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

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

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

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

Yes

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

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

(a) Region		(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
	CENTRAL AMERICA AND CARIBBEAN	1	PROGRAM SERVICES	INSURANCE	19,669,396
	CENTRAL AMERICA AND CARIBBEAN		INVESTMENT		66,609,550















3a	Sub-total ....	1			86,278,946
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)	1			86,278,946

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)

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

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

Page 4

Part IV

Foreign Forms

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
SCHEDULE F, PAGE 1, PART I, LINE 3	CENTRAL AMERICA AND CARIBBEAN 19,669,396 0 CENTRAL AMERICA AND CARIBBEAN 0 66,609,550

Schedule F (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	23,195,018	8,622,010	14,573,008	0.360 %
b	Medicaid (from Worksheet 3, column a) . . . . .	499,811,435	355,616,722	144,194,713	3.560 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	523,006,453	364,238,732	158,767,721	3.910 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	3,736,862		3,736,862	0.090 %
f	Health professions education (from Worksheet 5) . . .	103,325,709	16,454,364	86,871,345	2.140 %
g	Subsidized health services (from Worksheet 6) . . . .	36,498,380	31,026,648	5,471,732	0.130 %
h	Research (from Worksheet 7) .	6,595,145	3,642,708	2,952,437	0.070 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	729,544		729,544	0.020 %
j	Total. Other Benefits . .	150,885,640	51,123,720	99,761,920	2.460 %
k	Total. Add lines 7d and 7j .	673,892,093	415,362,452	258,529,641	6.370 %

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.

		(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing
2	Economic development
3	Community support	29,795	29,795
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	29,795	29,795

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

80,804,724

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. ......

1,616,094

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

Section B. Medicare

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

707,810,992

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

882,359,341

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

-174,548,349

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 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?5Name, 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)
1	UNIVERSITY OF MINNESOTA MEDICAL CEN 2450 RIVERSIDE AVENUE MINNEAPOLIS,MN554541450 SEE SECTION C, LINE 7D 366425	X	X	X	X	X	X
2	FAIRVIEW SOUTHDALE HOSPITAL 6401 FRANCE AVENUE S EDINA,MN554352104 SEE SECTION C, LINE 7D 366381	X	X				X
3	FAIRVIEW RIDGES HOSPITAL 201 E NICOLLET BLVD BURNSVILLE,MN553375714 SEE SECTION C, LINE 7D 365864	X	X				X
4	FAIRVIEW LAKES REGIONAL MEDICAL CTR 5200 FAIRVIEW BLVD WYOMING,MN550928013 SEE SECTION C, LINE 7D 365838	X	X				X
5	FAIRVIEW NORTHLAND REGIONAL HOSP 911 NORTHLAND DR PRINCETON,MN553712172 SEE SECTION C, LINE 7D 365842	X	X				X

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)

	UNIVERSITY OF MINNESOTA MEDICAL CEN
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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

Yes

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..................................

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

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

Yes

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

Hospital facility’s website (list url): SEE SECTION C, LINE 7D

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

If "Yes" (list url): SEE SECTION C, LINE 7D

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

10b

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

12a

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

12a

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

12b

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

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	UNIVERSITY OF MINNESOTA MEDICAL CEN
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

The FAP was widely available on a website (list url):

SEE SECTION C, LINE 16J

The FAP application form was widely available on a website (list url):

SEE SECTION C, LINE 16J

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C, LINE 16J

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	UNIVERSITY OF MINNESOTA MEDICAL CEN
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	UNIVERSITY OF MINNESOTA MEDICAL CEN
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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)

	FAIRVIEW SOUTHDALE HOSPITAL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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..................................

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

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

Yes

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

Hospital facility’s website (list url): SEE SECTION C, LINE 7D

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

If "Yes" (list url): SEE SECTION C, LINE 7D

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

10b

12a

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

12a

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

12b

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

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FAIRVIEW SOUTHDALE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

The FAP was widely available on a website (list url):

SEE SECTION C, LINE 16J

The FAP application form was widely available on a website (list url):

SEE SECTION C, LINE 16J

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C, LINE 16J

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

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

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

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FAIRVIEW SOUTHDALE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	FAIRVIEW SOUTHDALE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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)

	FAIRVIEW RIDGES HOSPITAL
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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..................................

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

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

Yes

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

Hospital facility’s website (list url): SEE SECTION C, LINE 7D

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

If "Yes" (list url): SEE SECTION C, LINE 7D

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

10b

12a

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

12a

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

12b

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

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FAIRVIEW RIDGES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

The FAP was widely available on a website (list url):

SEE SECTION C, LINE 16J

The FAP application form was widely available on a website (list url):

SEE SECTION C, LINE 16J

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C, LINE 16J

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

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

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

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FAIRVIEW RIDGES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	FAIRVIEW RIDGES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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)

	FAIRVIEW LAKES REGIONAL MEDICAL CTR
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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..................................

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

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

Yes

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

Hospital facility’s website (list url): SEE SECTION C, LINE 7D

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

If "Yes" (list url): SEE SECTION C, LINE 7D

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

10b

12a

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

12a

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

12b

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

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FAIRVIEW LAKES REGIONAL MEDICAL CTR
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

The FAP was widely available on a website (list url):

SEE SECTION C, LINE 16J

The FAP application form was widely available on a website (list url):

SEE SECTION C, LINE 16J

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C, LINE 16J

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

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

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

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FAIRVIEW LAKES REGIONAL MEDICAL CTR
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	FAIRVIEW LAKES REGIONAL MEDICAL CTR
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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)

	FAIRVIEW NORTHLAND REGIONAL HOSP
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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..................................

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

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

Yes

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

Hospital facility’s website (list url): SEE SECTION C, LINE 7D

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

If "Yes" (list url): SEE SECTION C, LINE 7D

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

10b

12a

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

12a

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

12b

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

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FAIRVIEW NORTHLAND REGIONAL HOSP
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

The FAP was widely available on a website (list url):

SEE SECTION C, LINE 16J

The FAP application form was widely available on a website (list url):

SEE SECTION C, LINE 16J

A plain language summary of the FAP was widely available on a website (list url):
SEE SECTION C, LINE 16J

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

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

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

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FAIRVIEW NORTHLAND REGIONAL HOSP
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	FAIRVIEW NORTHLAND REGIONAL HOSP
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 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
FACILITY 1, UNIVERSITY OF MINNESOTA MEDICAL CEN - PART V, LINE 3E	IN ORDER TO DETERMINE THE TOP HEALTH NEEDS IN THE COMMUNITY INDICATORS FROM SECONDARY DATA; DATA FROM WILDER RESEARCH ON THE LEADING CAUSES OF DEATH AND PREMATURE DEATH, AND THE SOCIAL DETERMINANTS OF HEALTH; AND PRIMARY DATA THAT MET TWO PIECES OF CRITERIA: (1) A NEED AND/OR BARRIER THAT WAS SAID MORE THAN ONE TIME, AND (2) A NEED AND/OR BARRIER THAT WAS REPEATED IN AT LEAST TWO OF THE GROUPS (E.G. BOTH A STAKEHOLDER INTERVIEW AND A COMMUNITY CONVERSATION) WERE USED. THE MEDICAL CENTER'S COMMUNITY HEALTH STEERING COMMITTEE REVIEWED AND VALIDATED FINDINGS FROM THE PRIMARY AND SECONDARY DATA, AND RECOMMENDED THREE HEALTH NEEDS BE ADOPTED FOR THE MEDICAL CENTER. THE THREE HEALTH NEEDS ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS. WEIGHTED CRITERIA WAS USED TO PRIORITIZE HEALTH NEEDS. HIGHEST WEIGHT WAS GIVEN TO THE TWO CRITERION DEEMED MOST IMPORTANT BY THE STEERING COMMITTEE - CONTINUING WORK IN PREVIOUS CHNA PRIORITY AREAS AND ENSURING FUTURE PRIORITIES ALIGNED WITH WHAT THE COMMUNITY IDENTIFIED AS TOP NEEDS. THE PRIORITIZATION CRITERIA WAS APPLIED TO THE TOP 30 HEALTH NEEDS IDENTIFIED IN THE MEDICAL CENTER COMMUNITY. THE TOP 10 HEALTH NEEDS INCLUDE: 1.MENTAL HEALTH 2.CHRONIC DISEASE 3.STRESS 4.STIGMA - MENTAL HEALTH 5.SUICIDE 6.HEART DISEASE 7.CANCER 8.PSYCHOLOGICAL TRAUMA 9.SUBSTANCE USE 10.TIED FOR TENTH (1) STROKE (2) CHRONIC LOWER RESPIRATORY DISEASE (3) ALZHEIMER'S DISEASE THROUGH A VOTING PROCESS, THE UNIVERSITY OF MINNESOTA MEDICAL CENTER COMMUNITY HEALTH STEERING COMMITTEE VALIDATED THE FOLLOWING PRIORITY HEALTH NEEDS: MENTAL HEALTH AND WELL-BEING HEALTHY LIFESTYLES AND ACCESS TO CARE AND RESOURCES. THESE THREE PRIORITIES ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS.
FACILITY 1, UNIVERSITY OF MINNESOTA MEDICAL CEN - PART V, LINE 5	UNIVERSITY OF MINNESOTA MEDICAL CENTER HAS CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) SINCE 1995 TO SYSTEMATICALLY IDENTIFY, ANALYZE, AND PRIORITIZE THE CRITICAL NEEDS OF THE COMMUNITY AND ADDRESS THOSE NEEDS. THE 2018 CHNA BUILDS UPON PREVIOUS ASSESSMENTS AND WAS DEVELOPED IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS, LOCAL PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. IT SERVES AS A TOOL FOR GUIDING POLICY, ADVOCACY, AND PROGRAM PLANNING. IT ALSO FULFILLS IRS REQUIREMENTS FOR CHNA AND IMPLEMENTATION STRATEGIES PURSUANT TO THE AFFORDABLE CARE ACT OF 2010, WHICH REQUIRES 501(C)(3) NONPROFIT HOSPITALS TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS AND PROVIDE AN ANNUAL EVALUATION OF IMPACT OF THE PREVIOUS IMPLEMENTATION STRATEGY. FOR ADDITIONAL DETAIL, SEE SECTION TITLED, EVALUATION OF IMPACT, 2019-2021 CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, THE MEDICAL CENTER AIMS TO: -UNDERSTAND THE HEALTH STATUS AND NEEDS OF THE COMMUNITY IT SERVES BY ANALYZING CURRENT DEMOGRAPHICS, HEALTH DATA, AND BY COLLECTING DIRECT INPUT FROM COMMUNITY MEMBERS AND ORGANIZATIONS. -IDENTIFY THE STRENGTHS, ASSETS, AND RESOURCES AVAILABLE IN THE COMMUNITY TO SUPPORT HEALTH AND WELL-BEING. -ADDRESS SIGNIFICANT HEALTH NEEDS THROUGH PARTNERSHIPS WITH COMMUNITY MEMBERS AND ORGANIZATIONS, PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. -CREATE A STRATEGIC IMPLEMENTATION PLAN REFLECTIVE OF THE DATA COLLECTED THROUGH THE CHNA PROCESS. -INFORM THE MEDICAL CENTER'S COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING LIST OF INDIVIDUALS ARE MEMBERS OF THAT STEERING COMMITTEE: ALYSSA SCHOEN, UNIVERSITY OF MINNESOTA MEDICAL CENTER ANN SHELP, UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL BRUCE MCCARTHY, PEOPLE'S CENTER CLINICS AND SERVICES CARLA NIELSON, MINNEAPOLIS POLICE DEPARTMENT FIRST PRECINCT CAROLINE DUNN O'BRIEN, EPIDEMIOLOGIST CONSULTANT IDOLLY OLIVIA, UNIVERSITY OF MINNESOTA MEDICAL CENTER KIARA ELLIS, MASONIC CANCER CENTER, UNIVERSITY OF MINNESOTA LILIANA TOBON-GOMEZ, HENNEPIN COUNTY HUMAN SERVICES AND PUBLIC HEALTH DEPARTMENT OSMAN HARARE, EAST AFRICA HEALTH PROJECT SARAH STEWART, CITY OF MINNEAPOLIS PUBLIC HEALTH DEPARTMENT SUSAN PALCHICK, HENNEPIN COUNTY HUMAN SERVICES AND PUBLIC HEALTH DEPARTMENT SUZANNE BURKE-LEHMAN, ST. KATE'S DEPARTMENT OF NURSING
FACILITY 1, UNIVERSITY OF MINNESOTA MEDICAL CEN - PART V, LINE 7D	SCHEDULE H, PART V, LINE 7A & LINE 10A: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE LOCATED AT: HTTP://WWW.FAIRVIEW.ORG/OUR-COMMUNITY-COMMITMENT/LOCAL-HEALTH-NEEDS
FACILITY 1, UNIVERSITY OF MINNESOTA MEDICAL CEN - PART V, LINE 11	COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) WERE CONDUCTED IN 2018. AN ESSENTIAL PART OF THE CHNA PROCESS WAS THE IDENTIFICATION OF PRIORITY NEEDS IN THE LOCAL COMMUNITY. THE HOSPITALS AND/OR MEDICAL CENTERS IDENTIFIED THE FOLLOWING PRIORITY NEEDS FOR UNIVERSITY OF MINNESOTA MEDICAL CENTER AND UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL: MENTAL HEALTH AND WELL-BEING, HEALTHY LIFESTYLES, ACCESS TO CARE AND SERVICES. EACH HOSPITAL AND/OR MEDICAL CENTER DEVELOPED A HOSPITAL SPECIFIC IMPLEMENTATION PLAN AROUND ITS PRIORITY HEALTH ISSUES ALONG WITH A SYSTEM FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE TO ADDRESS THEIR IDENTIFIED PRIORITY NEEDS. EACH PROGRAM IS EVALUATED ON AN ANNUAL BASIS AGAINST PROGRAM SPECIFIC ANTICIPATED IMPACTS. AS PART OF THE EVALUATION PROCESS EACH PROGRAM INDICATOR IS ASSIGNED A VALUE OF "GREEN", "YELLOW- OR "RED" BASED UPON THE CRITERIA THAT FOLLOWS. A RATING OF "GREEN" MEANS THAT THE PROGRAM (A) MET, OR EXCEEDED, 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO BOTH GOAL/S AND ANTICIPATED IMPACT/S (C) THERE IS AN EVALUATION TOOL WITH MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "YELLOW" MEANS THAT THE PROGRAM (A) HAD PARTIAL COMPLETION OF 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO EITHER GOAL/S OR ANTICIPATED IMPACT/S BUT NOT BOTH (C)THERE IS AN EVALUATION TOOL WITHOUT MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "RED" MEANS THAT THE PROGRAM (A) DID NOT COMPLETE THE 2019 HOSPITAL GOAL/S WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) THERE WAS NO COUNT DATA (C) THERE WAS NO EVALUATION TOOL/S. POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE INITIATIVES OFTEN TAKE MULTIPLE YEARS TO PLAN AND IMPLEMENT. USING A CDC EVALUATION FRAMEWORK EACH PSE INITIATIVE IS MONITORED AND EVALUATED ANNUALLY AGAINST ANTICIPATED ACTIVITIES AND MILESTONES LINKED TO THE SIX CONNECTED PSE EVALUATION STEPS. THE SIX CONNECTED STEPS OF PSE CHANGE WE TRACKED FOR MONITORING AND EVALUATION PURPOSES ARE (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, (3) FOCUS THE EVALUATION DESIGN, (4) GATHER CREDIBLE EVIDENCE, (5) JUSTIFY CONCLUSIONS, AND (6) ENSURE USE AND SHARE LESSONS LEARNED. OUR 2019 EVALUATION OF THE PSE INITIATIVES NOTE THE SPECIFIC PSE STEP/S FOR THAT INITIATIVES BASED ON THE ACTIVITIES. IN 2020 WE ARE IDENTIFYING PSE INITIATIVE SPECIFIC METRICS RELATED TO EACH STEP TO DEEPEN OUR EVALUATION OF OUTCOMES IN FUTURE YEARS. ANY PROGRAMMATIC ANTICIPATED IMPACT THAT RECEIVED A RATING OF "YELLOW- OR "RED" HAS A CORRESPONDING BRIEF EXPLANATION AND 2020 ACTION PLAN. IN 2020 WE WILL CONTINUE REFINING THE RATING SYSTEM AND CORRESPONDING PROGRAMMATIC AND PSE EVALUATION AS PART OF OUR COMMITMENT TO CONTINUOUS PROCESS IMPROVEMENT. DETAILED RESULTS AND ACTION PLANS ON PROGRAM AND PSE INITIATIVES ARE AVAILABLE UPON REQUEST. PRIORITY: MENTAL HEALTH AND WELLBEING THE UNIVERSITY OF MINNESOTA MEDICAL CENTER OFFERED THE EVIDENCE-BASED MENTAL HEALTH FIRST AID PROGRAM. THE PROGRAM INTRODUCES RISK FACTORS AND WARNING SIGNS OF COMMON MENTAL HEALTH AND SUBSTANCE USE DISORDERS, BUILDS UNDERSTANDING OF THEIR IMPACT, AND REVIEWS SUPPORT OPTIONS. THE INTERACTIVE COURSE TEACHES PARTICIPANTS HOW TO OFFER INITIAL HELP TO AN INDIVIDUAL WHO MAY BE EXPERIENCING A MENTAL HEALTH CONCERN OR CRISIS AND CONNECT THEM TO THE APPROPRIATE RESOURCES. YOUTH MENTAL HEALTH FIRST AID IS THE SECOND CORE PROGRAM WHICH FOCUSES ON MENTAL HEALTH CONCERNS AMONG YOUTH AGES 12-18. THE 2019 ANTICIPATED IMPACT FOR THE MENTAL HEALTH FIRST AID PROGRAMS WAS AN INCREASE IN PARTICIPANTS' ABILITY TO RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH AND MENTAL ILLNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 93% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THEY CAN RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH, SUBSTANCE USE AND MENTAL ILLNESS AS I ENCOUNTER THEM. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER OFFERED THE EVIDENCE-BASED STRESS REDUCTION SUITE WHICH INCLUDED TWO PROGRAMS (1) FLOURISH A RESTORATIVE FOUR-WEEK SERIES, THAT LETS PARTICIPANTS EXPERIENCE A VARIETY OF MIND-BODY PRACTICES DESIGNED TO PROMOTE A SENSE OF CALM, JOY, CONNECTION, AND INNER STRENGTH. A FEW OF THE PRACTICES EXPLORED ARE MOVING MEDITATION, JOURNALING, GUIDED IMAGERY, AND MINDFULNESS. (2) RESILIENCY AND STRESS MANAGEMENT TRAINING SERIES A RESTORATIVE SIX-WEEK SERIES, BASED ON CENTER MIND BODY MEDICINE, 90-MINUTE SESSIONS. PARTICIPANTS EXPERIENCE A VARIETY OF MIND-BODY PRACTICES DESIGNED TO PROMOTE A SENSE OF CALM, JOY, CONNECTION, AND INNER STRENGTH. A FEW OF THE PRACTICES EXPLORED BY PARTICIPANTS INCLUDE MOVING MEDITATION, JOURNALING, GUIDED IMAGERY, AND MINDFULNESS. THIS MIND BODY SERIES IS A PROVEN METHOD TO REDUCE STRESS, INCREASE SELF-ESTEEM, AND IMPROVE A PERSON'S OVERALL QUALITY OF LIFE. THE 2019 ANTICIPATED IMPACT FOR THE STRESS REDUCTION SUITE WAS A DECREASE IN PARTICIPANTS' PERCEIVED STRESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 1.77 POINTS DECREASE FROM PRE-PROGRAM-SURVEY TO POST-PROGRAM-SURVEY IN RESPONSE TO THE FOLLOWING METRIC: PARTICIPANTS' PERCEIVED STRESS. AVERAGE CHANGE (DECREASE) IN PARTICIPANTS' PERCEIVED STRESS ON A 10 POINT SCALE - THE HIGHER THE SCORE, THE MORE THE PERCEIVED STRESS. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER OFFERED SERVICES AT HEALTH COMMONS - CEDAR RIVERSIDE, A HEALTH AND WELLNESS DROP-IN CENTER LOCATED IN THE CEDAR RIVERSIDE NEIGHBORHOOD OF MINNEAPOLIS. HEALTH COMMONS IS OPEN FIVE DAYS A WEEK FOR TWO TO THREE HOURS AND PROVIDES THE FOLLOWING SERVICES: HEALTH CONSULTATIONS, NUTRITION AND PHYSICAL ACTIVITY CLASSES, MASSAGE AND HEALING TOUCH SERVICES, AND RESOURCES AND REFERRALS. THE 2019 ANTICIPATED IMPACT FOR HEALTH COMMONS - CEDAR RIVERSIDE WAS AN INCREASE IN PARTICIPANTS' SELF-REPORTED SOCIAL CONNECTEDNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 93.1% OF PARTICIPANTS THAT RESPONDED TO THE CONVENIENCE SAMPLE SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE THAT HEALTH COMMONS HAS MADE THEM FEEL MORE CONNECTED TO OTHERS. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER OFFERED SERVICES AT HEALTH COMMONS - THE LIVING ROOM, A HEALTH AND WELLNESS DROP-IN CENTER LOCATED IN NORTH MINNEAPOLIS. HEALTH COMMONS IS OPEN TWO DAYS A WEEK FOR THREE TO FOUR HOURS AND PROVIDES THE FOLLOWING SERVICES: HEALTH CONSULTATIONS, BLOOD PRESSURE CHECKS, HEALTH EDUCATION CLASSES, MASSAGE AND HEALING TOUCH SERVICES, AND RESOURCES AND REFERRALS. THE 2019 ANTICIPATED IMPACT FOR HEALTH COMMONS - THE LIVING ROOM WAS AN INCREASE IN PARTICIPANTS' SELF- REPORTED SOCIAL CONNECTEDNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 93.1% OF PARTICIPANTS THAT RESPONDED TO THE CONVENIENCE SAMPLE SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE THAT HEALTH COMMONS HAS MADE THEM FEEL MORE CONNECTED TO OTHERS. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER OFFERED THE TRAUMA INFORMED CONGREGATIONS PROGRAM, THE IMPLEMENTATION OF THE RISKING CONNECTION IN FAITH COMMUNITIES CURRICULUM ACROSS FAITH COMMUNITIES. RISKING CONNECTION HELPS CLERGY UNDERSTAND THE NATURE OF TRAUMA, ITS IMPACT ON PEOPLE AND HOW FAITH LEADERS CAN SUPPORT AND BRING HEALING TO TRAUMA SURVIVORS. THE 2019 ANTICIPATED IMPACT FOR THE TRAUMA INFORMED CONGREGATIONS PROGRAM WAS AN INCREASE IN CLERGY/LEADER UNDERSTANDING OF THE IMPACT OF TRAUMA ON TRAUMA SURVIVORS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 32% INCREASE FROM ON PRE-PROGRAM-SURVEY TO POST-PROGRAM-SURVEY FOR PARTICIPANTS THAT STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: I UNDERSTAND THE CONCEPTS OF TRAUMA AND THE IMPACT TRAUMA CAN HAVE ON TRAUMA SURVIVORS. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER OFFERED YOUTH GRIEF SERVICES SESSIONS AND CAMPS. YOUTH GRIEF SERVICES (YGS) PROVIDES A SAFE AND NURTURING PLACE WHERE FAMILIES CAN TURN FOR HELP AFTER A LOVED ONE DIES. YGS ASSISTS IN THE HEALING PROCESS THROUGH A NETWORK OF PROGRAMS AND SERVICES THAT SUPPORT, EDUCATE, AND CONNECT GRIEVING FAMILIES. THE 2019 ANTICIPATED IMPACT FOR YOUTH GRIEF SERVICES WAS AN INCREASE IN YOUTH PARTICIPANTS' KNOWLEDGE OF HEALTHY COPING STRATEGIES IN RESPONSE TO GRIEF. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - CAMP OUTCOME: 66% OF YOUTH INDICATED THAT THEY HAVE NEW TOOLS TO HELP THEM WITH THEIR GRIEF AFTER CAMP. SERIES OUTCOME: 53.0% OF YOUTH INDICATED THAT THEY CAN IDENTIFY (NAME) SOME HEALTHY WAYS TO EXPRESS THEIR GRIEF. EVALUATION OF SURVEY RESULTS WAS DONE FOR CAMP PARTICIPANTS AND SERIES PARTICIPANTS ON A PROGRAM LEVEL. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER COLLABORATED IN POLICY, SYSTEMS AND ENVIRONMENTAL (PSE) CHANGE AROUND RESPONDING TO TRAUMA IN SETTINGS SUCH AS SCHOOLS AND FAITH COMMUNITIES. THIS INITIATIVE INCLUDES ACTIVI
FACILITY 1, UNIVERSITY OF MINNESOTA MEDICAL CEN - PART V, LINE 13B	THE MINNESOTA ATTORNEY GENERAL AGREEMENT WAS USED IN THE DETERMINATION OF THE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
FACILITY 1, UNIVERSITY OF MINNESOTA MEDICAL CEN - PART V, LINE 16J	A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN VARIOUS LOCATIONS IN THE HOSPITAL. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/FINANCIAL- ASSISTANCE-POLICY-2020-FINAL-VERSION_EN.ASHX?LA=EN PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/BILLING/FAIRVIEW-CHARITY-CARE HTTP://WWW.FVFILES.COM/2266.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/4454EN-FINANCIAL- ASSISTANCE-PLS-2019.ASHX?LA=EN
FACILITY 2, FAIRVIEW SOUTHDALE HOSPITAL - PART V, LINE 3E	IN ORDER TO DETERMINE THE TOP HEALTH NEEDS IN THE COMMUNITY INDICATORS FROM SECONDARY DATA; DATA FROM WILDER RESEARCH ON THE LEADING CAUSES OF DEATH AND PREMATURE DEATH, AND THE SOCIAL DETERMINANTS OF HEALTH; AND PRIMARY DATA THAT MET TWO PIECES OF CRITERIA: (1) A NEED AND/OR BARRIER THAT WAS SAID MORE THAN ONE TIME, AND (2) A NEED AND/OR BARRIER THAT WAS REPEATED IN AT LEAST TWO OF THE GROUPS (E.G. BOTH A STAKEHOLDER INTERVIEW AND A COMMUNITY CONVERSATION) WERE USED. THE HOSPTIAL'S COMMUNITY HEALTH STEERING COMMITTEE REVIEWED AND VALIDATED FINDINGS FROM THE PRIMARY AND SECONDARY DATA, AND RECOMMENDED THREE HEALTH NEEDS BE ADOPTED FOR THE MEDICAL CENTER. THE THREE HEALTH NEEDS ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS. WEIGHTED CRITERIA WAS USED TO PRIORITIZE HEALTH NEEDS. HIGHEST WEIGHT WAS GIVEN TO THE TWO CRITERION DEEMED MOST IMPORTANT BY THE STEERING COMMITTEE - CONTINUING WORK IN PREVIOUS CHNA PRIORITY AREAS AND ENSURING FUTURE PRIORITIES ALIGNED WITH WHAT THE COMMUNITY IDENTIFIED AS TOP NEEDS. THE PRIORITIZATION CRITERIA WAS APPLIED TO THE TOP 21 HEALTH NEEDS IDENTIFIED IN THE FAIRVIEW SOUTHDALE COMMUNITY. THE TOP 10 HEALTH NEEDS INCLUDE: 1.MENTAL HEALTH 2.SUICIDE 3.OBESITY 4.TRANSPORTATION 5.COORDINATION OF CARE / NAVIGATION 6.CULTURALLY RESPONSIVE CARE AND BUILDING TRUST 7.LANGUAGE BARRIERS 8.SUBSTANCE USE 9.ACCESS TO HEALTH CARE / RESOURCES 10.TIED FOR TENTH (1) HOUSING (2) ACCESS TO HEALTHY AND AFFORDABLE FOODS THROUGH A VOTING PROCESS, THE FAIRVIEW SOUTHDALE COMMUNITY HEALTH STEERING COMMITTEE VALIDATED THE FOLLOWING PRIORITY HEALTH NEEDS: -MENTAL HEALTH AND WELL-BEING -HEALTHY LIFESTYLES -ACCESS TO CARE AND RESOURCES THESE THREE PRIORITIES ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS.
FACILITY 2, FAIRVIEW SOUTHDALE HOSPITAL - PART V, LINE 5	FAIRVIEW SOUTHDALE HOSPITAL HAS CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) SINCE 1994 TO SYSTEMATICALLY IDENTIFY, ANALYZE, AND PRIORITIZE THE CRITICAL NEEDS OF THE COMMUNITY AND ADDRESS THOSE NEEDS. THE 2018 CHNA BUILDS UPON PREVIOUS ASSESSMENTS AND WAS DEVELOPED IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS, LOCAL PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. IT SERVES AS A TOOL FOR GUIDING POLICY, ADVOCACY, AND PROGRAM PLANNING. IT ALSO FULFILLS IRS REQUIREMENTS FOR CHNA AND IMPLEMENTATION STRATEGIES PURSUANT TO THE AFFORDABLE CARE ACT OF 2010, WHICH REQUIRES 501(C)(3) NONPROFIT HOSPITALS TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS AND PROVIDE AN ANNUAL EVALUATION OF IMPACT OF THE PREVIOUS IMPLEMENTATION STRATEGY. FOR ADDITIONAL DETAIL, SEE SECTION TITLED, EVALUATION OF IMPACT, 2019-2021 CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, FAIRVIEW SOUTHDALE AIMS TO: -UNDERSTAND THE HEALTH STATUS AND NEEDS OF THE COMMUNITY IT SERVES BY ANALYZING CURRENT DEMOGRAPHICS, HEALTH DATA, AND BY COLLECTING DIRECT INPUT FROM COMMUNITY MEMBERS AND ORGANIZATIONS. -IDENTIFY THE STRENGTHS, ASSETS, AND RESOURCES AVAILABLE IN THE COMMUNITY TO SUPPORT HEALTH AND WELL-BEING. -ADDRESS SIGNIFICANT HEALTH NEEDS THROUGH PARTNERSHIPS WITH COMMUNITY MEMBERS AND ORGANIZATIONS, PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. -CREATE A STRATEGIC IMPLEMENTATION PLAN REFLECTIVE OF THE DATA COLLECTED THROUGH THE CHNA PROCESS. -INFORM FAIRVIEW SOUTHDALE COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING LIST OF INDIVIDUALS ARE MEMBERS OF THAT STEERING COMMITTEE: BRAD CAPOUCH, INCARNATION SAGRADO CORAZON DE JESUS DEB BARGER, FAIRVIEW CLINICS BLOOMINGTON DR. ELISA WRIGHT, FAIRVIEW SOUTHDALE HOSPITAL JILL HOLTER, VOLUNTEERS ENLISTED TO ASSIST PEOPLE (VEAP) MOHAMED DUALE, CITY OF EDEN PRAIRIE, COMMUNITY DEVELOPMENT NICK KELLEY, CITY OF BLOOMINGTON - PUBLIC HEALTH DIVISION PAUL MOOTY, FARIBAULT WOOLEN MILL DR. RICHARD KARULF, FAIRVIEW SOUTHDALE HOSPITAL RUTH BACHMAN, THE HOURGLASS FUND PROJECT DR. STEPHEN ROUSEY, MINNESOTA ONCOLOGY
FACILITY 2, FAIRVIEW SOUTHDALE HOSPITAL - PART V, LINE 7D	SCHEDULE H, PART V, LINE 7A & LINE 10A: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE LOCATED AT: HTTP://WWW.FAIRVIEW.ORG/OUR-COMMUNITY-COMMITMENT/LOCAL-HEALTH-NEEDS
FACILITY 2, FAIRVIEW SOUTHDALE HOSPITAL - PART V, LINE 11	COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) WERE CONDUCTED IN 2018. AN ESSENTIAL PART OF THE CHNA PROCESS WAS THE IDENTIFICATION OF PRIORITY NEEDS IN THE LOCAL COMMUNITY. THE HOSPITALS AND/OR MEDICAL CENTERS IDENTIFIED THE FOLLOWING PRIORITY NEEDS FOR FAIRVIEW SOUTHDALE HOSPITAL: MENTAL HEALTH AND WELL-BEING, HEALTHY LIFESTYLES, ACCESS TO CARE AND SERVICES. EACH HOSPITAL AND/OR MEDICAL CENTER DEVELOPED A HOSPITAL SPECIFIC IMPLEMENTATION PLAN AROUND ITS PRIORITY HEALTH ISSUES ALONG WITH A SYSTEM FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE TO ADDRESS THEIR IDENTIFIED PRIORITY NEEDS. EACH PROGRAM IS EVALUATED ON AN ANNUAL BASIS AGAINST PROGRAM SPECIFIC ANTICIPATED IMPACTS. AS PART OF THE EVALUATION PROCESS EACH PROGRAM INDICATOR IS ASSIGNED A VALUE OF "GREEN", "YELLOW- OR "RED" BASED UPON THE CRITERIA THAT FOLLOWS. A RATING OF "GREEN" MEANS THAT THE PROGRAM (A) MET, OR EXCEEDED, 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO BOTH GOAL/S AND ANTICIPATED IMPACT/S (C) THERE IS AN EVALUATION TOOL WITH MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "YELLOW" MEANS THAT THE PROGRAM (A) HAD PARTIAL COMPLETION OF 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO EITHER GOAL/S OR ANTICIPATED IMPACT/S BUT NOT BOTH (C)THERE IS AN EVALUATION TOOL WITHOUT MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "RED" MEANS THAT THE PROGRAM (A) DID NOT COMPLETE THE 2019 HOSPITAL GOAL/S WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) THERE WAS NO COUNT DATA (C) THERE WAS NO EVALUATION TOOL/S. POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE INITIATIVES OFTEN TAKE MULTIPLE YEARS TO PLAN AND IMPLEMENT. USING A CDC EVALUATION FRAMEWORK EACH PSE INITIATIVE IS MONITORED AND EVALUATED ANNUALLY AGAINST ANTICIPATED ACTIVITIES AND MILESTONES LINKED TO THE SIX CONNECTED PSE EVALUATION STEPS. THE SIX CONNECTED STEPS OF PSE CHANGE WE TRACKED FOR MONITORING AND EVALUATION PURPOSES ARE (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, (3) FOCUS THE EVALUATION DESIGN, (4) GATHER CREDIBLE EVIDENCE, (5) JUSTIFY CONCLUSIONS, AND (6) ENSURE USE AND SHARE LESSONS LEARNED. OUR 2019 EVALUATION OF THE PSE INITIATIVES NOTE THE SPECIFIC PSE STEP/S FOR THAT INITIATIVES BASED ON THE ACTIVITIES. IN 2020 WE ARE IDENTIFYING PSE INITIATIVE SPECIFIC METRICS RELATED TO EACH STEP TO DEEPEN OUR EVALUATION OF OUTCOMES IN FUTURE YEARS. ANY PROGRAMMATIC ANTICIPATED IMPACT THAT RECEIVED A RATING OF "YELLOW- OR "RED" HAS A CORRESPONDING BRIEF EXPLANATION AND 2020 ACTION PLAN. IN 2020 WE WILL CONTINUE REFINING THE RATING SYSTEM AND CORRESPONDING PROGRAMMATIC AND PSE EVALUATION AS PART OF OUR COMMITMENT TO CONTINUOUS PROCESS IMPROVEMENT. DETAILED RESULTS AND ACTION PLANS ON PROGRAM AND PSE INITIATIVES ARE AVAILABLE UPON REQUEST. PRIORITY: MENTAL HEALTH AND WELLBEING M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OFFERED THE EVIDENCE-BASED MENTAL HEALTH FIRST AID PROGRAM. THE PROGRAM INTRODUCES RISK FACTORS AND WARNING SIGNS OF COMMON MENTAL HEALTH AND SUBSTANCE USE DISORDERS, BUILDS UNDERSTANDING OF THEIR IMPACT, AND REVIEWS SUPPORT OPTIONS. THE INTERACTIVE COURSE TEACHES PARTICIPANTS HOW TO OFFER INITIAL HELP TO AN INDIVIDUAL WHO MAY BE EXPERIENCING A MENTAL HEALTH CONCERN OR CRISIS AND CONNECT THEM TO THE APPROPRIATE RESOURCES. YOUTH MENTAL HEALTH FIRST AID IS THE SECOND CORE PROGRAM WHICH FOCUSES ON MENTAL HEALTH CONCERNS AMONG YOUTH AGES 12-18. THE 2019 ANTICIPATED IMPACT FOR THE MENTAL HEALTH FIRST AID PROGRAMS WAS AN INCREASE IN PARTICIPANTS' ABILITY TO RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH AND MENTAL ILLNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 88% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THEY CAN RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH, SUBSTANCE USE AND MENTAL ILLNESS AS I ENCOUNTER THEM. M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OFFERED THE EVIDENCE-BASED STRESS REDUCTION SUITE WHICH INCLUDED TWO PROGRAMS (1) FLOURISH A RESTORATIVE FOUR-WEEK SERIES, THAT LETS PARTICIPANTS EXPERIENCE A VARIETY OF MIND-BODY PRACTICES DESIGNED TO PROMOTE A SENSE OF CALM, JOY, CONNECTION, AND INNER STRENGTH. A FEW OF THE PRACTICES EXPLORED ARE MOVING MEDITATION, JOURNALING, GUIDED IMAGERY, AND MINDFULNESS. (2) RESILIENCY AND STRESS MANAGEMENT TRAINING SERIES A RESTORATIVE SIX-WEEK SERIES, BASED ON CENTER MIND BODY MEDICINE, 90-MINUTE SESSIONS. PARTICIPANTS EXPERIENCE A VARIETY OF MIND-BODY PRACTICES DESIGNED TO PROMOTE A SENSE OF CALM, JOY, CONNECTION, AND INNER STRENGTH. A FEW OF THE PRACTICES EXPLORED BY PARTICIPANTS INCLUDE MOVING MEDITATION, JOURNALING, GUIDED IMAGERY, AND MINDFULNESS. THIS MIND BODY SERIES IS A PROVEN METHOD TO REDUCE STRESS, INCREASE SELF-ESTEEM, AND IMPROVE A PERSON'S OVERALL QUALITY OF LIFE. THE 2019 ANTICIPATED IMPACT FOR THE STRESS REDUCTION SUITE WAS A DECREASE IN PARTICIPANTS' PERCEIVED STRESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 2.72 POINTS DECREASE FROM PRE-PROGRAM-SURVEY TO POST-PROGRAM-SURVEY IN RESPONSE TO THE FOLLOWING METRIC: PARTICIPANTS' PERCEIVED STRESS. AVERAGE CHANGE (DECREASE) IN PARTICIPANTS' PERCEIVED STRESS ON A 10 POINT SCALE - THE HIGHER THE SCORE, THE MORE THE PERCEIVED STRESS. M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OFFERED THE TRAUMA INFORMED CONGREGATIONS PROGRAM, THE IMPLEMENTATION OF THE RISKING CONNECTION IN FAITH COMMUNITIES CURRICULUM ACROSS FAITH COMMUNITIES. RISKING CONNECTION HELPS CLERGY UNDERSTAND THE NATURE OF TRAUMA, ITS IMPACT ON PEOPLE AND HOW FAITH LEADERS CAN SUPPORT AND BRING HEALING TO TRAUMA SURVIVORS. THE 2019 ANTICIPATED IMPACT FOR THE TRAUMA INFORMED CONGREGATIONS PROGRAM WAS AN INCREASE IN CLERGY/LEADER UNDERSTANDING OF THE IMPACT OF TRAUMA ON TRAUMA SURVIVORS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 32% INCREASE FROM ON PRE-PROGRAM-SURVEY TO POST-PROGRAM-SURVEY FOR PARTICIPANTS THAT STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: I UNDERSTAND THE CONCEPTS OF TRAUMA AND THE IMPACT TRAUMA CAN HAVE ON TRAUMA SURVIVORS. EVALUATION OF SURVEY RESULTS WAS DONE ON A PROGRAM LEVEL AND NOT ON HOSPITAL LEVEL - 19 SURVEY RESPONDENTS NOT ALL FROM SOUTHDALE SERVICE AREA. M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OFFERED YOUTH GRIEF SERVICES SESSIONS AND CAMPS. YOUTH GRIEF SERVICES (YGS) PROVIDES A SAFE AND NURTURING PLACE WHERE FAMILIES CAN TURN FOR HELP AFTER A LOVED ONE DIES. YGS ASSISTS IN THE HEALING PROCESS THROUGH A NETWORK OF PROGRAMS AND SERVICES THAT SUPPORT, EDUCATE, AND CONNECT GRIEVING FAMILIES. THE 2019 ANTICIPATED IMPACT FOR YOUTH GRIEF SERVICES WAS AN INCREASE IN YOUTH PARTICIPANTS' KNOWLEDGE OF HEALTHY COPING STRATEGIES IN RESPONSE TO GRIEF. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - CAMP OUTCOME: 66% OF YOUTH INDICATED THAT THEY HAVE NEW TOOLS TO HELP THEM WITH THEIR GRIEF AFTER CAMP. SERIES OUTCOME: 53% OF YOUTH INDICATED THAT THEY CAN IDENTIFY (NAME) SOME HEALTHY WAYS TO EXPRESS THEIR GRIEF. EVALUATION OF SURVEY RESULTS WAS DONE FOR CAMP PARTICIPANTS AND SERIES PARTICIPANTS ON A PROGRAM LEVEL. M HEALTH FAIRVIEW SOUTHDALE HOSPITAL COLLABORATED IN POLICY, SYSTEMS AND ENVIRONMENTAL (PSE) CHANGE AROUND RESPONDING TO TRAUMA IN SETTINGS SUCH AS SCHOOLS AND FAITH COMMUNITIES. THIS INITIATIVE INCLUDES ACTIVITIES AND MILESTONES LINKED TO PSE EVALUATION STEPS (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, AND (3) FOCUS THE EVALUATION DESIGN. 2019 IMPACT: GREEN - AN EXECUTIVE COMMITTEE WAS FORMED. THEY BEGAN MEETING QUARTERLY, TO CREATE A PLAN TO BECOME A TRAUMA-INFORMED SYSTEM FOR M HEALTH FAIRVIEW PATIENTS. PROVIDED TRAUMA-INFORMED CARE TRAINING FOR BEHAVIORAL HEALTH EMPLOYEES. THIS WORK ALIGNS WITH THE COMMUNITY WORK, TRAUMA INFORMED CONGREGATIONS PROGRAMMING, BEING PROVIDED TO FAITH COMMUNITY LEADERS. PRIORITY: HEALTHY LIFESTYLES M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OFFERED THE EVIDENCE-BASED FALLS PREVENTION SUITE WHICH INCLUDED TWO PROGRAMS (1) MATTER OF BALANCE A PROGRAM DESIGNED TO REDUCE THE FEAR OF FALLING AND INCREASE ACTIVITY LEVELS AMONG OLDER ADULTS. IT INCLUDES 8 SESSIONS FOR A SMALL GROUP OF 8-12 PARTICIPANTS LED BY TWO TRAINED FACILITATORS. PARTICIPANTS LEARN TO VIEW FALLS AND FEAR OF FALLING AS CONTROLLABLE, SET REALISTIC GOALS TO INCREASE ACTIVITY, CHANGE THEIR ENVIRONMENT TO REDUCE FALL RISK FACTORS, AND EXERCISE TO INCREASE STRENGTH AND BALANCE. (2) TAI JI QUAN A RESEARCH-BASED 12-WEEK PROGRAM THAT IS DESIGNED TO KEEP OLDER ADULTS MOBILE AND INDEPENDENT. THE PROGRAM MEETS TWICE A WEEK FOR ONE HOUR. THE CLASSES WILL HELP PARTICIPANTS IMPROVE BALANCE, STRENGTHEN MUSCLES, AND REDUCE THE RISK OF FALLING. THE 2019 ANTICIPATED IMPACT FOR THE FALLS PREVENTION SUITE WAS A DECREASE PARTICIPANTS' FEAR OF FALLING. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 60% OF PARTICIPANTS INDICATED THAT THE PROGR
FACILITY 2, FAIRVIEW SOUTHDALE HOSPITAL - PART V, LINE 13B	THE MINNESOTA ATTORNEY GENERAL AGREEMENT WAS USED IN THE DETERMINATION OF THE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
FACILITY 2, FAIRVIEW SOUTHDALE HOSPITAL - PART V, LINE 16J	A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN VARIOUS LOCATIONS IN THE HOSPITAL. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/FINANCIAL- ASSISTANCE-POLICY-2020-FINAL-VERSION_EN.ASHX?LA=EN PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/BILLING/FAIRVIEW-CHARITY-CARE HTTP://WWW.FVFILES.COM/2266.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/4454EN-FINANCIAL- ASSISTANCE-PLS-2019.ASHX?LA=EN
FACILITY 3, FAIRVIEW RIDGES HOSPITAL - PART V, LINE 3E	IN ORDER TO DETERMINE THE TOP HEALTH NEEDS IN THE COMMUNITY INDICATORS FROM SECONDARY DATA; DATA FROM WILDER RESEARCH ON THE LEADING CAUSES OF DEATH AND PREMATURE DEATH, AND THE SOCIAL DETERMINANTS OF HEALTH; AND PRIMARY DATA THAT MET TWO PIECES OF CRITERIA: (1) A NEED AND/OR BARRIER THAT WAS SAID MORE THAN ONE TIME, AND (2) A NEED AND/OR BARRIER THAT WAS REPEATED IN AT LEAST TWO OF THE GROUPS (E.G. BOTH A STAKEHOLDER INTERVIEW AND A COMMUNITY CONVERSATION) WERE USED. THE HOSPITAL'S COMMUNITY HOSPITAL ADVISORY COUNCIL REVIEWED AND VALIDATED FINDINGS FROM THE PRIMARY AND SECONDARY DATA AND RECOMMENDED THREE HEALTH NEEDS TO BE ADOPTED FOR THE HOSPITAL. THE THREE HEALTH NEEDS ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS. WEIGHTED CRITERIA WAS USED TO PRIORITIZE HEALTH NEEDS. HIGHEST WEIGHT WAS GIVEN TO THE TWO CRITERION DEEMED MOST IMPORTANT BY THE STEERING COMMITTEE - CONTINUING WORK IN PREVIOUS CHNA PRIORITY AREAS AND ENSURING FUTURE PRIORITIES ALIGNED WITH WHAT THE COMMUNITY IDENTIFIED AS TOP NEEDS. THE PRIORITIZATION CRITERIA WAS APPLIED TO THE TOP 20 HEALTH NEEDS IDENTIFIED IN THE FAIRVIEW RIDGES COMMUNITY. THE TOP 10 HEALTH NEEDS INCLUDE: 1.MENTAL HEALTH 2.CHRONIC DISEASE 3.CANCER 4.STRESS 5.HEART DISEASE 6.STROKE 7.STIGMA - MENTAL HEALTH 8.DIABETES 9.HEALTHY EATING 10.TIED FOR TENTH (1) CHRONIC LOWER RESPIRATORY DISEASE (2) SUICIDE (3) ALZHEIMER'S DISEASE THROUGH A VOTING PROCESS, THE FAIRVIEW RIDGES COMMUNITY HOSPITAL ADVISORY COUNCIL VALIDATED THE FOLLOWING PRIORITY HEALTH NEEDS: -MENTAL HEALTH AND WELL-BEING -HEALTHY LIFESTYLES -ACCESS TO CARE AND RESOURCES THESE THREE PRIORITIES ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS.
FACILITY 3, FAIRVIEW RIDGES HOSPITAL - PART V, LINE 5	FAIRVIEW RIDGES HOSPITAL HAS CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) SINCE 1992 TO SYSTEMATICALLY IDENTIFY, ANALYZE, AND PRIORITIZE THE CRITICAL NEEDS OF THE COMMUNITY AND ADDRESS THOSE NEEDS. THE 2018 CHNA BUILDS UPON PREVIOUS ASSESSMENTS AND WAS DEVELOPED IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS, LOCAL PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. IT SERVES AS A TOOL FOR GUIDING POLICY, ADVOCACY, AND PROGRAM PLANNING. IT ALSO FULFILLS IRS REQUIREMENTS FOR CHNA AND IMPLEMENTATION STRATEGIES PURSUANT TO THE AFFORDABLE CARE ACT OF 2010, WHICH REQUIRES 501(C)(3) NONPROFIT HOSPITALS TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS AND PROVIDES AN ANNUAL EVALUATION OF IMPACT OF THE PREVIOUS IMPLEMENTATION STRATEGY. FOR ADDITIONAL DETAIL, SEE SECTION TITLED, EVALUATION OF IMPACT, 2019-2021 CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, FAIRVIEW RIDGES AIMS TO: -UNDERSTAND THE HEALTH STATUS AND NEEDS OF THE COMMUNITY IT SERVES BY ANALYZING CURRENT DEMOGRAPHICS, HEALTH DATA, AND BY COLLECTING DIRECT INPUT FROM COMMUNITY MEMBERS AND ORGANIZATIONS. -IDENTIFY THE STRENGTHS, ASSETS, AND RESOURCES AVAILABLE IN THE COMMUNITY TO SUPPORT HEALTH AND WELL-BEING. -ADDRESS SIGNIFICANT HEALTH NEEDS THROUGH PARTNERSHIPS WITH COMMUNITY MEMBERS AND ORGANIZATIONS, PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. -CREATE A STRATEGIC IMPLEMENTATION PLAN REFLECTIVE OF THE DATA COLLECTED THROUGH THE CHNA PROCESS. -INFORM FAIRVIEW RIDGES' COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING LIST OF INDIVIDUALS ARE MEMBERS OF THE HOSPITAL COMMUNITY HOSPITAL ADVISORY COUNCIL: BONNIE BRUESHOFF, RN, DAKOTA COUNTY PUBLIC HEALTH BRIAN KNAPP, FAIRVIEW RIDGES HOSPITAL CHUCK MATHEWS, ZEE MEDICAL SERVICE DAVE OSWALD, COLDWELL BANKER BURNET DR. DOUGLAS BAILEY, SURGICAL CONSULTANTS PA DR. FADY CHAMOUN, FAIRVIEW RIDGES HOSPITAL JANET MOHR, MN DEPARTMENT OF EDUCATION (RETIRED) JEFF MORTENSEN, 360 COMMUNITIES JEOFF WILL, CHIEF OPERATING OFFICER, ACUTE CARE HOSPITALS, RIDGES, SOUTHDALE, AND BETHESDA DR. JOHN HOUGHLAND, EMERGENCY PHYSICIANS PA JULIE SETHNEY, RN, FAIRVIEW RIDGES HOSPITAL KURT CHROUST, DDS, CHROUST FAMILY DENTISTRY LISA BRODSKY, MPH, SCOTT COUNTY PUBLIC HEALTH LYNN SCHOMBURG, FAIRVIEW RIDGES HOSPITAL MARIA HULTMAN, WELLS FARGO CORPORATE HR DR. MELISSA CLARK, METROPOLITAN PEDIATRIC SPECIALISTS PA PAUL KETTLER, FAIRVIEW RIDGES HOSPITAL PEGGY JOHNSON, DAKOTA ELECTRIC ASSOCIATION REV. JEFF MARIAN, PRINCE OF PEACE LUTHERAN CHURCH ROBERT (BOB) VOGEL, NEW MARKET BANK
FACILITY 3, FAIRVIEW RIDGES HOSPITAL - PART V, LINE 7D	SCHEDULE H, PART V, LINE 7A & LINE 10A: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE LOCATED AT: HTTP://WWW.FAIRVIEW.ORG/OUR-COMMUNITY-COMMITMENT/LOCAL-HEALTH-NEEDS
FACILITY 3, FAIRVIEW RIDGES HOSPITAL - PART V, LINE 11	COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) WERE CONDUCTED IN 2018. AN ESSENTIAL PART OF THE CHNA PROCESS WAS THE IDENTIFICATION OF PRIORITY NEEDS IN THE LOCAL COMMUNITY. THE HOSPITALS AND/OR MEDICAL CENTERS IDENTIFIED THE FOLLOWING PRIORITY NEEDS FOR FAIRVIEW RIDGES HOSPITAL: MENTAL HEALTH AND WELL-BEING, HEALTHY LIFESTYLES, ACCESS TO CARE AND SERVICES. EACH HOSPITAL AND/OR MEDICAL CENTER DEVELOPED A HOSPITAL SPECIFIC IMPLEMENTATION PLAN AROUND ITS PRIORITY HEALTH ISSUES ALONG WITH A SYSTEM FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE TO ADDRESS THEIR IDENTIFIED PRIORITY NEEDS. EACH PROGRAM IS EVALUATED ON AN ANNUAL BASIS AGAINST PROGRAM SPECIFIC ANTICIPATED IMPACTS. AS PART OF THE EVALUATION PROCESS EACH PROGRAM INDICATOR IS ASSIGNED A VALUE OF "GREEN", "YELLOW- OR "RED" BASED UPON THE CRITERIA THAT FOLLOWS. A RATING OF "GREEN" MEANS THAT THE PROGRAM (A) MET, OR EXCEEDED, 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO BOTH GOAL/S AND ANTICIPATED IMPACT/S (C) THERE IS AN EVALUATION TOOL WITH MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "YELLOW" MEANS THAT THE PROGRAM (A) HAD PARTIAL COMPLETION OF 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO EITHER GOAL/S OR ANTICIPATED IMPACT/S BUT NOT BOTH (C)THERE IS AN EVALUATION TOOL WITHOUT MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "RED" MEANS THAT THE PROGRAM (A) DID NOT COMPLETE THE 2019 HOSPITAL GOAL/S WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) THERE WAS NO COUNT DATA (C) THERE WAS NO EVALUATION TOOL/S. POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE INITIATIVES OFTEN TAKE MULTIPLE YEARS TO PLAN AND IMPLEMENT. USING A CDC EVALUATION FRAMEWORK EACH PSE INITIATIVE IS MONITORED AND EVALUATED ANNUALLY AGAINST ANTICIPATED ACTIVITIES AND MILESTONES LINKED TO THE SIX CONNECTED PSE EVALUATION STEPS. THE SIX CONNECTED STEPS OF PSE CHANGE WE TRACKED FOR MONITORING AND EVALUATION PURPOSES ARE (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, (3) FOCUS THE EVALUATION DESIGN, (4) GATHER CREDIBLE EVIDENCE, (5) JUSTIFY CONCLUSIONS, AND (6) ENSURE USE AND SHARE LESSONS LEARNED. OUR 2019 EVALUATION OF THE PSE INITIATIVES NOTE THE SPECIFIC PSE STEP/S FOR THAT INITIATIVES BASED ON THE ACTIVITIES. IN 2020 WE ARE IDENTIFYING PSE INITIATIVE SPECIFIC METRICS RELATED TO EACH STEP TO DEEPEN OUR EVALUATION OF OUTCOMES IN FUTURE YEARS. ANY PROGRAMMATIC ANTICIPATED IMPACT THAT RECEIVED A RATING OF "YELLOW- OR "RED" HAS A CORRESPONDING BRIEF EXPLANATION AND 2020 ACTION PLAN. IN 2020 WE WILL CONTINUE REFINING THE RATING SYSTEM AND CORRESPONDING PROGRAMMATIC AND PSE EVALUATION AS PART OF OUR COMMITMENT TO CONTINUOUS PROCESS IMPROVEMENT. DETAILED RESULTS AND ACTION PLANS ON PROGRAM AND PSE INITIATIVES ARE AVAILABLE UPON REQUEST. PRIORITY: MENTAL HEALTH AND WELLBEING M HEALTH FAIRVIEW RIDGES HOSPITAL OFFERED THE EVIDENCE-BASED MENTAL HEALTH FIRST AID PROGRAM. THE PROGRAM INTRODUCES RISK FACTORS AND WARNING SIGNS OF COMMON MENTAL HEALTH AND SUBSTANCE USE DISORDERS, BUILDS UNDERSTANDING OF THEIR IMPACT, AND REVIEWS SUPPORT OPTIONS. THE INTERACTIVE COURSE TEACHES PARTICIPANTS HOW TO OFFER INITIAL HELP TO AN INDIVIDUAL WHO MAY BE EXPERIENCING A MENTAL HEALTH CONCERN OR CRISIS AND CONNECT THEM TO THE APPROPRIATE RESOURCES. YOUTH MENTAL HEALTH FIRST AID IS THE SECOND CORE PROGRAM WHICH FOCUSES ON MENTAL HEALTH CONCERNS AMONG YOUTH AGES 12-18. THE 2019 ANTICIPATED IMPACT FOR THE MENTAL HEALTH FIRST AID PROGRAMS WAS AN INCREASE IN PARTICIPANTS' ABILITY TO RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH AND MENTAL ILLNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 100% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THEY CAN RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH, SUBSTANCE USE AND MENTAL ILLNESS AS I ENCOUNTER THEM. M HEALTH FAIRVIEW RIDGES HOSPITAL OFFERED THE TRAUMA INFORMED CONGREGATIONS PROGRAM, THE IMPLEMENTATION OF THE RISKING CONNECTION IN FAITH COMMUNITIES CURRICULUM ACROSS FAITH COMMUNITIES. RISKING CONNECTION HELPS CLERGY UNDERSTAND THE NATURE OF TRAUMA, ITS IMPACT ON PEOPLE AND HOW FAITH LEADERS CAN SUPPORT AND BRING HEALING TO TRAUMA SURVIVORS. THE 2019 ANTICIPATED IMPACT FOR THE TRAUMA INFORMED CONGREGATIONS PROGRAM WAS AN INCREASE IN CLERGY/LEADER UNDERSTANDING OF THE IMPACT OF TRAUMA ON TRAUMA SURVIVORS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 32% INCREASE FROM ON PRE-PROGRAM-SURVEY TO POST-PROGRAM-SURVEY FOR PARTICIPANTS THAT STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: I UNDERSTAND THE CONCEPTS OF TRAUMA AND THE IMPACT TRAUMA CAN HAVE ON TRAUMA SURVIVORS. EVALUATION OF SURVEY RESULTS WAS DONE ON A PROGRAM LEVEL AND NOT ON HOSPITAL LEVEL - 19 SURVEY RESPONDENTS NOT ALL FROM RIDGES SERVICE AREA. M HEALTH FAIRVIEW RIDGES HOSPITAL OFFERED YOUTH GRIEF SERVICES SESSIONS AND CAMPS. YOUTH GRIEF SERVICES (YGS) PROVIDES A SAFE AND NURTURING PLACE WHERE FAMILIES CAN TURN FOR HELP AFTER A LOVED ONE DIES. YGS ASSISTS IN THE HEALING PROCESS THROUGH A NETWORK OF PROGRAMS AND SERVICES THAT SUPPORT, EDUCATE, AND CONNECT GRIEVING FAMILIES. THE 2019 ANTICIPATED IMPACT FOR YOUTH GRIEF SERVICES WAS AN INCREASE IN YOUTH PARTICIPANTS' KNOWLEDGE OF HEALTHY COPING STRATEGIES IN RESPONSE TO GRIEF. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - CAMP OUTCOME: 66% OF YOUTH INDICATED THAT THEY HAVE NEW TOOLS TO HELP THEM WITH THEIR GRIEF AFTER CAMP. SERIES OUTCOME: 53% OF YOUTH INDICATED THAT THEY CAN IDENTIFY (NAME) SOME HEALTHY WAYS TO EXPRESS THEIR GRIEF. EVALUATION OF SURVEY RESULTS WAS DONE ON A PROGRAM LEVEL AND NOT ON HOSPITAL LEVEL - 19 SURVEY RESPONDENTS NOT ALL FROM RIDGES SERVICE AREA. M HEALTH FAIRVIEW RIDGES HOSPITAL OFFERED THE MOBILE SUBSTANCE USE DISORDER SUPPORT PROGRAM, SERVING ADULT RESIDENTS (18+) IN RAMSEY, DAKOTA, AND WASHINGTON COUNTIES WHO HAVE SUBSTANCE USE ISSUES THROUGH MOBILE SUDS TEAM WHO ARE PROFESSIONAL PEER RECOVERY SPECIALISTS AND CLINICAL STAFF WHO COLLABORATE TO DEVELOP INDIVIDUAL RECOVERY PLANS. THE 2019 ANTICIPATED IMPACT FOR THE MOBILE SUBSTANCE USE DISORDER SUPPORT PROGRAM WAS AN INCREASE IN THE NUMBER OF ACTIVE PARTICIPANTS IN THE RECOVERY PROGRAM. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - THERE WAS NO INCREASE IN ACTIVE PARTICIPANTS, 23 REFERRALS WERE RECEIVED. M HEALTH FAIRVIEW RIDGES HOSPITAL COLLABORATED IN POLICY, SYSTEMS AND ENVIRONMENTAL (PSE) CHANGE AROUND RESPONDING TO TRAUMA IN SETTINGS SUCH AS SCHOOLS AND FAITH COMMUNITIES. THIS INITIATIVE INCLUDES ACTIVITIES AND MILESTONES LINKED TO PSE EVALUATION STEPS (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, AND (3) FOCUS THE EVALUATION DESIGN. 2019 IMPACT: GREEN - AN EXECUTIVE COMMITTEE WAS FORMED. THEY BEGAN MEETING QUARTERLY, TO CREATE A PLAN TO BECOME A TRAUMA-INFORMED SYSTEM FOR M HEALTH FAIRVIEW PATIENTS. PROVIDED TRAUMA-INFORMED CARE TRAINING FOR BEHAVIORAL HEALTH EMPLOYEES. THIS WORK ALIGNS WITH THE COMMUNITY WORK, TRAUMA INFORMED CONGREGATIONS PROGRAMMING, BEING PROVIDED TO FAITH COMMUNITY LEADERS. PRIORITY: HEALTHY LIFESTYLES M HEALTH FAIRVIEW RIDGES HOSPITAL OFFERED THE EVIDENCE-BASED FALLS PREVENTION SUITE WHICH INCLUDED TWO PROGRAMS (1) MATTER OF BALANCE A PROGRAM DESIGNED TO REDUCE THE FEAR OF FALLING AND INCREASE ACTIVITY LEVELS AMONG OLDER ADULTS. IT INCLUDES 8 SESSIONS FOR A SMALL GROUP OF 8-12 PARTICIPANTS LED BY TWO TRAINED FACILITATORS. PARTICIPANTS LEARN TO VIEW FALLS AND FEAR OF FALLING AS CONTROLLABLE, SET REALISTIC GOALS TO INCREASE ACTIVITY, CHANGE THEIR ENVIRONMENT TO REDUCE FALL RISK FACTORS, AND EXERCISE TO INCREASE STRENGTH AND BALANCE. (2) TAI JI QUAN A RESEARCH-BASED 12-WEEK PROGRAM THAT IS DESIGNED TO KEEP OLDER ADULTS MOBILE AND INDEPENDENT. THE PROGRAM MEETS TWICE A WEEK FOR ONE HOUR. THE CLASSES WILL HELP PARTICIPANTS IMPROVE BALANCE, STRENGTHEN MUSCLES, AND REDUCE THE RISK OF FALLING. THE 2019 ANTICIPATED IMPACT FOR THE FALLS PREVENTION SUITE WAS A DECREASE PARTICIPANTS' FEAR OF FALLING. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 80% OF PARTICIPANTS INDICATED THAT THE PROGRAM SAID THEY DECREASED THEIR FEAR OF FALLING. M HEALTH FAIRVIEW RIDGES HOSPITAL OFFERED THE EVIDENCE-BASED LIVING WELL SUITE WHICH INCLUDED THREE PROGRAMS THAT WERE DEVELOPED BY STANFORD UNIVERSITY'S PATIENT EDUCATION RESEARCH CENTER. (1) CHRONIC DISEASE SELF- MANAGEMENT IS A WORKSHOP GIVEN 2.5 HOURS ONCE A WEEK, FOR SIX WEEKS OFFERED TO INDIVIDUALS AND THEIR CAREGIVERS WHO ARE LIVING WITH CHRONIC CONDITIONS. SUBJECTS ADDRESSED INCLUDE MEDICATION USE, COMMUNICATION WITH DOCTORS AND CAREGIVERS, NUTRITION, AND FITNESS- WITH PRACTICAL EXERCISES AND ADVICE DESIGNED TO MEET PARTICIPANTS' NEEDS. (2) CHRONIC PAIN SELF-MANAGEMENT IS A WORKSHOP GIVEN 2 HOURS ONCE A WEEK, FOR SIX WEEKS, IN COMMUNITY SETTINGS. THE WORKSH
FACILITY 3, FAIRVIEW RIDGES HOSPITAL - PART V, LINE 13B	THE MINNESOTA ATTORNEY GENERAL AGREEMENT WAS USED IN THE DETERMINATION OF THE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
FACILITY 3, FAIRVIEW RIDGES HOSPITAL - PART V, LINE 16J	A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN VARIOUS LOCATIONS IN THE HOSPITAL. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/FINANCIAL- ASSISTANCE-POLICY-2020-FINAL-VERSION_EN.ASHX?LA=EN PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/BILLING/FAIRVIEW-CHARITY-CARE HTTP://WWW.FVFILES.COM/2266.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/4454EN-FINANCIAL- ASSISTANCE-PLS-2019.ASHX?LA=EN
FACILITY 4, FAIRVIEW LAKES REGIONAL MEDICAL CTR - PART V, LINE 3E	IN ORDER TO DETERMINE THE TOP HEALTH NEEDS IN THE COMMUNITY INDICATORS FROM SECONDARY DATA; DATA FROM WILDER RESEARCH ON THE LEADING CAUSES OF DEATH AND PREMATURE DEATH, AND THE SOCIAL DETERMINANTS OF HEALTH; AND PRIMARY DATA THAT MET TWO PIECES OF CRITERIA: (1) A NEED AND/OR BARRIER THAT WAS SAID MORE THAN ONE TIME, AND (2) A NEED AND/OR BARRIER THAT WAS REPEATED IN AT LEAST TWO OF THE GROUPS (E.G. BOTH A STAKEHOLDER INTERVIEW AND A COMMUNITY CONVERSATION) WERE USED. THE MEDICAL CENTER'S COMMUNITY HEALTH STEERING COMMITTEE REVIEWED AND VALIDATED FINDINGS FROM THE PRIMARY AND SECONDARY DATA AND RECOMMENDED THREE HEALTH NEEDS TO BE ADOPTED FOR THE MEDICAL CENTER. THE THREE HEALTH NEEDS ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS. WEIGHTED CRITERIA WAS USED TO PRIORITIZE HEALTH NEEDS. HIGHEST WEIGHT WAS GIVEN TO THE TWO CRITERION DEEMED MOST IMPORTANT BY THE STEERING COMMITTEE - CONTINUING WORK IN PREVIOUS CHNA PRIORITY AREAS AND ENSURING FUTURE PRIORITIES ALIGNED WITH WHAT THE COMMUNITY IDENTIFIED AS TOP NEEDS. THE PRIORITIZATION CRITERIA WAS APPLIED TO THE TOP 20 HEALTH NEEDS IDENTIFIED IN THE FAIRVIEW LAKES COMMUNITY. THE TOP 10 HEALTH NEEDS INCLUDE: 1.MENTAL HEALTH 2.ADVERSE CHILDHOOD EXPERIENCES (ACES) 3.SUBSTANCE USE 4.ACCESS TO HEALTHY AND AFFORDABLE FOODS 5.SUICIDE 6.OBESITY 7.ALZHEIMER'S DISEASE 8.TRANSPORTATION 9.ACCESS AND AWARENESS OF SERVICES AND RESOURCES 10.TIED FOR TENTH (1) CANCER (2) HEART DISEASE (3) UNINTENTIONAL INJURY THROUGH A VOTING PROCESS, THE FAIRVIEW LAKES MEDICAL CENTER COMMUNITY HEALTH STEERING COMMITTEE VALIDATED THE FOLLOWING HEALTH NEEDS: -MENTAL HEALTH AND WELL-BEING -HEALTHY LIFESTYLES -ACCESS TO CARE AND RESOURCES THESE THREE PRIORITIES ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS.
FACILITY 4, FAIRVIEW LAKES REGIONAL MEDICAL CTR - PART V, LINE 5	FAIRVIEW LAKES MEDICAL CENTER HAS CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) SINCE 1998 TO SYSTEMATICALLY IDENTIFY, ANALYZE, AND PRIORITIZE THE CRITICAL NEEDS OF THE COMMUNITY AND ADDRESS THOSE NEEDS. THE 2018 CHNA BUILDS UPON PREVIOUS ASSESSMENTS AND WAS DEVELOPED IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS, LOCAL PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. IT SERVES AS A TOOL FOR GUIDING POLICY, ADVOCACY, AND PROGRAM PLANNING. IT ALSO FULFILLS IRS REQUIREMENTS FOR CHNA AND IMPLEMENTATION STRATEGIES PURSUANT TO THE AFFORDABLE CARE ACT OF 2010, WHICH REQUIRES 501(C)(3) NONPROFIT HOSPITALS TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS AND PROVIDE AN ANNUAL EVALUATION OF IMPACT OF THE PREVIOUS IMPLEMENTATION STRATEGY. FOR ADDITIONAL DETAIL, SEE SECTION TITLED, EVALUATION OF IMPACT, 2019-2021 CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, FAIRVIEW LAKES AIMS TO: -UNDERSTAND THE HEALTH STATUS AND NEEDS OF THE COMMUNITY IT SERVES BY ANALYZING CURRENT DEMOGRAPHICS, HEALTH DATA, AND BY COLLECTING DIRECT INPUT FROM COMMUNITY MEMBERS AND ORGANIZATIONS. -IDENTIFY THE STRENGTHS, ASSETS, AND RESOURCES AVAILABLE IN THE COMMUNITY TO SUPPORT HEALTH AND WELL-BEING. -ADDRESS SIGNIFICANT HEALTH NEEDS THROUGH PARTNERSHIPS WITH COMMUNITY MEMBERS AND ORGANIZATIONS, PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. -CREATE A STRATEGIC IMPLEMENTATION PLAN REFLECTIVE OF THE DATA COLLECTED THROUGH THE CHNA PROCESS. -INFORM FAIRVIEW LAKES' COMMUNITY BENEFIT ACTIVITIES. FAIRVIEW LAKES MEDICAL CENTER COMMUNITY HEALTH STEERING COMMITTEE -BRETT CARLSON, NORTH BRANCH AREA SCHOOLS -COLTON ANDERSON, CHISAGO COUNTY PUBLIC HEALTH -COURTNEY WEHRENBERG, CHISAGO COUNTY PUBLIC HEALTH -DEREK OTTO, YMCA FOREST LAKE -EMMA SHEPARD, CENTRAL MINNESOTA COUNCIL ON AGING -HAILEY FREEDLUND, PINE COUNTY HEALTH AND HUMAN SERVICES -JENNY KOLB, FAIRVIEW MEDICAL GROUP -JOANNE PLOETZ, FAIRVIEW COMMUNITY ADVISORY COUNCIL -DR. KELLIE KERSHISHNIK, FAIRVIEW MEDICAL GROUP -KIRK ERICKSON, YMCA FOREST LAKE -KRIS CLEMENTSON, FAIRVIEW MEDICAL GROUP -LINDA MADSEN, FOREST LAKE AREA SCHOOLS-RETIRED -LISA BURG, WASHINGTON COUNTY DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT -LISA MEARS, FAMILY PATHWAYS -PAMELA BATES, CHISAGO COUNTY PUBLIC HEATH -PAMELA TRUDEAU, CHERRYWOOD POINTE -DR. PAULA REHDER, FAIRVIEW MEDICAL GROUP -PAULA WOISCHKE, CENTRAL MINNESOTA COUNCIL ON AGING -ROSEMARY HOOLIHAN, FORMER FAIRVIEW LAKES MEDICAL CENTER BOARD MEMBER
FACILITY 4, FAIRVIEW LAKES REGIONAL MEDICAL CTR - PART V, LINE 7D	SCHEDULE H, PART V, LINE 7A & LINE 10A: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE LOCATED AT: HTTP://WWW.FAIRVIEW.ORG/OUR-COMMUNITY-COMMITMENT/LOCAL-HEALTH-NEEDS
FACILITY 4, FAIRVIEW LAKES REGIONAL MEDICAL CTR - PART V, LINE 11	COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) WERE CONDUCTED IN 2018. AN ESSENTIAL PART OF THE CHNA PROCESS WAS THE IDENTIFICATION OF PRIORITY NEEDS IN THE LOCAL COMMUNITY. THE HOSPITALS AND/OR MEDICAL CENTERS IDENTIFIED THE FOLLOWING PRIORITY NEEDS FOR FAIRVIEW LAKES MEDICAL CENTER: MENTAL HEALTH AND WELL-BEING, HEALTHY LIFESTYLES, ACCESS TO CARE AND SERVICES. EACH HOSPITAL AND/OR MEDICAL CENTER DEVELOPED A HOSPITAL SPECIFIC IMPLEMENTATION PLAN AROUND ITS PRIORITY HEALTH ISSUES ALONG WITH A SYSTEM FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE TO ADDRESS THEIR IDENTIFIED PRIORITY NEEDS. EACH PROGRAM IS EVALUATED ON AN ANNUAL BASIS AGAINST PROGRAM SPECIFIC ANTICIPATED IMPACTS. AS PART OF THE EVALUATION PROCESS EACH PROGRAM INDICATOR IS ASSIGNED A VALUE OF "GREEN", "YELLOW- OR "RED" BASED UPON THE CRITERIA THAT FOLLOWS. A RATING OF "GREEN" MEANS THAT THE PROGRAM (A) MET, OR EXCEEDED, 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO BOTH GOAL/S AND ANTICIPATED IMPACT/S (C) THERE IS AN EVALUATION TOOL WITH MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "YELLOW" MEANS THAT THE PROGRAM (A) HAD PARTIAL COMPLETION OF 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO EITHER GOAL/S OR ANTICIPATED IMPACT/S BUT NOT BOTH (C)THERE IS AN EVALUATION TOOL WITHOUT MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "RED" MEANS THAT THE PROGRAM (A) DID NOT COMPLETE THE 2019 HOSPITAL GOAL/S WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) THERE WAS NO COUNT DATA (C) THERE WAS NO EVALUATION TOOL/S. POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE INITIATIVES OFTEN TAKE MULTIPLE YEARS TO PLAN AND IMPLEMENT. USING A CDC EVALUATION FRAMEWORK EACH PSE INITIATIVE IS MONITORED AND EVALUATED ANNUALLY AGAINST ANTICIPATED ACTIVITIES AND MILESTONES LINKED TO THE SIX CONNECTED PSE EVALUATION STEPS. THE SIX CONNECTED STEPS OF PSE CHANGE WE TRACKED FOR MONITORING AND EVALUATION PURPOSES ARE (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, (3) FOCUS THE EVALUATION DESIGN, (4) GATHER CREDIBLE EVIDENCE, (5) JUSTIFY CONCLUSIONS, AND (6) ENSURE USE AND SHARE LESSONS LEARNED. OUR 2019 EVALUATION OF THE PSE INITIATIVES NOTE THE SPECIFIC PSE STEP/S FOR THAT INITIATIVES BASED ON THE ACTIVITIES. IN 2020 WE ARE IDENTIFYING PSE INITIATIVE SPECIFIC METRICS RELATED TO EACH STEP TO DEEPEN OUR EVALUATION OF OUTCOMES IN FUTURE YEARS. ANY PROGRAMMATIC ANTICIPATED IMPACT THAT RECEIVED A RATING OF "YELLOW- OR "RED" HAS A CORRESPONDING BRIEF EXPLANATION AND 2020 ACTION PLAN. IN 2020 WE WILL CONTINUE REFINING THE RATING SYSTEM AND CORRESPONDING PROGRAMMATIC AND PSE EVALUATION AS PART OF OUR COMMITMENT TO CONTINUOUS PROCESS IMPROVEMENT. DETAILED RESULTS AND ACTION PLANS ON PROGRAM AND PSE INITIATIVES ARE AVAILABLE UPON REQUEST. PRIORITY: MENTAL HEALTH AND WELLBEING M HEALTH FAIRVIEW LAKES MEDICAL CENTER OFFERED THE EVIDENCE-BASED MENTAL HEALTH FIRST AID PROGRAM. THE PROGRAM INTRODUCES RISK FACTORS AND WARNING SIGNS OF COMMON MENTAL HEALTH AND SUBSTANCE USE DISORDERS, BUILDS UNDERSTANDING OF THEIR IMPACT, AND REVIEWS SUPPORT OPTIONS. THE INTERACTIVE COURSE TEACHES PARTICIPANTS HOW TO OFFER INITIAL HELP TO AN INDIVIDUAL WHO MAY BE EXPERIENCING A MENTAL HEALTH CONCERN OR CRISIS AND CONNECT THEM TO THE APPROPRIATE RESOURCES. YOUTH MENTAL HEALTH FIRST AID IS THE SECOND CORE PROGRAM WHICH FOCUSES ON MENTAL HEALTH CONCERNS AMONG YOUTH AGES 12-18. THE 2019 ANTICIPATED IMPACT FOR THE MENTAL HEALTH FIRST AID PROGRAMS WAS AN INCREASE IN PARTICIPANTS' ABILITY TO RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH AND MENTAL ILLNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 95% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THEY CAN RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH, SUBSTANCE USE AND MENTAL ILLNESS AS I ENCOUNTER THEM. M HEALTH FAIRVIEW LAKES MEDICAL CENTER DID NOT OFFER THE OFFER THE TRAUMA INFORMED CONGREGATIONS PROGRAM IN THIS COMMUNITY. THE 2019 ANTICIPATED IMPACT FOR THE TRAUMA INFORMED CONGREGATIONS PROGRAM WAS AN INCREASE IN CLERGY/LEADER UNDERSTANDING OF THE IMPACT OF TRAUMA ON TRAUMA SURVIVORS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "RED". EXPLANATION: A LOCATION FOR THE TRAUMA INFORMED CONGREGATIONS CLASS WAS SELECTED IN A NEARBY GEOGRAPHY WITH THE BELIEF THAT FAITH COMMUNITY LEADERS FROM THIS HOSPITAL'S COMMUNITY WOULD ATTEND. THIS DID NOT TURN OUT TO BE THE CASE. 2020 ACTION PLAN: WE WILL UNDERTAKE MORE TARGETED RECRUITING BY PARTNERING WITH LOCAL FAITH COMMUNITIES. M HEALTH FAIRVIEW LAKES MEDICAL CENTER OFFERED YOUTH GRIEF SERVICES SESSIONS AND CAMPS. YOUTH GRIEF SERVICES (YGS) PROVIDES A SAFE AND NURTURING PLACE WHERE FAMILIES CAN TURN FOR HELP AFTER A LOVED ONE DIES. YGS ASSISTS IN THE HEALING PROCESS THROUGH A NETWORK OF PROGRAMS AND SERVICES THAT SUPPORT, EDUCATE, AND CONNECT GRIEVING FAMILIES. THE 2019 ANTICIPATED IMPACT FOR YOUTH GRIEF SERVICES WAS AN INCREASE IN YOUTH PARTICIPANTS' KNOWLEDGE OF HEALTHY COPING STRATEGIES IN RESPONSE TO GRIEF. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - CAMP OUTCOME: 66% OF YOUTH INDICATED THAT THEY HAVE NEW TOOLS TO HELP THEM WITH THEIR GRIEF AFTER CAMP. SERIES OUTCOME: 53.0% OF YOUTH INDICATED THAT THEY CAN IDENTIFY (NAME) SOME HEALTHY WAYS TO EXPRESS THEIR GRIEF. EVALUATION OF SURVEY RESULTS WAS DONE FOR CAMP PARTICIPANTS AND SERIES PARTICIPANTS ON A PROGRAM LEVEL. M HEALTH FAIRVIEW LAKES MEDICAL CENTER COLLABORATED IN POLICY, SYSTEMS AND ENVIRONMENTAL (PSE) CHANGE AROUND RESPONDING TO TRAUMA IN SETTINGS SUCH AS SCHOOLS AND FAITH COMMUNITIES. THIS INITIATIVE INCLUDES ACTIVITIES AND MILESTONES LINKED TO PSE EVALUATION STEPS (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, AND (3) FOCUS THE EVALUATION DESIGN. 2019 IMPACT: GREEN - AN EXECUTIVE COMMITTEE WAS FORMED. THEY BEGAN MEETING QUARTERLY, TO CREATE A PLAN TO BECOME A TRAUMA-INFORMED SYSTEM FOR M HEALTH FAIRVIEW PATIENTS. PROVIDED TRAUMA-INFORMED CARE TRAINING FOR BEHAVIORAL HEALTH EMPLOYEES. THIS WORK ALIGNS WITH THE COMMUNITY WORK, TRAUMA INFORMED CONGREGATIONS PROGRAMMING, BEING PROVIDED TO FAITH COMMUNITY LEADERS. PRIORITY: HEALTHY LIFESTYLES M HEALTH FAIRVIEW LAKES MEDICAL CENTER OFFERED THE EVIDENCE-BASED FALLS PREVENTION SUITE WHICH INCLUDED TWO PROGRAMS (1) MATTER OF BALANCE A PROGRAM DESIGNED TO REDUCE THE FEAR OF FALLING AND INCREASE ACTIVITY LEVELS AMONG OLDER ADULTS. IT INCLUDES 8 SESSIONS FOR A SMALL GROUP OF 8-12 PARTICIPANTS LED BY TWO TRAINED FACILITATORS. PARTICIPANTS LEARN TO VIEW FALLS AND FEAR OF FALLING AS CONTROLLABLE, SET REALISTIC GOALS TO INCREASE ACTIVITY, CHANGE THEIR ENVIRONMENT TO REDUCE FALL RISK FACTORS, AND EXERCISE TO INCREASE STRENGTH AND BALANCE. (2) TAI JI QUAN A RESEARCH-BASED 12-WEEK PROGRAM THAT IS DESIGNED TO KEEP OLDER ADULTS MOBILE AND INDEPENDENT. THE PROGRAM MEETS TWICE A WEEK FOR ONE HOUR. THE CLASSES WILL HELP PARTICIPANTS IMPROVE BALANCE, STRENGTHEN MUSCLES, AND REDUCE THE RISK OF FALLING. THE 2019 ANTICIPATED IMPACT FOR THE FALLS PREVENTION SUITE WAS A DECREASE PARTICIPANTS' FEAR OF FALLING. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 56% OF PARTICIPANTS INDICATED THAT THE PROGRAM SAID THEY DECREASED THEIR FEAR OF FALLING. M HEALTH FAIRVIEW LAKES MEDICAL CENTER OFFERED THE EVIDENCE-BASED LIVING WELL SUITE WHICH INCLUDED THREE PROGRAMS THAT WERE DEVELOPED BY STANFORD UNIVERSITY'S PATIENT EDUCATION RESEARCH CENTER. (1) CHRONIC DISEASE SELF- MANAGEMENT IS A WORKSHOP GIVEN 2.5 HOURS ONCE A WEEK, FOR SIX WEEKS OFFERED TO INDIVIDUALS AND THEIR CAREGIVERS WHO ARE LIVING WITH CHRONIC CONDITIONS. SUBJECTS ADDRESSED INCLUDE MEDICATION USE, COMMUNICATION WITH DOCTORS AND CAREGIVERS, NUTRITION, AND FITNESS- WITH PRACTICAL EXERCISES AND ADVICE DESIGNED TO MEET PARTICIPANTS' NEEDS. (2) CHRONIC PAIN SELF-MANAGEMENT IS A WORKSHOP GIVEN 2 HOURS ONCE A WEEK, FOR SIX WEEKS, IN COMMUNITY SETTINGS. THE WORKSHOP HELPS PARTICIPANTS, AND THEIR SUPPORT PERSON, DEAL WITH THE ONGOING ISSUES ASSOCIATED WITH CHRONIC PAIN. (3) DIABETES SELF-MANAGEMENT IS A 6 WEEK ONCE A WEEK PROGRAM DEVELOPED TO HELPS THOSE LIVING WITH DIABETES OR PRE-DIABETES TO IMPROVE THEIR GENERAL HEALTH. THE 2019 ANTICIPATED IMPACT FOR THE LIVING WELL SUITE WAS AN INCREASE PARTICIPANTS' PERCEPTION OF POSITIVE LIFESTYLE CHANGES. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 88% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THE PROGRAM HAS HELPED THEM MANAGE CHRONIC CONDITION (S). M HEALTH FAIRVIEW LAKES MEDICAL CENTER COLLABORATED IN POLICY, SYSTEMS AND ENVIRONMENTAL (PSE) CHANGE AROUND HEALTHY FOOD TRANSFORMATION ADDRESSING ISSUES SUCH AS FOOD INSECURITY, FOOD ACCESS, AND CHANGES TO CAFETERIA MENUS. THIS INITIATIVE INCLUDES ACTIVITIES AND MILESTONES
FACILITY 4, FAIRVIEW LAKES REGIONAL MEDICAL CTR - PART V, LINE 13B	THE MINNESOTA ATTORNEY GENERAL AGREEMENT WAS USED IN THE DETERMINATION OF THE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
FACILITY 4, FAIRVIEW LAKES REGIONAL MEDICAL CTR - PART V, LINE 16J	A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN VARIOUS LOCATIONS IN THE HOSPITAL. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/FINANCIAL- ASSISTANCE-POLICY-2020-FINAL-VERSION_EN.ASHX?LA=EN PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/BILLING/FAIRVIEW-CHARITY-CARE HTTP://WWW.FVFILES.COM/2266.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/4454EN-FINANCIAL- ASSISTANCE-PLS-2019.ASHX?LA=EN
FACILITY 5, FAIRVIEW NORTHLAND REGIONAL HOSP - PART V, LINE 3E	IN ORDER TO DETERMINE THE TOP HEALTH NEEDS IN THE COMMUNITY INDICATORS FROM SECONDARY DATA; DATA FROM WILDER RESEARCH ON THE LEADING CAUSES OF DEATH AND PREMATURE DEATH, AND THE SOCIAL DETERMINANTS OF HEALTH; AND PRIMARY DATA THAT MET TWO PIECES OF CRITERIA: (1) A NEED AND/OR BARRIER THAT WAS SAID MORE THAN ONE TIME, AND (2) A NEED AND/OR BARRIER THAT WAS REPEATED IN AT LEAST TWO OF THE GROUPS (E.G. BOTH A STAKEHOLDER INTERVIEW AND A COMMUNITY CONVERSATION) WERE USED. THE MEDICAL CENTER'S COMMUNITY HEALTH STEERING COMMITTEE REVIEWED AND VALIDATED FINDINGS FROM THE PRIMARY AND SECONDARY DATA AND RECOMMENDED THREE HEALTH NEEDS TO BE ADOPTED FOR THE MEDICAL CENTER. THE THREE HEALTH NEEDS ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS. WEIGHTED CRITERIA WAS USED TO PRIORITIZE HEALTH NEEDS. HIGHEST WEIGHT WAS GIVEN TO THE TWO CRITERION DEEMED MOST IMPORTANT BY THE STEERING COMMITTEE - CONTINUING WORK IN PREVIOUS CHNA PRIORITY AREAS AND ENSURING FUTURE PRIORITIES ALIGNED WITH WHAT THE COMMUNITY IDENTIFIED AS TOP NEEDS. THE PRIORITIZATION CRITERIA WAS APPLIED TO THE TOP 20 HEALTH NEEDS IDENTIFIED IN THE FAIRVIEW LAKES COMMUNITY. THE TOP 10 HEALTH NEEDS INCLUDE: 1.MENTAL HEALTH 2.ADVERSE CHILDHOOD EXPERIENCES (ACES) 3.SUBSTANCE USE 4.ACCESS TO HEALTHY AND AFFORDABLE FOODS 5.SUICIDE 6.OBESITY 7.ALZHEIMER'S DISEASE 8.TRANSPORTATION 9.ACCESS AND AWARENESS OF SERVICES AND RESOURCES 10.TIED FOR TENTH (1) CANCER (2) HEART DISEASE (3) UNINTENTIONAL INJURY THROUGH A VOTING PROCESS, THE FAIRVIEW NORTHLAND MEDICAL CENTER COMMUNITY HEALTH STEERING COMMITTEE VALIDATED THE FOLLOWING HEALTH NEEDS: -MENTAL HEALTH AND WELL-BEING -HEALTHY LIFESTYLES -ACCESS TO CARE AND RESOURCES THESE THREE PRIORITIES ARE CONSISTENT ACROSS ALL 11 FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS.
FACILITY 5, FAIRVIEW NORTHLAND REGIONAL HOSP - PART V, LINE 5	FAIRVIEW NORTHLAND MEDICAL CENTER HAS CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) SINCE 1996 TO SYSTEMATICALLY IDENTIFY, ANALYZE, AND PRIORITIZE THE CRITICAL NEEDS OF THE COMMUNITY AND TO ADDRESS THOSE NEEDS. THE 2018 CHNA BUILDS UPON PREVIOUS ASSESSMENTS AND WAS DEVELOPED IN PARTNERSHIP WITH COMMUNITY MEMBERS AND ORGANIZATIONS, LOCAL PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. IT SERVES AS A TOOL FOR GUIDING POLICY, ADVOCACY, AND PROGRAM PLANNING. IT ALSO FULFILLS IRS REQUIREMENTS FOR CHNA AND IMPLEMENTATION STRATEGIES PURSUANT TO THE AFFORDABLE CARE ACT OF 2010, WHICH REQUIRES 501(C)(3) NONPROFIT HOSPITALS TO CONDUCT AN ASSESSMENT AT LEAST EVERY THREE YEARS AND PROVIDE AN ANNUAL EVALUATION OF IMPACT OF THE PREVIOUS IMPLEMENTATION STRATEGY. FOR ADDITIONAL DETAIL, SEE SECTION TITLED, EVALUATION OF IMPACT, 2019-2021 CHNA IMPLEMENTATION STRATEGY. THROUGH THIS PROCESS, FAIRVIEW NORTHLAND AIMS TO: -UNDERSTAND THE HEALTH STATUS AND NEEDS OF THE COMMUNITY IT SERVES BY ANALYZING CURRENT DEMOGRAPHICS, HEALTH DATA, AND BY COLLECTING DIRECT INPUT FROM COMMUNITY MEMBERS AND ORGANIZATIONS. -IDENTIFY THE STRENGTHS, ASSETS, AND RESOURCES AVAILABLE IN THE COMMUNITY TO SUPPORT HEALTH AND WELL-BEING. -ADDRESS SIGNIFICANT HEALTH NEEDS THROUGH PARTNERSHIPS WITH COMMUNITY MEMBERS AND ORGANIZATIONS, PUBLIC HEALTH AGENCIES, AND OTHER HOSPITALS AND HEALTH SYSTEMS. -CREATE A STRATEGIC IMPLEMENTATION PLAN REFLECTIVE OF THE DATA COLLECTED THROUGH THE CHNA PROCESS. -INFORM FAIRVIEW NORTHLAND'S COMMUNITY BENEFIT ACTIVITIES. THE FOLLOWING LIST OF INDIVIDUALS ARE MEMBERS OF THAT STEERING COMMITTEE: ALISHA FUSSY, MILLE LACS COUNTY COMMUNITY HEALTH AMANDA LARSON, SHERBURNE COUNTY HEALTH AND HUMAN SERVICES DR. AMERICO FRABONI, FAIRVIEW MEDICAL GROUP BEN BARTON, PRINCETON PUBLIC SCHOOLS BRIDGET GRAVES, STERLING POINTE BRIDGET GRAVES, STERLING POINTE DAWN BESEMANN, LAKES & PINES COMMUNITY ACTION COUNCIL DR. JEREMY PETERSON, FAIRVIEW MEDICAL GROUP JULIA ESPE, PRINCETON PUBLIC SCHOOLS-RETIRED JULIE SCHMIDT, FAIRVIEW NORTHLAND MEDICAL CENTER KATHRYN BURSKI, KANABEC COUNTY COMMUNITY HEALTH MARK OLEEN, BREMER BANK MARTHA AHLSCHLAGER, STERLING POINTE PAULA WOISCHKE, CENTRAL MINNESOTA COUNCIL ON AGING SCOTT BERRY, BERRY LAW OFFICES
FACILITY 5, FAIRVIEW NORTHLAND REGIONAL HOSP - PART V, LINE 7D	SCHEDULE H, PART V, LINE 7A & LINE 10A: THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE LOCATED AT: HTTP://WWW.FAIRVIEW.ORG/OUR-COMMUNITY-COMMITMENT/LOCAL-HEALTH-NEEDS
FACILITY 5, FAIRVIEW NORTHLAND REGIONAL HOSP - PART V, LINE 11	COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) WERE CONDUCTED IN 2019. AN ESSENTIAL PART OF THE CHNA PROCESS WAS THE IDENTIFICATION OF PRIORITY NEEDS IN THE LOCAL COMMUNITY. THE HOSPITALS AND/OR MEDICAL CENTERS IDENTIFIED THE FOLLOWING PRIORITY NEEDS FOR FAIRVIEW NORTHLAND MEDICAL CENTER: MENTAL HEALTH AND WELL-BEING, HEALTHY LIFESTYLES, ACCESS TO CARE AND SERVICES. EACH HOSPITAL AND/OR MEDICAL CENTER DEVELOPED A HOSPITAL SPECIFIC IMPLEMENTATION PLAN AROUND ITS PRIORITY HEALTH ISSUES ALONG WITH A SYSTEM FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE TO ADDRESS THEIR IDENTIFIED PRIORITY NEEDS. EACH PROGRAM IS EVALUATED ON AN ANNUAL BASIS AGAINST PROGRAM SPECIFIC ANTICIPATED IMPACTS. AS PART OF THE EVALUATION PROCESS EACH PROGRAM INDICATOR IS ASSIGNED A VALUE OF "GREEN", "YELLOW- OR "RED" BASED UPON THE CRITERIA THAT FOLLOWS. A RATING OF "GREEN" MEANS THAT THE PROGRAM (A) MET, OR EXCEEDED, 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO BOTH GOAL/S AND ANTICIPATED IMPACT/S (C) THERE IS AN EVALUATION TOOL WITH MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "YELLOW" MEANS THAT THE PROGRAM (A) HAD PARTIAL COMPLETION OF 2019 HOSPITAL GOAL/S AS WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) IT HAS COUNT DATA TIED TO EITHER GOAL/S OR ANTICIPATED IMPACT/S BUT NOT BOTH (C)THERE IS AN EVALUATION TOOL WITHOUT MEASURE TIED TO ANTICIPATED IMPACT/S. A RATING OF "RED" MEANS THAT THE PROGRAM (A) DID NOT COMPLETE THE 2019 HOSPITAL GOAL/S WRITTEN IN HOSPITAL IMPLEMENTATION PLAN (B) THERE WAS NO COUNT DATA (C) THERE WAS NO EVALUATION TOOL/S. POLICY, SYSTEM, AND ENVIRONMENTAL (PSE) CHANGE INITIATIVES OFTEN TAKE MULTIPLE YEARS TO PLAN AND IMPLEMENT. USING A CDC EVALUATION FRAMEWORK EACH PSE INITIATIVE IS MONITORED AND EVALUATED ANNUALLY AGAINST ANTICIPATED ACTIVITIES AND MILESTONES LINKED TO THE SIX CONNECTED PSE EVALUATION STEPS. THE SIX CONNECTED STEPS OF PSE CHANGE WE TRACKED FOR MONITORING AND EVALUATION PURPOSES ARE (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, (3) FOCUS THE EVALUATION DESIGN, (4) GATHER CREDIBLE EVIDENCE, (5) JUSTIFY CONCLUSIONS, AND (6) ENSURE USE AND SHARE LESSONS LEARNED. OUR 2019 EVALUATION OF THE PSE INITIATIVES NOTE THE SPECIFIC PSE STEP/S FOR THAT INITIATIVES BASED ON THE ACTIVITIES. IN 2020 WE ARE IDENTIFYING PSE INITIATIVE SPECIFIC METRICS RELATED TO EACH STEP TO DEEPEN OUR EVALUATION OF OUTCOMES IN FUTURE YEARS. ANY PROGRAMMATIC ANTICIPATED IMPACT THAT RECEIVED A RATING OF "YELLOW- OR "RED" HAS A CORRESPONDING BRIEF EXPLANATION AND 2020 ACTION PLAN. IN 2020 WE WILL CONTINUE REFINING THE RATING SYSTEM AND CORRESPONDING PROGRAMMATIC AND PSE EVALUATION AS PART OF OUR COMMITMENT TO CONTINUOUS PROCESS IMPROVEMENT. DETAILED RESULTS AND ACTION PLANS ON PROGRAM AND PSE INITIATIVES ARE AVAILABLE UPON REQUEST. PRIORITY: MENTAL HEALTH AND WELLBEING M HEALTH FAIRVIEW NORTHLAND MEDICAL CENTER OFFERED THE EVIDENCE-BASED MENTAL HEALTH FIRST AID PROGRAM. THE PROGRAM INTRODUCES RISK FACTORS AND WARNING SIGNS OF COMMON MENTAL HEALTH AND SUBSTANCE USE DISORDERS, BUILDS UNDERSTANDING OF THEIR IMPACT, AND REVIEWS SUPPORT OPTIONS. THE INTERACTIVE COURSE TEACHES PARTICIPANTS HOW TO OFFER INITIAL HELP TO AN INDIVIDUAL WHO MAY BE EXPERIENCING A MENTAL HEALTH CONCERN OR CRISIS AND CONNECT THEM TO THE APPROPRIATE RESOURCES. YOUTH MENTAL HEALTH FIRST AID IS THE SECOND CORE PROGRAM WHICH FOCUSES ON MENTAL HEALTH CONCERNS AMONG YOUTH AGES 12-18. THE 2019 ANTICIPATED IMPACT FOR THE MENTAL HEALTH FIRST AID PROGRAMS WAS AN INCREASE IN PARTICIPANTS' ABILITY TO RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH AND MENTAL ILLNESS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 97% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THEY CAN RECOGNIZE AND CORRECT MISCONCEPTIONS ABOUT MENTAL HEALTH, SUBSTANCE USE AND MENTAL ILLNESS AS I ENCOUNTER THEM. M HEALTH FAIRVIEW NORTHLAND MEDICAL CENTER OFFERED THE TRAUMA INFORMED CONGREGATIONS PROGRAM, THE IMPLEMENTATION OF THE RISKING CONNECTION IN FAITH COMMUNITIES CURRICULUM ACROSS FAITH COMMUNITIES. RISKING CONNECTION HELPS CLERGY UNDERSTAND THE NATURE OF TRAUMA, ITS IMPACT ON PEOPLE AND HOW FAITH LEADERS CAN SUPPORT AND BRING HEALING TO TRAUMA SURVIVORS. THE 2019 ANTICIPATED IMPACT FOR THE TRAUMA INFORMED CONGREGATIONS PROGRAM WAS AN INCREASE IN CLERGY/LEADER UNDERSTANDING OF THE IMPACT OF TRAUMA ON TRAUMA SURVIVORS. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 32% INCREASE FROM ON PRE-PROGRAM-SURVEY TO POST-PROGRAM-SURVEY FOR PARTICIPANTS THAT STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: I UNDERSTAND THE CONCEPTS OF TRAUMA AND THE IMPACT TRAUMA CAN HAVE ON TRAUMA SURVIVORS. EVALUATION OF SURVEY RESULTS WAS DONE ON A PROGRAM LEVEL AND NOT ON HOSPITAL LEVEL - 19 SURVEY RESPONDENTS NOT ALL FROM NORTHLAND SERVICE AREA. M HEALTH FAIRVIEW NORTHLAND MEDICAL CENTER OFFERED YOUTH GRIEF SERVICES SESSIONS AND CAMPS. YOUTH GRIEF SERVICES (YGS) PROVIDES A SAFE AND NURTURING PLACE WHERE FAMILIES CAN TURN FOR HELP AFTER A LOVED ONE DIES. YGS ASSISTS IN THE HEALING PROCESS THROUGH A NETWORK OF PROGRAMS AND SERVICES THAT SUPPORT, EDUCATE, AND CONNECT GRIEVING FAMILIES. THE 2019 ANTICIPATED IMPACT FOR YOUTH GRIEF SERVICES WAS AN INCREASE IN YOUTH PARTICIPANTS' KNOWLEDGE OF HEALTHY COPING STRATEGIES IN RESPONSE TO GRIEF. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - CAMP OUTCOME: 66% OF YOUTH INDICATED THAT THEY HAVE NEW TOOLS TO HELP THEM WITH THEIR GRIEF AFTER CAMP. SERIES OUTCOME: 53% OF YOUTH INDICATED THAT THEY CAN IDENTIFY (NAME) SOME HEALTHY WAYS TO EXPRESS THEIR GRIEF. EVALUATION OF SURVEY RESULTS WAS DONE FOR CAMP PARTICIPANTS AND SERIES PARTICIPANTS ON A PROGRAM LEVEL. M HEALTH FAIRVIEW NORTHLAND MEDICAL CENTER COLLABORATED IN POLICY, SYSTEMS AND ENVIRONMENTAL (PSE) CHANGE AROUND RESPONDING TO TRAUMA IN SETTINGS SUCH AS SCHOOLS AND FAITH COMMUNITIES. THIS INITIATIVE INCLUDES ACTIVITIES AND MILESTONES LINKED TO PSE EVALUATION STEPS (1) ENGAGE STAKEHOLDERS, (2) DESCRIBE THE PROGRAM, AND (3) FOCUS THE EVALUATION DESIGN. 2019 IMPACT: GREEN - AN EXECUTIVE COMMITTEE WAS FORMED. THEY BEGAN MEETING QUARTERLY, TO CREATE A PLAN TO BECOME A TRAUMA-INFORMED SYSTEM FOR M HEALTH FAIRVIEW PATIENTS. PROVIDED TRAUMA-INFORMED CARE TRAINING FOR BEHAVIORAL HEALTH EMPLOYEES. THIS WORK ALIGNS WITH THE COMMUNITY WORK, TRAUMA INFORMED CONGREGATIONS PROGRAMMING, BEING PROVIDED TO FAITH COMMUNITY LEADERS. PRIORITY: HEALTHY LIFESTYLES M HEALTH FAIRVIEW NORTHLAND MEDICAL CENTER OFFERED THE EVIDENCE-BASED FALLS PREVENTION SUITE WHICH INCLUDED TWO PROGRAMS (1) MATTER OF BALANCE A PROGRAM DESIGNED TO REDUCE THE FEAR OF FALLING AND INCREASE ACTIVITY LEVELS AMONG OLDER ADULTS. IT INCLUDES 8 SESSIONS FOR A SMALL GROUP OF 8-12 PARTICIPANTS LED BY TWO TRAINED FACILITATORS. PARTICIPANTS LEARN TO VIEW FALLS AND FEAR OF FALLING AS CONTROLLABLE, SET REALISTIC GOALS TO INCREASE ACTIVITY, CHANGE THEIR ENVIRONMENT TO REDUCE FALL RISK FACTORS, AND EXERCISE TO INCREASE STRENGTH AND BALANCE. (2) TAI JI QUAN A RESEARCH-BASED 12-WEEK PROGRAM THAT IS DESIGNED TO KEEP OLDER ADULTS MOBILE AND INDEPENDENT. THE PROGRAM MEETS TWICE A WEEK FOR ONE HOUR. THE CLASSES WILL HELP PARTICIPANTS IMPROVE BALANCE, STRENGTHEN MUSCLES, AND REDUCE THE RISK OF FALLING. THE 2019 ANTICIPATED IMPACT FOR THE FALLS PREVENTION SUITE WAS A DECREASE PARTICIPANTS' FEAR OF FALLING. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 88% OF PARTICIPANTS INDICATED THAT THE PROGRAM SAID THEY DECREASED THEIR FEAR OF FALLING. M HEALTH FAIRVIEW NORTHLAND MEDICAL CENTER OFFERED THE EVIDENCE-BASED LIVING WELL SUITE WHICH INCLUDED THREE PROGRAMS THAT WERE DEVELOPED BY STANFORD UNIVERSITY'S PATIENT EDUCATION RESEARCH CENTER. (1) CHRONIC DISEASE SELF-MANAGEMENT IS A WORKSHOP GIVEN 2.5 HOURS ONCE A WEEK, FOR SIX WEEKS OFFERED TO INDIVIDUALS AND THEIR CAREGIVERS WHO ARE LIVING WITH CHRONIC CONDITIONS. SUBJECTS ADDRESSED INCLUDE MEDICATION USE, COMMUNICATION WITH DOCTORS AND CAREGIVERS, NUTRITION, AND FITNESS- WITH PRACTICAL EXERCISES AND ADVICE DESIGNED TO MEET PARTICIPANTS' NEEDS. (2) CHRONIC PAIN SELF-MANAGEMENT IS A WORKSHOP GIVEN 2 HOURS ONCE A WEEK, FOR SIX WEEKS, IN COMMUNITY SETTINGS. THE WORKSHOP HELPS PARTICIPANTS, AND THEIR SUPPORT PERSON, DEAL WITH THE ONGOING ISSUES ASSOCIATED WITH CHRONIC PAIN. (3) DIABETES SELF-MANAGEMENT IS A 6 WEEK ONCE A WEEK PROGRAM DEVELOPED TO HELPS THOSE LIVING WITH DIABETES OR PRE-DIABETES TO IMPROVE THEIR GENERAL HEALTH. THE 2019 ANTICIPATED IMPACT FOR THE LIVING WELL SUITE WAS AN INCREASE PARTICIPANTS' PERCEPTION OF POSITIVE LIFESTYLE CHANGES. THE ANTICIPATED IMPACT WAS ASSIGNED A VALUE OF "GREEN". 2019 IMPACT: GREEN - OUTCOME: 100.0% OF PARTICIPANTS THAT RESPONDED TO THE POST PROGRAM SURVEY INDICATED THAT THEY STRONGLY AGREE OR AGREE WITH THE FOLLOWING STATEMENT: THE PROGRA
FACILITY 5, FAIRVIEW NORTHLAND REGIONAL HOSP - PART V, LINE 13B	THE MINNESOTA ATTORNEY GENERAL AGREEMENT WAS USED IN THE DETERMINATION OF THE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
FACILITY 5, FAIRVIEW NORTHLAND REGIONAL HOSP - PART V, LINE 16J	A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN VARIOUS LOCATIONS IN THE HOSPITAL. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/FINANCIAL- ASSISTANCE-POLICY-2020-FINAL-VERSION_EN.ASHX?LA=EN PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/BILLING/FAIRVIEW-CHARITY-CARE HTTP://WWW.FVFILES.COM/2266.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.FAIRVIEW.ORG/~/MEDIA/FAIRVIEW/PDFS/BILLING/4454EN-FINANCIAL- ASSISTANCE-PLS-2019.ASHX?LA=EN

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?101
Name and address		Type of Facility (describe)
1	CLINICS - WYOMING 5200 FAIRVIEW BLVD WYOMING,MN55092	FREE STANDING CLINIC
2	CLINICS - FRIDLEY 6341 UNIVERSITY AVE NE FRIDLEY,MN55432	FREE STANDING CLINIC
3	CLINICS - ANDOVER 13819 HANSON BLVD NW ANDOVER,MN55304	FREE STANDING CLINIC
4	CLINICS - BROOKLYN PARK 1000 ZANE AVE NE BROOKLYN PARK,MN55443	FREE STANDING CLINIC
5	CLINICS - PRINCETON 919 NORTHLAND DRIVE PRINCETON,MN55371	FREE STANDING CLINIC
6	CVC - SOUTHDALE 6405 FRANCE AVE S STE W200 EDINA,MN55435	SPECIALTY CLINIC
7	CLINICS - BLAINE 10961 CLUB WEST PARKWAY NE BLAINE,MN55449	FREE STANDING CLINIC
8	GPO ADMIN 2450 RIVERSIDE AVE MINNEAPOLIS,MN55454	FREE STANDING CLINIC
9	CLINICS - ELK RIVER 290 MAIN ST NW STE 100 ELK RIVER,MN55330	FREE STANDING CLINIC
10	CLINICS - WYOMING PRIMARY CARE 5200 FAIRVIEW BLVD WYOMING,MN55092	FREE STANDING CLINIC
11	ORTHO LABS - FHME 2200 UNIVERSITY AVE W ST PAUL,MN55114	PT CLINIC
12	CVC - UMMC 2525 UNIVERSITY AVENUE SE MINNEAPOLIS,MN55414	SPECIALTY CLINIC
13	CLINICS - COLUMBIA HEIGHTS 4000 CENTRAL AVE NE COLUMBIA HEIGHTS,MN55421	FREE STANDING CLINIC
14	ONCOLOGY - UMMC 2525 UNIVERSITY AVENUE SE MINNEAPOLIS,MN55414	SPECIALTY CLINIC
15	SCPA - SOUTHDALE 6405 FRANCE AVE S EDINA,MN55435	SPECIALTY CLINIC
16	LAKES - HOMECARING & HOSPICE 5200 FAIRVIEW BLVD WYOMING,MN55092	SPECIALTY CLINIC
17	CLINICS - LINO LAKES 7455 VILLAGE DRIVE LINO LAKES,MN55014	FREE STANDING CLINIC
18	CLINICS - MAPLE GROVE 14500 99TH AVENUE N MAPLE GROVE,MN55369	FREE STANDING CLINIC
19	CLINICS - NORTH BRANCH 6413 OAK STREET NORTH BRANCH,MN55056	FREE STANDING CLINIC
20	CLINICS - CHISAGO 11725 STINSON AVE CHISAGO CITY,MN55013	FREE STANDING CLINIC
21	CLINICS - BLOOMINGTON LK XERXES 7901 XERXES AVENUE SOUTH BLOOMINGTON,MN55431	FREE STANDING CLINIC
22	SCPA - RIDGES 305 NICOLLET BLVD STE 372 BURNSVILLE,MN55337	SPECIALTY CLINIC
23	CLINICS - ZIMMERMAN 25945 GATEWAY DRIVE ZIMMERMAN,MN55398	FREE STANDING CLINIC
24	HAND CENTER - ORTHO 2512 7TH ST S STE R102 MINNEAPOLIS,MN55454	PT CLINIC
25	CLINICS - MILACA 150 10TH STREET NW MILACA,MN56353	FREE STANDING CLINIC
26	CLINICS - HUGO 14663 MERCANTILE DRIVE HUGO,MN55038	FREE STANDING CLINIC
27	CLINICS - RUSH CITY 760 W FOURTH STREET RUSH CITY,MN55069	FREE STANDING CLINIC
28	SCPA - VEIN SOLUTIONS 6405 FRANCE AVE S EDINA,MN55435	SPECIALTY CLINIC
29	CLINICS - BROOKLYN PARK UC 1000 ZANE AVE NE BROOKLYN PARK,MN55443	FREE STANDING CLINIC
30	CVC - RIDGES 305 NICOLLET BLVD STE 372 BURNSVILLE,MN55337	SPECIALTY CLINIC
31	CLINICS - HOSPITAL 1000 ZANE AVE NE BROOKLYN PARK,MN55443	FREE STANDING CLINIC
32	FV CLINICS - FSOC WYOMING 5200 FAIRVIEW BLVD WYOMING,MN55092	PT CLINIC
33	IAM - EDINA 6363 FRANCE AVE STE 100 EDINA,MN55435	PT CLINIC
34	SR SVCCS & OTHER CONTINUM SVCS 2450 RIVERSIDE AVENUE MINNEAPOLIS,MN55454	FREE STANDING CLINIC
35	CLINICS - BLOOMINGTON LK MPLS 1527 E LAKE STREET MINNEAPOLIS,MN55407	FREE STANDING CLINIC
36	IAM - BURNSVILLE 675 E NICOLLET BLVD 135 BURNSVILLE,MN55337	PT CLINIC
37	FV CLINICS - FS OC OAK RIDGE 675 E NICOLLET BLVD STE 250 BURNSVILLE,MN55337	PT CLINIC
38	IAM - EDEN PRAIRIE 775 PRAIRIE CENTER DRIVE 250 EDEN PRAIRIE,MN55344	PT CLINIC
39	FV CLINIC - SAVAGE 5725 LOFTUS LANE SAVAGE,MN55378	FREE STANDING CLINIC
40	ORTHO LABS - RIVERSIDE 606 24TH AVE S STE 301 MINNEAPOLIS,MN55454	PT CLINIC
41	ORTHO LABS - BURNSVILLE 501 NICOLLET BLVD STE LL50 BURNSVILLE,MN55337	PT CLINIC
42	IAM - WEST HEALTH 2805 CAMPUS DRIVE 115 PLYMOUTH,MN55441	PT CLINIC
43	BROOKLYN PARK SLEEP LAB 10000 ZANE AVE NE BROOKLYN PARK,MN55443	SPECIALTY CLINIC
44	IAM - EAGAN 1440 DUCKWOOD DRIVE EAGAN,MN55122	PT CLINIC
45	IAM - TRAINERS 4080 W BROADWAY 300 ROBBINSDALE,MN55422	PT CLINIC
46	IAM - HIGHLAND PARK 2155 FORD PARKWAY ST PAUL,MN55116	PT CLINIC
47	IAM - ARBOR LAKES 12000 ELM CREEK BLVD STE 120 MAPLE GROVE,MN55369	PT CLINIC
48	ORTHO LABS - ST PAUL 2200 UNIVERSITY AVE S STE 114 ST PAUL,MN55114	PT CLINIC
49	FV BLAINE PHYSICAL THERAPY 10961 CLUB WEST PARKWAY NE BLAINE,MN55449	PT CLINIC
50	CLINICS - INTEGRATED PRIMARY 2450 RIVERSIDE AVENUE MINNEAPOLIS,MN55454	FREE STANDING CLINIC
51	IAM - UNIVERSITY 2525 UNIVERSITY AVENUE SE MINNEAPOLIS,MN55414	PT CLINIC
52	IAM - BLOOMINGTON 600 W 98TH ST 390 BLOOMINGTON,MN55420	PT CLINIC
53	IAM - APPLE VALLEY 15650 CEDAR AVE 160 APPLE VALLEY,MN55124	PT CLINIC
54	IAM - BLAINE 1750 105TH AVE NE BLAINE,MN55449	PT CLINIC
55	IAM - ROSEMOUNT 15075 CIMARRON AVE 20 ROSEMOUNT,MN55068	PT CLINIC
56	IAM - PLYMOUTH 9750 ROCKFORD RD PLYMOUTH,MN55442	PT CLINIC
57	IAM - UPTOWN 3033 EXCELSIOR BLVD 225 MINNEAPOLIS,MN55416	PT CLINIC
58	CLINICS - ANDOVER UC 13819 HANSON BLVD NW ANDOVER,MN55304	FREE STANDING CLINIC
59	IAM - ST ANTHONY 2600 39TH AVE NE 220 ST ANTHONY,MN55421	PT CLINIC
60	IAM - MAPLE GROVE FV 14500 99TH AVE N STE 1-210 MAPLE GROVE,MN55369	PT CLINIC
61	IAM - ELK RIVER 800 FREEPORT AVE N 200 ELK RIVER,MN55330	PT CLINIC
62	ORTHO LABS - EDINA 6363 FRANCE AVE S STE 110 EDINA,MN55435	PT CLINIC
63	ORTHO LABS - ADMIN 2200 UNIVERSITY AVE W STE 114 ST PAUL,MN55114	PT CLINIC
64	IAM - BROOKLYN PARK 8559 EDINBROOK PKWY 104 BROOKLYN PARK,MN55443	PT CLINIC
65	IAM - ROBBINSDALE 4080 W BROADWAY 300 ROBBINSDALE,MN55422	PT CLINIC
66	IAM - LAKEVILLE 18592 JOPLIN AVE LAKEVILLE,MN55044	PT CLINIC
67	FV FRIDLEY PHYSICAL THERAPY 6341 UNIVERSITY AVE NE FRIDLEY,MN55432	PT CLINIC
68	IAM - LINO LAKES 7455 VILLAGE DR LINO LAKES,MN55014	PT CLINIC
69	CLINICS - CHISAGO SLEEP LAB 11725 STINSON AVE CHISAGO CITY,MN55013	SPECIALTY CLINIC
70	IAM - ROSEVILLE 1955 WEST COUNTY RD B2 ROSEVILLE,MN55113	PT CLINIC
71	FV BROOKLYN PARK 10000 ZANE AVE N BROOKLYN PARK,MN55443	FREE STANDING CLINIC
72	HAND CENTER - BURNSVILLE 675 E NICOLLET BLVD 225 BURNSVILLE,MN55337	PT CLINIC
73	HAND CENTER - EDINA 6363 FRANCE AVE S 105 EDINA,MN55435	PT CLINIC
74	IAM - HUGO 14712 VICTOR HUGO BOULEVARD HUGO,MN55038	PT CLINIC
75	ORTHO LABS - EDINA DME 6545 FRANCE AVE S SUITE 471 EDINA,MN55435	PT CLINIC
76	CLINICS - COMPLEX CARE 2450 RIVERSIDE AVE MINNEAPOLIS,MN55454	SPECIALTY CLINIC
77	ORTHO LABS - BLAINE 10961 CLUB WEST PARKWAY NE BLAINE,MN55449	PT CLINIC
78	FV COLUMBIA PARK 4000 CENTRAL AVE NE COLUMBIA HEIGHTS,MN55421	FREE STANDING CLINIC
79	IAM - MAPLEWOOD 1650 BEAM AVE LOWER LEVEL MAPLEWOOD,MN55109	PT CLINIC
80	IAM - WOODBURY 7616 CURRELL AVE 270 WOODBURY,MN55125	PT CLINIC
81	CVC - LAKES 5200 FAIRVIEW BLVD WYOMING,MN55092	SPECIALTY CLINIC
82	FV CLINICS - SKIN CARE CTR SUITE 310 300 WEST 98TH ST BLOOMINGTON,MN55420	SPECIALTY CLINIC
83	IAM - SAVAGE 5725 LOFTUS LANE SAVAGE,MN55378	PT CLINIC
84	IOR - NORTHEAST ST 650 TAFT ST NE 400 MINNEAPOLIS,MN55413	PT CLINIC
85	IAM - GOLDEN VALLEY 8301 GOLDEN VALLEY RD ST 202 GOLDEN VALLEY,MN55427	PT CLINIC
86	HAND CENTER - FSOC BLAINE 10961 CLUB WEST PARKWAY NE STE 200 BLAINE,MN55449	PT CLINIC
87	HAND CENTER - MAPLE GROVE 14500 99TH AVENUE SOUTH MAPLE GROVE,MN55369	PT CLINIC
88	ORTHO LABS - WYOMING 6363 FRANCE AVE S STE 110 EDINA,MN55435	PT CLINIC
89	ORTHO LABS - U OF M 500 HARVARD ST MINNEAPOLIS,MN55455	PT CLINIC
90	PHYSICIAN - PAIN CLINIC BLAINE 10961 CLUB WEST PARKWAY NE BLAINE,MN55449	SPECIALTY CLINIC
91	FSOC - OAK RIDGE 675 NICOLLET BLVD E BURNSVILLE,MN55337	PT CLINIC
92	HAND CENTER - ELK RIVER 800 FREEPORT AVE N 200 ELK RIVER,MN55330	PT CLINIC
93	FV PAIN CLINIC - COLUMBIA HEIGHTS 4000 CENTRAL AVE NE COLUMBIA HEIGHTS,MN55421	SPECIALTY CLINIC
94	FV GERIATRICS - BLUESTONE VISTA 2450 RIVERSIDE AVENUE MINNEAPOLIS,MN55454	SPECIALTY CLINIC
95	HAND CENTER - WEST HEALTH 2805 CAMPUS DRIVE STE 115 PLYMOUTH,MN55441	PT CLINIC
96	PHYSICIANS - LIFE STYLE MED 6401 FRANCE AVE S EDINA,MN55435	SPECIALTY CLINIC
97	CLINICS - FPOB 4000 CENTRAL AVE NE COLUMBIA HEIGHTS,MN55421	PT CLINIC
98	IOR OTHER 701 25TH AVENUE SOUTH STE 500 MINNEAPOLIS,MN55454	PT CLINIC
99	LIFESTYLE MEDICINE - WYOMING 5200 FAIRVIEW BLVD WYOMING,MN55092	SPECIALTY CLINIC
100	ONCOLOGY CLINIC 424 HARVARD STREET SE MINNEAPOLIS,MN55455	SPECIALTY CLINIC
101	CLINICS - PINE CITY 510 2ND STREET SE PINE CITY,MN55063	FREE STANDING CLINIC

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
SCHEDULE H, PART I, LINE 3C	PATIENTS THAT ARE ELIGIBLE FOR THE FAIRVIEW COMMUNITY CARE PROGRAM OR OTHER CHARITY CARE PLANS MAY RECEIVE A REDUCTION ON AMOUNTS OWED OR UP TO 100% OF TOTAL CHARGES. FAIRVIEW INFORMS PATIENTS ABOUT THE COMMUNITY CARE PROGRAM PRIOR TO DELIVERY OF SERVICES IF FEASIBLE AND AS APPROPRIATE AND DURING THE BILLING PROCESS. UNINSURED PATIENTS WITH HOUSEHOLD INCOME UP TO 200% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 100% DISCOUNT OF TOTAL CHARGES. UNINSURED PATIENTS WITH A HOUSEHOLD INCOME OF 201%-300% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR A 50% DISCOUNT OF TOTAL CHARGES. UNINSURED PATIENTS WITH A HOUSEHOLD INCOME GREATER THAN 300% OF THE FEDERAL POVERTY LEVEL AND BELOW 125,000 ARE CHARGED A DISCOUNT RATE EQUAL TO THE RATE FROM FAIRVIEW'S HIGHEST VOLUME PRIVATE PAYOR CONTRACT.
SCHEDULE H, PART I, LINE 7G	THERE ARE NO COSTS ASSOCIATED WITH PHYSICIAN CLINICS INCLUDED IN LINE 7G.
SCHEDULE H, PART I, LINE 7, COLUMN (F)	THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THERE IS NO BAD DEBT EXPENSE INCLUDED IN FORM 990 PART IX AS AN EXPENSE. DUE TO THE ADOPTION OF NEW GAAP REPORTING, THE BAD DEBT EXPENSE HAS BEEN INCLUDED WITH "DISCOUNTS" NETTED AGAINST PATIENT SERVICE REVENUE ON PART VIII OF FORM 990.
SCHEDULE H, PART I, LINE 7	THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A THROUGH 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. THE CALCULATION WAS UPDATED FOR TAX YEAR 2019 AS IT WAS DISCOVERED THAT COMMUNITY BENEFIT COSTS FOR FINANCIAL ASSISTANCE AND MEDICAID WERE OVERSTATED IN PRIOR YEARS. THE OVERSTATEMENT WAS RELATED TO THE ALLOCATION OF PROVIDER TAXES AND MISTREATMENT OF OFFSETTING REVENUE FROM THE UNCOMPENSATED POOL. FOR TAX YEAR 2019 THIS RESULTED IN THE PERCENT OF TOTAL EXPENSE TO CHANGE FROM 9.46% TO 6.37%. FHS WILL USE THIS CALCULATION IN FUTURE YEARS. FORM 990, SCHEDULE H, PART I, LINES 7E THROUGH 7J ARE REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION. FORM 990, SCHEDULE H, PART I, LINES 7E THROUGH 7J ARE REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION.
SCHEDULE H, PART II	FAIRVIEW HEALTH SERVICES IS AN INTEGRATED HEALTH CARE SYSTEM HEADQUARTERED IN MINNEAPOLIS, MINNESOTA. COMMUNITY BENEFIT ACTIVITY IS CARRIED OUT BY STAFF/LEADERSHIP AT EACH FACILITY BASED ON THE HEALTH CARE NEEDS IN THAT SERVICE AREA. THE FAIRVIEW CORPORATE COMMUNITY HEALTH DEPARTMENT SUPPORTS THE LOCAL WORK BY SHARING BEST PRACTICES, FINDING EFFICIENCIES AMONG HOSPITAL COMMUNITY HEALTH PROGRAMS AND STAFFING AS APPROPRIATE, COORDINATING THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND MORE. ACTIVITIES INCLUDE A COMMUNITY HOUSING INITIATIVE, ECONOMIC DEVELOPMENT COLLABORATIVE, LEADERSHIP DEVELOPMENT AND COALITION BUILDING. THE COMMUNITY BUILDING ACTIVITES ARE PERFORMED BUT THE FINANCIAL COSTS ARE NOT TRACKED. UNCOMPENSATED COSTS RESULTING FROM MEDICARE, MEDICAID AND STATE AND LOCAL INDIGENT CARE PROGRAMS ARE CONSIDERED AS COMMUNITY BENEFIT BECAUSE OF THE SIGNIFICANT DIFFERENCES BETWEEN ACTUAL COSTS AND REIMBURSEMENT. A REMARKABLE PROGRAM CALLED THE MINNESOTA IMMUNIZATION NETWORK INITIATIVE (MINI), A COLLABORATION LED BY FAIRVIEW AND SUPPORTED BY 108 COMMUNITY PARTNERS, WORKS TO REDUCE BARRIERS TO INFLUENZA VACCINATIONS FOR PEOPLE WHO ARE UNINSURED, UNDERINSURED, OR EXPERIENCING HOMELESSNESS IN OUR COMMUNITY. MINI PROVIDES FLU IMMUNIZATIONS FREE OF CHARGE TO LOW-INCOME AND UNINSURED INDIVIDUALS. AFTER 12 YEARS, MORE THAN 86,000 IMMUNIZATIONS HAVE BEEN GIVEN TO PREVENT INFLUENZA. THE MINI CLINICS ARE HOSTED AT NON-TRADITIONAL LOCATIONS SUCH AS LOCAL CHURCHES, MOSQUES, SCHOOLS, COMMUNITY CENTERS, FOOD PANTRIES, AND HOMELESS SHELTERS. THE CLINICS ARE HOSTED BY THE LOCAL PARTNER WHO PROVIDES THE SPACE, PROMOTION, AND INTERPRETERS. FAIRVIEW PROVIDES THE VACCINE, VACCINATORS, PAPERWORK - INCLUDING ANY NEEDED TRANSLATIONS - AND INFORMATION ABOUT OTHER LOCAL COMMUNITY RESOURCES. INFLUENZA VACCINATIONS ARE PROVIDED AT NO CHARGE TO PARTICIPANTS, AGES SIX MONTHS AND OLDER. THE PAST SEVERAL YEARS, MINI CLINICS HAVE EXPANDED THEIR REACH TO INCLUDE DENTAL VARNISH TREATMENTS AND ORAL HEALTH EDUCATION. FREE DENTAL VARNISH TREATMENTS ARE PROVIDED IN CONJUNCTION WITH OUR FLU SHOTS CLINICS OR ON THEIR OWN.
SCHEDULE H, PART III, LINE 2	THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THERE IS NO BAD DEBT EXPENSE INCLUDED IN FORM 990 PART IX AS AN EXPENSE. DUE TO THE ADOPTION OF NEW GAAP REPORTING, THE BAD DEBT EXPENSE HAS BEEN INCLUDED WITH "DISCOUNTS" NETTED AGAINST PATIENT SERVICE REVENUE ON PART VIII OF FORM 990.
SCHEDULE H, PART III, LINE 3	THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS THAT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS.
SCHEDULE H, PART III, LINE 4	CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. SEE NOTE 6 OF THE AUDITED FINANCIAL STATEMENTS FOR ADDITIONAL INFORMATION.
SCHEDULE H, PART III, LINE 8	IT IS PART OF FAIRVIEW'S MISSION THAT COMMUNITY BENEFIT ACTIVITY IS CARRIED OUT BY STAFF/LEADERSHIP AT EACH FACILITY BASED ON THE HEALTH CARE NEEDS IN THAT SERVICE AREA. THE MEDICARE COST TO CHARGE RATIO REPORTING IS CALCULATED SERVICE LINE BY SERVICE LINE. OTHER EXPENSES ARE CALCULATED USING THE OVERALL COST TO CHARGE RATIO. UNCOMPENSATED COSTS RESULTING FROM MEDICARE, MEDICAID AND STATE AND LOCAL INDIGENT CARE PROGRAMS ARE CONSIDERED A COMMUNITY BENEFIT BECAUSE OF THE SIGNIFICANT DIFFERENCES BETWEEN ACTUAL COSTS AND REIMBURSEMENT.
SCHEDULE H, PART III, LINE 9B	AFTER OUR PATIENTS HAVE RECEIVED SERVICES, IT IS THE POLICY OF FAIRVIEW HEALTH SERVICES TO BILL PATIENTS AND THEIR APPLICABLE PAYORS ON A TIMELY AND ACCURATE BASIS. DURING THIS BILLING AND COLLECTION PROCESS, FAIRVIEW STAFF IS COMMITTED TO PROVIDING QUALITY CUSTOMER SERVICE AND TIMELY FOLLOW UP ON ALL OUTSTANDING ACCOUNTS. BILLING: IT IS THE GOAL OF FAIRVIEW TO BILL ALL CLAIMS ACCURATELY AND ON A TIMELY BASIS. ALTHOUGH DEPENDENT ON INFORMATION AND COMMUNICATIONS FROM PATIENTS AND PAYORS, FAIRVIEW WILL PROVIDE SUFFICIENT FOLLOW UP SERVICE TO ENSURE THAT PATIENTS RECEIVE ACCURATE ACCOUNT AND BILLING INFORMATION AND HAVE THE OPPORTUNITY TO MAKE PAYMENT AND/OR APPLY FOR COMMUNITY CARE. FAIRVIEW HAS AGREED TO CERTAIN BILLING AND COLLECTION PRACTICES BY AN AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL'S OFFICE. THERE ARE FINANCIAL COUNSELORS AT EVERY ENTITY MONDAY THROUGH FRIDAY WHO INTERACT WITH THE PATIENTS IN PERSON AND OVER THE PHONE TO INFORM OF PROGRAMS AVAILABLE TO THEM AS WELL AS ASSIST THEM IN APPLYING FOR THE PROGRAMS. THE INFORMATION ABOUT NEEDING ASSISTANCE WITH PAYING THE BILL IS POSTED ON SIGNS IN THE HOSPITALS AND MATERIALS ARE DISTRIBUTED TO SELF-PAY PATIENTS BY REGISTRATION STAFF. THE STATEMENTS SENT OUT AFTER THE VISIT PROVIDE THIS INFORMATION AS WELL. IF A PATIENT/FAMILY MEMBER CALLS THE CENTRAL BUSINESS OFFICE CUSTOMER SERVICE STAFF TO ASK FOR ASSISTANCE WITH PAYING THEIR BILL, THEY ARE INFORMED ABOUT OPTIONS AT THAT TIME. FAIRVIEW PROVIDES AN INTERPRETER SERVICE THAT INTERPRETS CONVERSATIONS OVER THE PHONE. THIS SERVICE CAN BE USED EITHER AS A THREE WAY PHONE CALL OR THE FINANCIAL COUNSELOR, IN A ROOM WITH THE PATIENT OR FAMILY CAN PLACE THE CALL TOGETHER TO THE INTERPRETER PHONE SERVICE. THE INTERPRETER SERVICES LINE ACCOMMODATES CLOSE TO 200 LANGUAGES. THE BILLING PROCESS WILL BE ASSISTED BY THE FOLLOWING GUIDELINES: 1) FOR ALL INSURED PATIENTS, FAIRVIEW WILL BILL ALL THIRD PARTY PAYOR INFORMATION (AS PROVIDED BY OR VERIFIED BY THE PATIENT) ON A TIMELY AND ACCURATE BASIS. 2) FOR ALL UNINSURED PATIENTS WITH MINNESOTA RESIDENCY RECEIVING HOSPITAL BASED SERVICES DEEMED MEDICALLY NECESSARY, FAIRVIEW WILL APPLY AN UNINSURED DISCOUNT EQUAL TO THE DISCOUNT PROVIDER TO OUR LARGEST CONTRACTED NON-GOVERNMENT PAYOR, ANY REMAINING BALANCE WILL BE BILLED TO THE PATIENT IN A TIMELY AND MANNER. 3) ALL BILLED PATIENTS HAVE THE OPPORTUNITY TO CONTACT FAIRVIEW REGARDING FINANCIAL ASSISTANCE FOR THEIR ACCOUNTS. FINANCIAL ASSISTANCE MAY INCLUDE COMMUNITY CARE, PAYMENT ARRANGEMENTS, MEDICAL ASSISTANCE OR OTHER APPLICABLE PROGRAMS. 4) IF A PATIENT CONTACTS FAIRVIEW REGARDING COMMUNITY CARE BEFORE THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY OR ATTORNEY, AN APPLICATION AND REQUIRED DOCUMENTATION IS REQUESTED (INCOME VERIFICATION ETC.), THE ACCOUNT WILL THEN BE PROCESSED BASED ON THE OUTCOME OF THE COMMUNITY CARE DETERMINATION. 5) FAIRVIEW TAKES REASONABLE MEASURES TO AVOID REFERRING AN ACCOUNT TO COLLECTION UNLESS THERE ARE NO RESPONSES FROM THE PATIENT. IF A PATIENT CONTACTS FAIRVIEW REGARDING COMMUNITY CARE AFTER THEIR ACCOUNT HAS BEEN REFERRED TO A COLLECTION AGENCY OR ATTORNEY, FAIRVIEW WILL SEND AN APPLICATION TO THE PATIENT PROVIDED THE ACCOUNT MEETS THE COMMUNITY CARE REQUIREMENTS. IF THE COMPLETED APPLICATION ALONG WITH REQUIRED DOCUMENTATION (INCOME VERIFICATION, ETC.) IS SUBMITTED, ALL COLLECTION ACTION WILL BE SUSPENDED UNTIL THE PATIENT IS NOTIFIED OF FAIRVIEW'S DETERMINATION.
SCHEDULE H, PART VI, LINE 2	ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY IS CRITICALLY IMPORTANT TO CARRYING OUT THE FAIRVIEW HEALTH SERVICES MISSION: DRIVEN TO HEAL, DISCOVER, AND EDUCATE FOR LONGER, HEALTHIER LIVES. IN ORDER TO ACHIEVE OPTIMAL HEALTH FOR OUR COMMUNITY, WE MUST REACH BEYOND THE WALLS OF OUR MEDICAL CENTERS AND CLINICS TO UNDERSTAND THE HEALTH OF OUR COMMUNITY WHERE THEY LIVE. EACH OF FAIRVIEW'S HOSPITALS HAS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO SYSTEMATICALLY IDENTIFY, ANALYZE, AND PRIORITIZE THE CRITICAL HEALTH NEEDS OF THE COMMUNITY AND TO DEVELOP STRATEGIES TO ADDRESS THOSE NEEDS. THE 2018 CHNA BUILDS UPON PREVIOUS ASSESSMENTS AND WAS DEVELOPED IN PARTNERSHIP WITH COMMUNITY MEMBERS, ORGANIZATIONS, AND LOCAL PUBLIC HEALTH AGENCIES. EACH OF FAIRVIEW'S HOSPITALS AND MEDICAL CENTERS ARE COMMITTED TO IMPROVING THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. WE FULFILL OUR RESPONSIBILITY NOT ONLY THROUGH THE CHNA, BUT ALSO THROUGH EFFORTS INCLUDING: -A SUSTAINABLE FUNDING STRUCTURE THAT SUPPORTS INNOVATIVE AND COLLABORATIVE HEALTH PROJECTS THAT HAVE MEASURABLY IMPROVED HEALTH OUTCOMES AND EARNED NATIONAL RECOGNITION. -POLICIES AND BILLING PRACTICES THAT SUPPORT APPROPRIATE FINANCIAL ASSISTANCE FOR THOSE IN NEED. WHILE FAIRVIEW'S COMMUNITY HEALTH PROGRAMS ADDRESS THE NEEDS OF THE WHOLE COMMUNITY, OUR EFFORTS ARE FOCUSED ON SENIORS, PEOPLE EXPERIENCING POVERTY, PERSONS OF COLOR, AND INDIGENOUS PEOPLE. AN ESSENTIAL PART OF THE CHNA PROCESS WAS THE IDENTIFICATION OF PRIORITY HEALTH NEEDS IN THE LOCAL COMMUNITY. ALTHOUGH EACH FAIRVIEW HOSPITAL AND/OR MEDICAL CENTER WORKED FROM QUALITATIVE AND QUANTITATIVE DATA SPECIFIC TO THEIR COMMUNITY, THERE WERE LARGE OVERLAPS IN THE IDENTIFIED COMMUNITY NEEDS. THE HOSPITALS AND/OR MEDICAL CENTERS THREE PRIORITIES ARE CONSISTENT ACROSS ALL FAIRVIEW HOSPITALS AND MEDICAL CENTERS AND ARE INTENTIONALLY BROAD TO ALLOW FOR LOCAL VARIATION DURING THE IMPLEMENTATION PLANNING PROCESS. THE THREE PRIORITY HEALTH NEEDS ARE: MENTAL HEALTH AND WELL-BEING, HEALTHY LIFESTYLES AND ACCESS TO CARE AND RESOURCES. EACH HOSPITAL AND/OR MEDICAL CENTER DEVELOPED A HOSPITAL SPECIFIC IMPLEMENTATION PLAN AROUND THESE THREE PRIORITY HEALTH ISSUES.
SCHEDULE H, PART VI, LINE 3	FAIRVIEW MAKES INFORMATION ABOUT ITS CHARITY CARE PROGRAMS AVAILABLE ON ITS WEBSITE (WWW.FAIRVIEW.ORG). AT THE TIME OF REGISTRATION FOR SERVICES AND THROUGH WRITTEN MATERIALS IN LOBBIES AND WAITING ROOMS. FOR PATIENTS IDENTIFIED AS SELF-PAY (WHETHER THAT OCCURS BEFORE SERVICES ARE DELIVERED OR DURING THE BILLING CYCLE), FAIRVIEW UTILIZES A STANDARD PROCESS TO ASSIST PATIENTS LEARN ABOUT AND ACCESS ASSISTANCE FROM GOVERNMENT PROGRAMS OR FAIRVIEW'S CHARITY CARE PROGRAM. FOR UNINSURED PATIENTS SEEN IN A FAIRVIEW HOSPITAL, FAIRVIEW PARTNERS WITH AN EXTERNAL VENDOR WHO MEETS WITH SELF-PAY PATIENTS TO ASSIST THEM DETERMINE ELIGIBILITY FOR GOVERNMENT PROGRAMS OF FAIRVIEW'S CHARITY CARE PROGRAM. THE VENDOR WILL ALSO ASSIST PATIENTS WITH COMPLETING THE NECESSARY PAPERWORK TO ACCESS THESE RESOURCES. STAFF IN FAIRVIEW'S CENTRAL BUSINESS OFFICE HAVE A SELF-PAY TEAM, WHICH DIRECTS PATIENTS TO THE APPROPRIATE RESOURCES. THERE IS ALSO A COMMUNITY CARE COORDINATOR WHO ASSISTS IN GETTING PATIENTS CONNECTED TO ADDITIONAL RESOURCES FOR WHICH THEY MAY QUALIFY.
SCHEDULE H, PART VI, LINE 4	FAIRVIEW HEALTH SERVICES IS AN INTEGRATED HEALTH SYSTEM HEADQUARTERED IN MINNEAPOLIS, MINNESOTA. FAIRVIEW IS COMPRISED OF FIVE HOSPITALS AND ONE MEDICAL CENTER: 1) FAIRVIEW LAKES MEDICAL CENTER IN WYOMING, MN, 2) FAIRVIEW NORTHLAND MEDICAL CENTER IN PRINCETON, MN, 3) FAIRVIEW RIDGES HOSPITAL IN BURNSVILLE, MN, 4) FAIRVIEW SOUTHDALE HOSPITAL IN EDINA, MN, 5) UNIVERSITY OF MINNESOTA MEDICAL CENTER, MINNEAPOLIS, MN 6) FAIRVIEW MAPLE GROVE MEDICAL CENTER IN MAPLE GROVE, MN, A RELATED ENTITY FAIRVIEW ALSO HAS A FULL CONTINUUM OF HEALTH CARE SERVICES. SEE PART III PAGE 2 , LINES 4A, 4B AND 4C. FOR THE PURPOSES OF THE CHNA, FAIRVIEW'S COMMUNITIES ARE DEFINED AS THE POPULATION OF THE COMBINED ZIP CODES FOR FAIRVIEW'S HOSPITALS AND MEDICAL CENTER'S PRIMARY SERVICE AREAS. THESE ARE COMPRISED OF 161 ZIP CODES, NINE MINNESOTA COUNTIES (CHISAGO, DAKOTA, HENNEPIN, ITASCA, MILLE LACS, RAMSEY, SHERBURNE, ST. LOUIS, AND WASHINGTON) AND AN AREA OF WISCONSIN. ALL TOLD, FAIRVIEW'S COMMUNITIES REPRESENT A POPULATION OF 2,645,690 PEOPLE AND COVERS 6,969 SQUARE MILES. THESE ZIP CODES ARE HOME TO APPROXIMATELY 84 PERCENT OF FAIRVIEW'S PATIENTS. 1) FAIRVIEW LAKES MEDICAL CENTER IS LOCATED IN CHISAGO COUNTY AND HAS A PRIMARY SERVICE AREA OF INDIVIDUALS RESIDING IN ANOKA, CHISAGO, ISANTI, PINE AND WASHINGTON COUNTIES IN MINNESOTA. CHISAGO COUNTY HAS BECOME SLIGHTLY MORE DIVERSE, YET IS STILL MOSTLY WHITE RESIDENTS. THE PERCENTAGE OF WHITE RESIDENTS DECREASED BETWEEN 2000 AND 2016 BY THREE PERCENT. POPULATION INCREASES AMONG THE VARIOUS MINORITY RACIAL AND ETHNIC GROUPS HAS LED TO THE THREE PERCENTAGE POINT INCREASE IN RESIDENTS OF COLOR. THE PROPORTION OF CHISAGO COUNTY RESIDENTS AGE 65 AND OLDER HAS INCREASED, BUT IS STILL AT THE SAME LEVEL AS THE STATE OVERALL. CURRENTLY, 15 PERCENT OF CHISAGO COUNTY RESIDENTS ARE AGE 65 AND OLDER, COMPARED TO 10 PERCENT IN 2000. FAIRVIEW LAKES MEDICAL CENTER IS THE ONLY FAIRVIEW HOSPITAL IN THE PRIMARY SERVICES AREA. FAIRVIEW LAKES PROVIDES A FULL CONTINUUM OF SERVICES, FROM PRIMARY CARE SERVICES AT THE CLINIC TO HOME CARE SERVICES TO LONG-TERM CARE. 2) FAIRVIEW NORTHLAND MEDICAL CENTER HAS A PRIMARY SERVICE AREA OF INDIVIDUALS RESIDING IN SHERBURNE, BENTON, KANABEC, MILLE LACS AND ISANTI COUNTIES IN MINNESOTA. THE HOSPITAL IS UNIQUELY LOCATED ON THE BORDER OF MILLE LACS AND SHERBURNE COUNTIES. BOTH COUNTIES HAVE BECOME MORE ETHNICALLY DIVERSE OVER TIME. CURRENTLY 89 PERCENT OF THE RESIDENTS IN MILLE LACS COUNTY ARE WHITE, COMPARED TO 93 PERCENT IN 2000. THE NEXT MOST POPULOUS GROUP IS AMERICAN INDIAN RESIDENTS (SIX PERCENT). THE PROPORTION OF MILLE LACS COUNTY RESIDENTS AGE 65 AND OLDER HAS INCREASED, WITH THE COUNTY NOW HAVING A LARGER PERCENTAGE OF OLDER ADULTS THAN THE STATE OVERALL. CURRENTLY, NEARLY 18 PERCENT OF MILLE LACS COUNTY RESIDENTS ARE AGE 65 OR OLDER. CURRENTLY, 91 PERCENT OF THE RESIDENTS IN SHERBURNE COUNTY ARE WHITE, COMPARED TO 96 PERCENT IN 2000. THE NEXT MOST POPULOUS GROUPS ARE BLACK AND HISPANIC RESIDENTS AT THREE PERCENT. THE PROPORTION OF SHERBURNE COUNTY RESIDENTS AGE 65 AND OLDER HAS INCREASED, HOWEVER SHERBURNE COUNTY STILL HAS A SMALLER PERCENTAGE OF OLDER ADULTS THAN THE STATE OVERALL. CURRENTLY, NEARLY 11 PERCENT OF SHERBURNE COUNTY RESIDENTS ARE AGE 65 OR OLDER. FAIRVIEW NORTHLAND IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA. WITHIN THE SECONDARY SERVICE AREA, THERE ARE FOUR OTHER HOSPITALS. FAIRVIEW NORTHLAND PROVIDES A FULL CONTINUUM OF SERVICES, FROM PRIMARY CARE SERVICES TO HOME CARE. 3) FAIRVIEW RIDGES HOSPITAL IN BURNSVILLE, MN HAS A PRIMARY SERVICE AREA IN SCOTT AND DAKOTA COUNTIES. THE HOSPITAL IS LOCATED IN THE SOUTHERN PART OF THE GREATER MINNEAPOLIS-ST. PAUL METROPOLITAN AREA IN DAKOTA COUNTY. DAKOTA COUNTY HAS BECOME INCREASINGLY DIVERSE. WHILE DAKOTA COUNTY IS STILL MAJORITY-WHITE, WHITE RESIDENTS COMPRISE A SMALLER PERCENTAGE OF THE POPULATION TODAY COMPARED TO IN 2000 (79 PERCENT COMPARED TO 90 PERCENT, RESPECTIVELY). DURING THE SAME TIMEFRAME, THE PERCENTAGE OF BLACK AND HISPANIC RESIDENTS HAS MORE THAN DOUBLED, AS HAS THE PERCENTAGE OF FOREIGN-BORN RESIDENTS. THE PROPORTION OF DAKOTA COUNTY RESIDENTS AGE 65 AND OLDER HAS INCREASED, HOWEVER DAKOTA COUNTY STILL HAS A SMALLER PERCENTAGE OF OLDER ADULTS THAN THE STATE OVERALL. CURRENTLY, 14 PERCENT OF DAKOTA COUNTY RESIDENTS ARE AGE 65 AND OLDER, COMPARED TO SEVEN PERCENT IN 2000. FAIRVIEW RIDGES HOSPITAL IS A MULTI-SPECIALTY MEDICAL CENTER AND THE ONLY HOSPITAL SERVING THE PRIMARY SERVICE AREA. 4) FAIRVIEW SOUTHDALE HOSPITAL IN EDINA, MN HAS A PRIMARY SERVICE AREA OF INDIVIDUALS RESIDING IN HENNEPIN AND CARVER COUNTIES. THE HOSPITAL IS LOCATED IN HENNEPIN COUNTY WHICH HAS BECOME INCREASINGLY DIVERSE, WITH POPULATION GROWTH COMING AS A RESULT OF INCREASES IN RESIDENTS OF COLOR. WHILE MORE THAN HALF OF RESIDENTS ARE WHITE, THE POPULATION OF RESIDENTS OF COLOR HAS INCREASED BY TEN PERCENT SINCE 2000, WITH THE BIGGEST GROWTH IN BLACK RESIDENTS. THE PROPORTION HENNEPIN COUNTY RESIDENTS AGE 65 AND OLDER HAS INCREASED, HOWEVER HENNEPIN COUNTY STILL HAS A SLIGHTLY SMALLER PERCENTAGE OF OLDER ADULTS THAN THE STATE OVERALL. CURRENTLY, 14 PERCENT OF HENNEPIN COUNTY RESIDENTS ARE AGE 65 AND OLDER, COMPARED TO 11 PERCENT IN 2000. FAIRVIEW SOUTHDALE HOSPITAL IS ONE OF TWO HOSPITALS SERVING THE PRIMARY SERVICE AREA. IN THE LARGER AREA OF HENNEPIN AND CARVER COUNTIES, THERE ARE NINE HOSPITALS OR MEDICAL CENTERS SERVING THE COMMUNITY. FAIRVIEW SOUTHDALE IS A MULTI-SPECIALTY MEDICAL CENTER RATED BY HEALTHGRADES AS THE NUMBER ONE HOSPITAL IN MINNESOTA FOR HEART AND STROKE CARE. 5) UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW (UMMC), LOCATED IN MINNEAPOLIS, IS A TERTIARY ACADEMIC MEDICAL CENTER DRAWING PATIENTS FROM ACROSS THE TWIN CITIES REGION, THE STATE AND THE COUNTRY. UMMC IS A PARTNER WITH THE UNIVERSITY OF MINNESOTA AND UNIVERSITY OF MINNESOTA PHYSICIANS. THE MEDICAL CENTER IS LOCATED IN THE CEDAR-RIVERSIDE NEIGHBORHOOD OF MINNEAPOLIS IN HENNEPIN COUNTY. HENNEPIN COUNTY HAS BECOME INCREASINGLY DIVERSE, WITH POPULATION GROWTH COMING AS A RESULT OF INCREASES IN RESIDENTS OF COLOR. WHILE MORE THAN HALF OF RESIDENTS ARE WHITE, THE POPULATION OF RESIDENTS OF COLOR HAS INCREASED BY 10 PERCENT SINCE 2000, WITH THE BIGGEST GROWTH IN BLACK RESIDENTS. THE PROPORTION OF HENNEPIN COUNTY RESIDENTS AGE 65 AND OLDER HAS INCREASED, HOWEVER HENNEPIN COUNTY STILL HAS A SLIGHTLY SMALLER PERCENTAGE OF OLDER ADULTS THAN THE STATE OVERALL. CURRENTLY, 14 PERCENT OF HENNEPIN COUNTY RESIDENTS ARE AGE 65 AND OLDER, COMPARED TO 11 PERCENT IN 2000. THE UNIVERSITY OF MINNESOTA MEDICAL CENTER, FAIRVIEW IS THE ONLY MEDICAL CENTER IN THE CEDAR-RIVERSIDE NEIGHBORHOOD. 6) FAIRVIEW MAPLE GROVE MEDICAL CENTER, A RELATED ENTITY, SERVES INDIVIDUALS IN A PRIMARY SERVICE AREA WITHIN SHERBURNE, WRIGHT, HENNEPIN AND ANOKA COUNTIES IN MINNESOTA. FAIRVIEW MAPLE GROVE IS AN AMBULATORY MEDICAL CENTER, WORKING IN PARTNERSHIP WITH UNIVERSITY OF MINNESOTA PHYSICIANS.
SCHEDULE H, PART VI, LINE 5	AS A NONPROFIT HEALTH SYSTEM, FAIRVIEW REINVESTS ANY EXCESS REVENUES INTO THE CORE OPERATIONS OF THE ORGANIZATION. RESEARCH AND EDUCATION ARE AT THE VERY HEART OF THE MISSION. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, FAIRVIEW INVESTS MILLIONS OF DOLLARS EACH YEAR INTO GROUND-BREAKING RESEARCH AND EDUCATION OF OUR NEXT GENERATION OF HEALTHCARE WORKFORCE. FAIRVIEW ALSO PARTNERS WITH A MYRIAD OF HIGHER EDUCATIONAL INSTITUTIONS TO PROVIDE CLINICAL HANDS-ON TRAINING FOR FUTURE NURSES, PHARMACISTS, LABORATORY PROFESSIONALS AND MORE. FAIRVIEW SERVES AS A TRAINING SITE FOR RESIDENTS IN VARIOUS SPECIALITIES AND IS THE CORE TEACHING SITE FOR THE UNIVERSITY OF MINNESOTA RESIDENTS. SENIOR RESIDENTS AND FELLOWS PROVIDE FAIRVIEW SOME DEGREE OF CLINICAL SERVICE THAT WE WOULD OTHERWISE NOT RECEIVE.
SCHEDULE H, PART VI, LINE 6	FAIRVIEW HEALTH SERVICES IS AN INTEGRATED HEALTH CARE SYSTEM HEADQUARTERED IN MINNEAPOLIS, MINNESOTA. IT OPERATES FIVE COMMUNITY HOSPITALS, ONE ACADEMIC MEDICAL CENTER AND ONE AMBULATORY MEDICAL CENTER. COMMUNITY BENEFIT ACTIVITY IS CARRIED OUT BY STAFF/LEADERSHIP AT EACH FACILITY BASED ON THE HEALTH CARE NEEDS IN THAT SERVICE AREA. FAIRVIEW'S CORPORATE COMMUNITY HEALTH DEPARTMENT SUPPORTS THESE LOCAL EFFORTS BY SHARING BEST PRACTICES, FINDING EFFICIENCIES AMONG HOSPITAL COMMUNITY HEALTH LEADERS AS APPROPRIATE, COORDINATING THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND MORE.
SCHEDULE H, PART VI, LINE 7	MINNESOTA

Schedule H (Form 990) 2019

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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
FAIRVIEW HEALTH SERVICES

Employer identification number
41-0991680

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" 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) FAIRVIEW FOUNDATION 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454	41-1573810	501C3	1,689,565				HOSPITAL SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 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

SCHEDULE I, PAGE 1, PART I, LINE 2

FAIRVIEW HEALTH SERVICES SOLICITS GRANT FUNDING ONLY FOR PURPOSES THAT QUALIFY AS CHARITABLE, RESEARCH OR EDUCATION PURPOSES AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. FAIRVIEW'S PROCESSES AND PROCEDURES ADHERE TO FEDERAL GUIDELINES AND ARE SUBJECT TO AUDIT. THE SAME PROCESSES AND PROCEDURES ARE APPLIED FOR FEDERAL AS WELL AS PRIVATE GRANTS AND SERVICE AGREEMENTS. THE GRANT APPLICATION PROCESS IS MONITORED BY THE RESEARCH ADMINISTRATION GROUP AND THE APPLICATION OF GRANT FUNDS ARE MONITORED BY THE RESEARCH AND EDUCATION ACCOUNTING GROUP. THESE TWO GROUPS MEET MONTHLY TO ENSURE ALL GRANTS ARE BEING ADMINISTERED PROPERLY.

Schedule I (Form 990) 2019

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .........

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? ..

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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:

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

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

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

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 ............

Yes

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 ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JAMES HEREFORD PRESIDENT/CEO	(i) (ii)	1,503,003 -------------	1,648,436 -------------	138,639 -------------	223,823 -------------	43,085 -------------	3,556,986 -------------	-------------
2MICHAEL CAMPOLI M D SURGEON	(i) (ii)	1,842,040 -------------	9,938 -------------	51,424 -------------	19,000 -------------	39,138 -------------	1,961,540 -------------	-------------
3ROHANN LALL MD SURGEON	(i) (ii)	1,427,678 -------------	104,188 -------------	19,898 -------------	19,000 -------------	39,152 -------------	1,609,916 -------------	-------------
4DANIEL M FROMM CHIEF FINANCIAL OFCR	(i) (ii)	414,447 -------------	354,609 -------------	590,798 -------------	143,655 -------------	89,689 -------------	1,593,198 -------------	-------------
5JOHN DOHERTY SR. OPERATING EXEC.	(i) (ii)	467,794 -------------	242,039 -------------	385,158 -------------	122,217 -------------	106,670 -------------	1,323,878 -------------	-------------
6LAURA REED RN CHIEF NURSING OFFICE	(i) (ii)	818,943 -------------	326,256 -------------	-------------	98,202 -------------	43,085 -------------	1,286,486 -------------	-------------
7ROBERT BEACHER CHIEF OF SHARED CLIN	(i) (ii)	622,333 -------------	273,200 -------------	78,751 -------------	115,226 -------------	75,555 -------------	1,165,065 -------------	-------------
8MARK WELTON MD CHIEF MEDICAL OFFICE	(i) (ii)	655,678 -------------	297,303 -------------	-------------	111,059 -------------	44,573 -------------	1,108,613 -------------	-------------
9TRUDI TRYSLA CHIEF LEGAL COUNSEL	(i) (ii)	511,864 -------------	237,939 -------------	55,561 -------------	79,997 -------------	69,936 -------------	955,297 -------------	-------------
10CAROLYN JACOBSON CHIEF HR OFFICER	(i) (ii)	409,235 -------------	173,159 -------------	81,891 -------------	91,509 -------------	68,635 -------------	824,429 -------------	-------------
11WILLIAM OMILE MD SURGEON	(i) (ii)	684,755 -------------	-------------	46,637 -------------	25,000 -------------	45,505 -------------	801,897 -------------	-------------
12DAVID CROSBY CHIEF VALUE BASED SO	(i) (ii)	------------- 530,686	------------- 152,200	------------- 54,568	------------- 22,400	------------- 13,095	------------- 772,949	-------------
13JAMES LORGE MD SURGEON	(i) (ii)	601,606 -------------	36,245 -------------	52,659 -------------	19,000 -------------	39,955 -------------	749,465 -------------	-------------
14BRADLEY PIERCE MD PHYSICIAN	(i) (ii)	641,746 -------------	-------------	34,445 -------------	20,345 -------------	40,930 -------------	737,466 -------------	-------------
15JOHN BATSON CHEIF FINANCIAL OFF.	(i) (ii)	528,312 -------------	100,000 -------------	-------------	19,000 -------------	27,793 -------------	675,105 -------------	-------------
16ALISTAIR JACQUES FORMER CIO	(i) (ii)	-------------	141,003 -------------	475,426 -------------	-------------	-------------	616,429 -------------	-------------
17SAMEER BADLANI CHF INFORMATION OFF	(i) (ii)	394,908 -------------	70,000 -------------	29,644 -------------	17,315 -------------	18,386 -------------	530,253 -------------	-------------
18SCOTT WEBER CHF MRKTG COMM & DIG	(i) (ii)	300,844 -------------	70,000 -------------	-------------	14,831 -------------	21,106 -------------	406,781 -------------	-------------
19PATRICK BELLAND FORMER PRES-RIDGES	(i) (ii)	-------------	91,916 -------------	300,227 -------------	-------------	-------------	392,143 -------------	-------------
20SRIJOY MAHAPATRA CHF STRATEGY OFFICER	(i) (ii)	364,255 -------------	-------------	-------------	19,000 -------------	511 -------------	383,766 -------------	-------------
21MICHAEL J YOUSO PRES-GICH END 4-19	(i) (ii)	81,738 -------------	91,287 -------------	15,430 -------------	60,840 -------------	24,055 -------------	273,350 -------------	-------------
22JOHN HERMAN FORMER PRES NORTH	(i) (ii)	-------------	-------------	262,139 -------------	-------------	-------------	262,139 -------------	-------------
23PATRICK ADAMS CHF OF STAFF TO CEO	(i) (ii)	128,129 -------------	36,941 -------------	-------------	19,000 -------------	30,022 -------------	214,092 -------------	-------------
24MARK THOMAS FORMER PRES EB	(i) (ii)	-------------	-------------	114,412 -------------	-------------	-------------	114,412 -------------	-------------

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
SCHEDULE J, PAGE 1, PART I, LINE 4	JAMES HEREFORD 0 179,823 0 DANIEL M. FROMM 439,936 99,655 0 JOHN DOHERTY 214,490 78,217 0 LAURA REED, RN 0 54,202 0 ROBERT BEACHER 0 71,226 0 MARK WELTON, MD 0 67,059 0 TRUDI TRYSLA 0 54,997 0 CAROLYN JACOBSON 0 47,509 0 ALISTAIR JACQUES 475,426 0 0 PATRICK BELLAND 300,207 0 0 MICHAEL J YOUSO 15,430 28,358 0 JOHN HERMAN 262,139 0 0
SCHEDULE J, PAGE 1, PART I, LINE 7	FAIRVIEW HEALTH SERVICES PROVIDES LUMP SUM FINANCIAL AWARDS BASED ON SYSTEM-WIDE, BUSINESS UNIT AND/OR DEPARTMENTS FINANCIAL AND QUALITY MEASURES. ANNUAL GOALS, SPECIFICALLY TIED TO PRODUCTIVITY AND QUALITY INDICATORS, ARE SET FOR THE YEAR AND AN INCENTIVE PAID OUT ANNUALLY IF KEY GOALS AND MEASURES ARE ACHIEVED.
SCHEDULE J, PART III	THE PLAN IS ONLY OPEN TO A SELECT GROUP OF HIGHLY COMPENSATED EMPLOYEES. THE PLAN CONTRIBUTES THE DIFFERENCE OF WHAT 403(B) EMPLOYER CONTRIBUTIONS WERE MISSED FOR PARTICIPANTS WHO EARN MORE THAN THE IRS LIMIT ON ELIGIBLE COMPENSATION FOR QUALIFIED RETIREMENT PLANS. THE CONTRIBUTION IS UNFUNDED. THE PLAN COMPLIES WITH SECTION 457(F) OF THE CODE.

Schedule J (Form 990) 2019

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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
FAIRVIEW HEALTH SERVICES

Employer identification number
41-0991680

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF MINNEAPOLIS FAIRVIEW HEALTH SERVICES	41-6005375	60374VDV2	09-02-2015	122,972,746	SEE PART VI		X		X		X
B	CITY OF MINNEAPOLIS FAIRVIEW HEALTH SERVICES	41-6005375	60374VEF6	10-10-2018	279,898,918	SEE PART VI		X		X		X
C	CITY OF MINNEAPOLIS FAIRVIEW HEALTH SERVICES	41-6005375	60374VEG4	10-10-2018	223,525,000	SEE PART VI		X		X		X
D	HOUSING & REDEVEL CITY OF SAINT PAU FAIRVIEW HEALTH SERVICES	52-1440935	792909FMO	08-30-2017	224,728,004	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	8,875,000						9,585,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	122,972,746		282,389,696		223,525,000		224,728,004
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,409,724		1,976,281		1,020,103		2,014,876
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	31,000,000		55,628,993				191,063,551
11 Other spent proceeds .............	90,563,022		177,918,106		222,504,897		31,649,577
12 Other unspent proceeds .............			46,866,316
13 Year of substantial completion .............	2015						2017
	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 Ⅲ

Private Business Use

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

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		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		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.130 %		0.960 %		0.110 %		0.900 %
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 .........
6 Total of lines 4 and 5 .............	0.130 %		0.960 %		0.110 %		0.900 %
7 Does the bond issue meet the private security or payment test? ...		X		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		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		X

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
DIFFERENCES IN ISSUE PRICE EXPLANATION	CITY OF MINNEAPOLIS CITY OF MINNEPAOLIS PART I, COLUMN B: DIFFERENCES BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS.
PURPOSE OF ISSUE DESCRIPTION	CITY OF MINNEAPOLIS SEE PART VI
PURPOSE OF ISSUE DESCRIPTION	CITY OF MINNEAPOLIS SEE PART VI
PURPOSE OF ISSUE DESCRIPTION	CITY OF MINNEAPOLIS SEE PART VI
PURPOSE OF ISSUE DESCRIPTION	HOUSING & REDEVEL CITY OF SAINT PAUL SEE PART VI
ADDITIONAL INFORMATION	CITY OF MINNEAPOLIS PART I, LINE A, COLUMN (F): PURPOSE OF ISSUE DESCRIPTION NEW CONSTRUCTION AND REFUNDING OF BONDS ISSUED 4/15/1997, 5/10/2000, 5/21/2002, AND 5/10/2005
ADDITIONAL INFORMATION	CITY OF MINNEAPOLIS PART I, LINE B, COLUMN (F): PURPOSE OF ISSUE DESCRIPTION RENOVATION PROJECT AND REFUND BONDS ISSUED 10/29/2008
ADDITIONAL INFORMATION	CITY OF MINNEAPOLIS PART I, LINE C, COLUMN (F): PURPOSE OF ISSUE DESCRIPTION REFUND BONDS ISSUED 10/6/2010 PART I, ISSUER NAME C CITY OF MINNEAPOLIS, COLUMN (C) CUSIP: 60374V EG4 & 60374V EJ8
ADDITIONAL INFORMATION	HOUSING & REDEVEL CITY OF SAINT PAUL PART I, LINE D, COLUMN (F): PURPOSE OF ISSUE DESCRIPTION CAPITAL ACQUISITION AND TO REFUND CERTAIN TAXABLE DEBT

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( MEDICAL EQUIPM )	X	1	125,861	FAIR MARKET VALUE
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PAGE 2, PART II	MEDICAL EQUIPMENT WAS DONATED TO DIFFERENT LOCATIONS WITHIN FAIRVIEW HEALTH SERVICES. ALL MEDICAL EQUIPMENT WAS RECEIVED FROM ONE DONOR.

Schedule M (Form 990) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	MISSION: FAIRVIEW IS DRIVEN TO HEAL, DISCOVER AND EDUCATE FOR LONGER, HEALTHIER LIVES. VISION: FAIRVIEW IS DRIVING A HEALTHIER FUTURE. VALUES: DIGNITY: WE VALUE THE UNIQUENESS OF EACH PERSON AND WORK TO ENSURE EVERYONE'S RIGHT TO PRIVACY. WE RESPECT THE CULTURES, VALUES, BELIEFS AND TRADITIONS OF OTHERS AND HONOR THEIR TALENTS AND CONTRIBUTIONS. INTEGRITY: WE SAY WHAT WE MEAN AND DO WHAT WE SAY. WE COMMUNICATE OPENLY AND HONESTLY AND BEHAVE ETHICALLY. WE DEMAND THE BEST OF OURSELVES AND ACCEPT SHARED ACCOUNTABILITY FOR OUR ACTIONS. SERVICE: WE WORK TO MAKE A DIFFERENCE IN PEOPLE'S LIVES AND IN OUR COMMUNITIES. WE STRIVE FOR EXCELLENCE BY ANTICIPATING, MEETING AND EXCEEDING EXPECTATIONS. WE CONTINUALLY IMPROVE OUR PROGRAMS AND SKILLS THROUGH LEARNING AND INNOVATION. WE RESPONSIBLY MANAGE OUR RESOURCES. COMPASSION: WE RECOGNIZE AND RESPOND TO THE EMOTIONAL, SPIRITUAL AND PHYSICAL NEEDS OF ALL THE PEOPLE WE SERVE. WE CREATE A CARING ENVIRONMENT, CONDUCIVE TO HEALING, GROWTH AND WELL-BEING FOR ALL. INNOVATION: WE SUPPORT CLINICAL RESEARCH THAT LEADS TO TOMORROW'S CURES. WE ADVANCE NEW BUSINESS MODELS THAT WILL CHANGE HEALTH CARE. FROM THE BEDSIDE TO THE CALL CENTER, WE ARE COMMITTED TO CONTINUAL IMPROVEMENT. INNOVATION IS PART OF WHO WE ARE. FAIRVIEW'S MOST SIGNIFICANT ACTIVITIES: FAIRVIEW HEALTH SERVICES PROVIDES A FULL CONTINUUM OF HEALTH CARE SERVICES THROUGHOUT ITS SERVICE AREA WHICH INCLUDES MINNEAPOLIS-ST. PAUL, AS WELL AS COMMUNITIES THROUGHOUT GREATER MINNESOTA. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, FAIRVIEW STAFF AND PROVIDERS ARE REDESIGNING CARE DELIVERY AND PAYMENT TO PROVIDE GREATER VALUE-EXCEPTIONAL PATIENT CARE AND EXPERIENCE AT A LOWER TOTAL COST OF CARE. WE COMMIT OUR SKILLS AND RESOURCES TO THE BENEFIT OF THE WHOLE PERSON BY PROVIDING THE FINEST IN HEALTHCARE, WHILE ADDRESSING THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF INDIVIDUALS AND THEIR FAMILIES. WE FURTHER PLEDGE TO SUPPORT THE RESEARCH AND EDUCATION EFFORTS OF OUR PARTNER, THE UNIVERSITY OF MINNESOTA, AND ITS TRADITION OF EXCELLENCE.
FORM 990, PAGE 1, PART I, LINE 6	OUR VOLUNTEERS ARE VALUED MEMBERS OF THE HEALTH CARE TEAM, ENHANCING THE PATIENT AND FAMILY EXPERIENCE BY MEETING OUR PATIENTS' NEEDS. SOME OF THE SERVICES PROVIDED INCLUDE WAYFINDING FOR PATIENTS, FAMILIES AND VISITORS AND ESCORTS AND WHEELCHAIR TRANSPORTS FOR PATIENTS AND FAMILY MEMBERS. OUR VOLUNTEERS PROVIDE HOSPITALITY FOR PATIENTS, FAMILIES AND VISITORS AND PROVIDE ASSISTANCE WITH SPECIAL ONSITE AND COMMUNITY EVENTS AND ACTIVITIES.
FORM 990, PAGE 2, PART III, LINE 4A	PROVIDING MEDICAL SERVICES: FAIRVIEW HEALTH SERVICES IS AN AWARD-WINNING, NONPROFIT, INTEGRATED HEALTH SYSTEM PROVIDING EXCEPTIONAL HEALTH CARE ACROSS THE FULL SPECTRUM OF HEALTH CARE SERVICES. FOUNDED IN 1906, FAIRVIEW PROVIDES EXCEPTIONAL CARE TO PATIENTS AND COMMUNITIES AS ONE OF THE MOST COMPREHENSIVE AND GEOGRAPHICALLY ACCESSIBLE SYSTEMS IN MINNESOTA. THE FAIRVIEW SYSTEM CONSISTS OF 11 HOSPITAL, IT CONTROLS AND OPERATES UNIVERSITY OF MINNESOTA MEDICAL CENTER, THE ADULT AND PEDIATRIC TEACHING HOSPITAL OF THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL, HAS 9 COMMUNITY- BASED GENERAL ACUTE CARE HOSPITALS AND 1 LONG-TERM ACUTE CARE HOSPITAL; 56 PRIMARY CARE CLINICS; OVER 100 SPECIALTY CARE SERVICES; 10 URGENT CARE CLINICS; OCCUPATIONAL HEALTH CLINICS; 36 RETAIL AND SPECIALTY PHARMACIES; PHARMACY BENEFIT MANAGEMENT SERVICES; REHABILITATION CENTERS; COUNSELING; HOME CARE AND HOSPICE SERVICES; 90 OWNED AND MANAGED SENIOR CARE FACILITIES AND LONG-TERM CARE HOUSING FACILITIES (THROUGH EBENEZER SOCIETY, A FAIRVIEW SUBSIDIARY); EMERGENCY MEDICAL TRANSPORTATION; AN INTEGRATED PROVIDER NETWORK; AND HEALTH INSURER PREFERREDONE. FAIRVIEW'S 34,000+ EMPLOYEES AND NETWORK OF 5,000+ PROVIDERS EMBRACE INNOVATION AND NEW THINKING TO DRIVE A HEALTHIER FUTURE THROUGH HEALING, DISCOVERY AND EDUCATION. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, FAIRVIEW IS COMMITTED TO PARTICIPATING IN NATION-LEADING RESEARCH AND EDUCATING TOMORROW'S PHYSICIANS AND HEALTH CARE PROFESSIONALS. WE SERVE PATIENTS FROM ACROSS THE STATE OF MINNESOTA, THE UPPER MIDWEST AND BEYOND. IN ADDITION TO OUR EMPLOYED PHYSICIANS, WE WORK CLOSELY WITH THE ACADEMIC PHYSICIANS AT UNIVERSITY OF MINNESOTA PHYSICIANS AND WITH FAIRVIEW PHYSICIAN ASSOCIATES, A NETWORK OF INDEPENDENT PHYSICIANS. FAIRVIEW HAS ENJOYED A LONG PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA AND UNIVERSITY OF MINNESOTA PHYSICIANS, WHICH IS REPRESENTED IN THE UNIVERSITY OF MINNESOTA HEALTH BRAND. IN 2019, WE EXTENDED OUR PARTNERSHIP BY BUILDING M HEALTH FAIRVIEW AN ACADEMIC HEALTH SYSTEM DRIVING TO DELIVER BREAKTHROUGH CARE CLOSE TO HOME. THE HEALTH CARE AND MEDICAL SERVICES WHICH FAIRVIEW PROVIDES TO THE COMMUNITY INCLUDE, BUT ARE NOT LIMITED TO: PRIMARY, SPECIALTY, TERTIARY, AND QUATERNARY CARE; HOSPITAL AND PHYSICIAN SERVICES; SENIOR SERVICES; ASSISTED LIVING; HOME CARE AND HOSPICE; LONG-TERM CARE; URGENT CARE AND EMERGENCY SERVICES; PHARMACY; CARE OF MOTHERS AND CHILDREN; PHYSICAL THERAPY/SPORTS MEDICINE; REHABILITATION SERVICES; AND INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH CARE AND CHEMICAL DEPENDENCY SERVICES. FAIRVIEW PROVIDES SPECIALIZED CARE FOR THE TREATMENT OF CANCER, HEART DISEASE, DIABETES, WOUND CARE, CHRONIC CONDITIONS, SOLID ORGAN TRANSPLANT, BLOOD AND MARROW TRANSPLANT, AND MANY OTHER SPECIALTIES. FAIRVIEW ALSO OFFERS SOCIAL WORK SERVICES, HEALTH EDUCATION AND SUPPORT GROUPS, AND SERVICES FOR VARIOUS HEALTH ISSUES. FAIRVIEW HEALTH SERVICES PROVIDES CARE AT THESE HOSPITALS AND MEDICAL CENTER: FAIRVIEW LAKES MEDICAL CENTER IS A COMMUNITY HOSPITAL IN WYOMING, MINNESOTA WITH 61 LICENSED BEDS. SINCE OPENING IN 1998, THE MEDICAL CENTER WORKS WITH NEARBY FAIRVIEW PRIMARY AND SPECIALTY CLINICS, AND WITH UNIVERSITY OF MINNESOTA HEALTH SPECIALISTS, TO BRING A WIDE RANGE OF MEDICAL SERVICES TO THE SURROUNDING AREA. FAIRVIEW LAKES IS A BABYFRIENDLY HOSPITAL, DESIGNATED BY BABY FRIENDLY USA AND HAS BEEN RECOGNIZED AS A BREAST IMAGING CENTER OF EXCELLENCE BY AMERICAN COLLEGE OF RADIOLOGY. THE HOSPITAL WAS AWARDED A 4-STAR RATING IN THE 2019 CENTERS FOR MEDICARE & MEDICAID "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE LABOR AND DELIVERY, HEART CARE, CANCER CARE, BREAST CARE/MAMMOGRAPHY, ORTHOPEDIC SURGERY, GENERAL SURGERY, SPINE & BRAIN, AND SLEEP SERVICES. FAIRVIEW RANGE MEDICAL CENTER IS LOCATED IN HIBBING, MINN., AND HAS 175 LICENSED BEDS. FROM PREVENTION AND DISEASE MANAGEMENT TO THE MOST COMPLEX OF LIFE-THREATENING INJURIES AND ILLNESSES, FAIRVIEW RANGE PARTNERS WITH A BROAD NETWORK OF FAIRVIEW PROVIDERS AND UNIVERSITY OF MINNESOTA HEALTH SPECIALISTS TO BRING ADVANCED, HIGH-QUALITY CARE DIRECTLY TO THE REGION. FAIRVIEW RANGE WAS AWARDED A 4-STAR RATING IN THE 2019 CENTERS FOR MEDICARE & MEDICAID "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE BEHAVIORAL HEALTH, CANCER CARE, DIAGNOSTIC IMAGING, INTENSIVE CARE, PEDIATRIC CARE, AND A WOMEN'S HEALTH & BIRTH CENTER. FAIRVIEW RIDGES HOSPITAL OPENED IN BURNSVILLE IN 1985. IT PROVIDES COMPREHENSIVE, SPECIALIZED CARE TO THE SOUTHERN TWIN CITIES COMMUNITY WITH ITS 150 LICENSED BEDS. FAIRVIEW RIDGES HOSPITAL PROVIDES CARE FOR THE ENTIRE FAMILY, INCLUDING PEDIATRIC EMERGENCY CARE AND NEONATAL INTENSIVE CARE. THE HOSPITAL OFFERS ONSITE ACCESS TO SPECIALISTS IN EVERYTHING FROM HEART AND CANCER CARE TO MIDWIFERY AND SPORTS MEDICINE. FAIRVIEW RIDGES WAS AWARDED A 5-STAR RATING (THE HIGHEST AVAILABLE) IN THE 2019 CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE LABOR AND DELIVERY, HEART CARE, CANCER CARE, BREAST CENTER, ORTHOPEDIC SURGERY, GENERAL SURGERY, SPINE & BRAIN, PEDIATRIC INPATIENT, AND SLEEP SERVICES. FAIRVIEW SOUTHDALE HOSPITAL OPENED IN EDINA IN 1965. WITH 390 LICENSED BEDS, TODAY THE HOSPITAL IS KNOWN FOR ITS AWARD-WINNING HEART, STROKE, AND CANCER CARE. FAIRVIEW SOUTHDALE OFFERS CONVENIENT ACCESS TO MORE THAN 40 SPECIALTY SERVICES INCLUDING CARDIOLOGY, ORTHOPEDICS, ONCOLOGY, OBSTETRICS, PRIMARY CARE, NEUROSCIENCES, CRITICAL CARE, VASCULAR AND EMERGENCY SERVICES. FAIRVIEW SOUTHDALE WAS AWARDED A 5-STAR RATING (THE HIGHEST AVAILABLE) IN THE 2019 CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE LABOR AND DELIVERY, HEART CARE, CANCER CARE, A BREAST CENTER, ORTHOPEDIC SURGERY, GENERAL SURGERY, SPINE & BRAIN, A STROKE CENTER, AND SLEEP SERVICES. UNIVERSITY OF MINNESOTA MEDICAL CENTER AND UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL ARE THE ADULT AND PEDIATRIC TEACHING HOSPITALS OF THE UNIVERSITY OF MINNESOTA. THE MEDICAL CENTER AND ITS DOZENS OF ADULT AND PEDIATRIC SPECIALTY CLINICS ARE LOCATED ON BOTH THE EAST AND WEST BANKS OF THE UNIVERSITY OF MINNESOTA CAMPUS. WITH 1,700 LICENSED BEDS, UNIVERSITY OF MINNESOTA MEDICAL CENTER IS COMMITTED TO PROVIDING EXCEPTIONAL, INNOVATIVE HEALTH CARE, PAIRING GROUNDBREAKING TECHNOLOGY AND TREATMENTS WITH PATIENT-CENTERED CARE. OUR PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL AND UNIVERSITY OF MINNESOTA PHYSICIANS PROVIDES THE PLATFORM TO SPECIALIZE IN BREAKTHROUGH TREATMENTS, SURGICAL TECHNIQUES, AND LIFESAVING THERAPIES, AND TO TRAIN TOMORROW'S PHYSICIANS. CLINICAL TRIALS ADVANCE OUR CLINICAL SERVICES, BRINGING THE NEWEST RESEARCH AND IDEAS TO PATIENT CARE. WE ALSO PROVIDE AN IMPORTANT TRAINING ENVIRONMENT FOR RESIDENTS, FELLOWS, AND MANY OTHER HEALTH CARE LEARNERS. KEY SERVICES INCLUDE MATERNITY, HEART CARE, GENERAL SURGERY, CANCER CARE, SOLID ORGAN TRANSPLANTS, BLOOD MARROW TRANSPLANTS, AND PEDIATRIC SPECIALTIES. IN ADDITION TO HOSPITALS, FAIRVIEW MEDICAL GROUP INCLUDES FAIRVIEW AND HEALTHEAST CLINICS 56 PRIMARY CARE CLINICS AT LOCATIONS ACROSS THE GREATER METRO AREA. FAIRVIEW, IN PARTNERSHIP WITH UNIVERSITY OF MINNESOTA PHYSICIANS, PROVIDES EXCEPTIONAL CARE IN MORE THAN 100 SPECIALTY AREAS. OTHER CONTINUUM SERVICES FAIRVIEW OFFERS THROUGH RELATED ENTITIES INCLUDE FAIRVIEW HOME CARE AND HOSPICE, FAIRVIEW HOME MEDICAL EQUIPMENT, FAIRVIEW PHARMACY, INSTITUTE FOR ATHLETIC MEDICINE, FAIRVIEW REHABILITATION SERVICES, FAIRVIEW ACHIEVEMENT CENTER, FAIRVIEW PARTNERS, FAIRVIEW COUNSELING SERVICES, FAIRVIEW CARE MANAGEMENT AND COORDINATION, HEALTHEAST MEDICAL TRANSPORTATION, AND SUBSIDIZED HEALTH SERVICES. FOR MORE INFORMATION, VISIT WWW.FAIRVIEW.ORG.
FORM 990, PAGE 2, PART III, LINE 4B	COST OF PARTICIPATING IN GOVERNMENT PROGRAMS: FAIRVIEW IS COMMITTED TO SERVING THE HEALTH CARE NEEDS OF MEMBERS OF ITS COMMUNITY. TO SUPPORT FULL ACCESS TO SERVICES, FAIRVIEW PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH CARE PROGRAMS: MEDICARE, MEDICAID, AND MINNESOTACARE. REIMBURSEMENT FROM THESE PROGRAMS FOR SERVICES RENDERED, GENERALLY FALLS BELOW THE COST OF PROVIDING THE CARE. TO COMPENSATE FOR THE UNDER FUNDING BY GOVERNMENT PROGRAMS, FAIRVIEW MAKES A SIGNIFICANT FINANCIAL INVESTMENT TO OFFSET THESE LOSSES. IN 2019, FAIRVIEW INCURRED 64,733,415 OF TAXES AND SURCHARGE COSTS IN HEALTH CARE SERVICES THAT EXCEEDED THE REIMBURSEMENT RECEIVED BY PUBLIC PROGRAMS, SURCHARGE, TAXES AND FEES RELATED TO THESE PROGRAMS AND NOT INCLUDING MEDICARE. THE FOLLOWING IS A BREAKDOWN ON COSTS RELATED TO THE COST OF PARTICIPATING IN GOVERNMENT PROGRAMS: COSTS EXCEED MEDICAID REIMBURSEMENT: FAIRVIEW IS SERVING THOUSANDS OF LOW- INCOME INDIVIDUALS COVERED BY MEDICAL ASSISTANCE AND MINNESOTACARE. REIMBURSEMENT FROM THESE PROGRAMS IS LESS THAN FAIRVIEW'S COST OF PROVIDING CARE TO THESE PATIENTS. TOTAL MEDICAID SURTAX COSTS RELATED TO HOSPITALS, PHARMACIES, AND SURGICAL CENTERS WAS 25,457,520. MINNESOTACARE TAX: THE STATE OF MINNESOTA LEVIES A 2 PERCENT TAX ON CERTAIN HEALTHCARE PROVIDER REVENUES. MONEY GENERATED FROM THIS TAX HELPS TO DEFRAY THE COSTS INCURRED FROM MINNESOTACARE AND OTHER PROGRAMS/SERVICES FOR UNINSURED INDIVIDUALS. IN 2019, FAIRVIEW PAID 39,275,895 IN MINNESOTACARE TAXES. TAXES AND FEES: FAIRVIEW DOES PAY SOME PROPERTY TAX TO LOCAL AND STATE GOVERNMENT. THIS HELPS TO FUND CIVIL AND EDUCATIONAL SERVICES IN THE COMMUNITY. THE REAL ESTATE COSTS FOR 2019 TOTALED 5,937,861 AND THE SALES AND INCOME TAXES TOTALED 1,312,903. COSTS EXCEEDING MEDICARE REIMBURSEMENT: FAIRVIEW CARES FOR THOUSANDS OF INDIVIDUALS AGES 65 AND OLDER WHO ARE COVERED BY MEDICARE. FAIRVIEW INCURRED 174,548,349 OF MEDICARE REIMBURSEMENT SHORTFALLS. REIMBURSEMENT FROM MEDICARE IS LESS THAN FAIRVIEW'S COST OF PROVIDING CARE TO THE PATIENT. THE TOTAL COST OF PROVIDING THESE BENEFITS WAS 882,359,341.
FORM 990, PAGE 2, PART III, LINE 4C	THE PRIMARY PURPOSE OF OUR EDUCATIONAL AND RESEARCH PROGRAMS IS TO BENEFIT PATIENTS AND THE COMMUNITY AT LARGE BY EDUCATING HEALTH PROFESSIONALS BOTH WITHIN FAIRVIEW AND IN THE BROADER COMMUNITY, AND BY FOSTERING ADVANCES IN KNOWLEDGE AND EVIDENCE-BASED IMPROVEMENTS TO CLINICAL TREATMENTS AND APPROACHES TO HEALTH CARE DELIVERY. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA ACADEMIC HEALTH CENTER AND UNIVERSITY OF MINNESOTA PHYSICIANS, FAIRVIEW HAS A STRONG AND ABIDING COMMITMENT TO RESEARCH AND EDUCATION. TOGETHER, WE VIEW RESEARCH AS AN INTEGRAL AND CRITICAL COMPONENT IN PROVIDING EXCEPTIONAL CARE TO PATIENTS AND THE COMMUNITY. WE SEEK TO BE A NATIONAL LEADER IN CLINICAL RESEARCH AND A REGIONAL CENTER FOR CLINICAL RESEARCH ACTIVITIES. FAIRVIEW HEALTH SERVICES CONTINUED ITS FOCUS ON AND SUPPORT OF RESEARCH AND EDUCATION IN 2019. THIS COMMITMENT INCLUDED PROVIDING THE RESOURCES OF TIME, MONEY AND TALENT WHILE ENSURING THE FACILITIES, SUPPORTING INFRASTRUCTURES, AND PROCESSES WERE AVAILABLE TO FACILITATE AND ENCOURAGE THE CREATION OF NEW KNOWLEDGE. FAIRVIEW HAS MORE THAN 1,100 ACTIVE MEDICAL RESEARCH PROJECTS UNDERWAY ACROSS THE HEALTH CARE SYSTEM. RESEARCH RANGES FROM DEEP BRAIN STIMULATION TO ULTRASOUND TREATMENT OF RHEUMATOID ARTHRITIS, RECURRENT HYPOGLYCEMIA AND MANY OTHER TOPICS. FAIRVIEW OFFERS NUMEROUS SPONSORSHIPS AND TRAINING PROGRAMS, INTERNSHIPS, AND SCHOLARSHIPS TO EMPLOYEES AND THEIR DEPENDENTS - AS WELL AS TO STUDENTS IN OUR COMMUNITIES. FAIRVIEW PARTNERS WITH MORE THAN 160 SCHOOLS, 255 FAITH COMMUNITIES, AND 50 COMMUNITY GROUPS. FAIRVIEW HAS EDUCATIONAL PARTNERSHIPS WITH THE UNIVERSITY OF MINNESOTA AND ST. CATHERINE UNIVERSITY AND AFFILIATIONS WITH MANY OTHER INSTITUTIONS. FAIRVIEW ALSO OFFERS ITS OWN SPECIALIZED TRAINING PROGRAMS IN PERIOPERATIVE NURSING AND DIETETICS. EACH YEAR, ABOUT 6,500 COLLEGE AND GRADUATE STUDENTS PREPARING FOR CAREERS IN A WIDE RANGE OF MEDICAL FIELDS DO CLINICAL TRAINING, INTERNSHIPS, AND JOB SHADOWING AT FAIRVIEW HOSPITALS AND CLINICS. THROUGH FAIRVIEW'S CLOSE PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, EACH YEAR ROUGHLY 1,600 MEDICAL STUDENTS, RESIDENTS, AND FELLOWS TAKE COURSES AND DO ROTATIONS OF VARIOUS LENGTHS AT UNIVERSITY OF MINNESOTA MEDICAL CENTER AND UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL. ABOUT 224 MEDICAL STUDENTS DO ROTATIONS IN OTHER FAIRVIEW SETTINGS, INCLUDING FAIRVIEW'S PRIMARY CARE CLINICS. FAIRVIEW ALSO PROVIDES NUMEROUS CONTINUING EDUCATION OPPORTUNITIES TO ITS EMPLOYEES TO ENABLE THEM TO ENSURE THEY ARE KNOWLEDGEABLE ABOUT THE LATEST INNOVATIONS IN HEALTH CARE DELIVERY.
FORM 990, PART V, LINE 4B	CAYMAN ISLANDS
FORM 990, PAGE 6, PART VI, LINE 6	THE MEMBERS OF THE CORPORATION ARE THE INDIVIDUALS WHO CONSTITUTE THE DIRECTORS OF THIS CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 7A	THE BOARD HAS THREE CATEGORIES OF DIRECTORS: 1) 3 EX OFFICIO WHO ARE FAIRVIEW'S CEO AND THE UNIVERSITY'S VICE PRESIDENT OF MEDICAL SCHOOL AND A SENIOR LEADER OF THE UNIVERSITY MEDICAL SCHOOL OR OF THE UNIVERSITY APPOINTED, FROM TIME TO TIME, BY THE VICE PRESIDENT 2) 10 ELECTED DIRECTORS WHO ARE 1 DIRECTOR ELECTED BY THE REGENTS OF THE UNIVERSITY OF MINNESOTA AND 9 ELECTED BY THE BOARD AFTER NOMINATION FROM CERTAIN COMPONENTS OF THE FAIRVIEW SYSTEM; AND 3) BETWEEN 3 TO 8 AT-LARGE DIRECTORS ELECTED BY THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 7B	THE REGENTS OF THE UNIVERSITY OF MINNESOTA HAVE THE RIGHT TO APPROVE PROPOSED AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION IF THE AMENDMENT WOULD ADVERSELY AFFECT THEIR RIGHTS AND CERTAIN SALES OF SUBSTANTIALLY ALL OF FAIRVIEW'S ASSETS.
FORM 990, PAGE 6, PART VI, LINE 11B	THE TAX DEPARTMENT CONDUCTS A DETAILED REVIEW OF THE COMPLETED RETURN AND IT IS THEN REVIEWED BY AN INDEPENDENT TAX CONSULTANT. THE RETURN IS THEN ALSO REVIEWED BY FAIRVIEW'S GENERAL COUNSEL, FAIRVIEW'S CHIEF FINANCIAL OFFICER, CONTROLLER, AND VICE PRESIDENT AND TREASURER. THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW OF CONTENT. THE FORM 990 IS SUBSEQUENTLY PROVIDED TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING. UPON APPROVAL FROM THE BOARD OF DIRECTORS, THE FORM 990 IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12C	MANAGERS, DIRECTORS AND SENIOR MANAGEMENT OF FAIRVIEW ARE REQUIRED TO ANNUALLY COMPLETE FAIRVIEW'S DUTY OF LOYALTY AND CONFLICT OF INTEREST STATEMENT IN COMPLIANCE WITH FAIRVIEW'S CONFLICT OF INTEREST POLICY. DISCLOSURES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. CONFLICTS OF INTERESTS BY BOARD MEMBERS AND SENIOR MANAGEMENT ARE BROUGHT TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD, ALONG WITH ADDITIONAL DETAILED INFORMATION, FOR REVIEW. IN ADDITION, THE COMPLIANCE OFFICER COMPILES A SCHEDULE SHOWING REPORTED CONFLICTS OF INTEREST BY MANAGERS AND KEY EMPLOYEES IS ALSO PRESENTED TO THE CONFLICT OF INTEREST REVIEW COMMITTEE FOR REVIEW AND DISCUSSION. ANY PROBLEMATIC ISSUES ARISING FROM THESE DISCLOSURES ARE DISCUSSED AND RESOLVED BY THE COMMITTEE. BOARD MEMBERS AND MANAGEMENT EMPLOYEES ARE EXPECTED TO UPDATE THEIR CONFLICTS, AS NECESSARY, DURING THE YEAR.
FORM 990, PAGE 6, PART VI, LINE 15A	THE DETERMINATION OF EXECUTIVE COMPENSATION OF THE ORGANIZATION IS PROCESSED BY THE BOARD'S HUMAN RESOURCES COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS. THE FULL BOARD APPROVES EXECUTIVE COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 15B	THE DETERMINATION OF OFFICER AND KEY EMPLOYEE COMPENSATION OF THE ORGANIZATION IS PROCESSED BY THE BOARD'S HUMAN RESOURCES COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS.
FORM 990, PAGE 6, PART VI, LINE 19	FAIRVIEW HEALTH SERVICES MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. INSPECTION OF THE DOCUMENTS IS AVAILABLE AT THE CORPORATE FINANCE DEPARTMENT.
FORM 990, PART XI, LINE 9	UMF FUNDS 2,441,780 RELATED ORGS -109,194,479 DEFINED PENSION -4,118,950 TOTAL -110,871,649

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

FAIRVIEW HEALTH SERVICES

Employer identification number

41-0991680

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) FAIRVIEW PHARMACY SERVICES LLC 711 KASOTA AVE MINNEAPOLIS,MN55414 72-1586863	PHARMACY S	MN	1,252,030,198	126,238,242	FAIRVIEW FAIRVIEW HEALTH SERVICES
(2) FAIRVIEW MAPLE GROVE SURGERY CENTER 2450 RIVERSIDE AVENUE MINNEAPOLIS,MN55454 20-8335586	MEDICAL SU	MN	10,938,401	3,774,531	FAIRVIEW FAIRVIEW HEALTH SERVICES
(3) INTEGRADOSE COMPOUNDING SERVICES L 719 KASOTA AVE MINNEAPOLIS,MN55414 81-3927337	COMPOUNDIN	MN	1,722,585	1,014,510	FAIRVIEW FAIRVIEW HEALTH SERVICES

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)FAIRVIEW FOUNDATION 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1573810	FUNDRAISIN	MN	501C3	7	NA	Yes
(2)FAIRVIEW HOME CARE AND HOSPICE 2450 26TH AVENUE SOUTH MINNEAPOLIS,MN55406 41-1434246	HOME HEALT	MN	501C3	10	NA	Yes
(3)FAIRVIEW PHYSICIAN ASSOCIATES NETWO 3400 WEST 66TH STREET MINNEAPOLIS,MN55435 41-1753325	CLINICAL I	MN	501C3	10	NA	Yes
(4)RANGE REGIONAL HEALTH SERVICES & SU 750 EAST 34TH STREET HIBBING,MN55746 41-1293970	PATIENT HE	MN	501C3	3	NA	Yes
(5)EBENEZER SOCIETY 2722 PARK AVENUE SOUTH MINNEAPOLIS,MN55407 41-0706141	HEALTH CAR	MN	501C3	10	N/A	Yes
(6)FAIRVIEW AUXILIARY 6401 FRANCE AVENUE SOUTH MINNEAPOLIS,MN55435 41-1414831	SUPPORT	MN	501C3	12C	N/A	Yes
(7)PREFERREDONE COMMUNITY HEALTH PLAN 6105 GOLDEN HILLS DRIVE GOLDEN VALLEY,MN55416 41-1796007	INS	MN	501C4	12D	NA		No
(8)HEALTHEAST CARE SYSTEM 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 36-3617697	HOSPITAL	MN	501C	3	FAIRVIEW	Yes
(9)HEALTHEAST ST JOSEPH'S HOSPITAL 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-0693880	HOSPITAL	MN	501C3	3	FAIRVIEW	Yes
(10)HEALTHEAAT ST JOHN'S HOSPITAL 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 14-1456897	HOPSITAL	MN	501C3	3	FAIRVIEW	Yes
(11)HEALTHEAST WOODWINDS HOSPITAL 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1592761	HOSPITAL	MN	501C3	3	FAIRVIEW	Yes
(12)HEALTHEAST MEDICAL RESEARCH INSTITU 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1765832	MED RESEAR	MN	501C3	4	FAIRVIEW	Yes
(13)GRAND ITASCA CLINIC AND HOSPITAL 1601 GOLF COURSE ROAD GRAND RAPIDS,MN55744 41-1865874	HOSPITAL	MN	501C	3	FAIRVIEW	Yes
(14)GRAND ITASCA FOUNDATION 1601 GOLF COURSE ROAD GRAND RAPIDS,MN55744 41-1560554	FOUNDATION	MN	501C3	12A	FAIRVIEW	Yes
(15)D&T FACILITY MANAGEMENT COMPANY 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1928275	MANAGEMENT	MN	501C3	12A	FAIRVIEW		No

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

Cat. No. 50135Y

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) RIDGES SURGERY CENTER LLC 14101 FAIRVIEW DRIVE STE 400 BURNSVILLE,MN55337 46-2441825	SURGERY CE	MN	FAIRVIEW FAIRVIEW HEALTH SERVICES	RELATED	597,639	1,233,923		No			No	100.000 %
(2) HEALTHEAST SURGERY CENTER-MAPLEWOOD 1655 BEAM AVENUE MAPLEWOOD,MN55109 20-3349887	SURG CNTR	MN	FAIRVIEW FAIRVIEW HEALTH SERVICES	RELATED	518,489	8,958,529		No			No	100.000 %

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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) FAIRVIEW CLINICS 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1761760	PHYSICIAN	MN	N/A				Yes
(2) FAIRVIEW PHYSICIAN AND CLINIC SERVI 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1544996	PHYSICIAN	MN	N/A				Yes
(3) FAIRVIEW DEVELOPMENT COMPANY 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1568579	LEASEHOLD	MN	N/A				Yes
(4) FAIRVIEW EXPRESS CARE 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 20-5996177	PHYSICIAN	MN	N/A				Yes
(5) BEHAVIORAL HEALTHCARE PROVIDERS 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1805759	MENTAL HEA	MN	N/A				Yes
(6) FHS ASSURANCE LIMITED 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 CJ 98-0417513	SELF INSUR	CJ	N/A				Yes
(7) HEALTHEAST DIVERSIFIED SERVICES INC 2450 RIVERSIDE AVENUE SOUTH MINNEAPOLIS,MN55454 41-1388583	LAB & REAL	MN	N/A				Yes

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

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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) BEHAVIORAL HEALTHCARE PROVIDERS	M	30,442	FAIR MARKET VALUE
(2) BEHAVIORAL HEALTHCARE PROVIDERS	S	4,562,156	FAIR MARKET VALUE
(3) EBENEZER SOCIETY	M	476,635	FAIR MARKET VALUE
(4) EBENEZER SOCIETY	Q	935,227	FAIR MARKET VALUE
(5) EBENEZER SOCIETY	R	3,829,967	FAIR MARKET VALUE
(6) EXPRESS CARE	Q	1,161	FAIR MARKET VALUE
(7) EXORESS CARE	S	14,482,914	FAIR MARKET VALUE
(8) FAIRVIEW CLINICS	M	977,474	FAIR MARKET VALUE
(9) FAIRVIEW CLINICS	K	3,080,913	FAIR MARKET VALUE
(10) FAIRVIEW CLINICS	P	8,107	FAIR MARKET VALUE
(11) FAIRVIEW CLINICS	Q	9,273,591	FAIR MARKET VALUE
(12) FAIRVIEW CLINICS	S	8,473,597	FAIR MARKET VALUE
(13) FAIRVIEW DEVELOPMENT COMPANY	M	16,029	FAIR MARKET VALUE
(14) FAIRVIEW DEVELOPMENT COMPANY	P	174	FAIR MARKET VALUE
(15) FAIRVIEW DEVELOPMENT COMPANY	S	193,356	FAIR MARKET VALUE
(16) FAIRVIEW FOUNDATION	M	135,029	FAIR MARKET VALUE
(17) FAIRVIEW FOUNDATION	S	1,724,314	FAIR MARKET VALUE
(18) FAIRVIEW FOUNDATION	J	100,883	FAIR MARKET VALUE
(19) FAIRIVEW FOUNDATION	C	1,689,565	FAIR MARKET VALUE
(20) FAIRVIEW FOUNDATION	B	3,208,131	FAIR MARKET VALUE
(21) FAIRVIEW HOMECARE & HOSPICE	M	303,933	FAIR MARKET VALUE
(22) FAIRVIEW HOMECARE & HOSPICE	Q	795,055	FAIR MARKET VALUE
(23) FAIRVIEW HOMECARE & HOSPICE	S	2,786,532	FAIR MARKET VALUE
(24) FAIRVIEW HOMECARE & HOSPICE	K	132,614	FAIR MARKET VALUE
(25) FAIRVIEW PHYSICIAN ASSOCIATES NETWO	L	36,254	FAIR MARKET VALUE
(26) FAIRVIEW PHYSICIAN ASSOCIATES NETWO	S	1,306,165	FAIR MARKET VALUE
(27) RANGE REGIONAL HEALTH SERVICES	R	2,405,375	FAIR MARKET VALUE
(28) RANGE REGIONAL HEALTH SERVICES	M	554,523	FAIR MARKET VALUE
(29) RANGE REGIONAL HEALTH SERVICES	P	10,928	FAIR MARKET VALUE
(30) RANGE REGIONAL HEALTH SERVICES	Q	165,037	FAIR MARKET VALUE
(31) RANGE REGIONAL HEALHT SERVICES	L	45,272	FAIR MARKET VALUE
(32) GRAND ITASCA CLINIC AND HOSPITAL	R	21,423,327	FAIR MARKET VALUE
(33) GRAND ITASCA CLINIC AND HOSPITAL	M	458,939	FAIR MARKET VALUE
(34) GRAND ITASCA CLINIC AND HOSPITAL	P	25,062	FAIR MARKET VALUE
(35) GRAND ITASCA CLINIC AND HOSPITAL	Q	85,168	FAIR MARKET VALUE
(36) HEALTHEAST CARE SYSTEM	S	105,247,828	FAIR MARKET VALUE
(37) HEALTHEAST CARE SYSTEM	M	837,256	FAIR MARKET VALUE
(38) HEALTHEAST CARE SYSTEM	Q	744,449	FAIR MARKET VALUE
(39) HEALTHEAST CARE SYSTEM	P	534,014	FAIR MARKET VALUE
(40) HEALTHEAST CARE SYSTEM	K	344,386	FAIR MARKET VALUE

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

Schedule R (Form 990) 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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: FAIRVIEW IS DRIVEN TO HEAL, DISCOVER AND EDUCATE FOR LONGER, HEALTHIER LIVES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	17
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	22,623
6	Total number of volunteers (estimate if necessary) .............	6	4,590
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	348,770,184
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,363,390	5,437,437
9	Program service revenue (Part VIII, line 2g) .........	3,402,188,888	3,559,984,425
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	59,505,192	67,335,294
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	399,836,471	371,025,483
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	3,864,893,941	4,003,782,639
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,298,195	1,689,565
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,722,743,238	1,856,796,438
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,935,729,528	2,197,390,716
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,660,770,961	4,055,876,719
19	Revenue less expenses. Subtract line 18 from line 12.......	204,122,980	-52,094,080
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,024,449,142	5,216,914,002
21	Total liabilities (Part X, line 26).............	2,500,820,456	2,684,722,845
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,523,628,686	2,532,191,157

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,352,889,990 including grants of $ 1,689,565 ) (Revenue $ 2,477,573,343 )
	PROVIDING MEDICAL SERVICES: FAIRVIEW HEALTH SERVICES IS AN AWARD-WINNING, NONPROFIT, INTEGRATED HEALTH SYSTEM PROVIDING EXCEPTIONAL HEALTH CARE ACROSS THE FULL SPECTRUM OF HEALTH CARE SERVICES. FOUNDED IN 1906, FAIRVIEW PROVIDES EXCEPTIONAL CARE TO PATIENTS AND COMMUNITIES AS ONE OF THE MOST COMPREHENSIVE AND GEOGRAPHICALLY ACCESSIBLE SYSTEMS IN MINNESOTA. THE FAIRVIEW SYSTEM CONSISTS OF 11 HOSPITAL, IT CONTROLS AND OPERATES UNIVERSITY OF MINNESOTA MEDICAL CENTER, THE ADULT AND PEDIATRIC TEACHING HOSPITAL OF THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL, HAS 9 COMMUNITY- BASED GENERAL ACUTE CARE HOSPITALS AND 1 LONG-TERM ACUTE CARE HOSPITAL; 56 PRIMARY CARE CLINICS; OVER 100 SPECIALTY CARE SERVICES; 10 URGENT CARE CLINICS; OCCUPATIONAL HEALTH CLINICS; 36 RETAIL AND SPECIALTY PHARMACIES; PHARMACY BENEFIT MANAGEMENT SERVICES; REHABILITATION CENTERS; COUNSELING; HOME CARE AND HOSPICE SERVICES; 90 OWNED AND MANAGED SENIOR CARE FACILITIES AND LONG-TERM CARE HOUSING FACILITIES (THROUGH EBENEZER SOCIETY, A FAIRVIEW SUBSIDIARY); EMERGENCY MEDICAL TRANSPORTATION; AN INTEGRATED PROVIDER NETWORK; AND HEALTH INSURER PREFERREDONE. FAIRVIEW'S 34,000+ EMPLOYEES AND NETWORK OF 5,000+ PROVIDERS EMBRACE INNOVATION AND NEW THINKING TO DRIVE A HEALTHIER FUTURE THROUGH HEALING, DISCOVERY AND EDUCATION. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, FAIRVIEW IS COMMITTED TO PARTICIPATING IN NATION-LEADING RESEARCH AND EDUCATING TOMORROW'S PHYSICIANS AND HEALTH CARE PROFESSIONALS. WE SERVE PATIENTS FROM ACROSS THE STATE OF MINNESOTA, THE UPPER MIDWEST AND BEYOND. IN ADDITION TO OUR EMPLOYED PHYSICIANS, WE WORK CLOSELY WITH THE ACADEMIC PHYSICIANS AT UNIVERSITY OF MINNESOTA PHYSICIANS AND WITH FAIRVIEW PHYSICIAN ASSOCIATES, A NETWORK OF INDEPENDENT PHYSICIANS. FAIRVIEW HAS ENJOYED A LONG PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA AND UNIVERSITY OF MINNESOTA PHYSICIANS, WHICH IS REPRESENTED IN THE UNIVERSITY OF MINNESOTA HEALTH BRAND. IN 2019, WE EXTENDED OUR PARTNERSHIP BY BUILDING M HEALTH FAIRVIEW AN ACADEMIC HEALTH SYSTEM DRIVING TO DELIVER BREAKTHROUGH CARE CLOSE TO HOME. THE HEALTH CARE AND MEDICAL SERVICES WHICH FAIRVIEW PROVIDES TO THE COMMUNITY INCLUDE, BUT ARE NOT LIMITED TO: PRIMARY, SPECIALTY, TERTIARY, AND QUATERNARY CARE; HOSPITAL AND PHYSICIAN SERVICES; SENIOR SERVICES; ASSISTED LIVING; HOME CARE AND HOSPICE; LONG-TERM CARE; URGENT CARE AND EMERGENCY SERVICES; PHARMACY; CARE OF MOTHERS AND CHILDREN; PHYSICAL THERAPY/SPORTS MEDICINE; REHABILITATION SERVICES; AND INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH CARE AND CHEMICAL DEPENDENCY SERVICES. FAIRVIEW PROVIDES SPECIALIZED CARE FOR THE TREATMENT OF CANCER, HEART DISEASE, DIABETES, WOUND CARE, CHRONIC CONDITIONS, SOLID ORGAN TRANSPLANT, BLOOD AND MARROW TRANSPLANT, AND MANY OTHER SPECIALTIES. FAIRVIEW ALSO OFFERS SOCIAL WORK SERVICES, HEALTH EDUCATION AND SUPPORT GROUPS, AND SERVICES FOR VARIOUS HEALTH ISSUES. FAIRVIEW HEALTH SERVICES PROVIDES CARE AT THESE HOSPITALS AND MEDICAL CENTER: FAIRVIEW LAKES MEDICAL CENTER IS A COMMUNITY HOSPITAL IN WYOMING, MINNESOTA WITH 61 LICENSED BEDS. SINCE OPENING IN 1998, THE MEDICAL CENTER WORKS WITH NEARBY FAIRVIEW PRIMARY AND SPECIALTY CLINICS, AND WITH UNIVERSITY OF MINNESOTA HEALTH SPECIALISTS, TO BRING A WIDE RANGE OF MEDICAL SERVICES TO THE SURROUNDING AREA. FAIRVIEW LAKES IS A BABYFRIENDLY HOSPITAL, DESIGNATED BY BABY FRIENDLY USA AND HAS BEEN RECOGNIZED AS A BREAST IMAGING CENTER OF EXCELLENCE BY AMERICAN COLLEGE OF RADIOLOGY. THE HOSPITAL WAS AWARDED A 4-STAR RATING IN THE 2019 CENTERS FOR MEDICARE & MEDICAID "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE LABOR AND DELIVERY, HEART CARE, CANCER CARE, BREAST CARE/MAMMOGRAPHY, ORTHOPEDIC SURGERY, GENERAL SURGERY, SPINE & BRAIN, AND SLEEP SERVICES. FAIRVIEW RANGE MEDICAL CENTER IS LOCATED IN HIBBING, MINN., AND HAS 175 LICENSED BEDS. FROM PREVENTION AND DISEASE MANAGEMENT TO THE MOST COMPLEX OF LIFE-THREATENING INJURIES AND ILLNESSES, FAIRVIEW RANGE PARTNERS WITH A BROAD NETWORK OF FAIRVIEW PROVIDERS AND UNIVERSITY OF MINNESOTA HEALTH SPECIALISTS TO BRING ADVANCED, HIGH-QUALITY CARE DIRECTLY TO THE REGION. FAIRVIEW RANGE WAS AWARDED A 4-STAR RATING IN THE 2019 CENTERS FOR MEDICARE & MEDICAID "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE BEHAVIORAL HEALTH, CANCER CARE, DIAGNOSTIC IMAGING, INTENSIVE CARE, PEDIATRIC CARE, AND A WOMEN'S HEALTH & BIRTH CENTER. FAIRVIEW RIDGES HOSPITAL OPENED IN BURNSVILLE IN 1985. IT PROVIDES COMPREHENSIVE, SPECIALIZED CARE TO THE SOUTHERN TWIN CITIES COMMUNITY WITH ITS 150 LICENSED BEDS. FAIRVIEW RIDGES HOSPITAL PROVIDES CARE FOR THE ENTIRE FAMILY, INCLUDING PEDIATRIC EMERGENCY CARE AND NEONATAL INTENSIVE CARE. THE HOSPITAL OFFERS ONSITE ACCESS TO SPECIALISTS IN EVERYTHING FROM HEART AND CANCER CARE TO MIDWIFERY AND SPORTS MEDICINE. FAIRVIEW RIDGES WAS AWARDED A 5-STAR RATING (THE HIGHEST AVAILABLE) IN THE 2019 CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE LABOR AND DELIVERY, HEART CARE, CANCER CARE, BREAST CENTER, ORTHOPEDIC SURGERY, GENERAL SURGERY, SPINE & BRAIN, PEDIATRIC INPATIENT, AND SLEEP SERVICES. FAIRVIEW SOUTHDALE HOSPITAL OPENED IN EDINA IN 1965. WITH 390 LICENSED BEDS, TODAY THE HOSPITAL IS KNOWN FOR ITS AWARD-WINNING HEART, STROKE, AND CANCER CARE. FAIRVIEW SOUTHDALE OFFERS CONVENIENT ACCESS TO MORE THAN 40 SPECIALTY SERVICES INCLUDING CARDIOLOGY, ORTHOPEDICS, ONCOLOGY, OBSTETRICS, PRIMARY CARE, NEUROSCIENCES, CRITICAL CARE, VASCULAR AND EMERGENCY SERVICES. FAIRVIEW SOUTHDALE WAS AWARDED A 5-STAR RATING (THE HIGHEST AVAILABLE) IN THE 2019 CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE LABOR AND DELIVERY, HEART CARE, CANCER CARE, A BREAST CENTER, ORTHOPEDIC SURGERY, GENERAL SURGERY, SPINE & BRAIN, A STROKE CENTER, AND SLEEP SERVICES. UNIVERSITY OF MINNESOTA MEDICAL CENTER AND UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL ARE THE ADULT AND PEDIATRIC TEACHING HOSPITALS OF THE UNIVERSITY OF MINNESOTA. THE MEDICAL CENTER AND ITS DOZENS OF ADULT AND PEDIATRIC SPECIALTY CLINICS ARE LOCATED ON BOTH THE EAST AND WEST BANKS OF THE UNIVERSITY OF MINNESOTA CAMPUS. WITH 1,700 LICENSED BEDS, UNIVERSITY OF MINNESOTA MEDICAL CENTER IS COMMITTED TO PROVIDING EXCEPTIONAL, INNOVATIVE HEALTH CARE, PAIRING GROUNDBREAKING TECHNOLOGY AND TREATMENTS WITH PATIENT-CENTERED CARE. OUR PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL AND UNIVERSITY OF MINNESOTA PHYSICIANS PROVIDES THE PLATFORM TO SPECIALIZE IN BREAKTHROUGH TREATMENTS, SURGICAL TECHNIQUES, AND LIFESAVING THERAPIES, AND TO TRAIN TOMORROW'S PHYSICIANS. CLINICAL TRIALS ADVANCE OUR CLINICAL SERVICES, BRINGING THE NEWEST RESEARCH AND IDEAS TO PATIENT CARE. WE ALSO PROVIDE AN IMPORTANT TRAINING ENVIRONMENT FOR RESIDENTS, FELLOWS, AND MANY OTHER HEALTH CARE LEARNERS. KEY SERVICES INCLUDE MATERNITY, HEART CARE, GENERAL SURGERY, CANCER CARE, SOLID ORGAN TRANSPLANTS, BLOOD MARROW TRANSPLANTS, AND PEDIATRIC SPECIALTIES. IN ADDITION TO HOSPITALS, FAIRVIEW MEDICAL GROUP INCLUDES FAIRVIEW AND HEALTHEAST CLINICS 56 PRIMARY CARE CLINICS AT LOCATIONS ACROSS THE GREATER METRO AREA. FAIRVIEW, IN PARTNERSHIP WITH UNIVERSITY OF MINNESOTA PHYSICIANS, PROVIDES EXCEPTIONAL CARE IN MORE THAN 100 SPECIALTY AREAS. OTHER CONTINUUM SERVICES FAIRVIEW OFFERS THROUGH RELATED ENTITIES INCLUDE FAIRVIEW HOME CARE AND HOSPICE, FAIRVIEW HOME MEDICAL EQUIPMENT, FAIRVIEW PHARMACY, INSTITUTE FOR ATHLETIC MEDICINE, FAIRVIEW REHABILITATION SERVICES, FAIRVIEW ACHIEVEMENT CENTER, FAIRVIEW PARTNERS, FAIRVIEW COUNSELING SERVICES, FAIRVIEW CARE MANAGEMENT AND COORDINATION, HEALTHEAST MEDICAL TRANSPORTATION, AND SUBSIDIZED HEALTH SERVICES. FOR MORE INFORMATION, VISIT WWW.FAIRVIEW.ORG.

4b	(Code: ) (Expenses $ 953,030,619 including grants of $ ) (Revenue $ 1,065,956,716 )
	COST OF PARTICIPATING IN GOVERNMENT PROGRAMS: FAIRVIEW IS COMMITTED TO SERVING THE HEALTH CARE NEEDS OF MEMBERS OF ITS COMMUNITY. TO SUPPORT FULL ACCESS TO SERVICES, FAIRVIEW PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH CARE PROGRAMS: MEDICARE, MEDICAID, AND MINNESOTACARE. REIMBURSEMENT FROM THESE PROGRAMS FOR SERVICES RENDERED, GENERALLY FALLS BELOW THE COST OF PROVIDING THE CARE. TO COMPENSATE FOR THE UNDER FUNDING BY GOVERNMENT PROGRAMS, FAIRVIEW MAKES A SIGNIFICANT FINANCIAL INVESTMENT TO OFFSET THESE LOSSES. IN 2019, FAIRVIEW INCURRED 64,733,415 OF TAXES AND SURCHARGE COSTS IN HEALTH CARE SERVICES THAT EXCEEDED THE REIMBURSEMENT RECEIVED BY PUBLIC PROGRAMS, SURCHARGE, TAXES AND FEES RELATED TO THESE PROGRAMS AND NOT INCLUDING MEDICARE. THE FOLLOWING IS A BREAKDOWN ON COSTS RELATED TO THE COST OF PARTICIPATING IN GOVERNMENT PROGRAMS: COSTS EXCEED MEDICAID REIMBURSEMENT: FAIRVIEW IS SERVING THOUSANDS OF LOW- INCOME INDIVIDUALS COVERED BY MEDICAL ASSISTANCE AND MINNESOTACARE. REIMBURSEMENT FROM THESE PROGRAMS IS LESS THAN FAIRVIEW'S COST OF PROVIDING CARE TO THESE PATIENTS. TOTAL MEDICAID SURTAX COSTS RELATED TO HOSPITALS, PHARMACIES, AND SURGICAL CENTERS WAS 25,457,520. MINNESOTACARE TAX: THE STATE OF MINNESOTA LEVIES A 2 PERCENT TAX ON CERTAIN HEALTHCARE PROVIDER REVENUES. MONEY GENERATED FROM THIS TAX HELPS TO DEFRAY THE COSTS INCURRED FROM MINNESOTACARE AND OTHER PROGRAMS/SERVICES FOR UNINSURED INDIVIDUALS. IN 2019, FAIRVIEW PAID 39,275,895 IN MINNESOTACARE TAXES. TAXES AND FEES: FAIRVIEW DOES PAY SOME PROPERTY TAX TO LOCAL AND STATE GOVERNMENT. THIS HELPS TO FUND CIVIL AND EDUCATIONAL SERVICES IN THE COMMUNITY. THE REAL ESTATE COSTS FOR 2019 TOTALED 5,937,861 AND THE SALES AND INCOME TAXES TOTALED 1,312,903. COSTS EXCEEDING MEDICARE REIMBURSEMENT: FAIRVIEW CARES FOR THOUSANDS OF INDIVIDUALS AGES 65 AND OLDER WHO ARE COVERED BY MEDICARE. FAIRVIEW INCURRED 174,548,349 OF MEDICARE REIMBURSEMENT SHORTFALLS. REIMBURSEMENT FROM MEDICARE IS LESS THAN FAIRVIEW'S COST OF PROVIDING CARE TO THE PATIENT. THE TOTAL COST OF PROVIDING THESE BENEFITS WAS 882,359,341.

4c	(Code: ) (Expenses $ 103,325,709 including grants of $ ) (Revenue $ 16,454,364 )
	THE PRIMARY PURPOSE OF OUR EDUCATIONAL AND RESEARCH PROGRAMS IS TO BENEFIT PATIENTS AND THE COMMUNITY AT LARGE BY EDUCATING HEALTH PROFESSIONALS BOTH WITHIN FAIRVIEW AND IN THE BROADER COMMUNITY, AND BY FOSTERING ADVANCES IN KNOWLEDGE AND EVIDENCE-BASED IMPROVEMENTS TO CLINICAL TREATMENTS AND APPROACHES TO HEALTH CARE DELIVERY. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA ACADEMIC HEALTH CENTER AND UNIVERSITY OF MINNESOTA PHYSICIANS, FAIRVIEW HAS A STRONG AND ABIDING COMMITMENT TO RESEARCH AND EDUCATION. TOGETHER, WE VIEW RESEARCH AS AN INTEGRAL AND CRITICAL COMPONENT IN PROVIDING EXCEPTIONAL CARE TO PATIENTS AND THE COMMUNITY. WE SEEK TO BE A NATIONAL LEADER IN CLINICAL RESEARCH AND A REGIONAL CENTER FOR CLINICAL RESEARCH ACTIVITIES. FAIRVIEW HEALTH SERVICES CONTINUED ITS FOCUS ON AND SUPPORT OF RESEARCH AND EDUCATION IN 2019. THIS COMMITMENT INCLUDED PROVIDING THE RESOURCES OF TIME, MONEY AND TALENT WHILE ENSURING THE FACILITIES, SUPPORTING INFRASTRUCTURES, AND PROCESSES WERE AVAILABLE TO FACILITATE AND ENCOURAGE THE CREATION OF NEW KNOWLEDGE. FAIRVIEW HAS MORE THAN 1,100 ACTIVE MEDICAL RESEARCH PROJECTS UNDERWAY ACROSS THE HEALTH CARE SYSTEM. RESEARCH RANGES FROM DEEP BRAIN STIMULATION TO ULTRASOUND TREATMENT OF RHEUMATOID ARTHRITIS, RECURRENT HYPOGLYCEMIA AND MANY OTHER TOPICS. FAIRVIEW OFFERS NUMEROUS SPONSORSHIPS AND TRAINING PROGRAMS, INTERNSHIPS, AND SCHOLARSHIPS TO EMPLOYEES AND THEIR DEPENDENTS - AS WELL AS TO STUDENTS IN OUR COMMUNITIES. FAIRVIEW PARTNERS WITH MORE THAN 160 SCHOOLS, 255 FAITH COMMUNITIES, AND 50 COMMUNITY GROUPS. FAIRVIEW HAS EDUCATIONAL PARTNERSHIPS WITH THE UNIVERSITY OF MINNESOTA AND ST. CATHERINE UNIVERSITY AND AFFILIATIONS WITH MANY OTHER INSTITUTIONS. FAIRVIEW ALSO OFFERS ITS OWN SPECIALIZED TRAINING PROGRAMS IN PERIOPERATIVE NURSING AND DIETETICS. EACH YEAR, ABOUT 6,500 COLLEGE AND GRADUATE STUDENTS PREPARING FOR CAREERS IN A WIDE RANGE OF MEDICAL FIELDS DO CLINICAL TRAINING, INTERNSHIPS, AND JOB SHADOWING AT FAIRVIEW HOSPITALS AND CLINICS. THROUGH FAIRVIEW'S CLOSE PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, EACH YEAR ROUGHLY 1,600 MEDICAL STUDENTS, RESIDENTS, AND FELLOWS TAKE COURSES AND DO ROTATIONS OF VARIOUS LENGTHS AT UNIVERSITY OF MINNESOTA MEDICAL CENTER AND UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL. ABOUT 224 MEDICAL STUDENTS DO ROTATIONS IN OTHER FAIRVIEW SETTINGS, INCLUDING FAIRVIEW'S PRIMARY CARE CLINICS. FAIRVIEW ALSO PROVIDES NUMEROUS CONTINUING EDUCATION OPPORTUNITIES TO ITS EMPLOYEES TO ENABLE THEM TO ENSURE THEY ARE KNOWLEDGEABLE ABOUT THE LATEST INNOVATIONS IN HEALTH CARE DELIVERY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses3,409,246,318

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	19,769,406	737,454	2,141,295

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	5,001,673
e	Government grants (contributions)		1e	435,764

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g	125,861

h Total. Add lines 1a-1f.......		5,437,437

		Business Code
2a	MEDICARE-MEDICAID	624100	1,065,956,716	1,065,956,716
b	PATIENT CARE	624100	1,017,197,896	1,017,197,896
c	LABORATORY	621500	763,159,633	763,159,633
d	PHARMACY	446110	664,712,729	664,712,729
e	MEDICAL SERVICES	541900	15,539,170			15,539,170
f	All other program service revenue.		33,418,281	21,805,946	11,450,545	161,790
g	Total. Add lines 2a–2f .....		3,559,984,425

3 Investment income (including dividends, interest, and othersimilar amounts) ......			19,429,019			19,429,019
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		34,774,659	6a
b	Less: rental expenses		1,068,815	6b
c	Rental income or (loss)		33,705,844	6c
d	Net rental income or (loss).......			33,705,844			33,705,844
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	3,174,691	47,301,461	7a
b	Less: cost or other basis and sales expenses	2,569,877		7b
c	Gain or (loss)	604,814	47,301,461	7c
d	Net gain or (loss).........			47,906,275			47,906,275
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..
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..
10a	Gross sales of inventory, less returns and allowances ..
			10a	710,356,968
b	Less: cost of goods sold ..		10b	373,037,329
c	Net income or (loss) from sales of inventory..			337,319,639		337,319,639
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			4,003,782,639	3,532,832,920	348,770,184	116,742,098

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,689,565	1,689,565
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. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	12,333,455		12,333,455
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	1,385,123		1,385,123
7	Other salaries and wages........	1,469,925,471	1,131,374,599	338,550,872
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	77,049,604	61,282,977	15,766,627
9	Other employee benefits .......	194,472,629	150,855,661	43,616,968
10	Payroll taxes ...........	101,630,156	78,049,139	23,581,017
11	Fees for services (non-employees):
a	Management ......	179,205,122	155,545,197	23,659,925
b	Legal .........	6,065,470	77,838	5,987,632
c	Accounting ...........	716,937	9	716,928
d	Lobbying ...........	784,678	784,678
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	4,724,689		4,724,689
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	221,961,023	218,916,020	3,045,003
12	Advertising and promotion ....	5,069,338	17,773	5,051,565
13	Office expenses .......	86,662,290	64,490,469	22,171,821
14	Information technology ......
15	Royalties ..	525		525
16	Occupancy ...........	79,226,007	67,725,778	11,500,229
17	Travel ............	6,713,554	3,896,270	2,817,284
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	4,605,494	3,021,213	1,584,281
20	Interest ...........	40,071,359	39,795,213	276,146
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	117,817,026	73,459,349	44,357,677
23	Insurance ...	12,773,913	4,855,556	7,918,357
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	1,119,946,763	1,113,535,518	6,411,245
b	IMPAIRMENT CHARGES	126,893,732	126,893,732
c	LICENSES	79,376,842	19,985,677	59,391,165
d	TAXES-MEDICAL	64,733,416	64,733,416
e	All other expenses	40,042,538	28,260,671	11,781,867
25	Total functional expenses. Add lines 1 through 24e	4,055,876,719	3,409,246,318	646,630,401	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,065,611	1	1,024,466
2	Savings and temporary cash investments .........			515,925,664	2	343,624,664
3	Pledges and grants receivable, net ......			18,591,677	3	17,734,280
4	Accounts receivable, net .............			1,548,103,182	4	1,475,703,040
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			99,498,315	8	110,520,464
9	Prepaid expenses and deferred charges ......			29,722,050	9	37,712,683
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,239,848,706
b	Less: accumulated depreciation	10b	1,321,198,024	826,704,943	10c	918,650,682
11	Investments—publicly traded securities .			1,270,615,460	11	1,474,201,064
12	Investments—other securities. See Part IV, line 11 .....			193,127,246	12	209,942,625
13	Investments—program-related. See Part IV, line 11 ..			13,015,139	13	30,308,585
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			508,079,855	15	597,491,449
16	Total assets. Add lines 1 through 15 (must equal line 33)...			5,024,449,142	16	5,216,914,002

17	Accounts payable and accrued expenses .....	539,172,626	17	513,034,798
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	837,239,532	20	828,475,648
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
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 ..	529,490,000	23	518,975,000
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	594,918,298	25	824,237,399
26	Total liabilities. Add lines 17 through 25..	2,500,820,456	26	2,684,722,845

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	2,469,128,711	27	2,478,496,030
28	Net assets with donor restrictions ...........	54,499,975	28	53,695,127
	Organizations that do not follow FASB ASC 958, check here 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 ...........	2,523,628,686	32	2,532,191,157
33	Total liabilities and net assets/fund balances ........	5,024,449,142	33	5,216,914,002

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