Form990
Click to see list of attachments
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
Sanford Group Return
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO Box 5039 Rte 5218
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Sioux Falls, SD571175039
D Employer identification number

45-3791176
E Telephone number

G Gross receipts $ 4,788,006,530
F Name and address of principal officer:
Bill Gassen
2301 East 60th St
Sioux Falls,SD57104
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.sanfordhealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5851
K Form of organization:  
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: "Dedicated to sharing God's love through the work of health, healing and comfort."
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 5
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 2,940
6 Total number of volunteers (estimate if necessary) ............. 6 1,465
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 93,820,725
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 3,810,829
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 75,717,791 266,108,775
9 Program service revenue (Part VIII, line 2g) ......... 4,340,390,961 4,501,303,320
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,264,847 14,625,505
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 967,825 2,067,483
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 4,418,341,424 4,784,105,083
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 32,126,097 49,629,394
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 2,485,262,586 2,604,736,831
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,697,083,177 1,740,135,761
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 4,214,471,860 4,394,501,986
19 Revenue less expenses. Subtract line 18 from line 12....... 203,869,564 389,603,097
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,975,394,335 3,325,190,715
21 Total liabilities (Part X, line 26)............. 1,409,187,225 1,386,689,937
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,566,207,110 1,938,500,778
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
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Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2020)
Form 990 (2020)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: Part of the Sanford Health System, Sanford is committed to the healthcare needs of communities throughout South Dakota, North Dakota, Minnesota and Iowa. Sanford provides a full range of primary and specialty health care services.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 4,304,614,052 including grants of $ 49,583,394 ) (Revenue $ 4,492,958,325 )
Sanford is the nation's largest not-for-profit integrated rural health system providing medical services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area including a network of children's primary care clinic locations across the country and the world. Sanford operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford financially supports health and wellness, education and community development activities to improve the quality of life and strengthen communities throughout the region. Each of Sanford's facilities promotes health and healing that responds to the unique needs of the patients in the communities that Sanford serves, ensuring access to comprehensive and specialized services. A recently completed and published community health needs assessment indicated the important need for behavioral health services for our community members. Sanford is meeting this need through an integrated delivery system providing behavioral health within the medical home structure.Please see Schedule H for a description of additional services, community benefit activities, and the full spectrum of charity care that Sanford provides within the community.
4b (Code:   ) (Expenses $ 18,921,786 including grants of $ 0 ) (Revenue $ 3,498,697 )
Medical education is an important service for Sanford. Sanford provides the medical community with high quality educational and professional development that is evidence and research based; accredited for physicians, nurses, pharmacists, and Allied Health Professionals and scientists; inclusive of cultural diversity and addresses the need for specialty training.Sanford is dedicated to preparing health care professionals for the future. The Sanford PROMISE program connects students, educators and communities with science and research in health care at a secondary education age. Sanford works in partnership with the University of South Dakota - Sanford School of Medicine, and the University of North Dakota - School of Medicine to provide rotations for medical students, residencies and fellowships. Sanford works in partnership with an extensive group of higher learning organizations to provide student training and learning opportunities in many venues across our region.
4c (Code:   ) (Expenses $ 55,944,251 including grants of $ 46,000 ) (Revenue $ 4,846,298 )
Sanford Research and Sanford Research North are both non-profit health research organizations. Combined, both entities have more than 200 scientists and staff as well as centers, including: Children's Health, focused on pediatric rare diseases and cancer; The Sanford Project, seeking a cure for type 1 diabetes through the body's natural ability to regenerate cells; Health Outcomes and Prevention focusing on sudden infant death syndrome and birth-related disorders at study sites including United States Native American Reservations and South Africa; Genomic and Molecular Medicine with an emphasis on genomics, molecular biology, biobanking and immunotherapy; Edith Sanford Breast Cancer focusing on advanced molecular research and personalized treatment; Neurosciences, focused on the area of eating disorders, obesity and bariatric surgery outcomes as well as physiological aspects of eating and addiction and Clinical Research including participation in drug and device studies, the National Cancer Institute Community Clinical Oncology Program and the National Community Cancer Center Pilot Project.Sanford Research and Sanford Research North offer exciting challenges for researchers both in well-established projects and ever expanding research opportunities. Sanford offers opportunities to participate in clinical trials and to be a part of the changing face of medicine.
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet4,379,480,089
Form 990 (2020)
Form 990 (2020)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
Yes
 
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
4,224
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,940
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCH , GH , GM
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2020)
Form 990 (2020)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
5
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
MN , OR , CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletBill Marlette CFO & Treasurer2301 East 60th Street   Sioux Falls,SD57104 (605) 333-1000
Form 990 (2020)
Form 990 (2020)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Brent Teiken......................................................................
Chairperson
5.10
.................
2.01
X   X       68,500 0 0
(2) Don Jacobs......................................................................
Vice Chairperson
5.10
.................
2.01
X   X       44,000 0 0
(3) Neil Gulsvig......................................................................
Treasurer
5.10
.................
2.01
X   X       38,500 0 0
(4) Andy North......................................................................
Secretary
9.10
.................
2.01
X   X       310,804 0 0
(5) Mark Paulson MD......................................................................
Past Chair/Physician Regional Chair
57.99
.................
2.01
X   X       294,486 0 39,555
(6) Barb Everist......................................................................
Trustee
5.10
.................
2.01
X           36,500 0 0
(7) David Beito......................................................................
Trustee
5.10
.................
2.01
X           41,500 0 0
(8) James Cain......................................................................
Trustee
5.10
.................
2.01
X           35,500 0 0
(9) Maria Bell MD......................................................................
Trustee/Research Administrator
57.99
.................
2.01
X           1,013,142 0 42,910
(10) Patrick Durick......................................................................
Trustee
5.10
.................
2.01
X           36,000 0 0
(11) Mark Lundeen MD......................................................................
Trustee/Orthopedics Service Chair
57.99
.................
2.01
X           692,452 0 36,756
(12) Mark Lundeen MD......................................................................
See Sch J, Part III, Lines 4a-4b
57.99
.................
2.01
X           1,000,000 0 0
(13) Kelby K Krabbenhoft......................................................................
President & CEO (Thru 11/20)
49.64
.................
10.36
X   X       0 5,077,342 68,524
(14) Kelby K Krabbenhoft......................................................................
See Sch J, Part III, Lines 4a-4b
49.64
.................
10.36
X   X       0 44,353,819 0
(15) Bill Gassen III......................................................................
CAO/President & CEO (Start 11/20)
49.64
.................
10.36
X   X       0 1,517,151 103,667
(16) Bill Gassen III......................................................................
See Sch J, Part III, Lines 4a-4b
49.64
.................
10.36
X   X       0 1,100,000 0
(17) JoAnn L Kunkel......................................................................
Chief Financial Officer (Thru 9/20)
49.64
.................
10.36
    X       0 1,312,771 34,314
Form 990 (2020)
Form 990 (2020)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JoAnn L Kunkel........................................................................
See Sch J, Part III, Lines 4a-4b
49.64
.......................10.36
    X       0 6,847,438 0
(19) Bill Marlette........................................................................
CFO (Start 10/20) & Treasurer
48.83
.......................11.17
    X       0 1,749,053 31,556
(20) Bill Marlette........................................................................
See Sch J, Part III, Lines 4a-4b
48.83
.......................11.17
    X       0 5,903,232 0
(21) Jennifer Grennan........................................................................
Chief Legal Officer
55.00
.......................5.00
      X     0 1,003,640 108,065
(22) Allison Wierda-Suttle MD........................................................................
Sr VP, CMO (Thru 12/20)
60.00
.......................0.00
      X     0 1,182,234 37,661
(23) Allison Wierda-Suttle MD........................................................................
See Sch J, Part III, Lines 4a-4b
60.00
.......................0.00
      X     0 2,350,610 0
(24) Micah Aberson........................................................................
Executive VP, Sanford
25.00
.......................35.00
      X     0 1,463,400 125,764
(25) Micah Aberson........................................................................
See Sch J, Part III, Lines 4a-4b
25.00
.......................35.00
      X     0 1,100,000 0
(26) Bryan Nermoe........................................................................
President, Fargo
55.00
.......................5.00
      X     0 944,836 121,890
(27) Michael LeBeau MD........................................................................
President, Bismarck
60.00
.......................0.00
      X     0 1,165,587 121,552
(28) Michelle Micka........................................................................
Sr VP Finance, Health Service
55.00
.......................5.00
      X     0 716,436 91,111
(29) Nicholas Olson........................................................................
VP Finance
55.00
.......................5.00
      X     0 466,566 9,000
(30) Paul Hanson........................................................................
President, Sioux Falls
60.00
.......................0.00
      X     0 1,143,312 116,625
(31) Matt Hocks........................................................................
Chief Operating Officer
53.85
.......................6.15
      X     0 1,552,309 134,661
(32) Susan Jarvis........................................................................
President, Bemidji
60.00
.......................0.00
      X     0 711,416 90,645
(33) Daniel Blue........................................................................
President, World Clinics (Thru 6/20)
60.00
.......................0.00
        X   0 696,704 31,848
(34) Daniel Blue........................................................................
See Sch J, Part III, Lines 4a-4b
60.00
.......................0.00
        X   0 5,294,695 0
(35) Eric Belanger MD........................................................................
Physician
60.00
.......................0.00
        X   3,488,345 0 41,430
(36) Adam Stys MD........................................................................
Physician
60.00
.......................0.00
        X   2,974,550 0 40,906
(37) Tomasz Stys MD........................................................................
Physician
60.00
.......................0.00
        X   2,787,050 0 38,100
(38) William Brunner MD........................................................................
Physician
60.00
.......................0.00
        X   2,658,512 0 41,430
(39) Michelle Bruhn........................................................................
Former Sr VP Finance, Health Svc
55.00
.......................5.00
          X 0 964,337 112,265
(40) Daniel Olson........................................................................
Former President, Bemidji
60.00
.......................0.00
          X 0 365,711 37,898
(41) Kim Patrick........................................................................
Former CLO (Thru 12/20)
55.00
.......................5.00
          X 0 1,018,313 39,341
(42) Kim Patrick........................................................................
See Sch J, Part III, Lines 4a-4b
55.00
.......................5.00
          X 0 2,853,845 0
(43) Randy Bury........................................................................
Former Chief Administrative Officer
0.00
.......................60.00
          X 0 1,334,981 137,350
(44) Randy Bury........................................................................
See Sch J, Part III, Lines 4a-4b
0.00
.......................60.00
          X 0 359,927 0
(45) Nate White........................................................................
Former COO (Thru 4/20)
60.00
.......................0.00
          X 0 733,362 14,565
(46) Nate White........................................................................
See Sch J, Part III, Lines 4a-4b
60.00
.......................0.00
          X 0 3,281,646 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 15,519,841 98,564,673 1,849,389
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet2,249
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Owens & Minor Inc

12199 Collection Center
Chicago,IL60693
Medical Services 91,045,936
Focusone Solutions LLC

13609 California Street
Omaha,NE68154
Staffing Services 65,818,825
Medtronic USA

710 Medtronic Parkway
Minneapolis,MN55432
Medical Services 41,822,212
GE Healthcare

1053 W Grand Ave
Chicago,IL60642
Medical Services 27,309,549
Henry Carlson Construction

1205 Russell Street
Sioux Falls,SD57104
Construction 17,842,345
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1,734
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 51,413,992
e Government grants (contributions)1e 207,896,220
f All other contributions, gifts, grants, and similar amounts not included above1f 6,798,563
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 266,108,775
 Program Service RevenueAmt Business Code
2a Patient Services 621110 2,055,074,638 2,055,074,638    
b Medicare/Medicaid 621400 1,729,123,849 1,729,123,849    
c 340B Revenue 621300 413,719,835 413,719,835    
d Retail Sales 446199 105,041,843 99,433,230 5,608,613  
e Support Services 561439 60,332,580   59,819,113 513,467
f All other program service revenue. 138,010,575 124,985,680 5,311,118 7,713,777
g Total. Add lines 2a–2f .....MediumBullet 4,501,303,320
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 15,765,119     15,765,119
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 43,609     43,609
(ii) Personal (i) Real
6a Gross rents   4,421,473 6a
b Less: rental expenses   2,397,599 6b
c Rental income or (loss)   2,023,874 6c
d Net rental income or (loss).......MediumBullet 2,023,874     2,023,874
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 364,234   7a
b Less: cost or other basis and sales expenses 1,503,848   7b
c Gain or (loss) -1,139,614   7c
d Net gain or (loss).........MediumBullet -1,139,614     -1,139,614
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See instructions.....MediumBullet 4,784,105,083 4,399,255,351 93,820,725 24,920,232
Form 990 (2020)
Form 990 (2020)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 49,378,256 49,378,256
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 19,633 19,633
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 231,505 231,505
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 85,486,852 78,784,068 6,702,784  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 11,253,541   11,253,541  
7 Other salaries and wages........ 2,066,245,801 1,914,608,443 151,637,358  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 89,710,407 82,321,479 7,388,928  
9 Other employee benefits ....... 212,305,966 188,398,654 23,907,312  
10 Payroll taxes ........... 139,734,264 128,134,563 11,599,701  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 2,389,984 507,373 1,882,611  
c Accounting ........... 1,345,212 76,757 1,268,455  
d Lobbying ........... 555,796   555,796  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 93,782 93,782    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 226,025,550 194,878,623 31,146,927  
12 Advertising and promotion .... 22,463,880 9,352,583 13,111,297  
13 Office expenses ....... 50,892,397 33,420,366 17,472,031  
14 Information technology ...... 89,723,534 34,121,592 55,601,942  
15 Royalties ..        
16 Occupancy ........... 91,850,830 82,971,608 8,879,222  
17 Travel ............ 14,473,220 13,482,356 990,864  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 4,172,250 2,639,487 1,532,763  
20 Interest ........... 32,759,831 31,855,823 904,008  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 164,278,434 141,573,896 22,704,538  
23 Insurance ... 17,999,044 17,932,920 66,124  
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 1,043,732,190 1,044,138,897 -406,707  
b Other Taxes 11,979,306 11,035,149 944,157  
c Cert/Licenses/Subscript 10,238,808 8,635,425 1,603,383  
d Gain/Loss on Extinguish 5,162,802 5,162,802    
e All other expenses -50,001,089 305,724,049 -355,725,138  
25 Total functional expenses. Add lines 1 through 24e 4,394,501,986 4,379,480,089 15,021,897 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2020)
Form 990 (2020)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 21,434,357 1 219,648,573
2 Savings and temporary cash investments ......... 81,092,458 2 151,509,732
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 582,590,074 4 586,674,421
5 Loans and other receivables from 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) ...
105,504 6 130,819
7 Notes and loans receivable, net ........... 52,089,499 7 53,222,667
8 Inventories for sale or use ............ 90,430,284 8 120,774,742
9 Prepaid expenses and deferred charges ...... 49,922,293 9 56,561,572
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,559,400,353
b Less: accumulated depreciation 10b 1,852,273,120 1,682,943,205 10c 1,707,127,233
11 Investments—publicly traded securities . 1,778,446 11 1,809,675
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .. 42,214,085 13 36,615,860
14 Intangible assets ............... 51,961,717 14 49,809,306
15 Other assets. See Part IV, line 11 ........... 318,832,413 15 341,306,115
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,975,394,335 16 3,325,190,715
Liabilities 17 Accounts payable and accrued expenses ..... 308,796,732 17 385,250,057
18 Grants payable ... 9 18 36,213
19 Deferred revenue ......... 3,313,175 19 17,288,177
20 Tax-exempt bond liabilities ......... 770,491,636 20 660,831,231
21 Escrow or custodial account liability. Complete Part IV of Schedule D 226,251 21 231,916
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 .. 30,892,029 23 25,080,749
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 295,467,393 25 297,971,594
26 Total liabilities. Add lines 17 through 25.. 1,409,187,225 26 1,386,689,937
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 1,565,644,729 27 1,936,923,319
28 Net assets with donor restrictions ........... 562,381 28 1,577,459
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 1,566,207,110 32 1,938,500,778
33 Total liabilities and net assets/fund balances ........ 2,975,394,335 33 3,325,190,715
Form 990 (2020)
Form 990 (2020)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
4,784,105,083
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
4,394,501,986
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
389,603,097
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,566,207,110
5
Net unrealized gains (losses) on investments ...............
5
-873,812
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-16,435,617
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,938,500,778
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2020)
Form 990 (2020)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in 11a above?
11b
 
 
c
A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 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 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2020 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2020
(iii)
Distributable
Amount for 2020
1 Distributable amount for 2020 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 2020:
a From 2015.......  
b From 2016.......  
c From 2017.......  
d From 2018.......  
e From 2019.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2020 distributable amount  
i Carryover from 2015 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2020 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2020 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2020, 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 2020. 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 2021. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2016.....  
b Excess from 2017.....  
c Excess from 2018.....  
d Excess from 2019.....  
e Excess from 2020.....  
Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
List of orgaizations and public charity status: Sanford Health 509(a)(3) Sanford Medical Center 170(b)(1)(A)(iii) Sanford Clinic 170(b)(1)(A)(iii) Sanford Research 170(b)(1)(A)(iii) Sanford Research North 170(b)(1)(A)(iii) Sanford Home Health 509(a)(2) Sanford Health Network 170(b)(1)(A)(iii) Sanford World Clinics 170(b)(1)(A)(iii) Sanford North 509(a)(3) Sanford Medical Center Fargo 170(b)(1)(A)(iii) Sanford Clinic North 509(a)(2) Sanford Health Network North 509(a)(3) Sanford Health of Northern Minnesota 170(b)(1)(A)(iii) Baker Park, Inc. 509(a)(2) Sanford West 509(a)(3) Sanford Bismarck 170(b)(1)(A)(iii) Sanford Living Centers 509(a)(2)
Schedule A, Part I Part I, Line 12b - Sanford Health, Sanford North, Sanford West, and Sanford Health Network North are Type II supporting organizations. Detail for Schedule A, Part I Line 12, Column: (i) Sanford Medical Center; (ii) 46-0227855; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $40,481,835 Line 12, Column: (i) Sanford Clinic; (ii) 46-0447693; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $3,180,029 Line 12, Column: (i) Sanford Research; (ii) 46-0450378; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $640,199 Line 12, Column: (i) Sanford Research North; (ii) 45-0274828; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $90,646 Line 12, Column: (i) Sanford Home Health; (ii) 46-0282134; (iii) 509(a)(2); (iv) Yes; (v) $357,035 Line 12, Column: (i) Sanford Health Network; (ii) 46-0388596; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $10,144,144 Line 12, Column: (i) Sanford Clinic North; (ii) 91-1770748; (iii) 509(a)(2); (iv) Yes; (v) $5,540,944 Line 12, Column: (i) Sanford Medical Center Fargo; (ii) 45-0226909; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $48,073,981 Line 12, Column: (i) Sanford World Clinics; (ii) 26-2707628; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $338,196 Line 12, Column: (i) Sanford Health of Northern Minnesota; (ii) 41-1266009; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $10,743,064 Line 12, Column: (i) Baker Park, Inc.; (ii) 41-1372480; (iii) 509(a)(2); (iv) Yes; (v) $19,799 Line 12, Column: (i) Sanford Health Foundation North; (ii) 45-0398104; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) $408,924 Line 12, Column: (i) Sanford Bismarck; (ii) 45-0226700; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) $21,387,952 Line 12, Column: (i) Sanford Living Centers; (ii) 45-0416454; (iii) 509(a)(2); (iv) Yes; (v) $9,256 Line 12, Column: (i) Sanford Health Foundation West; (ii) 45-0397196; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) $110,258
Schedule A, Part III Line 1 - column: (a) 159,929; (b) 279,310; (c) 133,275; (d) 429,804; (e) 9,415,179; (f) 10,417,497 Line 2 - column: (a) 205,167,015; (b) 159,680,023; (c) 81,522,328; (d) 172,911,271; (e) 177,631,632; (f) 796,940,528 Line 6 - column: (a) 205,326,944; (b) 159,959,333; (c) 81,655,603; (d) 173,369,334; (e) 187,046,811; (f) 807,358,025 Line 8 - column: (f) 807,358,025 Line 9 - column: (a) 205,326,944; (b) 159,959,333; (c) 81,655,603; (d) 173,369,334; (e) 187,046,811; (f) 807,358,025 Line 10a - column: (a) 713,259; (b) 1,664,637; (c) 1,127,888; (d) 1,216,540; (e) 1,544,624; (f) 6,266,948 Line 10c - column: (a) 713,259; (b) 1,664,637; (c) 1,127,888; (d) 1,216,540; (e) 1,544,624; (f) 6,266,948 Line 11 - column: (a) 410,742; (b) 783,554; (c) 718,178; (d) 1,230,289; (e) 673,203; (f) 3,815,966 Line 13 - column: (a) 206,450,945; (b) 162,407,524; (c) 83,501,669; (d) 175,816,163; (e) 189,264,638 ; (f) 817,440,939 Line 15: 99.00% Line 16: 99.02% Line 17: 0.77% Line 18: 0.63% Line 19a: X Line 19b: X Part IV, Section A Line 1: Yes Line 2: No Line 3a: No Line 4a: No Line 5a: Yes Line 5b: No Line 5c: No Line 6: No Line 7: No Line 8: No Line 9a: No Line 9b: No Line 9c: No Line 10a: No Line 11a: No Line 11b: No Line 11c: No Part IV, Section C Line 1: Yes
Schedule A (Form 990 or 990-EZ) 2020


Additional Data


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

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Name of the organization
Sanford Group Return
 
Employer identification number

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






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
Name of organization
Sanford Group Return
 
Employer identification number
45-3791176
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 3
Name of organization
Sanford Group Return
 
Employer identification number

45-3791176
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 4
Name of organization
Sanford Group Return
 
Employer identification number

45-3791176
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2020

Schedule C (Form 990 or 990-EZ) 2020
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2017 (b) 2018 (c) 2019 (d) 2020 (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) 2020


Schedule C (Form 990 or 990-EZ) 2020
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
215,001
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
698,126
j
Total. Add lines 1c through 1i ....................................................................................................
913,127
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: The filing organization has memberships in the Alliance for 340B, South Dakota Association of Healthcare Organizations, North Dakota Hospital Association, Minnesota Hospital Association, Iowa Hospital Association, American Hospital Association, North Dakota Long Term Care Association, North Dakota Medical Group Management Association,Iowa Alliance in Home Care and Health Policy Consortium. A percentage of membership dues paid to these organizations relate to lobbying expenses. In addition, the organization employs certain individuals, and contracts with various lobbyists, to monitor legislative acts important to all Sanford entities on both state and national levels. Occasionally, Sanford employees send mailings to legislators on issues that may affect healthcare.
Schedule C (Form 990 or 990EZ) 2020


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 89,216,166 84,843,272 63,648,688 60,166,967 62,584,497
b Contributions ... 3,360,625 4,372,894 21,194,584 4,233,247 -2,436,209
c Net investment earnings, gains, and losses         18,679
d Grants or scholarships ... 574,611     751,526  
e Other expenditures for facilities
and programs ...
         
f Administrative expenses .... 67        
g End of year balance ...... 92,002,112 89,216,166 84,843,272 63,648,688 60,166,967
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Term endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .......................
3a(i)
 
No
(ii) Related organizations .......................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   120,278,346 120,278,346
b Buildings ....   1,629,683,858 705,426,959 924,256,899
c Leasehold improvements   78,964,294 49,691,812 29,272,482
d Equipment ....   1,685,746,177 1,068,990,392 616,755,785
e Other .....   44,727,678 28,163,957 16,563,721
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,707,127,233
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)Non-operating property 86,596,766
(2)Deferred compensation assets held for investment 171,037,326
(3)Other assets 20,837,888
(4)Enhanced Benefits 2,430,121
(5)Interest Receivable 34,059
(6)Right of Use Asset 60,369,955
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 341,306,115
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 297,971,594
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) 2020

Schedule D (Form 990) 2020
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part IV, Line 2b: Long term care facilities hold security deposits for tenants.
Part V, Line 4: Sanford Health Foundation, Sanford Health Foundation North, Sanford Health Foundation Hillsboro, Sanford Health Foundation of Northern Minnesota, Sandford Health Foundation of Thief River Falls and Sanford Health Foundation West hold endowment funds on behalf of the filing organization to be used for assistance in its activities and for providing health care, medical, or educational services.
Part X, Line 2: Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Group did not have a material income tax liability at December 31, 2020; some related organizations have established reserves.
Schedule D (Form 990) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
East Asia and the Pacific 0 0 Program Services Clinic operations (China), Investigation of potential additional clinic sites (New Zealand, Australia, Vietnam, Japan) 76,000
Sub-Saharan Africa 0 0 Program Services Clinic operations (Ghana) 3,107,000
Central America and the Caribbean 0 1 Program Services Investigation and support of new clinic site (Costa Rica) 98,000
Europe (Including Iceland & Greenland) 0 0 Program Services Clinic operations (Germany), Investigation of potential clinic sites (Ireland, Norway) 188,000
Middle East and North Africa 0 0 Program Services Travel, purchased goods and services 2,000
North America - Canada and Mexico 0 0 Program Services Investigation of potential clinic site (Mexico), purchased goods and services 9,000
East Asia and the Pacific 0 0 Investments China investments, beginning in 2014 800,000
Europe (Including Iceland & Greenland) 0 0 Investments Germany investments beginning in 2015 11,931,000
Sub-Saharan Africa 0 0 Investments Ghana investments, beginning in 2012 4,222,000
East Asia and the Pacific 0 0 Investments New Zealand investments, beginning in 2019 800,000
Middle East and North Africa 0 0 Investments Israel investments, beginning in 2018 1,300,000
North America - Canada and Mexico 0 0 Investments Mexico investments, beginning in 2019 250,000
           
           
           
           
           
3a Sub-total .... 0 1 16,211,000
b Total from continuation sheets to Part I ... 0 0 6,572,000
c Totals (add lines 3a and 3b) 0 1 22,783,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2020
Schedule F (Form 990) 2020
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
East Asia and the Pacific General Support 231,505 Bank Transfer     Cost
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
1
3 Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2020
Schedule F (Form 990) 2020Page 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) 2020
Schedule F (Form 990) 2020
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2020
Schedule F (Form 990) 2020
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
Part I, Line 2: Prior to disbursement all grant fund requests are reviewed to ensure the receiving organization and proposed use of funds align with Sanford's mission. Grants are disbursed by the organization only after the expenditure has been made and properly authorized by the organization along with related documentation to ensure the funds are not diverted for non-charitable use.
Part III Accounting Method:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2020
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    92,732,689 0 92,732,689 2.110 %
b Medicaid (from Worksheet 3, column a) . . . . .     592,684,292 393,314,659 199,369,633 4.540 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     685,416,981 393,314,659 292,102,322 6.650 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     12,078,191 554,595 11,523,596 0.260 %
f Health professions education (from Worksheet 5) . . .     18,783,445 3,498,697 15,284,748 0.350 %
g Subsidized health services (from Worksheet 6) . . . .     561,824,417 455,396,954 106,427,463 2.420 %
h Research (from Worksheet 7) .     55,810,083 47,146,716 8,663,367 0.200 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     40,288,252 0 40,288,252 0.920 %
j Total. Other Benefits . .     688,784,388 506,596,962 182,187,426 4.150 %
k Total. Add lines 7d and 7j .     1,374,201,369 899,911,621 474,289,748 10.800 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     100,000 0 100,000 0 %
2 Economic development     1,536 0 1,536 0 %
3 Community support     430,459 2,970 427,489 0.010 %
4 Environmental improvements     34,000 0 34,000 0 %
5 Leadership development and
training for community members
    1,167 0 1,167 0 %
6 Coalition building     4,227 0 4,227 0 %
7 Community health improvement advocacy     83,285 0 83,285 0 %
8 Workforce development     39,335 0 39,335 0 %
9 Other     0 0    
10 Total     694,009 2,970 691,039 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
55,080,234
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
869,170,146
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
957,173,174
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-88,003,028
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
11 Everist Health
 
Prevention of heart and cardiovascular disease through unique medical tech 22.840 % 15.340 %  
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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?24Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Sanford USD Medical Center
1305 W 18th Street
Sioux Falls,SD57117
www.sanfordhealth.org
SD 10564
Sanford Medical Center
460227855
X X X X     X     A
2 Sanford Medical Center Fargo
5225 23rd Avenue S
Fargo,ND58104
www.sanfordhealth.org
ND 5070
Sanford Medical Center Fargo
450226909
X X X X     X     A
3 Sanford Broadway Medical Center Fargo
801 Broadway North
Fargo,ND58122
www.sanfordhealth.org
ND 5018A
Sanford Medical Center Fargo
450226909
X X X X     X     A
4 Sanford Medical Center South University
1720 South University
Fargo,ND58103
www.sanfordhealth.org
ND 5068A
Sanford Medical Center Fargo
450226909
X X   X           A
5 Sanford Bismarck Medical Center
300 N 7th Street
Bismarck,ND58501
www.sanfordhealth.org
ND 5003A
Sanford Bismarck
450226700
X X   X     X     A
6 Sanford Bemidji Medical Center
1300 Anne Street NW
Bemidji,MN56601
www.sanfordhealth.org
MN 371073
Sanford Health of Northern Minnesota
411266009
X X         X     A
7 Sanford Medical Center Thief River Falls
3001 Sanford Parkway
Thief River Falls,MN56701
www.sanfordhealth.org
MN 371500
Sanford Health Network North
450409348
X X     X   X   Inpatient Mental Health A
8 Sanford Aberdeen Medical Center
2905 3rd Avenue SE
Aberdeen,SD57401
www.sanfordhealth.org
SD 65089
Sanford Health Network
460388596
X X         X     A
9 Sanford Worthington Medical Center
1018 6th Avenue
Worthington,MN56187
www.sanfordhealth.org
MN 371449
Sanford Health Network
460388596
X X         X     A
10 Sanford Sheldon Medical Center
118 N 7th Avenue
Sheldon,IA51201
www.sanfordhealth.org
IA 161381
Sanford Health Network
460388596
X X     X   X   Nursing Facility A
11 Sanford Vermillion Medical Center
20 S Plum Street
Vermillion,SD57069
www.sanfordhealth.org
SD 53082
Sanford Health Network
460388596
X X     X   X   Nursing Facility A
12 Sanford Chamberlain Medical Center
300 S Byron Blvd
Chamberlain,SD57325
www.sanfordhealth.org
SD 50302
Sanford Health Network
460388596
X X     X   X   Nursing Facility A
13 Sanford Luverne Medical Center
1600 N Kniss Avenue
Luverne,MN56156
www.sanfordhealth.org
MN 371352
Sanford Health Network
460388596
X X     X   X     A
14 Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220
www.sanfordhealth.org
MN 371019
Sanford Health Network
460388596
X X     X   X   Nursing Facility A
15 Sanford Jackson Medical Center
1430 N Highway
Jackson,MN56143
www.sanfordhealth.org
MN 371002
Sanford Health Network
460388596
X X     X   X     A
16 Sanford Tracy Medical Center
251 5th Street E
Tracy,MN56175
www.sanfordhealth.org
MN 371440
Sanford Health Network
460388596
X X     X   X     A
17 Sanford Hillsboro Medical Center
12 3rd Street SE
Hillsboro,ND58045
www.sanfordhealth.org
ND 5026A
Sanford Health Network North
450409348
X X     X   X     A
18 Sanford Medical Center Mayville
42 6th Avenue SE
Mayville,ND58257
www.sanfordhealth.org
ND 5034A
Sanford Health Network North
450409348
X X     X   X     A
19 Sanford Webster Medical Center
1401 W 1st Street
Webster,SD57274
www.sanfordhealth.org
SD 10573
Sanford Health Network
460388596
X X     X   X     A
20 Sanford Medical Center Wheaton
401 12th Street N
Wheaton,MN56296
www.sanfordhealth.org
MN 371390
Sanford Health Network North
450409348
X X     X   X     A
21 Sanford Bagley Medical Center
203 4th Street NW
Bagley,MN56621
www.sanfordhealth.org
MN 371484
Sanford Health of Northern Minnesota
411266009
X X     X   X     A
22 Sanford Canton-Inwood Medical Center
440 N Hiawatha Drive
Canton,SD57013
www.sanfordhealth.org
SD 51569
Sanford Health Network
460388596
X X     X   X     A
23 Sanford Clear Lake Medical Center
701 3rd Avenue S
Clear Lake,SD57226
www.sanfordhealth.org
SD 10533
Sanford Health Network
460388596
X X     X   X     A
24 Sanford Westbrook Medical Center
920 Bell Avenue
Westbrook,MN56183
www.sanfordhealth.org
MN 371439
Sanford Health Network
460388596
X X     X   X     A
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.sanfordhealth.org/about/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
see narrative for full url
b
see narrative for full url
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Part V, Section B Facility Reporting Group A
Facility Reporting Group A consists of: - Facility 1: Sanford USD Medical Center, - Facility 3: Sanford Broadway Medical Center Fargo, - Facility 4: Sanford Medical Center South University, - Facility 5: Sanford Bismarck Medical Center, - Facility 6: Sanford Bemidji Medical Center, - Facility 7: Sanford Medical Center Thief River Falls, - Facility 8: Sanford Aberdeen Medical Center, - Facility 9: Sanford Worthington Medical Center, - Facility 10: Sanford Sheldon Medical Center, - Facility 11: Sanford Vermillion Medical Center, - Facility 12: Sanford Chamberlain Medical Center, - Facility 13: Sanford Luverne Medical Center, - Facility 14: Sanford Canby Medical Center, - Facility 15: Sanford Jackson Medical Center, - Facility 16: Sanford Tracy Medical Center, - Facility 17: Sanford Hillsboro Medical Center, - Facility 18: Sanford Medical Center Mayville, - Facility 19: Sanford Webster Medical Center, - Facility 20: Sanford Medical Center Wheaton, - Facility 21: Sanford Bagley Medical Center, - Facility 22: Sanford Canton-Inwood Medical Center, - Facility 23: Sanford Clear Lake Medical Center, - Facility 24: Sanford Westbrook Medical Center, - Facility 2: Sanford Medical Center Fargo
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 6a: Sanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well-Being - Skilled Labor ForceAccording to the Council on Social Work Education, public policies that promote financial literacy, accessible financial products/economic resources, and opportunities to generate income and build assets help economic wellbeing. Sanford has developed a plan to provide various labor opportunities in the community. Priority 2: Mental/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Depression is one of the most common mental disorders in the U.S. and is caused by many factors. It is also among the most treatable of mental disorders. (National Institute of Mental Health)Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearEconomic Well-Being:In 2020, Sanford USD Medical Center (SUSDMC) continued a comprehensive approach to improve the economic well-being of our community. This included partnerships with higher education organizations for internships, LPN sponsorships, scholarships, residencies, and fellowships, along with supporting our workforce during the COVID pandemic. Educational OpportunitiesIn 2020, we sponsored 55 LPNs and 60 MAs (six through our traditional sponsorship and 54 through MedCerts). Our Certified Medical Assistance Program includes coverage of tuition with a 2-year work commitment. The Sanford Sons and Daughters program includes 273 people in physician education; who are in medical school, a residency, or a fellowship and they receive support including scholarships. The Heart of Tomorrow program provided scholarships of $1,000 to 100 high school or college aged children of Sanford employees. Sanford supports residencies in pediatrics and general surgery, and fellowships in cardiology and interventional cardiology. We partner with other health care facilities for residencies in internal medicine, pathology, transitional year, and family medicine. All programs continue at full capacity.Sanford began a nurse residency program, a 12-month training program to support the transition from student nurse to professional registered nurse. 409 RNs have graduated from the program with 620 in progress. Sanford also supports a student nurse internship, a 10-week summer program offering hands-on experience and professional guidance.Sanford partnered with local organizations to launch Classrooms to Careers for Sioux Falls high school students, to promote post-secondary education. Students earn dual credit from courses taught at Southeast Technical College. A multitude of resources are available for students to develop post-secondary education support/plans. There are now 37 students in this program, and plans for significant growth.Workforce SupportSanford Health is proud to have maintained and supported our workforce through COVID. We created the Sanford Family Stability Plan which offered a stability payment and covered health insurance premiums for those most affected by the pandemic. The Sanford Family also helped our own by making considerable contributions to the PTO donation bank and Employee Crisis Fund.To meet workforce demands, a streamlined just-in-time training program was developed with customized curriculums enabling employees to cross-train and work outside of their current role confidently and safely. During peak COVID additional nursing staff was hired. Finally, Sanford provided childcare to support our workforce and maintain adequate levels of staffing for healthcare workers and first responders during COVID-19 challenges, in partnership with the Sioux Falls School District and Avera.Behavioral Health and Mental Health Access:Sanford Sioux Falls continues to improve access to mental/behavioral health needs. Integrative Health Therapists are in each primary care clinic. PHQ-9 depression remission performance consistently exceeds the national benchmark. Sanford health effectively utilizes the integrated care model at the SUSDMC. In addition, telehealth utilization has increased.The mental/behavioral health team continues to grow. The Psychiatry and Psychology Clinic currently has 25 total providers, 2 adult psychiatrists, 3 child and adolescent psychiatrists, 6 APPs, 6 Psychologists, and 8 Behavioral Health Therapists.There are 24 Integrated Health Therapists in the region including 7 IHTs in Sioux Falls Primary Care Clinics, 2 IHTs covering specialty clinics, 1 IHT covering Oncology, 11 Network IHTs, and 3 Behavioral Health Therapists covering primary care locations in Sioux Falls. Two new IHT's will be starting April 2021 in Sioux Falls. Sanford has collaborated with the City of Sioux Falls, Minnehaha County, and Avera Health to create The Community Triage Center. It will be a voluntary and involuntary commitment mid-level care alternative for those with substance/alcohol abuse, along with potential mental illness co-morbidities who are non-violent. It is scheduled to open June 2021.In addition to In addition to a robust employee assistance program, the Clinician Well-Being Program has been expanded to support clinicians, residents, and fellows as they face unique challenges and stress. The program resources include, a WorkLife Concierge virtual assistant available 24/7, as well as access to peer coaching, mentoring, and free confidential counseling.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.SUSDMC created an incident command center and prepared a comprehensive surge plan. Modeling enabled leadership to make data-driven decisions in real time, supported by state/city models and the analytics team. Sanford addressed needs for PPE, equipment, beds, staffing, and other critical items. Other responses included reduced entrances at the medical center, employee/patient temperature screening, visitor restriction policy, converting to negative airflow rooms, floor graphics to remind patients and staff to social distance, Plexiglas shields for patient registration and scheduling, and limited elective surgeries to preserve PPE were implemented.Virtual visit volume increased significantly. Sanford also supported the Sioux Falls area with timely testing, infusion centers, a patient registry, and clinical trial opportunities. SUSDMC was a tertiary care destination center during the pandemic, fielding and caring for patients from across the region. Community education has been foundational to our COVID response. Dr. Mike Wilde has provided the community with regular COVID updates including City of Sioux Falls Emergency Operations Center press briefings, conversations with state and local leaders regarding vaccination planning, and community presentations at events such as the Chamber of Commerce and Rotary Club meetings. The SMC leadership team held around 30 pre-recorded employee town halls and a live town hall on vaccines, many Facebook Live events, and offered expert information on Sanford Health News site.Identified needs not directly addressed by this facility include: Economic- Need for affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and concern for homelessnessTransportation- Need for door-to-door transportation for community members who do not drive, and the availability of public transportationAging- Cost of long term care and memory careChild and Youth- Substance abuse by youth, childhood obesity, availability of services for at-risk youth, bullying, crime committed by youth, and teen suicideSafety- Abuse of prescription drugsAccess to Health Care- Availability of behavioral health providers, availability of mental health providers, access to affordable prescription drugs, and access to affordable healthcare
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccess to affordable health care is important to overall health. Health insurance, local care options, and a usual source of care can ensure access to health care. Access to care makes it easier to enter the health care system, find local care easily, pay for care, and get health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services so patients can secure timely appointments.Priority 2: Mental/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearHealthcare AccessIn 2020, Sanford was successful in adding access by recruiting additional Behavioral Health providers including; a MD adult psychiatrist, a PhD child psychologist, an APP in adult psychiatry, and Six Integrated Health Therapists.The Tele-behavioral health pilot project in schools launched in spring of 2020. After initial enrollment of two children, the schools in Fargo/Moorhead were shut down and additional enrollment of children was put on hold. The enrolled children were able to complete the program in their homes. The pilot project re-launched in fall of 2020 with 20 kids enrolled. Due to hybrid/virtual learning in schools, the pilot remained on hold until early 2021. Sanford Fargo also began efforts to increase walk in hours and weekend hours but due to COVID those efforts have been put on hold.In 2020, Sanford primary care added access to clinics by recruiting additional Family Medicine and Internal Medicine providers including: 1 APP and 4 MD's in family medicine, and 1 APP and 1 MD in internal medicine.In 2019, the Advanced Practice Fellowship was launched to promote role expansion of Advanced Practice Providers to improve access. The program is a one-year training program for nurse practitioners and physician assistants who have completed their primary training program and are licensed providers. We offer rotations in primary and specialty care for a year. Rural community options are included. Fellows are assigned a preceptor and they see 4-6 patients per day. The fellows practice within primary care clinics to learn the collaborative care practice model with our primary care physicians. However, the fellowship was delayed from August 2020 to January 2021 because of COVID.We opened a Post Hospital transition clinic 6 days a week for medically complex patients that were discharged from the hospital. With care management, social work, integrated health therapists and pharmacists. Now patients could be seen very soon after their discharge.The Pediatric Mental Health Care Access Program is a Sanford project that focuses on collaborative care opportunities for pediatric medical providers to enhance treatment of pediatric mental health difficulties in North Dakota. In this program, primary care providers receive training, mental health education, and expert consultation on treating mental health conditions in children. The program collaborates with the University of North Dakota School of Medicine and Health Sciences and the North Dakota Department of Health. It's funded by the Health Resource Services Administration.Mental Health and Substance Abuse Sanford Health began collaborating with a F5, a Fargo-based peer-to-peer substance abuse support program provider in 2019. The program began in August 2020 and is offered twice per week to inpatients detoxing from alcohol and other substances. Patients are encouraged to meet in a group setting. Outcomes that are measured include re-admission rates, emergency visits, and EMS encounters. At our Suboxone clinic, we are working towards co-prescribing Narcan with any opioid prescription. This is the next step in the effort to decrease deaths by overdose in our community. IHT services have increased in our clinics. Sanford Fargo now has 10 IHTs in primary care clinics, increasing from 9 in 2019. On average IHTs see five patients per day to assess and refer to medical detox or the withdrawal management unit.Sanford Fargo increased the number of medication assisted treatment certified providers in 2019. Five physicians received waivers to prescribe suboxone after completing an 8-hour training course. The program launched in early 2020 and five participants went through the treatment. Outcomes set to be measured include re-admission rates, number of emergency department visits, EMS encounters and rate of peer-to-peer group attendance (goal 50% attendance) for a six-month period beginning July 2020.Patient Health Questionnaires are used to assess patients and refer them to an IHT if needed. This process was disrupted due to COVID. Mental Health First Aid Training was paused in 2020 due to COVID. It will be replaced with BeHeard which has the capacity to be delivered both in-person and virtually.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in their ranking of states with the best vaccination rates.Sanford Fargo offered a home monitoring program for COVID positive patients and monitored patients' oxygen saturation levels, temperature, and symptoms. We also opened a drive through COVID-19 testing center. In 2020, 44,757 COVID-19 tests were conducted in the drive through garage. Early in COVID Sanford Fargo Transitioned to video visits. Over 65 iPads were deployed to all Primary Care and Behavioral Health providers to accommodate the shift. Video or in-person patient visits continue to be offered as a choice to patients.With partnership with local public health, area businesses, and other healthcare organizations two COVID vaccination centers opened in the Fargo/Moorhead community. Sanford Fargo vaccinated 4,539 employees during 2020. Public vaccine centers are opening in early 2021. Developed by the Sanford Center for Biobehavioral Research and the Behavioral Health Department Reach for Resilience is a mental health education, support, and consultation service for healthcare professionals suffering from mental health difficulties during the COVID-19 pandemic. Sanford also worked collaboratively to develop a webpage to provide information about the stresses and risks of the pandemic for mental health, adaptive coping techniques, resources for mental health and more.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, hunger, homelessness, and need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violenceTransportation - Need for door-to-door transportation for community members.Aging - Cost of long-term care and memory care, cost of in-home services, availability of resources for family and friends caring for elders, availability of resources to help the elderly stay safe in their homesChildren and Youth - Availability and cost of services for at-risk youth, cost and availability of quality childcare, substance abuse by youth, teen suicide, childhood obesity, and bullyingSafety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, child abuse and neglect, sex trafficking, and presence of street drugsCost of long term/memory care- Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccess to affordable health care is important to overall health. Health insurance, local care options, and a usual source of care can ensure access to health care. Access to care makes it easier to enter the health care system, find local care easily, pay for care, and get health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services so patients can secure timely appointments.Priority 2: Mental/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearHealthcare AccessIn 2020, Sanford was successful in adding access by recruiting additional Behavioral Health providers including; a MD adult psychiatrist, a PhD child psychologist, an APP in adult psychiatry, and Six Integrated Health Therapists.The Tele-behavioral health pilot project in schools launched in spring of 2020. After initial enrollment of two children, the schools in Fargo/Moorhead were shut down and additional enrollment of children was put on hold. The enrolled children were able to complete the program in their homes. The pilot project re-launched in fall of 2020 with 20 kids enrolled. Due to hybrid/virtual learning in schools, the pilot remained on hold until early 2021. Sanford Fargo also began efforts to increase walk in hours and weekend hours but due to COVID those efforts have been put on hold.In 2020, Sanford primary care added access to clinics by recruiting additional Family Medicine and Internal Medicine providers including: 1 APP and 4 MD's in family medicine, and 1 APP and 1 MD in internal medicine.In 2019, the Advanced Practice Fellowship was launched to promote role expansion of Advanced Practice Providers to improve access. The program is a one-year training program for nurse practitioners and physician assistants who have completed their primary training program and are licensed providers. We offer rotations in primary and specialty care for a year. Rural community options are included. Fellows are assigned a preceptor and they see 4-6 patients per day. The fellows practice within primary care clinics to learn the collaborative care practice model with our primary care physicians. However, the fellowship was delayed from August 2020 to January 2021 because of COVID.We opened a Post Hospital transition clinic 6 days a week for medically complex patients that were discharged from the hospital. With care management, social work, integrated health therapists and pharmacists. Now patients could be seen very soon after their discharge.The Pediatric Mental Health Care Access Program is a Sanford project that focuses on collaborative care opportunities for pediatric medical providers to enhance treatment of pediatric mental health difficulties in North Dakota. In this program, primary care providers receive training, mental health education, and expert consultation on treating mental health conditions in children. The program collaborates with the University of North Dakota School of Medicine and Health Sciences and the North Dakota Department of Health. It's funded by the Health Resource Services Administration.Mental Health and Substance Abuse Sanford Health began collaborating with a F5, a Fargo-based peer-to-peer substance abuse support program provider in 2019. The program began in August 2020 and is offered twice per week to inpatients detoxing from alcohol and other substances. Patients are encouraged to meet in a group setting. Outcomes that are measured include re-admission rates, emergency visits, and EMS encounters. At our Suboxone clinic, we are working towards co-prescribing Narcan with any opioid prescription. This is the next step in the effort to decrease deaths by overdose in our community. IHT services have increased in our clinics. Sanford Fargo now has 10 IHTs in primary care clinics, increasing from 9 in 2019. On average IHTs see five patients per day to assess and refer to medical detox or the withdrawal management unit.Sanford Fargo increased the number of medication assisted treatment certified providers in 2019. Five physicians received waivers to prescribe suboxone after completing an 8-hour training course. The program launched in early 2020 and five participants went through the treatment. Outcomes set to be measured include re-admission rates, number of emergency department visits, EMS encounters and rate of peer-to-peer group attendance (goal 50% attendance) for a six-month period beginning July 2020.Patient Health Questionnaires are used to assess patients and refer them to an IHT if needed. This process was disrupted due to COVID. Mental Health First Aid Training was paused in 2020 due to COVID. It will be replaced with BeHeard which has the capacity to be delivered both in-person and virtually.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in their ranking of states with the best vaccination rates.Sanford Fargo offered a home monitoring program for COVID positive patients and monitored patients' oxygen saturation levels, temperature, and symptoms. We also opened a drive through COVID-19 testing center. In 2020, 44,757 COVID-19 tests were conducted in the drive through garage. Early in COVID Sanford Fargo Transitioned to video visits. Over 65 iPads were deployed to all Primary Care and Behavioral Health providers to accommodate the shift. Video or in-person patient visits continue to be offered as a choice to patients.With partnership with local public health, area businesses, and other healthcare organizations two COVID vaccination centers opened in the Fargo/Moorhead community. Sanford Fargo vaccinated 4,539 employees during 2020. Public vaccine centers are opening in early 2021. Developed by the Sanford Center for Biobehavioral Research and the Behavioral Health Department Reach for Resilience is a mental health education, support, and consultation service for healthcare professionals suffering from mental health difficulties during the COVID-19 pandemic. Sanford also worked collaboratively to develop a webpage to provide information about the stresses and risks of the pandemic for mental health, adaptive coping techniques, resources for mental health and more.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, hunger, homelessness, and need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violenceTransportation - Need for door-to-door transportation for community members.Aging - Cost of long-term care and memory care, cost of in-home services, availability of resources for family and friends caring for elders, availability of resources to help the elderly stay safe in their homesChildren and Youth - Availability and cost of services for at-risk youth, cost and availability of quality childcare, substance abuse by youth, teen suicide, childhood obesity, and bullyingSafety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, child abuse and neglect, sex trafficking, and presence of street drugsCost of long term/memory care- Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccording to County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services. It is Sanford's goal that barriers to accessing health insurance coverage are reduced.Priority 2: Behavioral Health and Substance AbuseThe Substance Abuse and Mental Health Services Administration reports that "Mental and substance use disorders can have a powerful effect on the health of individuals, their families, and their communities. In 2014, an estimated 22.5 million Americans age 12 and older self-reported needing treatment for alcohol or illicit drug use, and 11.8 million adults self-reported needing mental health treatment or counseling in the past year."Sanford has made behavioral health and substance abuse a priority and developed strategies to reduce negative outcomes from mental/substance abuse disorders.Addressing of Significant Needs during Current YearAccess to Affordable CareSanford Health has integrated onsite financial advocates who specialize in healthcare coverage enrollment to help community members secure access to healthcare services. They help Sanford patients as well as community referrals. Individuals unable to secure healthcare coverage and facing medical bills they cannot afford are referred to Sanford's financial assistance program. FAP worked with patients and their families to reduce medical bills, eliminating a portion of or all of their charges. In total, Sanford Bismarck offered over $18.1 million to patients and families unable to pay their medical bills.To help homeless people access healthcare services and prescription medications, Sanford works with shelter residents to apply for and secure healthcare coverage through the state's Medicaid program. Through partnerships with Mandan Public Health, Bismarck/Burleigh Public Health, United Way and the local homeless shelter coalition, we have helped at-risk community members secure healthcare coverage, healthcare services and prescription medications.Often, patients who do not qualify for public assistance do not make enough money to afford the prescriptions they need to get well and stay well. We have helped these patients enroll in Marketplace health plans and provide financial assistance to help cover income gaps. In total, Sanford Bismarck assisted 895 individuals to secure healthcare coverage. When a patient temporarily is unable to afford the medications they need due to extenuating circumstances, e.g., sudden loss of employment, Sanford's Foundation assists them through a fund established to help community members. Sanford helped 800 patients to get the prescription medicine they needed but could not afford. Additionally, Sanford helped these individuals connect to vital community services necessary to regain their health, wellbeing, and financial independence. Meal vouchers, lodging, gas cards, and transportation were also provided to 355 patients. Three hundred new and expecting moms identified at risk for not having enough food received free meals and were connected to community food pantry resources.Behavioral Health and Substance Use Disorder Continuum of CareSanford Bismarck continued its partnership with Heartview, an addiction services provider, to help 11 expecting moms suffering from substance use disorder participate in medication-assisted treatment programming. Sanford and the Bismarck Public Schools expanded our partnership to provide behavioral health services onsite at Simle Middle School. In 2020, Sanford provided nearly 500 onsite visits for at-risk middle school students. During the summer, Sanford continued to see the students, providing video appointments to allow for continued care despite COVID-19. In the fall of 2020, Sanford expanded to a second school and will add a third school in the fall of 2021. Sanford's opioid stewardship program continues to reduce the volume of opioids prescribed to patients. In 2020 Sanford Bismarck further reduced both the number of opioid prescriptions and volume of tablets prescribed. The number of prescriptions dropped six percent (from 9,139 to 8,610 scripts) and the total number of tablets prescribed dropped nine percent (from 498,617 to 454,617 tablets). In total, Sanford Bismarck has decreased the number of prescriptions by nearly 40 percent and the number of tablets prescribed in half. Sanford Bismarck continued the partnership with Bismarck/Burleigh County behavioral health task force, a stakeholder group established to identify and address gaps in the community's substance abuse and behavioral health continuum of care. Additionally, Sanford joined the Bismarck/Burleigh Drug-Free Communities Task Force, representing community healthcare providers.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December, 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources across our footprint. Sanford evaluated more than 100 clinical trials for patient's treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Bismarck provided training to area community access hospitals (CAHs), teaching rural healthcare providers how to care for lower acuity COVID-positive patients. The training was beneficial in many ways. By helping rural providers to be better able to care for patients with COVID, smaller hospitals were able to provide care close to home for more community members and the CAHs helped offload patients when Sanford Bismarck was at 100 percent capacity. Sanford Bismarck offered a COVID-19 Hotline when it created a 24/7 call-in number for rural healthcare providers to call when they needed guidance on how to care for COVID-19 patients and know when the patient's acuity warranted a transfer to a Bismarck hospital. Supply chain offered support by providing personal protective equipment to smaller facilities having difficulty securing PPE at the height of North Dakota's patient surge. Sanford staff worked with community organizations to provide input on how to safely host events and provided updates on COVID precautions and vaccinations throughout the PHE. Telemedicine and phone visits were offered as much as possible to increase access to care. Sanford Bismarck also supported COVID-19 efforts through donations. Backpacks were provided to all second graders attending Bismarck's neediest elementary schools. Each backpack contained a hat, gloves, scarf, lunch bag, water bottle and a grocery store gift card. In partnership with Great Plains Food Bank, the Sanford administration team staffed a food bank drive-thru event for community members in need. The event provided boxes of groceries that included milk and fresh fruit and vegetables to more than 200 vehicles and impacting more than 800 people in need. Identified needs not directly addressed by this facility include:Economic - Homelessness, need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, affordable housing and hunger Aging Population - Cost of long term care, cost of memory care, and the cost of in-home servicesChildren and Youth - Cost and availability of quality childcare, substance abuse by youth, childhood obesity, teen suicide, availability and cost of services for at-risk youth, bullying, and teen tobacco use Crime/Safety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, presence of street drugs, child abuse and neglect, sex trafficking, and criminal activity
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well-BeingEconomic well-being factors can largely affect someone's physical and mental health, positively or negatively. Sanford Health has developed a strategic plan to address economic well-being of the Bemidji area alongside community leaders.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Depression is one of the most common mental disorders in the U.S. and is caused by many factors. It is also among the most treatable of mental disorders. (National Institute of Mental Health)Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearEconomic Well-BeingEvery year Sanford provides donations and sponsorships to numerous organizations in the area. Sanford Bemidji continued to develop the Sanford Health Kids Initiative addressing opportunities and partnerships for at-risk youth.In Bemidji one in five local children do not get enough to eat. Sanford Health, with Bemidji School District, and United Way of Bemidji took steps in 2019 to change that fact. The three organizations created a program called No Hungry Kids. Sanford Health made a 5 year $405,000 commitment to the program. It grew United Way's Backpack Buddies program and funded the school's Angel fund which covers student lunch debt. Sanford Employees packaged food for this program. The partnership enabled United Way to expand the program to all elementary schools in the district, coordinate a summer program, and initiate a "pantry" program at schools and universities in the area. As part of our COVID-19 Community response, we expanded No Hungry Kids to Blackduck, Kelliher & Red Lake with the United Way. Sanford Bemidji also funded the Backpack Buddies that provided backpacks including necessary school supplies to over 200 kids in need. This was accomplished through Sanford funding and staff donations, and staff prepared backpacks.Sanford also launched a program in the Children's Clinic called Reach Out and Read to address literacy, where children are given age appropriate books to take home and read at checkups. Doctors and nurses will also speak with parents about the importance of reading to their child. Sanford Bemidji coordinated the program with a local elementary school so staff could come to the classroom to read to children and talk about the importance of reading. This program has been paused due to COVID-19 and visitor restrictions, but should restart fall, 21. Sanford helped expand Social Emotional Learning skills by partnering with Peacemaker Resources, Bemidji Area Service Collaborative and Bemidji Area Schools. The expansion gave kindergarten through 3rd grade teachers and students, Social Emotional Learning training, where they learn about, feelings, empathy, and more.Sanford Bemidji has played an active role in positioning the Bemidji community for enhanced economic growth and development. We helped align Greater Bemidji, the Bemidji Chamber of Commerce, Downtown Business Alliance, and Visit Bemidji and sponsored the Bemidji 2030 visioning process. We also meet with entrepreneurs and business people who have an interest in Bemidji.Early 2021, Sanford took an active role in engagement with the Ridgeway Neighborhood Initiative, in partnership with the local Rotary club. This group works to reduce crime and violence at the various apartment buildings in the neighborhood. The RNI Committee leases an apartment (funded by Sanford Health) as a Rotary Resource Room where resources, classes, and training will be offered to the Ridgeway tenants. Mental Health and Substance AbusePrimeWest Residental Treatment Center was completed. This center includes five crisis residential stabilization beds for short-term individualized mental health services, and five beds for intensive residential treatment services assisting patients in need of more focused structure and care. Because of COVID the detox portion of the program was paused.Sanford's First Steps to Healthy Families program offers intensive case management to families with children under the age of 5 who are impacted by substance abuse. Services are provided in partnership with Beltrami County. Sanford Bemidji is exploring the possibility of partnership to open a day center for the local homeless community. In this Sanford would donate the former Upper Mississippi Mental Health Clinic to a community partner so they could convert the building to a day center for the homeless. Sanford received a $3.9 million, 2-year grant from SAMHSA to expand behavioral health services. The grant will allow Behavioral Health to be fully integrated into Sanford Bemidji Medical Center using the Certified Community Behavioral Health Clinic (CCBHC) model. Improving access to all CCBHC required services would greatly benefit the community. Behavioral Health has all the components of what is required though there will be improvements. This grant funding will currently offset some of our existing overhead and services as well as fund coverage for the Medicaid, under insured and uninsured populations. Sanford was recently awarded a grant in the amount of $400,000 from the state of Minnesota. This grant will help provide homelessness prevention and rapid re-housing. Behavioral health services expansion in secondary markets is currently in the exploratory phases.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December, 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources across our footprint. Sanford evaluated more than 100 clinical trials for patient's treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Sanford Bemidji advanced telemedicine capacities and expanded telemedicine usage. We have seen the best telehealth results in behavioral health. We also started to offer "Drive Up Visits". The concept included having designated parking spaces in our lot where patients could drive up and a member of our staff would bring them a tablet and help them connect to their provider. If the patient needed to be seen in-person, the patient was able to come in and be directly placed into a patient room to see the provider. We will continue collaboration with Fargo and our other regions to provide extended telemedicine services to keep patient care close to home.Sanford Health and Public Health leadership came together to share updates on COVID-19 in our community through roundtable discussions. Leaders from Sanford Health also participated in several speaking panels in Bemidji, and nearby counties. Staff implemented weekly meetings with regional public school leaders as they navigated COVIDWe partnered with Bemidji Area Schools and Blackduck School District to offer flu shots for students at their schools after COVID impacted our flu shot distribution. Over 600 students were vaccinated, which we considered a huge success. We hope to continue this program in the future. Sanford Health donated $3 Million across our footprint to Feeding America and local food banks. The impact for our region was nearly $700,000. In addition, staff from SHNM volunteered their time to distribute food to nearly 1,200 families in Bemidji and Park Rapids at the mobile food drive events.Identified needs not directly addressed by this facility include: Economic- Need for affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and concern for homelessnessTransportation- Need for door-to-door transportation for community members who do not drive, and the availability of public transportationAging- Cost of long term care and memory careChild and Youth- Substance abuse by youth, childhood obesity, availability of services for at-risk youth, bullying, crime committed by youth, and teen suicideSafety- Abuse of prescription drugsAccess to Health Care- Availability of behavioral health providers, availability of mental health providers, access to affordable prescription drugs and to affordable healthcare
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Depression is one of the most common mental disorders in the U.S. and is caused by many factors. It is also among the most treatable of mental disorders. (National Institute of Mental Health)Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Priority 2: Children and YouthMinnesota has one of the highest rates of parents in the workforce. Quality childcare should be culturally and linguistically responsive and should be provided by engaged and caring child care providers. Quality childcare incorporates physical activity time and developmental screening practices, and follows food safety guidelines. In addition, quality child care should be easily accessible for all families, regardless of location or socioeconomic status. Inadequate child care can lead to a host of health problems in the child's life.Sanford has developed strategies to combat the negative effects of inadequate childcare in the community.Addressing of Significant Needs during Current YearMental Health and Substance AbuseIn 2019, Sanford Thief River Falls received approval for the development and implementation of a substance use disorder (SUD) service line, but implementation of the program is on hold due to COVID-19. Sanford Thief River Falls completed the renovation of the facility that will house the SUD program in late fall of 2020. Application for licensure through the Minnesota Department of Human Services (DHS) was submitted in November 2020. However, the licensing division of DHS has been operating at greatly reduced staffing levels due to the impact of the COVID-19 pandemic. The reduced capacity has delayed review of the license application and is currently under DHS review as of February 2021. No indication on the timing of a decision has been provided. The program will open and begin providing services as soon as the license is received.The BHS-6 behavioral health screening tool is one of several depression screening tools available to providers to assess a patient's mental health relative to depression. Currently only Sanford One Care Clinics are using the BHS-6 screening tool and all other Sanford clinics are using the PHQ-9 patient health screening tool. TRF is using the PHQ-9 which has been incorporated into the EMR medical record as a screening prompt for providers on an annual basis for all primary care patients.In CY19 TRF's primary care provider teams achieved an overall administration percentage rate in excess of 90% for the PHQ-9; well above the target of 80%. Upon completion of the PHQ-9 screening and based on the individuals score, the provider may recommend additional screenings and further clinical follow-up with a mental health professional. Sanford has an algorithm that outlines each step in the process.Children and YouthThe children and youth priority has been significantly impacted by the COVID-19 pandemic. Employers have not been willing nor engaged in the development of childcare options and strategies, primarily due to the masking, social distancing, and business closure mandates from the state of Minnesota.Children's Therapeutic Support Services (CTSS) is a flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention. The program is provided in all Thief River Falls schools to address the dangers of drugs in addition to other mental health issues. The CTSS program has also been impacted by the COVID-19 pandemic as most schools discontinued in-school learning and implemented distance learning structures; effectively removing children from the CTSS model of behavioral health services. Referrals and engagement decreased during the school shut down/distance learning. Sanford Thief River Falls implemented telehealth services and did more in-home work with families that were willing. Referrals have seen a marked increase since schools returned to in-person learning and we would expect a return to normal caseloads by the end of March 2021.Additionally, TRF behavioral health staff make themselves available and participate with law enforcement educating school age children regarding the Drug Abuse Resistance Education (DARE) program every year. COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December, 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources across our footprint. Sanford evaluated more than 100 clinical trials for patient's treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Thief River Falls implemented all recommended guidelines issued by the CDC and/or Sanford, including masking, social distancing, visitation restrictions, temping employees, patients, visitors, etc. All staff were also re-educated on proper donning and doffing of PPE.To minimize patient and staff exposure, Sanford Thief River Falls developed and implemented curbside Covid-19 testing protocols to provide testing of all Persons under Suspicion (PUI's) without having them enter any of our buildings.An entire 14-bed wing of the medical center was converted to negative pressure rooms utilizing grant dollars from the federal government - these were in advance of the Cares Act Funds.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, household budgeting and money management, need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic abuse, and a skilled labor workforce Aging - Cost of long-term care and the cost and availability of memory care, cost of in-home care, and the availability of resources for grandparents caring for their grandchildrenChildren and Youth - Childhood obesity, substance abuse by youth, availability and cost of services for at-risk youth, teen tobacco use, bullying, crime committed by youth, and opportunities for youth-adult mentoring Safety - Abuse of prescription drugs, presence of drug dealers, presence of street drugs, child abuse and neglect, criminal activity, and domestic violenceHealth care - access to affordable health insurance coverage, access to affordable healthcare, access to affordable prescription drugs, use of emergency room services for primary health care, availability of specialist physicians, availability of non-traditional hours, availability of behavioral health (substance abuse) providers, access to affordable dental coverage, and availability of mental health providersSanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the findings of the CHNA and the needs with community leaders and public health agencies in the area.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointmentsPriority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearHealth Care AccessSanford Aberdeen Medical Center (SAMC) is committed to helping community members understand their health care insurance options. Our goal is that no one in our service area is denied necessary health care services due to lack of coverage and/or insufficient coverage. In 2020, SAMC staff continued to utilize Sanford Health Plan's website and related information and resources to provide relevant insurance information for individuals and companies as needed. This information on coverage options allows consumers to compare Sanford Health Plan's options to see what is right for them. SAMC staff continue to work closely with both Sanford Health Plan representatives as well as various local insurance agents regarding access to a range of insurance products and services for anyone in need. Additionally, SAMC has a representative onsite who assists patients with reviewing health insurance options which includes our Community Care Program. Sanford Health has a webpage to help answer questions for patients and/or directs patients to a representative for assistance. https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/insurance-information Mental Health and Substance AbuseSAMC seeks to ensure that mental health services are available in Aberdeen and the surrounding area. We aim to achieve a reduction in opioid prescriptions. To this end, Sanford Aberdeen Clinic is offering telemedicine options for psychiatry services to increase overall access to mental health care. To identify need and ensure access to appropriate care, PCP visits include a questionnaire assessment tool that is aligned with Sanford Health enterprise protocols for screening. This approach is a more holistic manner by embedding an Integrated Health Therapist (IHT) in our primary care clinics. The IHT also offers ongoing education on services offered through primary care. In 2020, the IHT saw a total of 166 patients (Jan. - June). Volumes were less than expected due to COVID-19 and the IHT resigning end of June 2020. A replacement IHT joined the team at the end of December 2020 and patient volumes are anticipated to increase in 2021 due to enhanced access. Finally, staff and providers are routinely given updates to Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates. Locally, SAMC leadership provided education and updates through communication at city council meetings, Brown County Emergency Management - Incident Command meetings and through social media. Community groups and businesses, including schools, daycares, restaurants, and entertainment venues, were provided COVID safety education that allowed them to remain open throughout the pandemic and provide a safe environment for their students, children, and customers. Sanford Health also provided frequent Q&A sessions with communities to keep them updated and answer questions. Identified needs not directly addressed by this facility include:Economics - Need for a skilled labor forceChildren and Youth - Childhood obesity, and substance abuse by youthAging - Cost of long term care, cost of memory careSafety - abuse of prescription drugsSanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the results of the CHNA and the unmet needs with community leaders.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical Center
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccording to County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services. It is Sanford's goal that barriers to accessing health insurance coverage are reduced.Priority 2: WellnessThe Centers for Disease Control and Prevention reports that Americans seriously underuse preventive services. Chronic diseases account for 70% deaths among Americans and 75% of U.S. health spending. However these diseases are largely preventable/treatable. Eating healthy, exercising regularly, avoiding tobacco, and receiving preventive services such as cancer screenings, preventive visits and vaccinations help people stay healthy. Sanford has made wellness and chronic disease prevention a priority and developed strategies to promote and improve cancer and chronic disease screening in the community. Addressing of Significant Needs during Current YearHealthcare AccessThe Nobles County Oral Health Taskforce was formed in late 2019 to identify potential solutions to local dental challenges. The group completed a prioritization process called the "Results-Based Accountability Strategy" In which strategies and solutions were offered to stakeholders to rank based on 4 criteria: Leverage, Feasibility, Specificity, and Values.From this process, local dental solutions were identified that were realistic and attainable. The following strategies were selected: Create an oral hygiene education kit for childrenProvide oral health education Create a group to support oral health needs in a multitude of ways including resourcing, programs, and fundingDevelop health system intervention to address and coordinate the oral health needs of youth in the communityAn action plan was created and a follow-up meeting was scheduled for March, but focus quickly shifted to COVID-19, and the meeting was canceled. The dental taskforce has not yet reconvened, but remains a top priority for our community. In May 2020, Sanford Worthington initiated a Community Advisory Council. The council had a COVID focus to start, but has expanded beyond that to aid in improving healthcare access. Efforts were made by the local CAP agency to secure funding that would allow the Children's Dental Service (CDS) of Minnesota to continue to come to Worthington monthly in 2021. They are able to schedule appointments for many dental services, regardless of income or insurance status and most pay little to nothing for the service. Grants awarded by SWIF and the local healthcare foundation will fund CDS for the next year.WellnessTo advance Lung Cancer screening service and promotion, the Sanford Worthington team met early in 2020 to plan for launching a screening program. A contract with American College of Radiology was drafted, but COVID intervened before there was a chance to finalize. The team will re-initiate this by 3rd quarter of 2021. Sanford Worthington offers Radiation Oncology services with a multi-million dollar reinvestment to replace the linear accelerator completed in October 2020. The outcome is increased local access to curative radiation therapy due to upgraded equipment. Sanford Worthington has maintained solid heart and vascular screening numbers thought COVID. Colonoscopies have dropped in that same time and Sanford Worthington is making a push to increase them.At the end of 2019, seven local bilingual leaders were trained to teach the Living Well with Diabetes and Chronic Conditions classes, but no leaders were able to teach a class in 2020 due to COVID. Two classes were scheduled for early 2021. Meetings with Worthington primary care physicians took place to educate them about the program and teach them how to make an EPIC referral. So far, the Worthington physicians have submitted the most referrals of any other Sanford facility in the network, except for Sioux Falls.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, COVID-19 response began middle of March 2020. In April, in only 72 hours' time, Sanford worked with state and local partners to mobilize a mass drive-through COVID-19 testing opportunity for JBS employees. It was the first of its kind in Minnesota, and many others that followed were modeled off our set up. It was set up in the local Worthington hockey arena - 1,087 tests were completed over 4 days. Sanford Worthington clinic then set up a permanent drive-through testing location adjacent to the clinic. Testing continues to occur seven days a week. By end of 2020, approximately 9,900 tests have been completed.Sanford Worthington opened and operated a "COVID Respiratory Clinic" in response to the overwhelming need for follow-up and care to the most ill COVID-19 patients.In May, Sanford Worthington initiated another community collaboration: the Sanford Community Advisory Council. The council is comprised of community representatives of 20 organizations. The collective mission of the council is working collaboratively to provide meaningful patient and family experiences and supportive resources for Nobles County residents to live healthily through partnerships between health care and community stakeholders. A top focus at the start of this meeting was COVID response: being transparent about what was happening inside of healthcare, keeping each other informed on the status of the community, identifying resources, gaps, and opportunities to respond together to needs.Community mask use and mask education was identified as an early priority. Over 30 individuals were recruited to sew masks, coordinated by the hospital auxiliary volunteers. Over 5,500 masks were made, and another 2,000 Hanes masks secured by PH and Sanford. The Hanes masks were distributed in a large community drive-through mask event that included education in multiple languages. The handmade masks were given to local businesses to protect workers and those most vulnerable, as well as during community food distribution events that took place for Nobles County. Masking education was shared in many languages and through many channels to reach the culturally diverse community, including verbally from trusted community partners (many council members themselves), social media outlets, at the JBS plant, through written material, and in the local newspaper and local radio. Identified needs not directly addressed by this facility include:Economics - Availability of affordable housingTransportation - Availability of public transportationAging - Cost of long term care, availability of memory care, and the cost of in-home servicesChildren and Youth - Availability and cost of quality childcare, availability of services for at-risk youth, teen pregnancy, childhood obesity, bullying, substance abuse by youth and the availability of activities for children and youthMental Health - drug use and abuse, depression, stress, and alcohol use and abuseSanford will not develop strategy to address the availability of affordable housing, the availability of public transportation, the cost and availability of long-term care, memory care. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the assessed needs with community leaders that have expertise in the various needs of the community.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Substance abuse is another high raking concern for community members. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Protective factors include: Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford has made children and youth a significant priority and has developed strategies to offer support programs that provide children and youth with safe and healthy environments.Priority 2: Mental Health and Substance Abuse Mental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearChildren and YouthSanford Sheldon takes great pride in supporting the youth of the community in various events. 2020 saw the continued support of the Shop with a Cop program, which provides children in the community the opportunity to go back to school for new school supplies. Sanford Sheldon purchased backpacks for the program. This year there was a need for 90 backpacks. The summer lunch program was held differently due to the pandemic; however Sanford Sheldon was still able to support the program, which delivered meals directly to the students. Need for the program increased as students were not in the school building from mid-March through August. To ensure employees and their children had proper meals Sanford Sheldon was offered the opportunity for freezer meals. This provided staff and their families four free freezer meals for a family of four. The opportunity was provided three times. As many as 130 employees participated in the meal preparation.Local daycares closed due to COVID-19 but due to the necessity of maintaining staffing levels there was a need to develop options for staff to utilize so they could still deliver healthcare to the community. In response, a facility-based daycare program was established for children of Sanford employees.Mental Health and Substance AbuseSanford Sheldon Medical Center is continuing its commitment to meeting the mental health and substance abuse needs of our patients and all community residents. Sanford now employs Psychiatric Mental Health Nurse Practitioner Stacey Jumbeck in addition to the mental health counseling available from Dr. Matthew Eggers and IHT Mark Daniels via telemedince. Sanford Sheldon is able to diagnose and treat the mental health needs of many patients with therapy and prescribing medications for patients who have mental health disorders or substance abuse problems. Sanford Sheldon has seen an increase in both the mental health and substance abuse of our patients due to COVID-19. The increased demands are being met with therapists providing services at Sanford Sheldon.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Sheldon offered telemedicine clinic visit options to patients who wanted to maintain a physical distance due to COVID-19 concerns, but still needed medical care. The telemedicine clinic visit would occur via video with the patient's healthcare provider, allowing patients to remain in their home but still receive basic medical care. The local chamber provided Sanford Sheldon an opportunity to record healthcare educational videos by our medical providers. The videos were posted on the chamber's Facebook page and provided the opportunity to communicate the latest concerns in the community that needed to be addressed.The radio station also provided Sanford Sheldon the opportunity to do weekly interviews and stories on the current COVID-19 issues we were seeing in the community.Identified needs not directly addressed by this facility include:Economic - Need for skilled labor force, affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and household budgeting and money managementAging - Cost of long term care, cost of memory care, and the cost of in-home services Safety - Abuse of prescription drugsHealth Care - Availability of mental health providers, availability of behavioral health providers, access to affordable health insurance coverage, access to affordable health care, access to affordable prescription drugs, and access to affordable vision insurance
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well Being Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Sanford Vermillion has made affordable housing and economic well-being a significant priority and has developed strategies to work with community partners and community leaders to improve the availability of affordable housing in the community.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common, and most treatable, mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health, behavioral health, and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearEconomic Well-Being - Availability of Affordable Housing and FoodSanford Vermillion continues to collaborate with the City of Vermillion, the Vermillion Chamber & Development Company, and local community programs to increase awareness and support the community efforts to provide affordable housing and food assistance opportunities for those in need.In 2020, the City of Vermillion issued permits for four apartment complexes with ten units each, one apartment complex with four units, and 13 new single-family homes Sanford Vermillion has also continued to collaborate with the Vermillion Chamber & Development Company (VCDC) on the second phase of housing development at the Bliss Pointe Planned Development District now that the first phase is complete. The second phase focuses on smaller, more affordable housing developments in the center of the 30 acres of land purchased by the VCDC. COVID-19 did not impact the construction of housing units as much as it did many of the other types of businesses in Vermillion. Sanford Vermillion also continues to support the local food assistance programs in Vermillion by being one of the top donors in the community to the local United Way, which funds the Community Connection Center (CCC) that opened in 2019. The CCC houses the United Way, Welcome Table, Vermillion Food Pantry, Weekend Backpack Program and Salvation Army services under one roof in downtown Vermillion for a one-stop shop for their clients. Unfortunately, COVID-19 did affect our ability to participate in the weekly Welcome Table weekly free meal in 2020. However, the hope is to be able to soon provide the meal at least twice a year, similar to the past. Sanford Vermillion staff also participated in providing Meals on Wheels to the community two weeks per year and were able to continue this in 2020 as well.Mental Health - Substance Abuse and Binge Drinking Sanford Vermillion saw an 8% decline in Mental Health visits from a total of 1,349 completed visits in 2019 to a total of 1,236 completed visits in 2020. This is likely due to COVID-19 in 2020. However, a number of visits were shifted to telehealth and video visits rather than in-person visits and actually saw an increase in these type of visits over 2019. Telehealth and video visits also had the benefit of decreasing the number of typical no-show appointments from patients, as it was more convenient and private for them. Sanford Vermillion continues to employ the same providers, which includes a full-time Integrated Behavioral Therapist (IHT)/Psychologist who works 5 days per week and an IHT/Clinical Social Worker who provides counseling two days per week. Additionally, Sanford Vermillion continues to offer a monthly Psychiatric specialty outreach clinic. The provider utilized the telehealth/video visits during 2020 as an option for clients and had an increase in these types of visits as well. Two Integrated Health Therapists provided Sanford Vermillion staff with two in-services during 2020 on coping with stress during COVID-19, which were well-attended and appreciated by the staff. A private counselor is still available in the community for patients as well as Lewis & Clark Behavioral Health, which employs counselors in the Vermillion community including a licensed alcohol and addiction counselor that has privileges at Sanford Vermillion.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Vermillion offered several services and resources to the community in response to the pandemic. Sanford Vermillion Clinic shifted from in-person visits to video visits for patients with COVID-19 symptoms to reduce the risk of exposure for staff and other patients. Similarly, drive through COVID-19 testing was implemented early, and although operational plans changed a few times, staff was able to test over 100 patients per hour. For patients that contracted the virus, Sanford Vermillion was one of the first facilities to offer Bam Bam Infusion Therapy to reduce the severity of illness and likelihood of hospitalization for highest risk patients. The therapy began in late 2020 and we completed 20 doses for patients by the end of the year.Sanford Vermillion also implemented mitigation strategies for long-term care facilities to keep staff and residents safe during COVID-19. These strategies included PPE education, weekly COVID-19 testing, hand hygiene, staff screenings, resident assessments, isolating sick residents, and visitor limitations. Staff were successful in keeping residents in the nursing home COVID-free until mid-December and then were able to limit it to a small number of residents without significant spread.Sanford Vermillion used several platforms to keep the Vermillion community educated on COVID-19. Long-term care residents were updated as changes occurred in the facilities including if there was a new positive staff member or positive resident or change in the visitation policy. Sanford Vermillion participated in the Vermillion Area & Chamber Development Company's UpNEXT videoconferences with community leaders/businesses to provide the community with Sanford Vermillion's COVID-19 update. Sanford Vermillion partnered with the University of South Dakota (USD) to make plans for an alternate care site for up to 40 patients if needed during COVID-19 should hospital capacity become overwhelmed. Arrangements were made for staff accommodations on the USD campus for COVID-19 positive and suspected positive staff that would need to quarantine and may not be able to do so at home. USD also provided excess PPE supplies to the hospital during times of shortage when vendors were unable to fill orders. Although the alternative plans were never acted upon, it was comforting for all involved to know we had backup plans for our patients and staff.Identified needs not directly addressed by this facility include:Aging - Cost of long term care, cost of memory care, and cost of in-home servicesChildren and Youth - Substance abuse by youth, and childhood obesitySafety - Culture of excessive drinkingHealth Care - Access to affordable health insurance, access to affordable health care, and cost of affordable prescription drugs
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Substance abuse is another high raking concern for community members. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Protective factors include: Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford has made children and youth a significant priority and has developed strategies to offer support programs that provide children and youth resources for healthy living.Addressing of Significant Needs during Current YearMental Health/Behavioral Health and Substance AbuseSanford Chamberlain Medical Center provides education on substance abuse prevention and behavioral health for students and parents of local schools. Sanford Chamberlain engaged in work with the Chamberlain school district, embedding a licensed mental health counselor in the high school/middle school and elementary school one day per week. Chamberlain schools were virtual from March to May 2020, impacting reach. Sanford Chamberlain works with the Chamberlain Middle School in supporting a curriculum around social/emotional well-being. The social/emotional curriculum is live in classrooms, circulating through 6th to 8th grade students. To increase community safety and decrease substance abuse, Sanford Chamberlain Medical Center has previously trained community members on Mental Health First Aid and intended to continue this services in 2020. Unfortunately, although Sanford Chamberlain has a certified trainer, the Mental Health First Aid training sessions were put on hold due to COVID-19.To advance opioid prescribing best practices, staff and providers are routinely given updates on Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically. Children and YouthSanford Chamberlain intends to make the Sanford fit wellness program available to local schools as well as parents of students. SCMC hosted Sanford fit night in conjunction with parent teacher conferences at the Chamberlain elementary school on February 13, 2020. Approximately 200 people attended the event. Camp FUEL is a summer camp for area youth where healthy eating, exercise, and health outcomes are explored. The camp took place in summer 2019 and plans are underway to hold a Camp FUEL again in 2020. The 2020 camp strategy was paused due to COVID-19.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Chamberlain Medical Center supported the community through a variety of initiatives. SCMC was the primary COVID testing site for the tri-county area of Brule, Buffalo, and Lyman Counties. Community Education was also a key component of their COVID response with educational resources shared locally through social media, schools, and the Chamber of Commerce along with virtual offerings of the Better Choices Better Health program. Other community involvement and support included innovative offerings such as drive-thru Thanksgiving meals, drive-thru flu shots, a drive-thru ice cream treat day, and outdoor walk-in Wednesday interviews.Sanford Chamberlain supported our clinical and non-clinical staff throughout the pandemic in numerous ways including meal certificates, individual treats throughout the year, to-go monthly meals prepared by Dietary, and catered meals. Administration also created an "Island Retreat Break Room" with decorations, a picture station, themed mocktails and treats, and staff massages to create some relaxation, levity, and comradery for the staff.Identified needs not directly addressed by this facility include:Economic - Need for a skilled labor forceAging - Cost of long-term care, and the cost of memory care Safety - presence of drug dealers, presence of street drugs, and abuse of prescription drugs Health Care - Access to affordable health care, and access to affordable health insurance coverageSanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford shared the findings of the CHNA research and these unmet needs with community leaders and community stakeholders.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1 Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointments.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearImproving Health Care Access2020 was a year of change. Patient access improved with patients having same day access to providers as all providers have same day appointments held on their schedules to ensure timely access to care. Additionally, Sanford Luverne moved to a rapid deployment of more telehealth and video visit access due to COVID-19. This was instrumental in allowing patients to stay connected to their providers for care during the pandemic. Many patients prefer the face-to-face visits with their providers, but the expectation is that telehealth visit offerings will continue beyond this year. A new family medicine physician is scheduled to join Sanford Luverne in December of 2022 to further expand access.To improve price transparency in 2020, Sanford focused on meeting the new state of Minnesota and CMS mandates by focusing on a goal of displaying shoppable services in a consumer-friendly format and comprehensive listing of pricing for services. Price transparency continues to be a focus for the finance team and will continue to see ongoing efforts to improve this for our patients.Sanford Luverne continues to support dental health access in the community efforts with the mobile dental clinic for lower income residents through promotion and financial support. The mobile dental services were suspended with COVID-19 so access has been more of a challenge for residents needing the service. The community is losing its local dentist due to their relocating. However, a new dentist was successfully recruited to the community to continue the current level of local access. Improving the Mental Health of the CommunitySanford Luverne's Integrated Health Therapist (IHT) had local mental health providers begin a monthly education event through community education to align IHT and crisis resource team with area mental health services for timely access. Approximately 30-40 people attend each event. Meetings were paused in March after the pandemic began but is intended to resume as soon as they are able. The group has focused on encouraged positive messages within the community this past year, has developed a resource listing of options for care, and has done a lot of work as part of our community "Brain Health" initiative. Sanford Luverne's integrated health therapist had 388 individual patient sessions in 2020.The clinic continues to work on management of depression and anxiety to decrease their severity. Sanford's RN care manager resigned at the end of 2020 and a new staff member has been oriented in that role. As of September 2020, 23.3% had optimal depression metrics at six months and 23.5% at 12 months. The six-month quality metric was slightly less than at the end of 2019 but much better at the 12-month mark. Due to quality metric changes in 2019, a comparable for December is not available.The arrival of COVID-19 resulted in increased substance use within the community. Two years of recruitment efforts for a substance use counselor were successful in 2020. The new team member has improved access to care and allowed Sanford Luverne to continue to hold group therapy sessions, although social distancing requirements required larger rooms and smaller groups.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Luverne eliminated all non-essential surgeries, transitioned to mostly online video visits and delayed outpatient care beginning in March. During this time, the focus was ensuring safety measures were implemented to protect our staff and ensure they had the necessary supplies to care for and treat covid patients. Sanford Luverne has taken a lead role in education, COVID-19 testing, and COVID-19 vaccinations during 2020. Sanford Luverne's ambulance team worked with all county first responders to ensure they had the right PPE, knew how to use it, had the right supplies to care for patients, and conducted training sessions with the county first responder teamsIn response to hearing of increased demand on the local food shelf, staff members contributed food and volunteered to package food for distribution to those who needed assistance. In addition, Sanford Health invested in all the area food banks through support of Second Harvest. Sanford Luverne is seeing increased mental health concerns and substance use with due to COVID-19. Sanford's behavioral health therapist is working internally with the wellness committee focusing on staff mental health and resiliency. In addition, she is working with the community "Brain Health" task force on ways to improve brain health in community initiatives. Substance use staff continue to work with county drug courts and providing outpatient assessments and treatment in an individual and group setting to ensure that care is received in a timely manner.Identified needs not directly addressed by this facility include:Economic - Need for a skilled labor force, affordable housing, and employment optionsAging - Cost of long term care, availability of memory care, and cost of in-home servicesChildren and Youth - availability and cost of quality childcare, availability and cost of services for at-risk youth, substance abuse by youth, bullying, and teen suicide.Sanford will not develop strategy to address the cost of long term care, the availability of memory care, the availability and cost of quality child care. However, Sanford shared the results of the CHNA research with community leaders and agencies with expertise to the identified needs. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health According the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Canby has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Mental Health Mental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPhysical HealthSanford Canby Medical Center (SCMC) remains committed to improving the physical health of the greater Canby, MN community. Once again, SCMC provided sponsorship support to various activities and events in the community. Donation requests are reviewed at administrative council meetings; events/activities aligning with the promotion of healthy living are given strong consideration. Due to the Covid-19 pandemic, many organizations faced challenges holding traditional group events, and many were canceled. However, in 2020, approximately $3,200 was donated to events/organizations of the Canby community including the Canby Golf Course, City of Canby tennis court fundraiser, and Canby 4 Kids.The COVID-19 pandemic forced the Canby, MN schools to move to remote learning in the Spring of 2020. However, SCMC provided the schools with nearly 400 sets of fitKids workout cards that were sent home in virtual learning packets. The cards contained a set of instructions and students could easily follow the steps in order to get a short, 5-minute workout by selecting a warm-up activity card, move activity card, and cool-down activity card. While COVID-19 greatly impacted the ability to meet face-to-face in 2020, Sanford Canby offered pre-diabetes classes in the months of July, August, and November. The diabetes support group was able to meet in the months of February, September, November, and December. In addition, Sanford Canby provided meeting space for bariatric weight loss support group members and provided meeting space for a public educational session - Understanding Alzheimer's and Dementia. Sanford Canby Medical Center successfully conducted the Sanford Power program with 15 area Canby student athletes. The program is designed to prepare young athletes for safe competition by focusing on speed training, agility training, plyometric training, and strength training. COVID-19 prohibited the program from taking place in person, and therefore was held virtually. Mental HealthThe Sanford Canby Pathways Support Group offers support, resources, and routes to thrive and better manage life with chronic conditions. This group provides strategies, solutions, and resources to aid members along an empowered pathway in living life after diagnosis of a chronic disease. The group is open to anyone with, or caregiving for, a person with, a chronic medical condition including Parkinson's, memory loss, vision loss, cancer, heart disease, mental health, grief/loss, or pain. However, the COVID-19 pandemic prohibited the support group from meeting in 2020. Sanford Canby Medical Center utilizes the PHQ-9 screening tool within the electronic medical record to help in the identification of mental health needs. Through the medical home program, RN care manager, and PHQ-9 screening, we can offer and refer mental health services to those with scores indicative of depression. Through quality measures, we are able to track and measure depression remission. In January 2020, 11% of patients recorded remission in 12 months; In January 2021, 8.3% of patients recorded remission. The remission goal is 48.4% of patients. Screening for depression was added to the quality measures in 2021 and includes screening all patients ages 12 and over for depression symptoms and follow-up. This screening is done at least every twelve months. Sanford Canby also expanded mental health services to include a psychiatrist who provides telemedicine visits.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Canby was quick to take action with screening procedures and visitor restrictions put into effect. Leadership teams met frequently to assess the state of the pandemic and lead the local pandemic response. COVID-19 laboratory testing evolved throughout the year with SCMC eventually able to conduct a PCR, in-house, 30-minute Covid-19 test for emergency room patients and hospital inpatients. In-house antigen test for symptomatic patients was added in November. SCMC also retrofitted two hospital rooms for negative air flow in response to the need to treat COVID-19 patients locally. Outpatient monoclonal antibody therapies were added, which has seen great success in reducing hospitalizations resulting from Covid-19 infections. The long-term care administrator conducted a weekly call for resident families to feel connected and informed to their loved ones' care as staffing challenges arose due to employee infections and residents became infected with the virus.Beyond the clinic, hospital staff members posted workout videos online for wellness center members to safely exercise in their own homes when the facility was forced to close. N95 mask fit testing was offered to outside organizations including fire department staff and police. On March 16, 2020 Sanford Canby hosted a parent support group session "Covid-19 Prepare Your Home." Identified needs not directly addressed by this facility include:Economic - Employment options, and skilled labor forceAging - Cost of long term care and memory care, and cost of in-home servicesChildren and Youth - Bullying, and availability of quality childcareHealth Care - Access to affordable health insurance, cost of affordable vision insurance, access to affordable prescription drugs, cost of affordable dental insurance coverage, and access to affordable healthcare
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and Youth According to the Centers for Disease Control, obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion. Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer. Sanford Jackson has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity. Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearChildren and YouthSanford Jackson Medical Center is working to create awareness of health behaviors for children and parents in our community through several initiatives. Marketing Specialists continue to strengthen relationships with community members specifically for Jackson's annual Kids Tri for Health. The 2020 Tri for Health was scheduled for June but was cancelled due to COVID-19. Planning is underway for the 2021 Tri for Health that is slated for June 11 and 12, 2021. The Sanford Fit Kids curriculum is utilized at various community events, speaking engagements, and in the resource bags for participants in Tri for Health. This year its utilization in schools and other activities were curtailed as COVID-19 resulted in schools and activities moving into the virtual space or were cancelled.Sanford Jackson Medical Center supported Families in the Community throughout 2020 through sponsorship of organizations such as Jackson County Libraries Summer Program and the new Jackson City Splash Pad. Department managers and providers visited with 10th grade high school students interested in healthcare career paths in December.Mental Health and Substance AbuseMental health and behavioral health care continues to be a pressing need for the community. Sanford Jackson Medical Center's goal is to decrease patients presenting to the emergency room with mental and behavioral health issues as well as to decrease substance abuse within the community. Sanford Jackson Medical Center is working internally and with community partners to decrease substance abuse in the area via several projects.SJMC's RN Health Coach specializes in customized care plans for patients needing support in weight loss initiatives, diabetes management, smoking cessation, or assistance in navigating primary care. A key voice in the community, the RN Health Coach has provided education resources at the 2020 Jackson Farm and Home Show. The Weight Loss Support group has transitioned to Facebook Live format for our patients. Providers discuss tobacco use rates and the impact on care for people with diabetes and vascular disease, specifically. The Performance Improvement team monitors these measurements quarterly and updates action plans for all members involved in patient care. To advance opioid prescribing best practices, staff and providers are routinely given updates on Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically. SJMC's Integrated Health Therapist leads a community task force comprised of representatives from Des Moines Valley Health and Human Services (Public Health), law enforcement officials, EMS, industry leaders, Southwest Mental Health, and Family Services Network. This task force meets quarterly to discuss behavioral health issues of all ages, available resources, and the impact on our community. The "Ask the Expert" column in the local newspaper educated the community on the National Prescription Drug Take Back Days held in April and October 2020. The public was informed of the ability to take outdated medication for disposal to the law enforcement center in Jackson year round.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, SJMC collaborated with Des Moines Valley Health and Human Services-the local public health department-to provide education to the community via newspaper and radio. Newspaper topics included How to Stop the Spread, covid testing, antibody testing, rapid covid testing, Don't Put Your Health on Hold, and vaccine updates.Handmade mask donations were accepted and made available to patients as needed. As a result, over 1,000 masks were made and distributed.Several programmatic changes were implemented to support the health and wellness of the community during the pandemic. Patient visits were offered through several mediums for those that did not need to present in person for appointments, including MyChart, Facetime, Zoom, and verbal visits. Jackson and Lakefield clinics conducted nearly 600 virtual and verbal visits from March through December 2020. To further lessen exposure, drive up COVID-19 testing was available through the ambulance garage and the clinic time for symptomatic (ie "sick") patients to be seen was condensed to the end of each day allowing the continuation of healthy patient care throughout the day. In addition, to ensure the health and safety of our staff and patients, a screener was placed at the entrance of the facility. The screener continues today taking temperatures and asking screening questions related to COVID-19 symptoms and exposure.Identified needs not directly addressed by this facility include:Children and Youth - Availability and cost of quality childcare, bullying, availability and cost of services for at-risk youth, substance abuse by youth, teen tobacco use, and opportunities for mentoringAging - Cost of long term care, availability and cost of memory careHealth Care - Availability of non-traditional hours, access to affordable health insurance, access to affordable health care, access to affordable prescription drugs, cost of affordable dental insurance coverage
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: WellnessAccording the Center for Disease Control, obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Tracy has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Health Care AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made health care access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to health care are successful in securing timely appointments.Addressing of Significant Needs during Current YearWellnessDietician and RN Health Coach services continued to be offered and referred to in 2020. Sanford Tracy's dietician had 10 visits in 2020, from 11 in 2019. The RN Health Coach had 227 visits in 2020, which was an increase from 182 visits in 2019. The medical supplies that were purchased for low-income/in-need patients were all distributed in 2019. Discussions were progressing on how to find funding to continue this initiative/project but were halted in early 2020 due to COVID-19. The intention is to begin brainstorming once again on how to revive this project. 2020 saw staff continue with the Sanford fit program with the Tracy Area Elementary 4th grade class., which focuses on health lifestyle choices to decrease childhood obesity. Unfortunately, the 2020 session was cut short due to COVID-19 and the schools transitioning to distance learning. Resources for at-home learning and exercise were provided to local teachers. The 4th graders took a pre-test, but were unable to take the post-test, so we were unable to measure their learning from the program.Health Care AccessTo support mental health awareness Sanford Tracy continued awareness campaigns for telemedicine services. Local behavioral health services began in 2020 but were quickly halted in March due to COVID-19. Yet, provider referrals were a major factor in the continued use of Sanford Tracy's in-house behavioral health services. Behavioral Health providers in Tracy saw 77 new referrals in 2020 and a grand total of 1,016 visits for the year. The slight decline in visits may be attributed to COVID-19 and the hesitancy for patients to seek care.Orthopedic and dermatology outreach were scheduled to begin in early 2020 to expand specialty services. However, due to unforeseen circumstances not related to COVID-19, the services did not come to fruition. Sanford continues to look at options for both orthopedic and dermatology outreach services, however, COVID-19 slowed that process down in 2020.The medical supplies that were purchased for low-income/in-need patients were all distributed in 2019. Discussions were progressing on how to find funding to continue this initiative/project but were halted in early 2020 due to COVID-19. The intention is to begin brainstorming once again on how to revive this project. COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Tracy's COVID-19 Response included several measures and greatly reduced the possibility of exposures and infection of the virus for our communities. Measures included the implementation of telehealth visits, phone visits, and drive through COVID-19 testing to limit patients coming into our facility, masking, screening, and visitor guidelines, and COVID-19 pre-op testing before all surgical procedures.Identified needs not directly addressed by this facility include:Economic - Need for employment options, and availability of a skilled labor forceChildren and Youth - Availability of quality childcareAging - Cost of long term care, availability and cost of memory careMental Health and Substance Abuse - Depression, stress, dementia and Alzheimer's
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Hillsboro has made transportation a significant priority and has developed a strategy to work in collaboration with city and county leadership and the department of human services to explore options for the local community and county members.Addressing of Significant Needs during Current YearMental Health Services Sanford Mayville continues to use the PHQ-9 patient health questionnaire on initial and certain follow-up appointments and appropriate patients to ensure those in need of mental health services are identified and offered treatment. The panel management team is completing follow-up for new depression diagnosis.Both Sanford Mayville and Sanford Hillsboro have implemented IHTs (integrated health therapist) into the Clinics, mostly by tele-health due to the COVID-19 pandemic. 1-3 patients per day are being seen by telehealth from each Clinic. Patients and Providers feel it is going well and it is used quite frequently.Hillsboro's Go Live for Senior Life Solutions outpatient group therapy program was scheduled to start Summer of 2020 with an estimated 4-10 patients per day by the end of 2020. Due to the COVID-19 pandemic the program start date was delayed until December 2020. The delay resulted in patients not being seen virtually until January 2021.TransportationSanford Hillsboro and Sanford Mayville coordinated with Traill County to provide a public directory of transportation options, which is available throughout the county. Traill County has a bus/van available for use and seemed to be working very well in the community. Unfortunately, COVID-19 stopped all transportation in 2020. Sanford Hillsboro worked with the City of Hillsboro as they submitted a grant to secure and autonomous bus to transport residents throughout the city. The City did not receive the grant that was submitted and has moved away from any other such types of public transportation for the city.From a healthcare perspective, Sanford offers and promotes several virtual healthcare options in response to COVID-19 and the subsequent impact on travel. Offerings include video visits, telehealth, and e-visits.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Mayville, Sanford Hillsboro, and Traill County Public Health are partnering on a COVID-19 vaccination effort starting the week of January 25, 2021. The effort includes weekly vaccination events.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, and employment optionsAging - Cost of long term care and memory care, availability of resources for family and friends caring for elders the cost of in-home services, cost of in-home services, and help making out a will or healthcare directiveChildren and Youth - Availability of quality childcare, childhood obesity, cost of quality childcare, the availability of services for at-risk youth, bullying, substance abuse by youth, cost of activities, cost of services for at-risk youth, opportunities for youth-adult mentoring, and teen tobaccos useSafety - Culture of excessive drinking, and abuse of prescription drugsHealth Care - Access to affordable health insurance, access to affordable healthcare, access to affordable prescription drugs, access to affordable dental insurance, and access to affordable vision insurance Sanford will not develop strategy to address the cost of long term care and memory care because the state of North Dakota through the Department of Human Services controls the cost. Memory care cannot be added to the LTC facility. Safety issues such as the culture of excessive drinking, and abuse of prescription drugs are issues that the city council and the sheriff's office are issues that the community stakeholders are addressing. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Mayville has made transportation a significant priority and has developed a strategy to work in collaboration with city and county leadership and the department of human services to explore options for the local community and county members. Addressing of Significant Needs during Current YearMental Health Services Sanford Mayville continues to use the PHQ-9 patient health questionnaire on initial and certain follow-up appointments and appropriate patients to ensure those in need of mental health services are identified and offered treatment. The panel management team is completing follow-up for new depression diagnosis.Both Sanford Mayville and Sanford Hillsboro have implemented integrated health therapists (IHTs) into the Clinics, primarily via telehealth due to the COVID-19 pandemic. 1-3 patients per day are being seen by telehealth from each Clinic. Patients and Providers feel it is going well and it is used quite frequently.Hillsboro's Go Live for Senior Life Solutions outpatient group therapy program was scheduled to start Summer of 2020 with an estimated 4-10 patients per day by end of 2020 year. Due to the COVID-19 pandemic program start date was delayed until December 2020. The delay resulted in patients not being seen virtually until January 2021.TransportationSanford Hillsboro and Sanford Mayville coordinated with Traill County to provide a public directory of transportation options, which is available throughout the county. Traill County has a bus/van available for use and seemed to be working very well in the community. Unfortunately, COVID-19 stopped all transportation in 2020. From a healthcare perspective, Sanford offers and promotes several virtual healthcare options in response to COVID-19 and the subsequent impact on travel. Offerings include video visits, telehealth, and e-visits.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Mayville, Sanford Hillsboro, and Traill County Public Health are partnering on a COVID-19 vaccination effort starting the week of January 25, 2021. The effort includes weekly vaccination events.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, and employment optionsAging - Cost of long term care and memory care, availability of resources for family and friends caring for elders, cost of in-home services, and help making out a will or healthcare directiveChildren and Youth - Bullying, availability and cost of quality childcare, childhood obesity, cost of activities for children and youth, availability and cost of services for at-risk youth, substance abuse by youth, opportunities for youth-adult mentoring, and teen tobacco useSafety - Concerned about the culture of excessive drinking, and abuse of prescription drugsHealth Care - Access to affordable health insurance, cost of affordable vision insurance, access to affordable prescription drugs, cost of affordable dental insurance coverage, and access to affordable healthcareSanford will not directly develop strategy to address the cost of long term care and memory care because the state of North Dakota through the Department of Human Services controls the cost. Sanford has deferred to the local nursing home which does have an Alzheimer's unit. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Aging ServicesAccording to the Administration for Community Living, families are the major provider of long-term care for older adults and people with disabilities in the U.S. Research indicates that caregiving also exacts a significant emotional, physical, and financial toll. With nearly half of all caregivers older than age 50, many are vulnerable to a decline in their own health. Studies have shown that coordinated support services can reduce caregiver depression, anxiety, and stress, and enable them to provide care longer, which avoids or delays the need for costly institutional care.Sanford has made the aging population a significant priority and has developed strategies to support caregivers through community services. The creation of collaborative partners will provide the necessary support to make a positive impact on caregivers and to provide the tools to support their work.Addressing of Significant Needs during Current YearMental HealthAs need continues to increase, Sanford Webster aims to ensure that access to mental health services are available for the community. Access is achieved through improved access for mental health specialty care, psychiatry outreach services, and the Bridging Health and Home program. Bridging Health and Home is offered to support older adults in our rural areas. Bridging Health and Home services are free for adults age 55 and older and offers compassion and care to those wishing to remain at home as long as possible.Sanford Webster continues to actively offer access to mental health services through telemedicine. Dr. Mark Daniels is a psychologist and integrated health therapist based in Vermillion, SD offering care to Webster residents. Drs. Nuss and Eggers also support the local community and offer psychiatry services via telehealth. Volume has continued to increase with an average of over 20 patients per month coming for services. Aging PopulationSanford Webster continues to stay active in support of the community's aging population. Unfortunately, the caregiver support group-which offered supportive services to 59 local caregivers in 2019-has not met due to COVID-19 and the better balance class has not been as active with limiting the number of people in a space due to the pandemic. As such, participant numbers trail the 300 total residents that participated in 2019. Lori Reetz at the clinic has started offering Chronic Care Management to the community. We work with individuals with two or more chronic conditions to help them work toward their individual goals of managing their conditions. Currently, 26 individuals are registered with the program and the team has worked with over 30 people since inception of the program. COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Webster has offered care to patients with every level of care, including clinic visits, inpatient hospital, outpatient therapy, swing bed and terminal Covid care. Sanford completed over 1,600 Covid vaccines affecting over 800 individual patients and administered 48 Bamlanivimab infusions to patients in the community. This monoclonal antibody therapy has been very effective in the treatment of patients with COVID-19. Sanford Webster has provided community education through the paper with over five stories related to COVID-19 education. Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, need to maintain energy efficient homes, household budgeting and money management skills, and skilled labor forceChildren and Youth - Bullying, availability of activities for children and youth, childhood obesity, substance abuse by youth, availability and cost of services for at-risk youth, opportunities for adult-youth mentoring, teen tobacco use, and education about birth controlSafety - Presence of street drugs, culture of excessive drinking, presence of drug dealers, abuse of prescription drugs, domestic violence, crime, and child abuse and neglectHealth Care - Access to affordable health insurance, access to affordable vision insurance, access to affordable health care, and access to affordable prescription drugs
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Worthington Medical Center
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health Mental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and depression. All patients in the primary care setting will have a Patient Health Questionnaire (PHQ-9) completed at each visit. The PHQ-9 is an assessment tool used for screening, diagnosing, measuring, and monitoring the severity of depression. Patients are evaluated to determine if there is a need to provide additional services. Sanford is providing on-site mental health services and has implemented telehealth services to improve access to psychiatry services. Priority 2: Economic Well BeingFood security means access by all people at all times to enough food for an active, healthy life. Food insecurity describes a household's inability to provide enough food for every person to live an active, healthy life. According to United States Department of Agriculture, an estimated 12.3 percent of American households were food insecure at least some time during the year in 2016, meaning they lacked access to enough food for an active, healthy life for all household members. That is essentially unchanged from 12.7 percent in 2015. The prevalence of very low food security also essentially unchanged, at 4.9 percent in 2016 and 5.0 percent in 2015. Sanford has made economic well-being specific to food security a significant priority and has developed a strategic plan to sustain the backpack program and food distribution for students in the community.Addressing of Significant Needs during the Current YearMental HealthSanford Wheaton experienced a significant change in depression scores during 2020 due to COVID-19. The pandemic made significant changes to everyone's life and the clinic setting was no different. All patients that are currently under the care of the telehealth psychiatrist receive a PHQ 9 on each visit. The remainder of patients are screened when deemed necessary by the provider, after med changes and to fall into the measured goal need to be done at 4-6 month and 11-13 months. However, the number of patients that came to our facility decreased dramatically in 2020 due to the pandemic, which in turn resulted in fewer patients that allowed for depression screenings through the clinic channel. Sanford Wheaton's depression score decreased every month from March to October but did start increasing again as patients returned to the clinic.Psychiatry and psychology appointments did continue in the midst of COVID-19, but most of these visits have been done through the patient's home via telehealth. Very few patients came to our facility for those visits, which continued through the end of the year. Sanford Wheaton was fortunate to receive a grant from the MN Department of Health for a project of depression and adolescents. This has also been difficult due to the pandemic as many of the strategies were getting groups of students together. We will continue this project into 2021 although the funding cycle ends. Below is the calendar year with the measurement on depression trending regression.Depression Management 19.2%, 16.7%, 17.6%, 12.0%, 12.0%, 11.5%, 10.3%, 8.6%8.3%, 7.7%, 8.3%, 10.8% Economic Well-BeingThe Backpack Program started in 2016 and continued throughout 2020. The program delivers between 80-120 bags monthly to kids age 4 - 18 years twice a month. During COVID-19 additional food was given in each bag. Funding is received through private donations and has sustained throughout this time. Bethlehem Covenant, which served approximately 60 people with a free meal every Wednesday night in 2019, was not able to provide the meals throughout the pandemic due to social distancing issues.Sanford Wheaton continues to collect food for the local food bank and assist with the local food drive each year.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Wheaton implemented all recommended guidelines issued by the CDC and/or Sanford, including masking, social distancing, visitation restrictions, temping employees, patients, visitors, etc. Staff were re-educated on the proper donning and doffing of PPE with continual changes as new information and guidelines became available. To minimize patient and staff exposure, Sanford Wheaton developed and implemented curbside COVID-19 testing protocols in order to provide testing of all Persons Under Suspicion (PUI's) without having them enter any of our buildings.We also secured additional patient care equipment with CARES Act dollars due to increased census.Identified needs not directly addressed by this facility include:Children and Youth - opportunities for youth-adult mentoring, bullying, availability of activities for children and youth, childhood obesity, and teen tobacco use Aging - Cost of long term care, availability of memory care, cost of in-home services, and the availability of activities for seniors.Safety - Abuse of prescription drugs, presence of drug dealers and street drugs, child abuse and neglect, crime, culture of excessive and binge drinking, and domestic violenceHealth Care - Access to affordable health insurance coverage, availability of mental health and substance abuse providers, access to affordable health care, availability of specialist physicians, access to affordable prescription drugs, use of emergency room services for primary health care, access to affordable vision insurance coverage, availability of doctors, physician assistants or nurse practitioners, and availability of non-traditional hours.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthAccording the U.S. Department of Drug Enforcement Administration (DEA), nationally almost 20 percent of students surveyed admit to using marijuana at least once during the last 30 days, and 13 percent of students surveyed admitted driving when they used marijuana within the last 30 days.Researchers have identified risk factors that can increase a person's chances for misuse, and protective factors that can reduce the risk. However, many people with risk factors do not abuse substances. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Youth may also be more likely to try drugs because of circumstances or events called risk factors. Examples of risk factors include: Poor grades in school Engaging in alcohol or drug use at a young age Friends and peers who engage in alcohol or drug use Persistent, progressive, and generalized substance use, misuse, and use disorders by family members Conflict between parents or between parents and children, including abuse or neglect BullyingProtective factors include:Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford Health Bagley has made children and youth a significant priority and has developed strategies to expand education for healthy lifestyle choices, provide opportunities for local employment and careers, and provide outreach for teen and adolescent behavioral health services.Addressing of Significant Needs during Current YearMental Health and Substance AbuseIn 2019, Sanford Bagley selected a current Family Medicine Nurse Practitioner and supported their return to school to receive a Psychiatric Nurse Practitioner Certification. The intent was to have a local expert in Psychiatric Medication Management for the community. The Psychiatric Nurse Practitioner completed their clinical rotations and began seeing patients at the Bagley and Clearbrook clinics in 2019. At the time, they were able to see patients with both medical and mental health concerns due to the double certification. Unfortunately, the provider had personal commitments that led them to leave their role at Sanford in 2020. Mental health support for the local community continues through psychiatric telehealth, and outreach from Sanford Bemidji Medical Center.Pharma providers use Sanford Prescribing algorithms for opioid prescribing. This allows for a standard approach to opioid prescribing to patients - eliminating the patient trying different doctors to get different answers. Contracts are being used with patients as part of the opioid prescription process, having the patient and provider sign an agreement on how to safely utilize the prescribed medication. In the event we feel a provider is prescribing opioids outside of the guidelines we can audit each provider's prescriptions.Crisis services report in person for crisis visits. The crisis services team is a group out of Sanford Bemidji that can assist our providers in the event they have a patient in the middle of a mental health crisis. The crisis team can help determine the most appropriate next service. For example: a patient comes into the Emergency Department saying they are suicidal. Our provider can have the crisis team help determine next steps - inpatient vs. outpatient vs. other treatment. Children and YouthSanford Bagley intends to make the Sanford fit wellness program available to local schools as well as parents of students. SBMC hosted Sanford fit night in conjunction with parent teacher conferences at the Bagley elementary school on February 13, 2020. Approximately 200 people attended the event. Further expansion into additional districts at an appropriate time due to COVID-19 is under consideration.Sanford Bagley continued to partner with local school districts to support community youth. Unfortunately, most events were cancelled due to the COVID-19 pandemic. We have had the opportunity for our RN Health Coach to meet with patients for education on healthy lifestyle choices. In addition, online education opportunities were available to our patients.Sanford Health Northern Minnesota hired and onboarded a teen/adolescence psychiatric nurse practitioner and a full-time licensed psychologist in September 2019. Approximately 600 patients were seen in 2020.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates. Locally, Sanford Bagley partnered with local public health, emergency management, school districts, local businesses, and long-term care to provide a community centric response to COVID-19. Weekly meetings continued through 2020 into 2021. For COVID-19 testing, Sanford Bagley created a drive through COVID-19 specimen site to allow for ease of collection. We partnered with long term care, school districts, and local public health to complete necessary mass testing events. Sanford Bagley continued the partnerships with local public health and long-term care to provide COVID-19 vaccination opportunities to our patients. Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, concern for homelessness, food insecurity, and a need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic abuseAging - Cost of long term care, and availability of memory careSafety - Child abuse and neglect, crime, presence of street drugs, abuse of prescription drugs, presence of drug dealers, and domestic violenceHealth Care - Use of emergency services for primary care, and access to mental health/behavioral health providers
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well-Being - Affordable HousingResources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Priority 2: Behavioral Health and Mental Health Access - Substance Abuse by YouthMental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearEconomic Well-Being - Availability of Affordable HousingThe Canton area is in need of more affordable housing units to increase the well-being of community members. SCIMC is collaborating with the Canton Economic Development Committee to expand options for local residents. A Sanford Senior Director is the president of the Canton Economic Development Corporation (CEDC) and has been working with CEDC board for the past two years on this project. We have secured the option to purchase land with the goal of starting development of two 16-plex apartment buildings and approximately 10 villa-type homes in 2021, with additional custom homes to begin in late 2022. Three potential developers for the land were interviewed and the ultimate developer has been selected with a final agreement in the works.Behavioral Health and Mental Health Access - Youth Substance Abuse SCIMC has not been able to get into the local school districts since March of 2020 due to COVID-19. The lack of access has resulted in SCIMC's inability to provide and/or sponsor any educational material to the local school. SCIMC intends to re-start the efforts once things open again and provide additional information to the local high school and middle school kids and their families. SCIMC has a number of valuable resources deployed in previous years to support the CHNA, including vaping education seminars and screening services. COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, SCIMC provided additional resources for patients to see providers through video visits and verbal visits. COVID-19 and vaccine information were provided to the public to educate and promote understanding of the topics. Local vaccine clinics for businesses essential works and to patients in the 65 + age group have given out over 1,800 doses of the vaccine. The hospital and the SCIMC Foundation provided staff with Canton Cash, Inwood Bucks, and gift certificates to support local businesses.Identified needs not directly addressed by this facility include:Economic - Employment options, a skilled labor force, household budgeting and money management, and maintaining livable and energy efficient homesTransportation - Availability of good walking or biking options, and driving habits related to speed and road rageAging - Cost of long term care and memory care, cost of in-home services, availability of memory care, availability of resources to help the elderly stay safe in their homes, and availability of resources for caregiversSafety - Abuse of prescription drugs in the community, presence of drug dealers in the communityHealth Care - Access to affordable health insurance, access to affordable vision insurance, availability of health care services for Native American people, access to affordable dental insurance, availability of non-traditional hours, availability of prevention programs, and availability of specialist physicians Children and Youth - Cost and availability of activities for children, cost and availability of quality childcare, cost and availability of services for at-risk youth, bullying, childhood obesity, teen tobacco use, teen suicide, and opportunities for youth mentoringMental Health and Substance Abuse - Depression, stress, dementia and Alzheimer's disease, drug use and abuse, smoking and tobacco use, alcohol use and abuse, and exposure to second hand smoke
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: TransportationAdequate transportation is an essential quality of life issue. People who live in rural areas, people with low incomes or disabilities, seniors, etc. have a harder time receiving healthcare, accessing basic needs, and interacting with the community because of transportation. They often must rely on public or private transportation services to receive needed health care.Sanford Health Clear Lake has made transportation a priority and developed a strategy to work in collaboration with community organizations to explore options for the local community and county members. Priority 2: Physical HealthObesity is a serious and complex health issue. It can be caused by behavior or genetics or a combination of both. Behaviors can include dietary choices, physical activity, medication use, and others. Environmental factors such as education or culture can also contribute to obesity. Obesity is a serious concern because it's highly related to poor health, reduced quality of life, and to morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Clear Lake has made physical health specific to obesity a priority and developed a strategy to improve physical health and reduce the negative health effects of obesity.Addressing of Significant Needs during Current YearTransportationThrough the efforts of motivated individuals in the Clear Lake Community, including Sanford Clear Lake staff, the transit project sustained traction throughout the COVID-19 pandemic. Virtual meetings were utilized to discuss and improve public transit.Community Transit of Watertown/Sisseton received approval by the SDDOT to expand its operations to include Deuel County. Beginning on August 4, 2020, Deuel County Community Transit kicked off service by providing scheduled weekly trips to Watertown, Brookings, and Sioux Falls. Handicapped accessible public transportation was made available to all ages. Service is limited to medical, educational, and employment purposes. The Healthy Hometown project experienced delays and cancelations due to COVID-19. The walking audit to determine the walkability of the City of Clear Lake had to be rescheduled due to travel bans for Wellmark staff leading the project. The Healthy Hometown group still meets virtually to address other projects and hopes to schedule a walking audit Spring 2021. Physical Health Sanford Clear Lake Medical Center is committed to improving the physical health of the Clear Lake community with a particular focus on reducing negative health effects from obesity. 2020 was a challenging year for Sanford Clear Lake Wellness Center. Due to COVID-19, the wellness center closed its doors from March 13 - May 11, 2020. However, Sanford Clear Lake Wellness Center sponsored three separate fitness/wellness challenges in 2020. "March Madness" encouraged daily routine exercise with 23 participants before it was discontinued with the pandemic-related closure of the wellness center. A "Lazy Triathlon" in July and August allowed participants to complete a triathlon at their own pace. Participants who completed the challenge were to return completed log sheet to be entered for a prize. Unfortunately, log sheets were not returned. A "Holiday Hustle" in December encouraged healthy lifestyles by having participants complete a healthy task each day in the month of December. One participant returned a completed log sheet.The Healthy Hometown committee continued work through the pandemic. Virtual meetings allowed committee members to continue to work on projects set forth in the overall master plan designed for Clear Lake in 2019. Staff took on the task of implementing healthy options at concessions and improving access to drinking water in the community. School administration supported this project and provided resources and contact information that enabled the project's success. The impact of making healthier options available at concessions was measured by the frequency of re-ordering and re-supplying the healthier items, i.e. Veggie Straws, fresh fruit, trail mix, and string cheese. A promotional poster at concession informed patrons of the availability of the healthier options. The poster was also shared through social media. Implementation plans for healthier concession options at youth summer recreation concessions were also made, but, due to the COVID-19 pandemic, youth summer recreation activities were altered and concessions were not available. Increasing access to water proved to be a more difficult tactic. Plans were made with city officials to meet and discuss the goals of the project. Unfortunately, the meeting was canceled, and organizers were encouraged to submit a proposal to the city council for approval. Developing a proposal without key information hindered the success of the project. However, due to the COVID-19 pandemic, Deuel School installed five additional water bottle filling stations for students to access while at school.In the spring of 2020, the city council made a proposal for a walking trail at the city park. Sanford Clear wrote a letter to the city in support of the project due to its promotion of physical activity.The CHNA planning team meets monthly and reviews sponsorship requests for community events. In 2020, approximately $1600 was donated to events and organizations including the Clear Lake Baseball Association, Deuel Area Development, Inc., and New Hope Walk for Cancer to name a few. COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Clear Lake Medical Center (SCLMC) was quick to take action with screening procedures and visitor restrictions. Leadership teams met frequently to assess the state of the pandemic and lead the local response. COVID-19 laboratory testing evolved throughout the year with SCLMC eventually able to conduct a PCR, in-house, 30-minute Covid-19 test for emergency room patients and hospital inpatients. In-house antigen test for symptomatic patients was added in November.SCLMC initially transferred COVID-19 patients to the Sanford USD Medical Center in Sioux Falls. However, increasing case counts and hospitalizations necessitated the treatment of COVID-19 patients locally at a designated area within the med/surge unit. Sanford Clear Lake was also able to provide outpatient monoclonal antibody therapies, which has seen great success in reducing hospitalizations resulting from COVID-19 infections.Once vaccines received emergency use authorization from the FDA, Sanford Clear Lake was eager to play a role in the vaccination effort. By December, the first vaccinations had been given to frontline staff. Staff continue to work closely with state officials and county officials in the vaccination effort and continue to work through population lists and priority lists to provide vaccinations to the public. Identified needs not directly addressed by this facility include:Economic Well-Being - Employment options, skilled labor force, availability of affordable housing and the need for budgeting and money management.Children and Youth - Childhood obesity and bullying Aging - Cost of long term care, availability of resources and cost of services to help the elderly stay in the homes, availability of activities for seniors, and availability and cost of memory careSafety - Abuse of prescription drugsHealth Care - Access to affordable health insurance, access to affordable health care, and availability of behavioral and mental health providersMental Health and Substance Abuse - Depression, stress and tobacco use
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: WellnessAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Westbrook has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Mental Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearWellnessDietician and RN Health Coach Services continued to be offered in 2020 as needed. There were five in-person dietician visits in 2020 and zero dietician telemed visits. The RN Health Coach had 152 visits in 2020, an increase over 2019 levels.As part of the community education effort, staff attended local high school basketball games in February 2020 (for the 2nd year in a row) to share heart health information with the community. Staff also worked with A.C.E. to provide a Bone Builders class two times a week and a Matter of Balance class periodically for area seniors at Peterson Estates, a senior living facility attached to Sanford Westbrook. In March, all community education programs were put on pause due to COVID-19. 2020 saw staff continue the Sanford fit program, which focuses on healthy lifestyle choices to prevent childhood obesity, with the Westbrook Walnut Grove Elementary 4th grade class. Unfortunately, the 2020 session was cut short due to COVID-19 and the schools going to distance learning. Resources for at home learning and exercise were provided to the teachers. The 4th graders took a pre-test, but were unable to take the post-test, hindering ability to measure participant learning from the program.Mental Health and Substance AbuseThe initiative focuses on enhanced access and awareness of community resources for mental health and substance abuse. This includes working with community partners to create new and promote current recovery program options, promoting telemedicine options for behavioral health, and providing community education. The awareness campaigns for telemedicine services and local behavioral health services continued into 2020 but were quickly halted in March due to COVID-19. However, provider referrals were a major factor in the continued use of Sanford Westbrook's in-house behavioral health services. Behavioral Health providers in Westbrook saw 27 new referrals in 2020 and a grand total of 752 visits for the year.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Westbrook's COVID Response included several measures that greatly reduced the possibility of exposures and infection of COVID19 for our communities. Measures included the implementation of telehealth visits, phone visits, and drive through COVID-19 testing to limit patients coming into our facility, masking, screening, and visitor guidelines, and COVID-19 pre-op testing before all surgical procedures.Identified needs not directly addressed by this facility include:Economic Well-Being - Need for employment options, household budgeting, money management and the availability of a skilled labor force Transportation - Availability of public transportationChildren and Youth - Availability and cost of quality childcare, childhood obesity, and teen tobacco useAging - Cost of long term care, and cost of memory careSafety - Abuse of prescription drugs Health Care - Access to affordable health insurance and access to affordable health care
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were inculded.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessment
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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?198
Name and address Type of Facility (describe)
1 1 - Sanford Clinic Aberdeen
3015 3rd Avenue SE
Aberdeen,SD57401
Medical Clinic
2 2 - Sanford Clinic Aberdeen Surgical Center
3015 3rd Avenue SE
Aberdeen,SD57401
Ambulatory Surgery Center
3 3 - Sanford Health Adrian Clinic
201 Maine Ave
Adrian,SD56110
Rural Health Clinic
4 4 - Sanford Health Broadway Clinic
1527 Broadway Street
Alexandria,MN56308
Medical Clinic
5 5 - Sanford Health Easton Place Clinic
510 - 22nd Avenue E Suite 602
Alexandria,MN56308
Medical Clinic
6 6 - Sanford Bagley Clinic
1656 Central St W
Bagley,MN56621
Rural Health Clinic
7 7 - Sanford Bagley Eye Center & Optical
14 2nd St NE
Bagley,MN56621
Eye Care Center
8 8 - Sanford Tracy Balaton Clinic
551 Highway 14 E
Balaton,MN56115
Medicare Certified Rural Health Clinic
9 9 - Sanford Health Bassett Family Clinic
103 Clark St
Bassett,NE68714
Medical Clinic
10 10 - Sanford Health Baudette Eye Center
103 Main St
Baudette,MN56623
Eye Care Center
11 11 - Baker Park Inc
803 Dewey Avenue
Bemidji,MN56601
Assisted Living Center
12 12 - Edith Sanford Breast Center Bemidji
1233 34th St NW
Bemidji,MN56601
Women's Health
13 13 - Sanford Bemidji 1611 Anne St Clinic
1611 Anne St NW
Bemidji,MN56601
Medical Clinic
14 14 - Sanford Bemidji 1705 Ann St Clinic
1705 Anne St NW
Bemidji,MN56601
Medical Clinic
15 15 - Sanford Bemidji Downtown Eye Center & Op
506 Beltrami Ave NW
Bemidji,MN56601
Eye Care Center
16 16 - Sanford Bemidji Home Care & Hospice
3201 Pine Ridge Ave NW
Bemidji,MN56601
Home Care and Hospice
17 17 - Sanford Bemidji Main Clinic
1233 34th St NW
Bemidji,MN56601
Medical Clinic
18 18 - Sanford Dialysis Bemidji
1300 Anne Street NW
Bemidji,MN56601
Dialysis
19 19 - Sanford Health Neilson Place
1000 Anne St NW
Bemidji,MN56601
Skilled Nursing Facility
20 20 - Sanford Health Trillium
930 Anne Street NW
Bemidji,MN56601
Assisted Living Center
21 21 - Sanford Health Windsong
1010 Anne Street N
Bemidji,MN56601
Assisted Living Center
22 22 - Sanford Joe Lueken Cancer Center
1233 34th St NW
Bemidji,MN56601
Cancer Center
23 23 - Sanford Behavioral Health Headwaters ACT
116 3rd St NW
Bemidji,MN56601
Behavioral Health Treatment Center
24 24 - Sanford Health PrimeWest Residential
3124 Hannah Ave NW
Bemidji,MN56601
Behavioral Health & Addiction Center
25 25 - Sanford Clinic Beresford
600 W Cedar Street
Beresford,SD57004
Rural Health Clinic
26 26 - Bismarck Cancer Center
500 N 8th Street
Bismarck,ND58501
Cancer Center
27 27 - Sanford Birth Center
300 N 7th Street
Bismarck,ND58501
Birth Center
28 28 - Sanford Cancer Center Bismarck
300 N 7th Street
Bismarck,ND58501
Cancer Center
29 29 - Sanford Tom & Frances Leach Bismarck Dia
209 N 7th Street
Bismarck,ND58501
Dialysis Center
30 30 - Sanford Clinic
222 N 7th Street
Bismarck,ND58501
Medical Clinic
31 31 - Sanford Children's North Clinic
765 W Interstate Ave
Bismarck,ND58503
Children's Clinic
32 32 - Sanford Bemidji Blackduck Clinic
81 1st St NW
Blackduck,MN56630
Medical Clinic
33 33 - Sanford Boyden Clinic
3971 320th St
Boyden,IA51234
Medical Clinic
34 34 - Sanford Brandon Family Medicine Clinic
1105 E Holly Blvd
Brandon,SD57005
Medical Clinic
35 35 - Sanford Health Brookings Clinic
922 - 22nd Avenue S
Brookings,SD57006
Medical Clinic
36 36 - Sanford Canby Clinic
112 St Olaf Avenue
Canby,MN56220
Medicare Certified Rural Health Clinic
37 37 - Sanford Canby Dental Clinic
11 St Olaf Ave S
Canby,MN56220
Dental Clinic
38 38 - Sanford Canby Dialysis Unit
112 St Olaf Avenue S
Canby,MN56220
Medicare Certified End Stage Renal Dialysis
39 39 - Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220
Medicare Certified Home Health Agency
40 40 - Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220
Class F Home Care Provider
41 41 - Sanford Health Canby Sylvan Place
212 St Olaf Avenue S
Canby,MN56220
Housing with Services
42 42 - Sanford Health CanistotaUSD Clinic
320 W Main St
Canistota,SD57012
Rural Health Clinic
43 43 - Sanford Canton Clinic
400 N Hiawatha Drive
Canton,SD57013
Rural Health Clinic
44 44 - Sanford Health Canton Hiawatha Heights
398 N Hiawatha Drive
Canton,SD57013
Assisted Living Center
45 45 - Sanford Bemidji Cass Lake Clinic
219 Grant Utley Ave NW
Cass Lake,MN56633
Medical Clinic
46 46 - Sanford Chamberlain Clinic
300 S Byron Blvd
Chamberlain,SD57325
Rural Health Clinic
47 47 - Sanford Health Chamberlain Care Center
300 S Byron Blvd
Chamberlain,SD57325
Nursing Facility
48 48 - Sanford Home Health & Hospice Chamberlai
110 W Beebe Ave
Chamberlain,SD57325
Home Health Care & Hospice
49 49 - Sanford Health Clark Clinic
211 N Commercial Street
Clark,SD57225
Rural Health Clinic
50 50 - Sanford Clear Lake Clinic
701 3rd Avenue S
Clear Lake,SD57226
Rural Health Clinic
51 51 - Sanford Clear Lake Medical Center
701 3rd Avenue S
Clear Lake,SD57226
Home Health Care
52 52 - Sanford Bagley Clearbrook Clinic
22 Elm Street
Clearbrook,MN56634
Rural Health Clinic
53 53 - Sanford Health Dakota Dunes Clinic
350 Oak Tree Ln
Dakota Dunes,SD57049
Medical Clinic
54 54 - Sanford Health Dell Rapids Orchard Hills
200 W 10th Street
Dell Rapids,SD57022
Assisted Living Center
55 55 - Sanford Dialysis
1234 Washington Ave Suite B
Detroit Lakes,MN56501
Dialysis Center
56 56 - Sanford Health Detroit Lakes Clinc & Sam
1245 Washington Avenue
Detroit Lakes,MN56501
Ambulatory Surgery Center/Clinic
57 57 - Sanford Health Detroit Lakes Eye Center
1245 Washington Avenue
Detroit Lakes,MN56501
Eye Care Center
58 58 - Sanford Health West Dickinson Clinic
2615 Fairway Street
Dickinson,ND58601
Medical Clinic
59 59 - Sanford Health East Dickinson Clinic
33 9th St W
Dickinson,ND58601
Medical Clinic
60 60 - Sanford Health Hearing Center Dickinson
1531 W Villard St
Dickinson,ND58601
Hearing Center
61 61 - Sanford Health 621 DeMers Ave Clinic
621 DeMers Ave NW
East Grand Forks,MN56721
Medical Clinic
62 62 - Sanford Health 929 Central Ave Clinic
929 Central Ave
East Grand Forks,MN56721
Medical Clinic
63 63 - Sanford Health EGF Dermatology Clinic
625 DeMers Ave NW
East Grand Forks,MN56721
Medical Clinic
64 64 - Sanford Home Care East Grand Forks
404 DeMers Ave
East Grand Forks,MN56721
Home Health Care
65 65 - Sanford Health Edgeley Clinic
506 2nd St
Edgeley,ND58433
Medical Clinic
66 66 - Sanford Luverne Edgerton Clinic
733 Main Ave
Edgerton,MN56128
Rural Health Clinic
67 67 - Sanford Health Ellendale Clinic
141 Main St
Ellendale,ND58436
Rural Health Clinic
68 68 - Sanford Health Enderlin Clinic
201 4th Avenue
Enderlin,ND58027
Rural Health Clinic
69 69 - Sanford Clinic Estelline
305 Hospital Drive
Estelline,SD57234
Rural Health Clinic
70 70 - Edith Sanford Breast Center Fargo
737 Broadway N
Fargo,ND58102
Women's Health
71 71 - Sanford 1711 Medical Building
1711 University Drive S
Fargo,ND58103
Medical Clinic
72 72 - Sanford 1717 Medical Building
1717 Medical Building
Fargo,ND58103
Medical Clinic
73 73 - Sanford Broadway Clinic
801 Broadway N
Fargo,ND58102
Medical Clinic
74 74 - Sanford Children's Broadway Clinic
737 Broadway
Fargo,ND58102
Medical Clinic
75 75 - Sanford Dialysis Fargo
2801 S University Drive
Fargo,ND58122
Dialysis
76 76 - Sanford I-94 Clinic
5225 23rd Avenue South
Fargo,ND58104
Medical Clinic
77 77 - Sanford Home Care Fargo
100 4th Street S
Fargo,ND58103
Home Health Agency
78 78 - Sanford Roger Maris Cancer Center
840 4th Street N
Fargo,ND58102
Cancer Center
79 79 - Sanford South University Eye Center & Op
1717 S University Dr
Fargo,ND58103
Eye Care Center
80 80 - Sanford Children's Southwest Clinic
2701 13th Ave S
Fargo,ND58103
Children's Clinic
81 81 - Sanford Southpointe Eye Center & Optical
2400 32nd Ave S
Fargo,ND58103
Eye Care Center
82 82 - Sanford Health Finley Clinic
407 Washington Ave
Finley,ND58230
Rural Health Clinic
83 83 - Sanford Health Forman Clinic
336 Main St SW
Forman,ND58032
Rural Health Clinic
84 84 - Sanford Dialysis Fort Yates
100 N River Road
Fort Yates,ND58538
Dialysis Center
85 85 - Sanford Health Fosston Eye Center & Opti
111 2nd St NE
Fosston,MN56542
Eye Care Center
86 86 - Sanford Rock Rapids George Clinic
101 N Main
George,IA51237
Rural Health Clinic
87 87 - Sanford Health Gwinner Clinic
69 ND 13
Gwinner,ND58040
Medical Clinic
88 88 - Sanford Health Halstad Clinic
445 1st Street E
Halstad,MN56548
Rural Health Clinic
89 89 - Sanford Health Hartford Clinic
905 N Oaks Ave
Hartford,SD57033
Medical Clinic
90 90 - Sanford Sheldon Hartley Clinic
512 3rd St NE
Hartley,IA51346
Medical Clinic
91 91 - Sanford Hawley Clinic
1412 Main St
Hawley,MN56549
Medical Clinic
92 92 - Sanford Health Comstock Corner
12 3rd Street SE
Hillsboro,ND58045
Assisted Living Center
93 93 - Sanford Hillsboro Care Center
12 3rd Street SE
Hillsboro,ND58045
Hospital Based-Nursing Facilities LTC
94 94 - Sanford Health Hillsboro Clinic
315 East Caledonia
Hillsboro,ND58045
Rural Health Clinic
95 95 - Sanford Health Dialysis Hospers
112 Sunrise Drive
Hospers,IA51238
End Stage Renal Dialysis
96 96 - Sanford Health International Falls Eye C
1400 Highway 71
International Falls,MN56649
Eye Care Center
97 97 - Sanford Health Inwood Clinic
303 E Jefferson St
Inwood,IA51240
Medical Clinic
98 98 - Sanford Clinic Ipswich
110 5th Avenue
Ipswich,SD57451
Rural Health Clinic
99 99 - Sanford Jackson Clinic
1430 North Highway
Jackson,MN56143
Medicare Certified Rural Health Clinic
100 100 - Sanford Dialysis Jamestown
300 2nd Avenue NE
Jamestown,ND58401
Dialysis Center
101 101 - Sanford Health Hearing Center Jamestown
904 5th Ave NE
Jamestown,ND58401
Hearing Center
102 102 - Sanford Health Jamestown 2nd Ave Clinic
300 2nd Avenue NE
Jamestown,ND58401
Medical Clinic
103 103 - Sanford Health Jamestown 5th Ave Clinic
904 5th Ave NE
Jamestown,ND58401
Medical Clinic
104 104 - Sanford Health Kelliher Clinic
243 Clark Ave N
Kelliher,MN56650
Medical Clinic
105 105 - Sanford Chamberlain Kimball Clinic
101 S Main St
Kimball,SD57355
Rural Health Clinic
106 106 - Sanford Children's Clinic
3001 Daggett St
Klamath Falls,OR97601
Medical Clinic
107 107 - Sanford Health Lake Norden Clinic
512 Main Ave
Lake Norden,SD57248
Rural Health Clinic
108 108 - Sanford Jackson Lakefield Clinic
209 Main Street
Lakefield,MN56150
Medicare Certified Rural Health Clinic
109 109 - Sanford Health Lake Park Clinic
215 N Market St
Lake Park,IA51347
Medical Clinic
110 110 - Sanford Health LaMoure Clinic
101 1st Ave SW
LaMoure,ND58458
Rural Health Clinic
111 111 - Sanford Health Lennox Clinic
108 S Main
Lennox,SD57039
Rural Health Clinic
112 112 - Sanford Health Lidgerwood Clinic
21 Wiley Ave S
Lidgerwood,ND58053
Medical Clinic
113 113 - Sanford Health Lisbon Clinic
102 10th Ave W
Lisbon,ND58054
Medical Clinic
114 114 - Sanford Home Care Lisbon
404 Forest St
Lisbon,ND58054
Home Health Care
115 115 - Sanford Home Health Luverne
304 N McKenzie St
Luverne,MN56156
Home Health Care
116 116 - Sanford Luverne Clinic
1601 Sioux Valley Dr
Luverne,MN56156
Medical Clinic
117 117 - Sanford Luverne Hospice
217 N Oakley St
Luverne,MN56156
Medicare Certified Hospice
118 118 - Sanford Dialysis
323 SW 10th Street
Madison,SD57042
End Stage Renal Dialysis
119 119 - Sanford Hospice Madison
900 2nd Avenue
Madison,MN56256
Hospice (licensed in SD)
120 120 - Sanford Health Mahnomen Clinic
410 W 4th St
Mahnomen,MN56557
Rural Health Clinic
121 121 - Sanford Home Care Mahnomen
414 W Jefferson Ave
Mahnomen,MN56557
Home Health Care
122 122 - Sanford Home Care Bismarck
910 18th Street NW
Mandan,ND58554
Home Health Agency
123 123 - Sanford East Mandan Clinic
102 Mandan Ave
Mandan,ND58554
Medical Clinic
124 124 - Sanford Home Care Mayville
49 7th Ave SE
Mayville,ND58257
Home Health Care
125 125 - Sanford Mayville Clinic
600 1st St SE
Mayville,ND58257
Medical Clinic
126 126 - Sanford Health Highway 2 Clinic
801 21st Ave SE
Minot,ND58701
Medical Clinic
127 127 - Sanford Health Northwest Clinic
1500 21st Ave NW
Minot,ND58701
Medica
128 128 - Sanford Health Minneota Clinic
700 N Monroe St
Minneota,MN56264
Rural Health Clinic
129 129 - Sanford Health Mitchell Clinic
2100 Highland Way
Mitchell,SD57301
Medical Clinic
130 130 - Sanford Dialysis Morris
400 1st Street East
Morris,MN56267
Dialysis
131 131 - Sanford Health Mountain Lake Clinic
308 N 8th Street
Mountain Lake,MN56159
Medicare Certified Rural Health Clinic
132 132 - Sanford Health Oakes Clinic
420 7th St S
Oakes,ND58474
Medical Clinic
133 133 - Sanford Children's Clinic
3605 Vista Way
Oceanway,CA92056
Children's Clinic
134 134 - Sanford Health Park Rapids Clinic
110 7th St W
Park Rapids,MN56470
Medical Clinic
135 135 - Sanford Health Parkers Prairie Clinic
115 E Soo Street
Parkers Prairie,MN56361
Medical Clinic
136 136 - Sanford Health Pelican Rapids Clinic
211 East Mill Street
Pelican Rapids,MN56572
Rural Health Clinic
137 137 - Sanford Home Care Pelican Rapids
211 East Mill Street
Pelican Rapids,MN56572
Home Health Care
138 138 - Sanford Health Pierre Clinic
521 E Sioux Ave
Pierre,SD57501
Medical Clinic
139 139 - Sanford Dialysis Red Lake
24760 Hospital Drive
Red Lake,MN56671
Dialysis
140 140 - Sanford Rock Rapids Clinic
803 South Green Street
Rock Rapids,IA51246
Rural Health Clinic
141 141 - Sanford Sheldon Sanborn Clinic
321 Main Street
Sanborn,IA51248
Medical Clinic
142 142 - Sanford Health Sheldon Care Center
118 North Seventh Avenue PO Box 250
Sheldon,IA51201
Home Health Agency and Hospice
143 143 - Sanford Senior Care Sheldon
118 North Seventh Avenue PO Box 250
Sheldon,IA51201
Hospital Based-Nursing Facilities
144 144 - Sanford Sheldon Clinic
800 Oak Street
Sheldon,IA51201
Rural Health Clinic
145 145 - Ava's House
1320 W 17th Street
Sioux Falls,SD57104
Nursing Facility
146 146 - Sanford 10th & Phillips Acute Care & Ort
136 S Phillips Ave
Sioux Falls,SD57104
Medical Clinic
147 147 - Sanford 27th & Sycamore Family Medicine
4405 E 26th St
Sioux Falls,SD57103
Medical Clinic
148 148 - Sanford 32nd & Ellis Clinic
2601 S Ellis Road
Sioux Falls,SD57106
Medical Clinic
149 149 - Sanford Family Medicine 34th & Kiwanis
2701 S Kiwanis Ave
Sioux Falls,SD57105
Medical Clinic
150 150 - Sanford 49th & Oxbow Family Medicine
3401 W 49th Street
Sioux Falls,SD57106
Medical Clinic
151 151 - Sanford 4th & Sycamore Family Medicine
600 N Sycamore Ave
Sioux Falls,SD57110
Medical Clinic
152 152 - Sanford Cancer Center
1309 W 17th St
Sioux Falls,SD57104
Cancer Center
153 153 - Sanford Children's MB2 Clinic
1205 S Grange Ave
Sioux Falls,SD57105
Children's Clinic
154 154 - Sanford Children's Residency Clinic
6101 S Louise Ave
Sioux Falls,SD57108
Children's Clinic
155 155 - Sanford Children's Specialty Clinic
1605 W 22nd St
Sioux Falls,SD57117
Children's Clinic
156 156 - Sanford Dialysis Sioux Falls
1321 W 22nd Street
Sioux Falls,SD57117
Dialysis Center
157 157 - Sanford Eye Center & Optical
1621 S Minnesota Ave
Sioux Falls,SD57105
Eye Care Center
158 158 - Sanford Fetal Care Center
1500 W 22nd Street
Sioux Falls,SD57105
Birth Center
159 159 - Sanford Health Midtown Family Planning C
1205 S Grange Ave
Sioux Falls,SD57105
Medical Clinic
160 160 - Sanford Hospice
2710 West 12th Street
Sioux Falls,SD57104
Hospice (licensed in MN and SD)
161 161 - Sanford Imagenetics
1321 W 22nd Street
Sioux Falls,SD57117
Genetics
162 162 - Sanford Home Health Sioux Falls
2710 West 12th Street
Sioux Falls,SD57104
Home Health Care
163 163 - The Birth Place
1305 W 18th Street
Sioux Falls,SD57105
Birth Center
164 164 - Sanford Health Eye Clinic
2310 S Marion Rd 140
Sioux Falls,SD57106
Eye Care Center
165 165 - Northern Lights Community Residence
921 Atlantic Ave N
Thief River Falls,MN56701
Community Residence
166 166 - Sanford Behavioral Health Outpatient Cli
120 Labree Avenue S
Thief River Falls,MN56701
Behavioral Health Treatment Center
167 167 - Sanford Dialysis Thief River Falls
120 Labree Avenue S
Thief River Falls,MN56701
Dialysis
168 168 - Sanford Health Thief River Falls Eye Cen
1720 Highway 59 S
Thief River Falls,MN56701
Eye Care Center
169 169 - Sanford Medical Center Thief River Falls
1720 Highway 59 S
Thief River Falls,MN56701
Medical Clinic
170 170 - Sanford Health Tracy O'Brien Court
410 State Street
Tracy,MN56175
Housing with Services
171 171 - Sanford Tracy Clinic
249 Fifth Street E
Tracy,MN56175
Medicare Certified Rural Health Clinic
172 172 - Shetek Medical Services
251 5th St E
Tracy,MN56175
Medical Clinic
173 173 - Sanford Health Twin Valley Clinic
501 2nd St NW
Twin Valley,MN56584
Rural Health Clinic
174 174 - Sanford Health Ulen Clinic
108 Viking Avenue W
Ulen,MN56585
Rural Health Clinic
175 175 - Sanford Health Valley City Clinic
520 Chautauqua Blvd
Valley City,ND58072
Medical Clinic
176 176 - Sanford Health Vermillion Clinic
20 S Plum Street
Vermillion,SD56069
Medical Clinic
177 177 - Sanford Health Vermillion Dakota Gerdens
126 S Plum Street
Vermillion,SD57069
Residential Living Center
178 178 - Sanford Hospice
848 East Cherry Street
Vermillion,SD57069
Hospice
179 179 - Sanford Vermillion Care Center
20 S Plum Street
Vermillion,SD57069
Nursing Facility
180 180 - Sanford Dialysis
111 Washington Ave NW
Wagner,SD57380
Dialysis Center
181 181 - Sanford Clinic Wahpeton
332 2nd Ave N
Wahpeton,ND58075
Medical Clinic
182 182 - Sanford Health Wahpeton Eye Center & Opt
332 2nd Ave N
Wahpeton,ND58075
Eye Care Center
183 183 - Sanford Health Walker Clinic
614 Michigan Avenue
Walker,MN56484
Rural Health Clinic
184 184 - Sanford Health Walker Rehab
106 5th St S
Walker,MN56484
Rehabilitative Services
185 185 - Sanford Tracy Walnut Grove Clinic
810 8th St
Walnut Grove,MN56180
Medicare Certified Rural Health Clinic
186 186 - Sanford Health Watertown Clinic
901 4th Street NW
Watertown,SD57201
Medical Clinic
187 187 - Sanford Webster Clinic
101 Peabody Drive
Webster,SD57274
Rural Health Clinic
188 188 - Sanford Health Westrook Peterson Estates
1012 9th Street
Westbrook,MN56183
Housing with Services
189 189 - Sanford Westbrook Clinic
920 Bell Avenue
Westbrook,MN56183
Medicare Certified Rural Health Clinic
190 190 - Sanford Home Care Wheaton
405 12th St N
Wheaton,MN56926
Home Health Care
191 191 - Sanford Wheaton Clinic
401 12th St N
Wheaton,MN56926
Rural Health Clinic
192 192 - Sanford Clinic Windom
591 2nd Avenue N
Windom,MN56101
Medicare Certified Rural Health Clinic
193 193 - Sanford Hospice Winner
745 E 8th Street
Winner,SD57580
Hospice
194 194 - Sanford Dialysis
1018 Sixth Avenue
Worthington,MN56187
Dialysis Center
195 195 - Sanford Health Cancer Center
1018 Sixth Avenue
Worthington,MN56187
Cancer Center
196 196 - Sanford Hospice
1151 Ryans Road Suite 100
Worthington,MN56187
Hospice (licensed in SD)
197 197 - Sanford Worthington Clinic
1680 Diagonal Road
Worthington,MN56187
Medical Clinic
198 198 - Sanford Worthington Medical Center
1018 Sixth Avenue
Worthington,MN56187
Medicare Certified End Stage Renal Dialysis
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 3c: Sanford Health does not deny care to anyone based on the ability to pay. Sanford's Financial Assistance (charity care) policy provides discounted and free services to patients who lack the resources to be fully responsible for the healthcare they receive. The Financial Assistance Policy is designed to ensure the entire community served by Sanford has access to needed healthcare services. Eligibility for discounted or free services under the Financial Assistance Policy is based on income levels and family size. Generally, individuals earning income of up to 375% of the Federal Poverty Income Guidelines are eligible for varying levels of discounts, including full discounts for certain income levels. Applications for coverage under the program may be obtained at any Sanford patient registration area.The primary scope of Sanford's financial assistance matrix considers family income and family size to objectively determine financial need. The family income range varies from 0-225% up to 375% of the Federal Poverty Level (FPL). An applicant over 375% may be eligible for some level of financial assistance based on a review of additional factors such as: the size of the account balance, debt-to-income ratio, current assets, current liabilities, IRS food expense allowances, monthly cash flow, etc.Additionally, it is possible for a family to qualify in one segment (based on income and family size alone) but be moved to a more generous (for the patient) segment based on the other financial variables mentioned above. An applicant may be denied if they have substantial assets and applicants are considered on a case by case basis.The Amount Generally Billed (AGB) discount percentage is the least amount Sanford can discount for any patient qualifying under the Sanford Financial Assistance Policy. It is the percentage used for the lowest level of assistance granted for those qualifying under the Sanford Financial Assistance Policy as listed on Appendix 1 - Sliding Discount Schedule for Assistance. Anyone else qualifying for assistance at greater levels will receive discount amounts greater than the Sanford AGB discount amount. Part I, Line 5b: Sanford as a whole did not exceed its financial assistance budget for CY 2020, however, if they would have exceeded their budget it would not impact their ability to serve any patients and no patients would be disallowed services. The organization provided free or discounted services to patients who were eligible for free or discounted care.Part I, Line 6: Sanford Health's Community Benefit Annual Report is posted annually on the Sanford website at:http://www.sanfordhealth.org/about/community-benefit
Part I, Line 7: Cost to Charge Ratios are used to calculate the amounts on Line 7a - 7c (Financial Assistance, Medicaid Shortfall, and Other Means-Tested Government Programs) and also Line 7g (Subsidized Health Services) for each of the subsidiaries included in the return. All other amounts for Lines 7e, 7f, 7h and 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio, or similar cost accounting methodology. These costs still represent the costs to provide benefits.
Part I, Line 7g: Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. Each loss has been calculated after removing losses associated with bad debts, financial assistance and Medicaid. Although these services generate overall losses to Sanford, they continue to meet the needs of the communities served. Various services that generate losses are provided by Sanford through physician practices. For CY 2020, subsidized health services provided through clinic physician practices generated losses of $98,339,610.
Part II, Community Building Activities: Sanford Health is a not-for-profit organization dedicated to the work of health and healing for the public good. Sanford is committed to giving back to the communities in which its employees and patients live and work. Sanford invests resources in order to produce the best outcomes for patient care, education, research, and community enrichment, and partners with others to ensure that the community is a welcoming, healthy environment and one that attracts and sustains a diverse Sanford workforce to deliver the best patient care and much needed medical research. Sanford considers requests for funding and in kind support for new and ongoing programs with all areas supporting the above goals, such as basic human services, education and workforce development by recruiting physicians and other health professionals to medical shortage or underserved areas and collaborating with educational institutions to train and recruit health professionals, advocating community health improvement through efforts to support policies and programs that safeguard or improve public health and help to ensure access to health care services.
Part III, Line 2: Bad debt expense at cost is determined using the same cost to charge ratios that are used to calculate Financial Assistance and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad Debt Expense.
Part III, Line 3: It is Sanford's policy to make financial assistance available to patients who fit the financial assistance criteria. It is the organization's goal to make certain that Sanford is proactive in identification of the patients who need help with financial concerns. Financial counselors make every effort to ensure that financial assistance eligible patients do not progress to bad debt. For this reason, a dollar amount for bad debt is not included.
Part III, Line 4: The audited financial statements of Sanford do not include a bad debt footnote. Sanford reports bad debt in accordance with generally accepted accounting principles (GAAP).
Part III, Line 8: Per IRS instructions, Sanford has identified the cost associated with providing Medicare services from the Medicare cost report. The Medicare cost report calculations are total expense less expenses deemed "unallowable" per Medicare regulations. The net expense is then used to calculate the cost per day and cost to charge ratios which are multiplied by the Medicare days and ancillary charges to determine the cost of providing Medicare services. If all expenses that Sanford incurred were included on the Medicare cost report; this would show a shortfall of approximately $303,103,745. Sanford believes this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if it was not provided by Sanford.
Part III, Line 9b: Sanford will provide services at no cost or reduced cost to patients who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guideline will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commercial insurance, or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges. Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle.Sanford has zero tolerance for abusive, harassing, oppressive, false, deceptive, or misleading language of collections conduct. This zero tolerance applies to internal Sanford staff and third party collection vendors and attorneys.Neither Sanford nor any of its third party collection vendors will take any extraordinary collection efforts until Sanford and the third party collection vendor have made reasonable efforts to determine if a patient is eligible for financial assistance under the Financial Assistance Policy.
Part VI, Line 2: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Part VI, Line 3: Sanford employs a variety of strategies to make certain that the organization is transparent in the communication of financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities display signage in registration areas advising patients of their ability to request financial assistance. The signage was made available in English and Spanish. Alternate languages were included on the signage that basically stated, if you need interpreter services, please inquire at the registration desk. Financial Assistance applications were available in English, Spanish, Chinese, German, Hindi, Korean, Laotian and Vietnamese upon request or on the Sanford website. All healthcare workers who identify patients with financial need are encouraged to provide patients or their designees a financial application. This may include, but not be limited to the following areas: Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial Counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services.Sanford's Financial Assistance Program is available to anyone who qualifies for assistance. This program ensures that all people receive the care they need, regardless of their financial situation. Sanford makes Financial Assistance information available to community agencies and referral organizations. Financial Assistance information is also available on the Sanford website at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policyfinancial-assistance-policy
Part VI, Line 4: Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 24 hospitals and nearly 448 clinics in 158 locations in nine states and three countries. Sanford Health's approximately 36,000 employees, including 1,500 physicians, make it the largest employer in the Dakotas. Sanford USD Medical Center - Sioux Falls, South DakotaSioux Falls is the largest city in the state of South Dakota and is the County seat of Minnehaha County. Sioux Falls also extends into Lincoln County. The 2020 U.S. Census Bureau estimates a total population of 187,809 for Sioux Falls. According to the 2020 County Health Rankings, the population of Minnehaha County is 82.0% white, 6.0% African American, 2.8% American Indian, 2.1% Asian and 5.1% Hispanic. Sioux Falls is a significant regional health care center. Only 2% of the population is reported to be not proficient in English. The median household income in Sioux Falls is $63,200.Sanford Medical Center Fargo - Fargo, North DakotaFargo is the largest city in North Dakota, accounting for 24% of the state's population. Fargo is also the county seat of Cass County. The 2020 United States Census estimates the population of Fargo was 125,209. According to the 2020 County Health Rankings, the population of Cass County is 84.4% white, 6.2% African American, 1.5% American Indian, 3.4% Asian and 2.8% Hispanic. Only 1% of the population is reported to be not proficient in English. The median household income is $64,000. Sanford Bemidji Medical Center - Bemidji, MinnesotaBemidji is located in Beltrami County, Minnesota. Bemidji houses many Native American Services, including the Indian Health Service. The city is the central hub of the Red Lake Indian Reservation, White Earth Indian Reservation, and the Leech Lake Indian Reservation. According to the 2020 United States Census estimates, the population of Bemidji is 15,452. According to the 2020 County Health Rankings, the population of Beltrami County is 71.7% white, 0.8% African American, 22% American Indian, 0.8% Asian and 2.6% Hispanic. 0% of the population is reported to be not proficient in English. The median household Income is $54,600.Sanford Bismarck Medical Center - Bismarck, North DakotaBismarck is a city located in Burleigh County in central North Dakota. Bismarck is experiencing fast-paced growth as a direct result of oil development throughout the western part of the state. Bismarck is the state capital and is the second largest city in the state of North Dakota with an estimated population of 74,018. According to the 2020 County Health Rankings, the population of Burleigh County is 88.2% white, 2.3 African American, 4.3% American Indian, 0.9% Asian and 2.8% Hispanic. 0% of the population is reported to be not proficient in English. The median household income is $70,100.Sanford Network HospitalsSanford Health Network Hospitals is a network of rural hospitals located throughout South Dakota, North Dakota, Minnesota, and Iowa.Sanford ClinicsSanford Clinic is a multi-specialty clinic comprised of 1,400 physicians providing services in the US as well as internationally.
Part VI, Line 5: Sanford maintains an open medical staff. Community Boards - The Sanford Board of Trustees was comprised of 12 members at the end of the calendar year, including 8 community members, 3 physicians and the CEO. Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve patients and communities.
Part VI, Line 6: Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 24 hospitals and nearly 450 clinics in nine states and three countries. Sanford Health's 36,000 employees, including 1,500 physicians, make it the largest employer in the Dakotas.Sanford Health provides services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area and a network of children's primary care clinic locations across the country and world. Sanford Health operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford Health financially supports health and wellness, education and community development activities to improve the quality of life and strenghten communities throughout the region. Each facility promotes health and healing that responds to the unique needs of the patients in the community, ensuring access to comprehensive and specialized services. Part VI, Line 7: Community benefit reporting is not required and therefore not filed in North Dakota, South Dakota, Nebraska or Iowa. Filing in Minnesota is voluntary.
Schedule H (Form 990) 2020
Additional Data


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) ABERDEEN CATHOLIC SCHOOL
1400 N Dakota Street
Aberdeen,SD57401
46-0334005 501(c)(3) 25,000       Capital Campaign for Revitalizing Roncalli High School to include building renovations with a new geothermal heating and cooling system, new windows new spinkler and fire alarm system, new lights and ceilings, adding new boys & girls bathrooms to each wing and new faculty bathrooms; new carpeting in m ost classrooms and upgraded central offices.
(2) ABERDEEN FAMILY YMCA
5 S STATE ST
ABERDEEN,SD57401
46-0255779 501(c)(3) 15,000       Capital Campaign for their Youth Development Center
(3) ABERDEEN LIBRARY FOUNDATION
PO BOX 1008
ABERDEEN,SD57402
46-0428183 501(c)(3) 10,000       General Support
(4) ABERDEEN PUBLIC SCHOOLS FOUNDA
1224 S 3RD ST
ABERDEEN,SD57401
46-0423109 501(c)(3) 40,000       Foundation donation contribution $20k; Scholarship fund contribution $10k; Student activity contribution $10k
(5) ABERDEEN SCHOOL DISTRICT
1224 3RD ST SOUTH
ABERDEEN,SD57401
46-6000912 115 10,800       Donations toward support of sports events at the Aberdeen School District via scoreboard contract
(6) ACTIVE GENERATIONS
2300 W 46TH ST
SIOUX FALLS,SD57105
46-0305500 501(c)(3) 5,797       Hot meal bags donation $3800; $1997 Active Generations at the Levitt
(7) ALEXANDRIA AREA ARTS ASSN
618 BROADWAY ST
ALEXANDRIA,MN56308
51-0171992 501(c)(3) 10,000       Donation to the area arts program
(8) ALL STAR BOOSTER CLUB
3009 S PHILIPS AVE
SIOUX FALLS,SD57105
36-3897227 501(c)(3) 10,000       Donation toward the state gymnastics meet $10k
(9) ALLIANCE FOR CELL THERAPY NOW
611 PENNSYLVANIA AVE SE 267
WASHINGTON,DC20003
47-5183080 501(c)(6) 100,000       Donation to advance national cell therapy registry
(10) ALUMNI ATHLETICA LLC
3000 MIDLANTIC DR STE 100
MOUNT LAUREL,NJ08054
84-3266506   300,000       General Support
(11) ALZHEIMERS ASSOC
225N MICHIGAN AVE FLOOR 17
CHICAGO,IL60601
13-3039601 501(c)(3) 11,500       Walk to End Alzheimer's
(12) AMERICAN CANCER SOCIETY CANCER ACTION NETWORK INC
555 11TH ST NW
WASHINGTON,DC20004
52-2340031 501(c)(4) 7,500       Relay for Life & Gala events in Sioux Falls and Fargo
(13) AMERICAN FOUNDATION FOR SUICIDE PREVENTION
120 WALL STREET FL 29
NEW YORK,NY10005
13-3393329 501(c)(3) 11,000       Out of Darkness Walk
(14) AMERICAN RED CROSS
808 WEST AVE N
SIOUX FALLS,SD57104
53-0196605 501(c)(3) 45,000       Crisis funding donations, general support
(15) AMERICAN CANCER SOCIETY
250 WILLIAMS ST 4TH FL
ATLANTA,GA30303
13-1788491 501(c)(3) 554,500       Coaches vs Cancer and Relay for Life & Gala events in Sioux Falls and Fargo
(16) AMERICAN GOLD GYMNASTICS INC
2001 17TH AVE S
FARGO,ND58103
45-0333196 501(c)(3) 40,000       Annual donation pledge for support and sports medicine
(17) ARTS PARTNERSHIP
1104 2ND AVE S STE 315
FARGO,ND58104
23-7108936 501(c)(3) 15,000       Donation that funds many small grants to FM area arts organizations
(18) AUGUSTANA UNIVERSITY
2001 S SUMMIT AVE
SIOUX FALLS,SD57197
46-0224588 501(c)(3) 2,093,625       Horizon 2030 Gift; General Support; Scholarships; PS Professorship
(19) BEMIDJI AREA SCHOOLS
502 Minnesota Ave
BEMIDJI,MN56619
41-6000181 115 120,600       Angel Fund Donation
(20) BEMIDJI BLUE OX MARATHON
PO Box 633
Bemidji,MN56619
46-1700357 501(c)(3) 7,500       General Support
(21) BEMIDJI COMMUNITY ARENA CORP
PO BOX 1726
BEMIDJI,MN566191726
81-3622011 501(c)(3) 109,971       Donation to Naming Rights and Sign Sponsorship
(22) BEMIDJI JAYCEES
PO BOX 293
BEMIDJI,MN56619
41-1383120 501(c)(4) 8,803       General Support
(23) BEMIDJI SYMPHONY ORCHESTRA
PO BOX 3136
BEMIDJI,MN56619
39-2017074 501(c)(3) 12,500       Donation to the Support of the local symphony for the community
(24) BIG IDEA COMMITTEE (ABERDEEN CHAMBER OF COMMERCE)
416 PRODUCTION STREET NORTH
ABERDEEN,SD57401
46-0103710 501(C)(6) 6,500       Support for development and wellness initiatives in Aberdeen
(25) BIO GIRLS INC
4151 38TH STSTE A
FARGO,ND58104
81-0792142 501(c)(3) 7,800       Donation to self-esteem programming for girls 7-12
(26) BISHOP DUDLEY HOSPITALITY HOUS
101 N INDIANA AVE
SIOUX FALLS,SD57103
91-1836526 501(c)(3) 22,000       Donation to homeless shelter
(27) BISHOP OGORMAN CATHOLIC SCHOOL
3100 W 41ST ST
SIOUX FALLS,SD57105
46-0413591 501(c)(3) 64,250       Donation to Teacher's Salary Inititive, Dakota Bowl and Charity Tournament
(28) BISMARCK CANCER CENTER
500 N 8TH ST
BISMARCK,ND58501
45-0454363 501(c)(3) 16,000       General Support
(29) BISMARCK EVENT CENTER CITY OF BISMARCK
221 N 5TH ST
BISMARCK,ND58501
45-6002036 115 5,397       Sanford Classic-venue rental fee host ESBC Clasic basketball games
(30) BISMARCK LARKS BASEBALL TEAM
300 N 4TH ST STE 103
BISMARCK,ND58501
81-3163412   39,500       2020 Sponsorship in relation to Sports Med coverage contract
(31) BISMARCK MANDAN CHAMBER FDTN
1640 BURNT BOAT DR
BISMARCK,ND58503
26-3807225 501(c)(3) 17,000       Community Bowl Project & Bis Public Schools Tournament Fund
(32) BISMARCK MANDAN CHAMBER EDC
1640 BURNT BOAT DR
BISMARCK,ND58503
45-0116753 501(c)(6) 17,536       Culmination of several different community events for 2021
(33) BISMARCK PARKS AND RECREATION DISTRICT
400 E FRONT AVE
BISMARCK,ND58504
45-0409352 115 10,250       Schaumberg Ice Expansion $10k; $250 Babe Ruth World Series Donation
(34) BISMARCK PUBLIC SCHOOLS
806 N WASHINGTON ST
BISMARCK,ND58501
45-6000242 115 136,800       Sports Complex, Academic Donation and Athletics Donations
(35) THE BISMARCK STATE COLLEGE FOUNDATION
PO BOX 5587
BISMARCK,ND585065587
45-0358929 501(c)(3) 800,000       Health Sciences Pledge
(36) BOY SCOUTS OF AMERICA VOYAGEURS AREA COUNCIL
3877 STEBNER RD
HERMANTOWN,MN55811
41-0695583 501(c)(3) 6,542       General Support
(37) BOYS & GIRLS CLUB OF ABERDEEN AREA INC
1121 1ST AVE SE
ABERDEEN,SD57401
23-7062273 501(c)(3) 9,350       It Just Takes One annual campaign and annual Golf for Kids event
(38) BOYS & GIRLS CLUB OF THE BEMIDJI AREA
PO BOX 191
BEMIDJI,MN566190191
81-0599601 501(c)(3) 11,040       Donation to support at risk youth programs in the Bemidji Area
(39) BRANDON VALLEY BASEBALL ASSOC
PO BOX 605
BRANDON,SD57005
46-0401362 501(c)(3) 28,000       Field of Dreams Project
(40) BRANDON VALLEY BOOSTER CLUB
PO BOX 572
BRANDON,SD57005
46-0393971 501(c)(3) 40,500       Scoreboards $10,500; Video board donation $40k
(41) BRANDON VALLEY SCHOOL
300 S SPLITROCK BLVD
BRANDON,SD57005
46-6002577 501(c)(6) 7,300       Academics & athletics, Power Program, OSM logo wear and State Championship donations
(42) BROOKINGS HEALTH SYSTEM
525 Western Ave
Brookings,SD57006
46-6000069 115 20,000       Progress Lives Here capital campaign donation $20k
(43) BSC MLT
PO Box 5587
Bismarck,ND585065507
45-0358929 501(c)(3) 73,164       General Support
(44) BSN SPORTS LLC
PO Box 660176
Dallas,TX76206
47-2460272   7,436       Bismarck Event Center Annual Advertising
(45) CAMP CAMBRIA FOUNDATION
805 ENTERPRISE DR EAST H
BELLE PLAINE,MN56011
47-4296984 501(c)(3) 200,000       Tennis court reconstruction
(46) CANTON SCHOOLS
800 N MAIN ST
CANTON,SD57013
46-6002143 115 16,435       Annual use of Suite at Newman Outdoor Field for employee and community engagement
(47) CAPTAIL VOLLEYBALL CLUB
607 WEYBURN DR
BISMARCK,ND58503
81-1302972 501(c)(3) 7,500       Splash Pad donation
(48) CHAMBER OF COMMERCE FMWF
PO BOX 2443
FARGO,ND581082443
45-0448041 501(c)(6) 15,620       Sheldon Events Center donation
(49) CHARIS MINISTRY PARTNERS
1300 E 10TH ST
SIOUX FALLS,SD57103
38-3775128 501(c)(3) 7,000       Webster Active Living Trail donation
(50) CHILDREN OF THE NATIONS
PO BOX 3970
SILVERDALE,WA98383
91-1702551 501(c)(3) 15,000       Huether Family Aquatics Center donation
(51) CHILDRENS HOME SOCIETY OF SD
PO BOX 1749
SIOUX FALLS,SD571011749
46-0224542 501(c)(3) 12,900       Donation - Youth empowering non-profit organization
(52) Children's Hospital Colorado
13123 E 16TH AVE
AURORA,CO80045
84-0166760 501(c)(3) 240,000       Building Project Capital Campaign donation
(53) CITY OF BISMARCK
221 N 5TH ST
BISMARCK,ND58501
45-6002036 115 35,000       Annual Contribution per donation agreements in support of various programs such as nursing and sports medicine
(54) CITY OF CANBY
210 N Dakota Street
Canton,SD57013
46-6000083 115 7,500       Tennis court reconstruction
(55) CITY OF FARGO
225 4TH STREET N
FARGO,ND58102
45-6002069 115 6,500       Annual use of Suite at Newman Outdoor Field for employee and community engagement
(56) CITY OF JACKSON
80 W Ashely Street
Jackson,MN56143
41-6005262 115 10,000       Splash Pad donation
(57) CITY OF SHELDON
416 9th Street PO Box 276
Sheldon,IA51201
42-6005194 115 50,000       Sheldon Events Center donation
(58) CITY OF WEBSTER
PO BOX 539
WEBSTER,SD57274
46-6000530 115 7,143       Webster Active Living Trail donation
(59) CITY OF YANKTON
PO BOX 176
YANKTON,SD57078
46-6000567 115 10,000       Huether Family Aquatics Center donation
(60) COLLISION FIRST PRIORITY OF SIOUX FALLS
3815 S WESTERN AVE
SIOUX FALLS,SD57105
26-3765706 501(c)(3) 12,000       Donation - Youth empowering non-profit organization
(61) COMMUNITY MEMORIAL HOSPITAL
814 JACKSON ST
BURKE,SD57523
46-0219795 501(c)(3) 25,000       Building Project Capital Campaign donation
(62) CONCORDIA COLLEGE
901 8TH STREET S
MOORHEAD,MN565609981
41-0693977 501(c)(3) 886,000       Annual Contribution per donation agreements in support of various programs such as nursing and sports medicine
(63) CREIGHTON UNIVERSITY
2500 California Plaza
Omaha,NE68178
47-0376583 501(c)(3) 250,000       General Support
(64) CURA FOUNDATION
PO BOX 5298
NEW YORK,NY10185
26-1150435 501(c)(3) 1,000,000       Vatican Foundation
(65) CYSTIC FIBROSIS FOUNDATION
4550 MONTGOMERY AVE N SUITE 1100
BETHESDA,MD20814
13-1930701 501(c)(3) 17,500       Support to seven events throughout the region for Cystic Fibrosis fundraisers to include Great Strides walks in Fargo, SF, Brookings, Bismarck, Rapid City; a golf tournament and Corks & Kegs event in SF. ($5,000 for each event) Battle for Brooks team in SF for $500.
(66) DAKOTA ALLIANCE SOCCER CLUB
401 W 39TH ST
SIOUX FALLS,SD57105
46-0359817 501(c)(3) 74,250       Yearly donation of $60k; donation of black competitive jerseys $11,250; Legends grant $3000
(67) DAKOTA MEDICAL FOUNDATION
4141 28TH AVE SOUTH
FARGO,ND58104
45-6012318 501(c)(3) 25,000       Donation for Recovery Reinvented - North Dakota's First lady conference in regards to addiction
(68) DAKOTA STATE UNIVERSITY
820 N WASHINGTON AVE
MADISON,SD57042
46-6000364 501(c)(3) 524,840       Ortho Sports Med Contract
(69) DAKOTA WEST ARTS COUNCIL INC
1810 SCHAFER ST STE 2
BISMARCK,ND58501
45-0358000 501(c)(3) 10,000       Capital City Christmas $10k
(70) DENNY SANFORD PREMIER CENTER
1201 N WEST AVE
SIOUX FALLS,SD57104
23-2511871 501(c)(3) 61,600       Donation for Mamava nursing pods
(71) DETROIT LAKES SCHOOLS
702 LAKE AVE
DETROIT LAKES,MN56501
41-0971772 115 20,000       Annual Contribution per donation agreement for sports medicine program
(72) DICKINSON STATE UNIVERSITY
291 CAMPUS DRIVE
DICKINSON,ND58601
45-6002480 501(c)(3) 9,750       Athletic scholarship donation $6,750; Nursing Scholarship $3k
(73) DOMESTIC VIOLENCE & RAPE (WOMEN'S ALLIANCE INC)
PO Box 1081
DICKINSON,ND58601
45-0354762 501(c)(3) 20,000       General Support
(74) DOW RUMMEL
1321 W DOW RUMMEL ST
SIOUX FALLS,SD57104
46-0271277 501(c)(3) 25,000       Capital campaign fund development donation
(75) DOWNTOWN SIOUX FALLS INC
230 S PHILIPS AVE STE 306
SIOUX FALLS,SD57104
36-3627217 501(c)(4) 24,371       Yearly donation for Downtown trolley
(76) DUNCAN REGIONAL HOSPITAL
1407 WHISENANT DR
DUNCAN,OK73533
20-2772056 501(c)(3) 50,000       General Support
(77) ECI BASKETBALL
3826 CALGARY CIRCLE
BISMARCK,ND58503
  15,000       Youth Sports Health and Wellness Donation
(78) EMBE
300 W 11TH ST
SIOUX FALLS,SD57104
46-0234998 501(c)(3) 14,000       Events support: In Her Shoes, Girls on the Run, Women's Day of Service, Lego League, Giving Tuesday
(79) EMERGING PRAIRIE
122 1/2 BROADWAY N
FARGO,ND58102
81-0742137 501(c)(3) 15,000       Tedx donation - $15,000
(80) FAMILY ADVOCACY CENTER OF NORTHERN MINNESOTA
800 BEMIDJI AVE N STE 4
BEMIDJI,MN566013072
20-2102302 501(c)(3) 16,500       General Support
(81) FAMILY FEST
PO BOX 90646
SIOUX FALLS,SD57109
81-2254064 501(c)(3) 7,000       Yearly donation to large family and child oriented event highlighting Sanford's Children Hospital
(82) FAMILY WELLNESS
2960 SETER PARKWAY
FARGO,ND58104
27-2862697 501(c)(3) 6,000       Donation supporting wellness through nutrician and helathy cooking skills
(83) FARGO SCHOOLS
415 4th St N
Fargo,ND57192
45-6012318 501(c)(3) 125,050       Annual Contribution per donation agreement for sports medicine program; Donations to scholarships, health tech trades, lunch fund
(84) FARGO YOUTH HOCKEY ASSOCIATION
831 17TH AVE N
FARGO,ND58102
36-3548649 501(C)(3) 15,000       Donation to the annual FYHA Squirt International Hockey Tournaments and Hockey night in Fargo
(85) FEEDING SOUTH DAKOTA
3511 N 1st Avenue
SIOUX FALLS,SD57104
36-3293534 501(c)(3) 1,027,500       COVID-19 food insecurity support
(86) FIRST TEE OF SOUTH DAKOTA
PO BOX 88938
SIOUX FALLS,SD57109
46-0449824 501(c)(3) 50,000       Yearly donation $30k; Golf fundraising event $5k; Sanford International donation $15k
(87) FIRSTLINK
4357 13TH AVE S STE 107L
FARGO,ND58103
45-0419491 501(c)(3) 45,000       $25K donation to Community Addiction Navigator program, $1K - Annual Breakfast/Giving Tree
(88) FOLDS OF HONOR KC INC
PO BOX 9246
PRAIRIE VILLAGE,KS662080246
45-2803323 501(c)(3) 30,000       Legends Grant
(89) FOOD BANK OF IOWA
PO BOX 1517
DES MOINES,IA50305
42-1177880 501(c)(3) 10,000       COVID-19 food insecurity support
(90) FOOD BANK OF SIOUXLAND INC
1313 11TH ST
SIOUX CITY,IA51105
42-1381516 501(c)(3) 40,000       COVID-19 food insecurity support
(91) FORWARD SIOUX FALLS
PO Box 907
Sioux Falls,SD57101
46-0396647 501(c)(6) 351,250       Yearly donation support for SF business development
(92) LEVITT AT THE FALLS
524 N MAIN AVE 106
SIOUX FALLS,SD57104
61-1699910 501(c)(3) 89,000       Chamber Appeals donation $12k, Yearly contribution $75k naming support; $2k Edith night
(93) FUELING OUR FUTURE
PO BOX 2443
FARGO,ND58108
83-2467021   125,000       Economic Deveopment Fund, FMWF Chamber and GFMEDC
(94) GATEWAY TO SCIENCE
1810 SCHAFER STREET STE 1
BISMARCK,ND58501
45-0443517 501(c)(3) 10,000       Discovery of Science 5 year pledge
(95) GIRL SCOUTS- DAKOTA HORIZONS
1101 S MAIN ROAD
SIOUX FALLS,SD57106
46-0260744 501(c)(3) 30,000       Yearly donation to cover several fundraising events: Cookies Corks & Brews, Amplify your Adventure, S'more Brews Please; The BIG Event, Giving Hearts Day, SD Gives, Girl Scouts Giving Day
(96) GLOBAL HEALTH CORPS INC
1 Penn Plaza Suite 6271
New York,NY10119
80-0512336 501(c)(3) 125,000       General Support
(97) GLOBAL INTERDEPENDENCE CENTER
100 N INDEPENDENCE MALL W Suite 5
PHILADELPHIA,PA191061521
23-2138619 501(c)(3) 25,000       Yearly support for World Clinics participation
(98) GLORY HOUSE OF SIOUX FALLS
4000 S WEST AVE
SIOUX FALLS,SD57105
46-0308425 501(c)(3) 15,000       Chamber Appeals donation for halfway housing support
(99) SD GOVERNORS OFFICE OF ECONOMIC DEVELOPMENT
711 EAST WELLS AVENUE
PIERRE,SD57501
46-6000364 115 100,000       Yearly donation support for the Governor's Office fundraising which include the Buffalo Roundup and Pheasant Hunt events
(100) GRAY ACADEMY
5757 W CENTURY BLVD STE 410
LOS ANGELES,CA90045
83-1590154 501(c)(3) 10,000       Donation to cure Batten Disease
(101) GREAT PLAINS FOOD BANK
1720 3rd Ave N
Fargo,ND58102
45-0226421 501(c)(3) 1,025,000       COVID-19 food insecurity support
(102) GREAT PLAINS ZOO
805 S KIWANIS AVE
SIOUX FALLS,SD57104
46-6015015 501(c)(3) 65,000       Yearly donation support for the Great Plains Zoo
(103) GREATER BEMIDJI
102 1ST ST WEST STE 101
BEMIDJI,MN56601
36-3367707 501(c)(3) 85,000       General Support
(104) GREATLIFE CARES FDN
3800 W 53RD ST
SIOUX FALLS,SD57106
47-2447820 501(c)(3) 16,000       Yearly donation $1k; Challenge for a Cause event support
(105) GROUND WORKS GROUND WORKS MIDWEST
102 N KROHNS PL STE 116
SIOUX FALLS,SD57103
47-5498537 501(c)(3) 37,500       Yearly SD Ag in the classroom program donation
(106) HARRISBURG SCHOOL DISTRICT
200 WILLOW ST
HARRISBURG,SD57032
46-6002218 115 130,983       Ortho Sports Med Contract
(107) HELPLINE CENTER INC
1000 N WEST AVE STE 310
SIOUX FALLS,SD571041314
23-7424387 501(c)(3) 56,000       Yearly donation $10k; Volunteer donation $3,500; High school texting support program $35k; Camp Capacity donation $7,500
(108) HIBBING COMMUNITY COLLEGE
1515 E 25TH ST
HIBBING,MN554857813
41-6046970 501(c)(3) 6,000       General Support
(109) HUETHER FAMILY MATCH POINTE
4210 N BOBHALLA DR
SIOUX FALLS,SD57107
45-2784394 501(c)(3) 17,100       General Support
(110) INDEPENDENT SCHOOL DISTRICT 518
1117 MARINE AVE
WORTHINGTON,MN561871610
41-6008522 115 20,000       Athletic Training support and athletic scholarships
(111) INNOVATIVE OFFICE SOLUTIONS
151 EAST CLIFF RD
BURNSVILLE,MN55337
36-4550688   13,497       Clothing/apparel donations to OSM schools
(112) PEACE OFFICE JAIL CHAPLAINS ASSOCIATION
PO BOX 6444
FARGO,ND58102
20-4363997 501(c)(3) 6,000       Donation supporting mission of jail chaplains
(113) JAMESTOWN PARKS & REC
1002 2ND Ave SE
Jamestown,ND58401
75-1597713 501(c)(3) 5,700       Donation in support of new wellness center and for park dasherboards
(114) JAMESTOWN SOCCER FEDERATION
PO BOX 1804
JAMESTOWN,ND58402
45-0363454 501(c)(3) 10,000       Donation in support of the local soccer club
(115) JDRF MN CHAPTER DAKOTA
1305 W 18TH STREET
SIOUX FALLS,SD571175039
23-1907729 501(c)(3) 25,000       Juvenile diabetes yearly support, JDRF One Walk donation
(116) JUNIOR ACHIEVEMENT OF SD
300 S PHILLIPS AVESTE L102
SIOUX FALLS,SD57104
46-0306352 501(c)(3) 38,225       Yearly donation pledge and statewide expansion annual drive
(117) KIDS CHANCE OF SOUTH DAKOTA
300 S MAIN AVE
SIOUX FALLS,SD57104
47-4439997 501(c)(3) 8,000       Yearly donation support for children's higher education
(118) LAKER BOOSTER CLUB INC
1301 ROOSEVELT AVE
DETROIT LAKES,MN56501
20-2297807 501(c)(3) 5,100       Donation and support of Mollberg Field Schoreboard update, a multi year donation
(119) LEADERSHIP SOUTH DAKOTA
PO BOX 675
PLATTE,SD57369
82-0880122 501(c)(3) 20,000       Yearly donation commitment
(120) LEGEND HOCKEY
322 E 8TH ST STE 206
SIOUX FALLS,SD57103
26-4544536   35,000       Ortho Sports Med support
(121) LEGENDS OF GOLD
PO BOX 287
BERESFORD,SD57004
27-3794971 501(c)(3) 41,500       Donation to training center for youth athletes to quality for the Olympics - yearly donation $40k; Easter Wrestling Tournament support $1500
(122) THE LEUKEMIA & LYMPHOMA SOCIETY INC
3 INTERNATIONAL DR STE 200
RYE BROOK,NY105737501
13-5644916 501(c)(3) 7,500       Light the Night Sioux Falls event support
(123) LIFESCAPE CHILDREN'S CARE HOSPITAL AND SCHOOL
2501 WEST 26TH ST
SIOUX FALLS,SD57105
46-0233030 501(c)(3) 52,300       Donation to foundation for handicapped children's care; Legends grant
(124) LINCOLN HIGH SCHOOL
201 E 38th Street
Sioux Falls,SD57105
46-6002586 501(c)(3) 30,800       Ortho Sports Med Contract
(125) LIRA DANCE THEATRE COMPANY LLC
402 E 20TH ST
SIOUX FALLS,SD57105
82-0987880   10,000       Dance scholarships donation
(126) LUCILE SALTER PACKARD CHILDRENS HOSPITAL AT STANFORD
PO BOX 741202
LOS ANGELES,CA900741202
77-0003859 501(c)(3) 240,000       General Support
(127) LUTHERAN SOCIAL SERVICES
705 East 41st Street Ste 200
SIOUX FALLS,SD571056048
46-0224731 501(c)(3) 5,250       Taste of Cultures & Mentor Appreciation Breakfast donations $5k; Aberdeen annual fundraising event $250
(128) LUTHERAN SOCIAL SERVICES OF NORTH DAKOTA
PO BOX 389
FARGO,ND581070389
45-0226421 501(c)(3) 16,000       Various Donations in regards to Healthy Families, Mental wellness, Building Bridges and cooking healthy
(129) LUVERNE PUBLIC SCHOOLS
709 NORTH KNISS AVE
LUVERNE,MN56156
41-1784004 115 10,000       Donation toward Wellness & Weight room for school system
(130) MAKE A WISH FOUNDATION OF NORTH DAKOTA
4143 26TH AVE S STE 104
FARGO,ND58104
45-0393770 501(c)(3) 52,400       State wide donation in support of the Make A Wish program of giving trips to sick children
(131) MANDAN PARK DISTRICT
2600 46TH AVE SE
MANDAN,ND58554
45-6002119 115 10,000       New Headset System
(132) MANDAN PUBLIC SCHOOLS
901 Division St NW
MANDAN,ND58554
45-6001098 115 12,500       New Headset System - Memorial Ballpark Pledge
(133) MAYVILLE STATE UNIVERSITY
330 THIRD ST NE
MAYVILLE,ND58257
45-6002485 501(c)(3) 27,600       Annual Contribution per donation agreement for sports medicine program, training room and scholarships
(134) MCCROSSAN BOYS RANCH
47135 260TH ST
SIOUX FALLS,SD57107
46-0311913 501(c)(3) 12,100       Banquest fundraising event; Use of horses contract; Rodeo fundraising event; Legends grant
(135) MCKENZIE COUNTY HEALTHCARE SYS
709 4TH AVE NE
WATFORD CITY,ND58854
77-0637498 501(c)(3) 100,000       Annual pymnt on $1 million pledge
(136) METHODIST MEDICAL CENTER FOUNDATION
221 NE GLEN OAK AVE
PEORIA,IL61636
51-0186460 501(c)(3) 100,000       General Support
(137) METRO AREA TOURNAMENT COMMITTEE
415 NORTH 4TH ST
FARGO,ND58102
45-0458883 501(c)(3) 40,000       Donation to committee for region and state tournaments that take place throughout the year in the metro area
(138) MITCHELL PARKS & RECREATION
612 North Main Street
Mitchell,SD57301
46-6000305 115 15,000       Donation toward providing a personal trainer at the Mitchell Rec Center
(139) MINNESOTA STATE UNIVERSITY MANKATO FOUNDATION INC
236 WIGLEY ADMINISTRATION CTR
MANKOTA,MN56001
41-6033423 501(c)(3) 340,000       Ortho Sports Med Contract
(140) MN WEST FOUNDATION
1593 11TH AVENUE
GRANITE FALLS,MN56241
36-3266500 501(c)(3) 10,000       Ortho Sports Med Contract/Scholarship support
(141) MISSOURI SLOPE AREAWIDE UNITED WAY
515 N 4TH ST
BISMARCK,ND58501
45-0387741 501(c)(3) 32,250       Premiere Sponsorship Co-Branding with UW; Backpack Program; Corporate Donation
(142) MOORHEAD SCHOOLS LEGACY FOUNDATION
2410 14TH ST S
MOORHEAD,MN56560
81-2603701 501(c)(3) 40,550       Donation in support of Moorhead Schools Foundation which supports educational experiences
(143) MOORHEAD YOUTH ASSOCIATIONS
707 SE Main Ave
Moorhead,MN56560
23-7221429 501(c)(3) 50,000       Donation in Support of youth sport activities
(144) MOVE TO HEAL SOUTH DAKOTA
1309 S GLENDALE AVE
SIOUX FALLS,SD57105
84-3832884 501(c)(3) 5,500       Support for GSS and Children's Hospital programming
(145) MINNESOTA STATE UNIVERSITY MOORHEAD
1104 7TH AVE SOUTH
MOORHEAD,MN56563
41-1687554 115 300,000       Annual Contribution per donation agreement for sports medicine program, nursing program and scholarships
(146) MUSCULAR DYSTROPHY ASSOCIATION INC
222 SOUTH RIVERSIDE PLAZA S STE
1500
CHICAGO,IL606066000
13-1665552 501(c)(3) 10,000       Enterprise donations for Muscle Walks and Toast to Life events
(147) NAMI SIOUX FALLS
PO BOX 89213
SIOUX FALLS,SD57109
36-3593641 501(c)(3) 6,500       NAMI Annual conference and NAMI walk support
(148) National Kidney Foundation
30 EAST 33RD STREET
NEW YORK,NY10016
13-1673104 501(c)(3) 33,000       Enterprise yearly donations for Kidney Walks, Keep Health Screening, Big Ask Big Give program and golf fundraiser events
(149) NATIONAL MULTIPLE SCLEROSIS SOCIETY GREATER NORTHWEST CHAPTER
2829 UNIVERSITY AVE SE 900
MINNEAPOLIS,MN55414
91-0742424 501(c)(3) 25,000       Yearly donation pledge payment $15k
(150) ND ASSISTIVE
3240 15TH ST S SUITE B
FARGO,ND58104
27-0260522 501(c)(3) 100,000       Donation in support of assistive technolgy for people with various disabilities
(151) ND SAFETY COUNCIL
1710 Canary Ave Suite A
BISMARCK,ND58501
45-0353009 501(c)(3) 25,000       General Support
(152) NDSCS
800 N 6TH ST
WAHPETON,ND580760002
45-0407617 501(c)(3) 8,500       Annual Contribution for workforce affairs, wildcat golf tournament and scholarships
(153) NDSU
PO BOX 6050
FARGO,ND581086050
45-6002439 501(c)(3) 1,796,585       Annual Contribution for sports medicine program, nursing program and scholarships
(154) MIAMI CHILDRENS HEALTH SYSTEM FOUNDATION
3100 SW 62ND AVE
MIAMI,FL33155
46-1784918 501(c)(3) 2,000,000       General Support
(155) NORTH COUNTRY FOOD BANK
1011 11TH AVE NE
EAST GRAND FORKS,MN56721
41-1459758 501(c)(3) 650,000       COVID-19 food insecurity support
(156) MISSISSIPPI HEADWATERS AREA DENTAL HEALTH CENTER
1405 ANNE ST NW
BEMIDJI,MN56601
84-1711812 501(c)(3) 21,500       Donation to support dental health project in the community
(157) NORTHERN STATE UNIVERSITY
1200 S JAY ST
ABERDEEN,SD574017198
46-6000364 115 769,500       Ortho Sports Med Contract
(158) NORTHERN SUN INTERCOLLEGIATE CONFERENCE
2999 COUNTY RD 42 W
BURNSVILLE,MN55306
41-1783486 501(c)(3) 130,000       Ortho Sports Med Contract
(159) NORTHWESTERN COLLEGE
101 7TH ST SW
ORANGE CITY,IA51041
42-0698196 501(c)(3) 50,000       Donation commitment; Science capital project building
(160) OAK GROVE LUTHERAN SCHOOL
124 N TERRACE
FARGO,ND58102
45-0226473 501(c)(3) 30,000       Annual Contribution per donation agreement for sports medicine, spring gala, various sports camps and scholarships
(161) OUTDOOR ADVENTURE FOUNDATION
415 38TH ST S STE E
FARGO,ND58103
27-0192316 501(c)(3) 10,000       Project Lead the Way; Summer camps; annual business partner
(162) PETIT KICKS SOCCER
8920 BRIARDALE DR
BISMARCK,ND58504
47-3418017   10,000       Soccer Academy-Athletic Donation
(163) PLAINS ART MUSEUM
704 1ST AVE N
FARGO,ND58102
41-1260780 501(c)(3) 12,500       Annual donation to Gala and Art4All programing
(164) PRESIDENTS BOWL COMMITTEE OF SIOUX FALLS INC
PO BOX 1443
SIOUX FALLS,SD571011443
91-1776303 501(c)(3) 10,000       Donation to support the local high schools activities/events $10k
(165) Professional Patient Advocates in Life Sciences
94 HILLANDALE ROAD
DANBURY,CT06811
47-2878879 501(c)(3) 20,000       General Support
(166) PROJECT PREP OLYMPIC DEVELOPMENT PROGRAM
PO BOX 385970
BLOOMINGTON,MN55438
04-3644163 501(c)(3) 12,500       Donation in support of the Upper Midwest High School Elite League for Olympic Development
(167) RAPID CITY CLUB FOR BOYS INC
320 N 4TH ST
RAPID CITY,SD57701
46-0277778 501(c)(3) 10,000       Club for Boys Capital Campaign donation
(168) REALTORS FOR KIDS
2415 W 57TH ST
SIOUX FALLS,SD57108
26-2681308 501(c)(3) 6,000       Fundraising event to benefit children's health needs $6k
(169) RED RIVER CHILDRENS ADVOCACY
100 S 4TH ST STE 302
FARGO,ND58103
20-1095721 501(c)(3) 25,000       Donation of Support for services for abused children and donation for their annual gala
(170) REINBOWS INC
43341 480TH AVE
WINDOM,MN56101
20-8775427 501(c)(3) 7,000       Equine assisted therapy for disabled children
(171) RONALD MCDONALD HOUSE CHARITY OF THE RED RIVER VALLEY INC
4757 AGASSIZ XING S
FARGO,ND58104
45-0365598 501(c)(3) 100,000       $100K - Annual Contribution per donation agreement towards their building and $5K donation for Annual Sweetheart Ball
(172) RONALD MCDONALD HOUSE CHARITY
825 S Lake Road
SIOUX FALLS,SD57104
46-0371152 501(c)(3) 6,000       General support
(173) ROOSEVELT HIGH SCHOOL
6600 W 41ST ST
SIOUX FALLS,SD57106
46-6002586 501(c)(3) 24,800       Ortho Sports Med Contract
(174) SAMARITANS FEET
PO BOX 78992
CHARLOTTE,NC282717045
14-1880905 501(c)(3) 1,000,000       Captial campaign pledge matching donation
(175) Sanford Health Foundation
PO Box 5039 RTE 5218
Sioux Falls,SD571175039
36-3297853 501(c)(3) 6,608,000       General Support
(176) Sanford Health Foundation North
PO Box 5039 RTE 5218
Sioux Falls,SD571175039
45-0398104 501(c)(3) 2,024,586       General Support
(177) Sanford Health Foundation of Northern Minnesota
PO Box 5039 RTE 5218
Sioux Falls,SD571175039
41-1389317 501(c)(3) 615,988       General Support
(178) Sanford Health Foundation West
PO Box 5039 RTE 5218
Sioux Falls,SD571175039
45-0397196 501(c)(3) 1,040,009       General Support
(179) The Evangelical Lutheran Good Samaritan Foundation
PO Box 5039 RTE 5218
Sioux Falls,SD571175039
46-0422866 501(c)(3) 2,105,619       General Support
(180) Park District of the City of Fargo
225 4TH STREET N
FARGO,ND58102
45-6002069 115 295,055       Land Development Costs
(181) SOUTH DAKOTA HIGH SCHOOL BASKETBALL COACHES ASSOCIATION
1404 YOSEMITE LANE
BROOKINGS,SD57006
81-1379554 501(c)(3) 8,500       Scholarship program donation $8500
(182) SD BIOTECH ASSOC
2329 N CAREER AVE STE 115
SIOUX FALLS,ND57107
37-1518658 501(c)(6) 6,000       General Support for Research
(183) SOUTH DAKOTA CATTLEMENS ASSOCIATION
116 N EUCLID AVE STE C
PIERRE,ND57501
46-0365649 501(c)(5) 15,000       Donation to fundraising event for Feeding SD $15k
(184) SD COMMUNITY FOUNDATION
1714 N LINCOLN AVE
PIERRE,SD57501
46-0398115 501(c)(3) 10,000       Donation to the SD Veterans Cemetery -$10k
(185) SD GOLF ASSOCIATION
PO BOX 88938
SIOUX FALLS,SD57109
46-0310847   35,000       Junior Golf donation to foundation for scholarships
(186) SD GUARDIANSHIP PROGRAM INC
PO BOX 794
Pierre,SD57501
46-0366602 501(c)(3) 10,000       Donation for court appointed guardianship for adults who cannot afford assistance - yearly commitment $10k
(187) SOUTH DAKOTA HALL OF FAME
1480 SOUTH MAIN
CHAMBERLAIN,SD57325
46-0324210 501(c)(3) 50,000       Annual commitment donation $50k
(188) SD HIGH SCHOOL ACTIVITIES
PO Box 1217
Pierre,SD575011217
46-0226882 501(c)(3) 125,000       Yearly donation agreement in support of high school athletics across the state $125k
(189) SD HIGH SCHOOL COACHES ASSOC
801 W EAGLE RIDGE ST
SIOUX FALLS,SD57108
23-7297479 501(c)(3) 22,500       Ortho Sports Med contract
(190) SD LAW ENFORCEMENT CHARITIES
101 SOUTH MAIN AVE STE 100
SIOUX FALLS,SD57104
46-0440378 501(c)(3) 15,000       Yearly donation commitment to children's fundraising charity event
(191) SOUTH DAKOTA MILITARY HERITAGE ALLIANCE INC
1600 W RUSSELL ST
SIOUX FALLS,SD57104
83-2381925 501(c)(3) 500,000       Donation for military and Vet services center and programming
(192) SOUTH DAKOTA YOUTH SOCCER ASSOCIATION
2127 S MINNESOTA AVE STE 201
SIOUX FALLS,SD57105
23-7183054 501(c)(3) 20,000       Yearly donation pledge $20k
(193) SD STATE UNIV
PO Box 525
BROOKINGS,SD57007
46-0273801 501(c)(3) 18,300       Ortho Sports Med contracts including donations
(194) SD STATE UNIV FOUNDATION
PO Box 525
BROOKINGS,SD57007
46-0273801 501(c)(3) 3,363,500       Ortho Sports Med Contract
(195) SD SYMPHONY ORCHESTRA
300 North Dakota Ave Ste 116
Sioux Falls,SD57104
46-6017026 501(c)(3) 60,000       Yearly support donation $60k
(196) SD SYNOD
2001 S SUMMIT AVE
SIOUX FALLS,SD57197
36-3512774 501(c)(3) 20,000       Capital campaign for their Woyatan Retreat Center renovations donation $20k
(197) SECOND HARVEST NORTH CENTRAL FOOD BANK
PO BOX 5130
GRAND RAPIDS,MN55744
41-1782776 501(c)(3) 75,000       COVID-19 food insecurity support
(198) SECOND HARVEST HEARTLAND
7101 WINNETKA AVE N
BROOKLYN PARK,MN55428
23-7417654 501(c)(3) 275,000       COVID-19 food insecurity support
(199) SF AREA COMMUNITY FOUNDATION
200 N CHERAPA PL
SIOUX FALLS,SD57103
31-1748533 501(c)(3) 142,500       Donation toward SD Salutes fundraising event $5k; Youth advisory council donation $500
(200) SF CHRISTIAN HIGH SCHOOL
6120 S CHARGER CIRCE
SIOUX FALLS,SD57108
46-0340024 501(c)(3) 137,500       Ortho Sports Med Contract
(201) SF CYCLONES
PO BOX 361
SIOUX FALLS,SD57101
27-4705069 501(c)(3) 28,500       Yearly donation support $20k; Legends Grants; Various team sponsorships
(202) SIOUX FALLS SWIM TEAM
PO BOX 758
SIOUX FALLS,SD57101
46-0343732 501(c)(3) 25,000       Yearly donation commitment $25k
(203) SIOUX FALLS TENNIS ASSOCIATION
PO BOX 89512
SIOUX FALLS,SD57109
36-3916958 501(c)(3) 7,000       SD Open tournament; Legends grant
(204) SIOUX FALLS YOUTH HOCKEY ASSOCIATION
5000 S MINNESOTA AVE
SIOUX FALLS,SD57108
46-0427805 501(c)(3) 29,000       Yearly donation commitment $25k; Legends grant; individual team requests
(205) SF LACROSSE BOOSTER CLUB
3813 W 80th St
Sioux Falls,SD57108
46-4887667   15,000       General Support
(206) SHEYENNE VALLEY COMMUNITY FOUN
250 WEST MAIN ST
VALLEY CITY,SD58072
46-4371645 501(c)(3) 6,000       Annual Contribution per donation agreement for Wellness Center
(207) SHILOH CHRISTIAN SCHOOL
1915 Shiloh Dr
Bismarck,ND58503
45-0348120 501(c)(3) 68,000       Vision 2015 Pledge: Building Contribution: Phase II; Academic & Athletic Donation
(208) SIOUX COUNCIL BOY SCOUTS
800 N WEST AVE
SIOUX FALLS,SD57104
46-0224599 501(c)(3) 31,300       Chamber Appeals Climb With Us; Friends of Scouting shootout
(209) SIOUX EMPIRE JUNIOR GOLF ASSN
7708 W VISTA PARK ST
SIOUX FALLS,SD57106
20-5858531 501(c)(3) 20,000       GreatLife Junior Golf Challenge
(210) SIOUX EMPIRE UNITED WAY
1000 N W AVE 120
SIOUX FALLS,SD571041314
46-0233701 501(c)(3) 150,538       Yearly pledge donation support
(211) SIOUX FALLS AREA CASA PROGRAM
PO BOX 1901
SIOUX FALLS,SD57101
46-0430647 501(c)(3) 10,000       Yearly fundraising events to include the Bakker Crossing Charity Pro Am $10k
(212) SIOUX FALLS ARTS COUNCIL
326 E 8TH ST 106 AB
SIOUX FALLS,SD57103
46-0354287 501(c)(3) 10,000       Yearly donation in support of the local arts and sculpture walk in SF
(213) SIOUX FALLS HOPE COALITION
2211 W CHERRYWOOD CIR
SIOUX FALLS,SD57108
82-2097994 501(c)(3) 25,000       Donation in support of every child having access to attend preschool - $25k
(214) SIOUX FALLS LUTHERAN SCHOOL
308 W 37TH ST
SIOUX FALLS,SD57105
46-0343381 501(c)(3) 1,001,000       Ortho Sports Med Contract
(215) SIOUX FALLS POWER HOCKEY
5808 S PRAIRIE VIEW CT
SIOUX FALLS,SD57108
47-1795011 501(c)(3) 40,000       Donation in support of youth hockey and our sports medicine program
(216) SIOUX FALLS PUBLIC SCHOOL EDUCATION FOUNDATION
PO BOX 560
SIOUX FALLS,SD57101
26-3537657 501(c)(3) 7,500       Public School Proud grant program
(217) SIOUX FALLS SCHOOL DISTRICT
201 E 38TH ST
SIOUX FALLS,SD57105
46-6002586 501(c)(3) 101,900       Donations for multiple commitments: Scoreboards; Angel Fund; CTE Health Careers Camp; Project Lead the Way; Workforce Development HOSA; State Tournament event; Ortho Sports Med
(218) SIOUX FALLS SPORTS AUTHORITY
200 N PHILLIPS AVE SUITE 304
SIOUX FALLS,SD57104
20-5850491 501(c)(3) 2,822,000       Ortho Sports Med Contract
(219) SIOUX FALLS STORM TYTAN ENTERPRISES LLC
5901 S SOUTHEASTERN AVE 104
SIOUX FALLS,SD57108
27-0805922   82,000       Ortho Sports Med Contract paid
(220) SIOUX FALLS WOMEN RUN LLC
5235 S Sweetbriar Ct
SIOUX FALLS,SD57108
81-3518734 501(c)(6) 15,000       Donation to women's running event fundraiser $15k
(221) SOUTH DAKOTA CHAMBER OF COMMERCE & INDUSTRY (SDC-BAC)
PO BOX 190
PIERRE,SD57501
46-0141180 501(c)(6) 35,000       Yearly membership, Economic Development Seminar
(222) SOUTHWEST INITIATIVE FOUNDATION
15 3RD AVE NW
HUTCHINSON,MN55350
41-1555592 501(c)(3) 10,000       Windom Community Foundation donation
(223) SPECIAL OLYMPICS SOUTH DAKOTA
800 E I-90 LANE
SIOUX FALLS,SD57104
46-0359776 501(c)(3) 18,000       Yearly commitment $10k; Plane Pull fundraising event $5k; Legends Grant $3k
(224) SPOKE N SPORT
2019 S MINNESOTA AVENUE
SIOUX FALLS,SD57105
46-0446017   5,112       Donations to the Parallel 44 Bike Team via Jacqueline Palfy - Sanford Employee request
(225) ST JOHN PAUL II CATHOLIC
5600 25TH ST S
FARGO,ND581047123
45-0403317 115 25,000       Annual Contribution per donation agreement for sports medicine and as a Gold Partner to the schools for support
(226) STRAWBALE WINERY SOUTH ENTERPRISES
47215 257TH STREET
RENNER,SD57055
68-0525735   10,000       Yearly donation to Folk-Off fundraising event $10k
(227) SUMMIT LEAGUE INC
4000 N HERCULES AVE STE 200
SIOUX FALLS,SD571071401
39-1417116 501(c)(3) 1,600,000       Ortho Sports Med Contract
(228) SUSAN G KOMEN BREAST CANCER
8707 WEST CENTER RD STE 101
OMAHA,NE68124
26-0056671 501(c)(3) 12,500       Yearly donation to fundraising event
(229) TEA AREA SCHOOL DISTRICT
PO Box 488
Tea,SD57064
50-0005151 115 22,200       Ortho Sports Med Contract
(230) THE BANQUET
900 E 8TH ST
SIOUX FALLS,SD57103
46-0387495 501(c)(3) 30,501       Donation commitment $25k for yearly support; Run for Food fundraising event at Thanksgiving $5k; meal sponsor
(231) THEODORE ROOSEVELT PRESIDENTIAL LIBRARY FOUNDATION
PO BOX 338
MEDORA,ND58645
47-1324043 501(c)(3) 100,000       Donation Commitment $100k
(232) THIEF RIVER FALLS NORSKIES
PO BOX 952
THIEF RIVER FALLS,MN56701
81-2982246   6,380       Donation for Ice Logo, Dasher Boards, Programs, jerseys, tickets
(233) TRACY AREA PUBLIC SCHOOLS
934 PINE ST
TRACY,MN56175
90-0501338 115 15,000       $15k to the Tracy Independent School District for their Veterans Memorial Center Revitalization Project; General Support
(234) TRI CITY STORM SOCCER CLUB
1323 23RD ST S STE A
FARGO,ND58103
36-3346894 501(c)(3) 10,000       Annual Contribution to support soccer programs for the youth
(235) UND ALUMNI ASSOCIATION & FOUNDATION
3501 UNIVERSITY AVE STOP 8157
GRAND FORKS,ND58202
45-0348296 501(c)(3) 100,000       Donations to UND's School of Health & Wellness
(236) UNITED WAY OF BEMIDJI AREA
PO BOX 27
BEMIDJI,MN56619
41-1567744 501(c)(3) 98,830       General Support
(237) UNITED WAY OF CASS-CLAY
PO BOX 1609
FARGO,ND581071609
41-0810008 501(c)(3) 218,344       Annual Corporate donation for Fargo area programs
(238) UNITED WAY OF NORTHEASTERN SOUTH DAKOTA
PO BOX 1065
ABERDEEN,SD574021065
23-7086355 501(c)(3) 10,450       Yearly commitment payment $10k; Stamp Out Hunder Food Drive $450
(239) UNIVERSITY OF SOUTH DAKOTA FOUNDATION
1110 N DAKOTA ST
VERMILLION,ND57069
46-6018891 501(c)(3) 1,515,340       Ortho Sports Med contracts/scholarships
(240) UNIV OF SOUTH DAKOTA
414 E Clark
Vermillion,SD57069
46-6018891 501(c)(3) 968,752       Ortho Sports Med contracts
(241) UNIVERSITY OF JAMESTOWN
6085 COLLEGE LANE
JAMESTOWN,ND58405
45-0231180 501(c)(3) 16,000       Annual Contribution per donation agreements for Dine & Bid, Scoreboard, Arts, Gator Donation
(242) UNIVERSITY OF NEBRASKA
3835 Holdredge St
Lincoln,MN685830742
47-0049123 501(c)(3) 250,000       General Support
(243) UP AQUATICS INC
3740 ASPYN LANE N
FARGO,ND58102
27-1181382 501(c)(3) 30,000       Annual Contribution per donation agreement for new building/pool for area
(244) SANFORD SCHOOL OF MEDICINE
414 EAST CLARK ST
VERMILLION,SD57069
46-6000364 115 81,168       General Support
(245) VERMILLION AREA CHAMBER AND DEVELOPMENT CO
2 E MAIN STSTE 101
VERMILLION,SD57069
46-0284795 501(c)(3) 15,000       Vermillion NOW economic development campaign
(246) VILLAGE FAMILY SERVICE CENTER
808 3RD AVE S STE 101
FARGO,ND58103
45-0226423 501(c)(3) 102,000       $100K - Annual Contribution per donation agreement towards programming, the rest is donation for hole at Bobcat Open, Wine & Dining table, Big Brother Big Sister bowling
(247) VILLAGE NORTHWEST UNLIMITED
330 VILLAGE CIRCLE
SHELDON,IA51201
42-1044017 501(c)(3) 77,500       General Support $50k; Golf benefit fundraiser; Run, Rock & Roll fundraiser
(248) VOLUNTEERS OF AMERICA DAKOTAS
PO Box 89306
SIOUX FALLS,SD57109
23-7353508 501(c)(3) 40,500       HomePlace Capital Campaign $40k; RC Soup for a Cause $500
(249) WASHINGTON PAVILION
PO Box 984
Sioux Falls,SD57101
46-0435791 501(c)(3) 92,700       Yearly Pilar Partnership donation agreement to include the Kirby Science Discovery Center Fit Zone & Health Quest area
(250) WATERTOWN COMMUNITY FOUNDATION
211 E KEMP AVE
WATERTOWN,SD57201
46-0350319 501(c)(3) 20,000       City of Watertown softball complex
(251) WATERTOWN DEVELOPMENT COMPANY
PO BOX 332
WATERTOWN,SD57201
47-0813269 501(c)(3) 15,000       Grow Watertown Campaign
(252) WAVE WEBSTER 2020
513 MAIN ST
WEBSTER,SD57274
20-1307620 501(c)(3) 15,000       Webster 2020 Inc
(253) WEST FARGO PUBLIC SCHOOL DIST
207 W MAIN AVE
WEST FARGO,SD58078
45-6000298 115 6,900       Donations to Programming and scholarships for kids to attend
(254) WESTERN ILLINOIS UNIVERSITY FOUNDATION
1 UNIVERSITY CIRCLE SHERMAN HALL
303
MACOMB,SD614551390
37-6046814 501(c)(3) 250,000       Kevin Lampe Sanford Basketball Endowment
(255) WHEATON AREA SCHOOLS
1700 3 AVE S
WHEATON,ND56296
41-6004390 501(c)(3) 5,050       Annual Contribution for bleachers at the school
(256) WINGS OF VALOR INC
45618 278TH ST
PARKER,SD57053
84-3711088 501(c)(3) 50,000       Lease property & fund operations donation for a hunting lodge to serve disabled veterans $50k
(257) WINNER REGIONAL HEALTH AND WELLNESS FOUNDATION
745 E 8TH ST
WINNER,SD57580
36-3739631 501(c)(3) 100,000       General Support
(258) YELLOW JACKET FOUNDATION
1200 UNIVERSITY ST UNIT 9506
BELLE FOURCHE,SD57717
51-0151319 501(c)(3) 27,000       Black Hills State University donation $25k; Scholarships $2k
(259) YMCA OF CASS & CLAY COUNTIES (FARGO MOORHEAD)
400 1ST AVE S
FARGO,ND58103
45-0232096 501(c)(3) 18,000       Donations for Livestrong, Partner of Youth and Nurse station for camp
(260) YMCA SIOUX FALLS REGION
230 S Minnesota Ave
Sioux Falls,SD57104
46-0225021 501(c)(3) 54,500       Capital Campaign; Golf Classic
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
230
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
32
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
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) DAKOTA UNITED RUGBY CLUB 1 7,500     Ortho Sports Med Contract
(2) RIGGS PREMIER FOOTBALL LLC 3 12,133     SD High School Football Coaches Association clinic, flag football tournament support
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Part I, Line 2: Prior to disbursement all grant fund requests are reviewed to ensure the receiving organization and proposed use of funds align with Sanford's mission.
Schedule I (Form 990) 2020



Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
Yes
 
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Andy North
Secretary
(i)

(ii)
310,804
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
310,804
-------------
0
0
-------------
0
2Mark Paulson MD
Past Chair/Physician Regional Chair
(i)

(ii)
281,084
-------------
0
15,000
-------------
0
-1,598
-------------
0
12,271
-------------
0
27,284
-------------
0
334,041
-------------
0
0
-------------
0
3Maria Bell MD
Trustee/Research Administrator
(i)

(ii)
906,084
-------------
0
54,000
-------------
0
53,058
-------------
0
14,250
-------------
0
28,660
-------------
0
1,056,052
-------------
0
0
-------------
0
4Mark Lundeen MD
Trustee/Orthopedics Service Chair
(i)

(ii)
691,892
-------------
0
0
-------------
0
560
-------------
0
14,250
-------------
0
22,506
-------------
0
729,208
-------------
0
0
-------------
0
5Mark Lundeen MD
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
1,000,000
-------------
0
0
-------------
0
0
-------------
0
1,000,000
-------------
0
0
-------------
0
6Kelby K Krabbenhoft
President & CEO (Thru 11/20)
(i)

(ii)
0
-------------
3,028,187
0
-------------
1,971,204
0
-------------
77,951
0
-------------
45,148
0
-------------
23,376
0
-------------
5,145,866
0
-------------
0
7Kelby K Krabbenhoft
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
44,353,819
0
-------------
0
0
-------------
0
0
-------------
44,353,819
0
-------------
8,183,861
8Bill Gassen III
CAO/President & CEO (Start 11/20)
(i)

(ii)
0
-------------
1,098,215
0
-------------
244,003
0
-------------
174,933
0
-------------
101,820
0
-------------
1,847
0
-------------
1,620,818
0
-------------
0
9Bill Gassen III
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
1,100,000
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
1,100,000
0
-------------
0
10JoAnn L Kunkel
Chief Financial Officer (Thru 9/20)
(i)

(ii)
0
-------------
852,418
0
-------------
309,501
0
-------------
150,852
0
-------------
11,827
0
-------------
22,487
0
-------------
1,347,085
0
-------------
0
11JoAnn L Kunkel
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
6,847,438
0
-------------
0
0
-------------
0
0
-------------
6,847,438
0
-------------
221,828
12Bill Marlette
CFO (Start 10/20) & Treasurer
(i)

(ii)
0
-------------
1,210,291
0
-------------
317,501
0
-------------
221,261
0
-------------
29,289
0
-------------
2,267
0
-------------
1,780,609
0
-------------
0
13Bill Marlette
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
5,903,232
0
-------------
0
0
-------------
0
0
-------------
5,903,232
0
-------------
1,662,810
14Jennifer Grennan
Chief Legal Officer
(i)

(ii)
0
-------------
690,022
0
-------------
205,000
0
-------------
108,618
0
-------------
83,700
0
-------------
24,365
0
-------------
1,111,705
0
-------------
0
15Allison Wierda-Suttle MD
Sr VP, CMO (Thru 12/20)
(i)

(ii)
0
-------------
831,467
0
-------------
212,004
0
-------------
138,763
0
-------------
12,244
0
-------------
25,417
0
-------------
1,219,895
0
-------------
0
16Allison Wierda-Suttle MD
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
2,350,610
0
-------------
0
0
-------------
0
0
-------------
2,350,610
0
-------------
185,678
17Micah Aberson
Executive VP, Sanford
(i)

(ii)
0
-------------
1,044,294
0
-------------
252,003
0
-------------
167,103
0
-------------
101,820
0
-------------
23,944
0
-------------
1,589,164
0
-------------
0
18Micah Aberson
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
1,100,000
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
1,100,000
0
-------------
0
19Bryan Nermoe
President, Fargo
(i)

(ii)
0
-------------
791,837
0
-------------
22,000
0
-------------
130,999
0
-------------
98,220
0
-------------
23,670
0
-------------
1,066,726
0
-------------
0
20Michael LeBeau MD
President, Bismarck
(i)

(ii)
0
-------------
779,095
0
-------------
257,502
0
-------------
128,990
0
-------------
95,820
0
-------------
25,732
0
-------------
1,287,139
0
-------------
0
21Michelle Micka
Sr VP Finance, Health Service
(i)

(ii)
0
-------------
520,072
0
-------------
127,504
0
-------------
68,860
0
-------------
67,020
0
-------------
24,091
0
-------------
807,547
0
-------------
0
22Nicholas Olson
VP Finance
(i)

(ii)
0
-------------
342,144
0
-------------
78,750
0
-------------
45,672
0
-------------
8,245
0
-------------
755
0
-------------
475,566
0
-------------
0
23Paul Hanson
President, Sioux Falls
(i)

(ii)
0
-------------
795,197
0
-------------
214,526
0
-------------
133,589
0
-------------
98,340
0
-------------
18,285
0
-------------
1,259,937
0
-------------
0
24Matt Hocks
Chief Operating Officer
(i)

(ii)
0
-------------
1,096,674
0
-------------
280,005
0
-------------
175,630
0
-------------
110,570
0
-------------
24,091
0
-------------
1,686,970
0
-------------
0
25Susan Jarvis
President, Bemidji
(i)

(ii)
0
-------------
509,622
0
-------------
88,400
0
-------------
113,394
0
-------------
65,820
0
-------------
24,825
0
-------------
802,061
0
-------------
0
26Daniel Blue
President, World Clinics (Thru 6/20)
(i)

(ii)
0
-------------
408,573
0
-------------
191,251
0
-------------
96,880
0
-------------
14,250
0
-------------
17,598
0
-------------
728,552
0
-------------
0
27Daniel Blue
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
5,294,695
0
-------------
0
0
-------------
0
0
-------------
5,294,695
0
-------------
0
28Eric Belanger MD
Physician
(i)

(ii)
3,454,788
-------------
0
0
-------------
0
33,557
-------------
0
14,250
-------------
0
27,180
-------------
0
3,529,775
-------------
0
0
-------------
0
29Adam Stys MD
Physician
(i)

(ii)
2,952,874
-------------
0
0
-------------
0
21,676
-------------
0
14,250
-------------
0
26,656
-------------
0
3,015,456
-------------
0
0
-------------
0
30Tomasz Stys MD
Physician
(i)

(ii)
2,633,748
-------------
0
0
-------------
0
153,302
-------------
0
14,250
-------------
0
23,850
-------------
0
2,825,150
-------------
0
0
-------------
0
31William Brunner MD
Physician
(i)

(ii)
2,655,125
-------------
0
0
-------------
0
3,387
-------------
0
14,250
-------------
0
27,180
-------------
0
2,699,942
-------------
0
0
-------------
0
32Michelle Bruhn
Former Sr VP Finance, Health Svc
(i)

(ii)
0
-------------
700,526
0
-------------
171,002
0
-------------
92,809
0
-------------
87,900
0
-------------
24,365
0
-------------
1,076,602
0
-------------
0
33Daniel Olson
Former President, Bemidji
(i)

(ii)
0
-------------
315,818
0
-------------
5,300
0
-------------
44,593
0
-------------
13,953
0
-------------
23,945
0
-------------
403,609
0
-------------
0
34Kim Patrick
Former CLO (Thru 12/20)
(i)

(ii)
0
-------------
678,576
0
-------------
206,853
0
-------------
132,884
0
-------------
14,250
0
-------------
25,091
0
-------------
1,057,654
0
-------------
0
35Kim Patrick
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
2,853,845
0
-------------
0
0
-------------
0
0
-------------
2,853,845
0
-------------
0
36Randy Bury
Former Chief Administrative Officer
(i)

(ii)
0
-------------
888,856
0
-------------
280,005
0
-------------
166,120
0
-------------
111,985
0
-------------
25,365
0
-------------
1,472,331
0
-------------
0
37Randy Bury
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
359,927
0
-------------
0
0
-------------
0
0
-------------
359,927
0
-------------
226,838
38Nate White
Former COO (Thru 4/20)
(i)

(ii)
0
-------------
365,485
0
-------------
300,000
0
-------------
67,877
0
-------------
14,250
0
-------------
315
0
-------------
747,927
0
-------------
0
39Nate White
See Sch J, Part III, Lines 4a-4b
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
3,281,646
0
-------------
0
0
-------------
0
0
-------------
3,281,646
0
-------------
237,188
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Part I, Line 1a On Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate, in accordance with written policies. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Travel for Companions - Limited travel for companions is required for certain annual meetings. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Tax Indemnification and gross-up payments - Certain compensation may be grossed up to include appropriate tax amounts. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are included as fringe benefits, and taxed as such. Part I, Line 3: The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2020.
Part I, Lines 4a-b Part I, Line 4a Severance or Change of Control and Line 4b Supplemental Nonqualified Retirement Plan Payments. Line 4a-Severance or Change of Control Upon hire or promotion, select officers and key employees sign an Executive Severance Agreement (the "Agreement"). The Agreement provides that the executive will receive a multiple of his or her salary (based on years of service or position) as a payment in the event of a defined separation event, which can include an involuntary separation or an employee voluntarily leaving for a defined contractual reason. Final separation payments might vary from the amount provided in the Agreement as a result of negotiations surrounding early retirements and post-separation obligations and incentives (the "Separation" payment). Line 4b-Supplemental Nonqualified Retirement Plan Payments-Defined Benefit SERP Annuity Plan In 1983, a Defined Benefit Supplemental Executive Retirement Plan ("DB SERP annuity plan") was established. The DB SERP annuity plan provided lifetime annuity payments to plan participants based on their historical salary and years of service. The annuity benefit was designed to provide a similar benefit as provided by the qualified defined benefit pension plan. As of 2020, Kelby Krabbenhoft and Bill Marlette, with 24 and 31 years of service respectively, were the only two remaining participants. In November 2020, the Sanford Board of Trustees made the decision to accelerate termination of the DB SERP annuity plan to limit future financial liability and because Sanford does not intend to use an average pay/annuity supplemental structure on a go forward basis. Kelby Krabbenhoft's and Bill Marlette's benefit had been previously accrued for and disclosed as retirement and other deferred compensation on historical 990 forms. As a result of the plan termination, the total benefit was vested and reportable as taxable income on the plan participants' W-2s in 2020. Line 4b-Supplemental Nonqualified Retirement Plan Payments-Defined Benefit SERP Lump Sum Plans As also required by plan termination rules, Sanford terminated all other defined benefit supplemental executive retirement plans. Kelby Krabbenhoft participated in a DB SERP lump sum plan tied to retention and his succession plan. Mark Lundeen participated in a separate DB SERP lump sum plan tied to retention. Line 4b-Supplemental Nonqualified Retirement Plan Payments-Defined Contribution SERP Plan Sanford sponsors a Defined Contribution Supplemental Executive Retirement Plan ("DC SERP plan") for select officers or key employees. The DC SERP plan provides that Sanford will make discretionary contributions into participant accounts. Certain of the below officers or key employees were paid as a result of a vesting event which include reaching a pre-established retirement age or a defined separation event. Line 4a and 4b-Payments The following individuals received severance or change of control payments and/, or supplemental nonqualified retirement plan payments: Mark Lundeen, 40 years of service: DB SERP lump sum plan $ 1,000,000 Kelby Krabbenhoft, 24 years of service: Separation $15,000,000 DB SERP annuity and lump sum plans $29,353,819 Total $44,353,819 Bill Gassen III, 9 years of service: Retention plan agreement $1,100,000 JoAnn Kunkel, 28 years of service: Separation $6,498,707 DC SERP plan $ 348,731 Total $6,847,438 Bill Marlette, 31 years of service: DB SERP annuity plan $5,903,232 Allison Wierda-Suttle, 19 years of service: Separation $2,008,332 DC SERP plan $ 342,278 Total $2,350,610 Micah Aberson, 6 years of service: Retention plan agreement $1,100,000 Daniel Blue, 31 years of service: Separation $5,058,502 DC SERP plan $ 236,193 Total $5,294,695 Kim Patrick, 21 years of service: Separation $2,853,845 Randy Bury, 40 years of service: DC SERP plan $ 359,927 Nate White, 16 years of service: Separation $2,970,256 DC SERP plan $ 311,390 Total $3,281,646
Part I, Line 6 Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production.
Part I, Line 7 Certain employees are eligible for a discretionary incentive bonus. Bonuses are paid based on the achievement of financial and other goals.
Schedule J (Form 990) 2020

Additional Data


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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VHY3 09-14-2004 70,073,989 2004: New construction of healthcare facilities   X   X   X
B City of Fargo
 
45-6002069 307479CK9 02-09-2011 134,069,821 2011: Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002 X     X   X
C South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VVM3 11-01-2012 128,733,641 2012E: New construction and remodeling of healthcare facilities   X   X   X
D City of Chamberlain
 
46-0000094 000000000 12-30-2010 4,000,000 2010 Chamb: New construction of long-term care facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 03-29-2012 66,185,000 2012AB: Refunding bonds issued 9/12/2001 and 10/15/2002   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 06-14-2012 45,000,000 2012D:Refinance taxable indebtedness used to construct healthcare facility   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VWA8 08-05-2014 52,083,720 2014A: Current refund 2004A issued 9/14/2004   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VXE9 10-28-2014 207,014,209 2014B: New construction and remodeling of healthcare facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VZW7 10-21-2015 192,641,206 2015:New construction & advanced refunding of bonds issued 4/19/07, 5/22/07   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 10-28-2016 50,000,000 2016: New Construction, equipment and improvements   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 56,675,000 57,960,000   2,344,257
2 Amount of bonds legally defeased ..............   74,700,000    
3 Total proceeds of issue .................. 71,581,953 134,069,821 129,135,779 4,000,000
4 Gross proceeds in reserve funds ............. 67,057   6 1,123
5 Capitalized interest from proceeds .............       31,874
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 150,032 1,470,647 1,906,127
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 45,000,000 127,665,132 4,000,000
11 Other spent proceeds ............. 66,160,644 134,069,821 52,083,720  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2013 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, 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 2019, 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  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 ............. 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
  X   X   X    
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X X   X  
c No rebate due? ......... X   X     X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
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? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ...   X   X   X   X
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X   X   X   X
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Date Rebate Computation Performed Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 03/29/2013 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 10/30/2019 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 11/12/2020
Schedule K, Part I, Bond Issues Bonds issued 10/28/2014, column(c) CUSIP #: 83755VXF6 and 83755VXE9 Bonds issued 9/14/2004, column(c) CUSIP #: 83755VHY3 and 83755VHZ0
Part I, Column e and Part II, Line 3 Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4 The amounts shown here consist of debt service fund deposits.
Part III Part III has not been completed for the 2011 City of Fargo bonds or for the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6 With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield- restricted advance refunding escrow financed with proceeds of bonds.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  


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

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VHY3 09-14-2004 70,073,989 2004: New construction of healthcare facilities   X   X   X
B City of Fargo
 
45-6002069 307479CK9 02-09-2011 134,069,821 2011: Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002 X     X   X
C South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VVM3 11-01-2012 128,733,641 2012E: New construction and remodeling of healthcare facilities   X   X   X
D City of Chamberlain
 
46-0000094 000000000 12-30-2010 4,000,000 2010 Chamb: New construction of long-term care facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 03-29-2012 66,185,000 2012AB: Refunding bonds issued 9/12/2001 and 10/15/2002   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 06-14-2012 45,000,000 2012D:Refinance taxable indebtedness used to construct healthcare facility   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VWA8 08-05-2014 52,083,720 2014A: Current refund 2004A issued 9/14/2004   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VXE9 10-28-2014 207,014,209 2014B: New construction and remodeling of healthcare facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VZW7 10-21-2015 192,641,206 2015:New construction & advanced refunding of bonds issued 4/19/07, 5/22/07   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 10-28-2016 50,000,000 2016: New Construction, equipment and improvements   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 56,675,000 57,960,000   2,344,257
2 Amount of bonds legally defeased ..............   74,700,000    
3 Total proceeds of issue .................. 71,581,953 134,069,821 129,135,779 4,000,000
4 Gross proceeds in reserve funds ............. 67,057   6 1,123
5 Capitalized interest from proceeds .............       31,874
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 150,032 1,470,647 1,906,127
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 45,000,000 127,665,132 4,000,000
11 Other spent proceeds ............. 66,160,644 134,069,821 52,083,720  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2013 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, 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 2019, 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  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 ............. 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
  X   X   X    
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X X   X  
c No rebate due? ......... X   X     X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
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? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ...   X   X   X   X
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X   X   X   X
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Date Rebate Computation Performed Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 03/29/2013 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 10/30/2019 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 11/12/2020
Schedule K, Part I, Bond Issues Bonds issued 10/28/2014, column(c) CUSIP #: 83755VXF6 and 83755VXE9 Bonds issued 9/14/2004, column(c) CUSIP #: 83755VHY3 and 83755VHZ0
Part I, Column e and Part II, Line 3 Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4 The amounts shown here consist of debt service fund deposits.
Part III Part III has not been completed for the 2011 City of Fargo bonds or for the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6 With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield- restricted advance refunding escrow financed with proceeds of bonds.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  


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

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number
45-3791176
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VHY3 09-14-2004 70,073,989 2004: New construction of healthcare facilities   X   X   X
B City of Fargo
 
45-6002069 307479CK9 02-09-2011 134,069,821 2011: Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002 X     X   X
C South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VVM3 11-01-2012 128,733,641 2012E: New construction and remodeling of healthcare facilities   X   X   X
D City of Chamberlain
 
46-0000094 000000000 12-30-2010 4,000,000 2010 Chamb: New construction of long-term care facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 03-29-2012 66,185,000 2012AB: Refunding bonds issued 9/12/2001 and 10/15/2002   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 06-14-2012 45,000,000 2012D:Refinance taxable indebtedness used to construct healthcare facility   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VWA8 08-05-2014 52,083,720 2014A: Current refund 2004A issued 9/14/2004   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VXE9 10-28-2014 207,014,209 2014B: New construction and remodeling of healthcare facilities   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 83755VZW7 10-21-2015 192,641,206 2015:New construction & advanced refunding of bonds issued 4/19/07, 5/22/07   X   X   X
South Dakota Health and Educational Facilities Authority
 
46-0315509 000000000 10-28-2016 50,000,000 2016: New Construction, equipment and improvements   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 56,675,000 57,960,000   2,344,257
2 Amount of bonds legally defeased ..............   74,700,000    
3 Total proceeds of issue .................. 71,581,953 134,069,821 129,135,779 4,000,000
4 Gross proceeds in reserve funds ............. 67,057   6 1,123
5 Capitalized interest from proceeds .............       31,874
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 150,032 1,470,647 1,906,127
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 45,000,000 127,665,132 4,000,000
11 Other spent proceeds ............. 66,160,644 134,069,821 52,083,720  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2012 2013 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2019, 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 2019, 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  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 2
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   X   X    
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 %  
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 %  
6 Total of lines 4 and 5 ............. 0 % 0 % 0 %  
7 Does the bond issue meet the private security or payment test? ...   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
  X   X   X    
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X X   X  
c No rebate due? ......... X   X     X   X
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X     X   X X  
Schedule K (Form 990) 2020

Schedule K (Form 990) 2020
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
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? ........                
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ...   X   X   X   X
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X   X   X   X
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
Date Rebate Computation Performed Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 03/29/2013 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 10/30/2019 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 11/12/2020
Schedule K, Part I, Bond Issues Bonds issued 10/28/2014, column(c) CUSIP #: 83755VXF6 and 83755VXE9 Bonds issued 9/14/2004, column(c) CUSIP #: 83755VHY3 and 83755VHZ0
Part I, Column e and Part II, Line 3 Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4 The amounts shown here consist of debt service fund deposits.
Part III Part III has not been completed for the 2011 City of Fargo bonds or for the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6 With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield- restricted advance refunding escrow financed with proceeds of bonds.
Schedule K (Form 990) 2020

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
(1) Ryan Patrick Family member of - K Patrick Education/Student Loans   X 120,000 130,819   No Yes   Yes  
Total ...............Small Bullet $ 130,819
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2020
Schedule L (Form 990 or 990-EZ) 2020
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Kathryn Nermoe B Nermoe - family relationship 119,366 Compensation   No
(2) Mallory Nermoe B Nermoe - family relationship 36,340 Compensation   No
(3) Annette White N White - family relationship 1,456,798 Compensation   No
(4) Melinda Anderson M Paulson - family relationship 125,105 Compensation   No
(5) John Durick P Durick - family relationship 141,337 Compensation   No
(6) Louis Krabbenhoft K Krabbenhoft - family relationship 202,205 Compensation   No
(7) Megan Hemmelgarn M Paulson - family relationship 26,104 Compensation   No
(8) Daniel Aberson M Aberson - family relationship 518,768 Compensation   No
(9) Christina Olson N Olson - family relationship 289,455 Compensation   No
(10) Barb Everist Joint Venture in Everist Health 6,000,000 Sanford contributed $6M into Everist Health during the previous years. As a result, Sanford and Barb Everist both owned more than a 10% interest in this company.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Return Reference Explanation
Part V, Line 3a: Sanford Health, Sanford Medical Center, Sanford North, Sanford Medical Center Fargo, Sanford Clinic North, Sanford Clinic, Sanford Bismarck and Sanford World Clinics have unrelated business gross income over $1,000.
Part V, Line 4a: Sanford World Clinics has an interest in financial accounts in the foreign countries of Ghana, China and Germany.
Form 990, Part VI, Section A, line 2 The following officers, board members, and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Allison Wierda-Suttle, Bill Gassen, Bill Marlette, Bryan Nermoe, Jennifer Grennan, JoAnn Kunkel, Kelby Krabbenhoft, Maria Bell, Mark Lundeen, Mark Paulson, Micah Aberson, Michael LeBeau, Michelle Bruhn, Michelle Micka, Paul Hanson, Randy Bury, Matt Hocks, Nicholas Olson, Susan Jarvis.
Form 990, Part VI, Section A, line 6 Sanford is governed by a Board of Trustees (BOT) that has ultimate strategic and decision making authority. The BOT delegates certain activities and responsibilities to Boards of each of Sanford's primary operating subsidiaries. The unique nature and complexity of the subsidiaries requires each to have a delegated Board with a singular entity focus. Such bodies, referred to as Boards of Directors and Boards of Governors, address matters such as credentialing, accreditation standards, developing budgets, programs and facilities on an entity-specific basis, and generally consist of individuals distinct from the BOT. These Boards function much like committees in a traditional corporate structure. The BOT then acts as a holding company Board, synthesizing and reconciling each entity's programs and budgets into a system-wide strategic plan. This structure of governance produces a significant number of trustees, governors and directors. Subsidiaries included within this group tax return consist of Sanford Health, Sanford North, Sanford Medical Center, Sanford Medical Center Fargo, Sanford Clinic, Sanford Clinic North, Sanford Health Network, Sanford Health Network North, Sanford Home Health, Sanford Research, Sanford Research North, Sanford World Clinics, Sanford Health of Northern Minnesota, Baker Park, Inc., Sanford West, Sanford Bismarck and Sanford Living Centers. The Board of Trustees of Sanford is also the Board of Trustees for Sanford Health, Sanford North and Sanford West, and Sanford is the sole corporate member of these entities. These entities, in turn, are the sole corporate members of the subsidiaries. The actions approved by a subsidiary's Board of Directors are then approved by the Sanford Board of Trustees.
Form 990, Part VI, Section A, line 7a The Sanford Board of Trustees appoints the board members for the Boards of Directors and Boards of Governors of the subsidiary entities.
Form 990, Part VI, Section A, line 7b The Sanford Board of Trustees approves the actions approved by the Boards of Directors and Boards of Governors of the subsidiary entities. Form 990, Part VI, Section B, line 10b: Sanford North, Sanford Clinic and Sanford Health Network have local chapters, branches or affiliates over which the organization has the legal authority to exercise direct or indirect supervision and control.
Form 990, Part VI, Section B, line 11b The Form 990 is prepared internally by the Tax Department and reviewed by executive management. An external accounting firm reviews the return. The Tax Departmemt prepares return highlights and key disclosures for the Board of Trustees meeting prior to the return filing date. Before the return is filed, a complete copy is provided to the current Board of Trustees.
Form 990, Part VI, Section B, line 12c The annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards of subsidiary entities, officers, and key employees for all entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis if potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest, and how to manage them.
Form 990, Part VI, Section B, line 15 The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2020. Part VI, Line 16a: Sanford Health, Sanford Medical Center, Sanford Clinic, Sanford Medical Center Fargo and Sanford Clinic North have participated in joint ventures with taxable entities.
Form 990, Part VI, Section C, line 19 Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents.
Form 990, Part VII, Section A The Sanford Board of Trustees has ultimate goverance responsibilities for each major operating entity within Sanford. In addition, a Board of Directors is established for each major operating entity. This Board has specific responsibilities delegated from the Board of Trustees. Generally these responsibilities are related to the oversight of the day to day operations of that entity.
Form 990, Part VII, Section B We are reporting one group of top five employees and independent contractors for the entire group. Amounts listed as compensation for the five highest compensated independent contractors include payments for both materials and services.
Form 990, Part XI, line 9: Capital Contributions to subsidiaries -83,028,402. DB Pension Actuarial Gains/Losses -12,299,562. Net payroll paid by parent net of other expenses paid for affiliates 78,892,347.
Form 990 Elections Form 990, Page 1, Line H(a) - Listing of Subordinate Organizations: Names, Addresses, and EINs Sanford Health 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 31-1527032 Sanford USD Medical Center 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0227855 Sanford Home Health 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0282134 Sanford Health Network 1305 W 18th Street Sioux Falls, SD 57105 EIN: 46-0388596 Sanford Clinic 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0447693 Sanford Research 2301 E 60th Street N Sioux Falls, SD 57104 EIN: 46-0450378 Sanford Research North 120 8th Street South Fargo, ND 58103 EIN: 45-0274828 Sanford World Clinics 1305 W 18th Street Sioux Falls, SD 57105 EIN: 26-2707628 Sanford North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0385890 Sanford Clinic North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 91-1770748 Sanford Medical Center Fargo 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0226909 Sanford Health Network North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0409348 Sanford Health of Northern Minnesota 1300 Anne Street NW Bemidji, MN 56601 EIN: 41-1266009 Baker Park, Inc. 803 Dewey Avenue NW Bemidji, MN 56601 EIN: 41-1372480 Sanford West 300 N 7th Street Bismarck, ND 58501 EIN: 45-0397195 Sanford Bismarck 300 N 7th Street Bismarck, ND 58501 EIN: 45-0226700 Sanford Living Centers 1000 18th Street NW, Suite 1 Mandan, ND 58554 EIN: 45-0416454
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


Additional Data


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

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

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) Lincoln County Real Estate Trust
100 S Phillips Ave
Sioux Falls,SD57104
46-6126929
Real Estate SD 0 0 Sanford Health
 
(2) PPK Family Trust
100 S Phillips Ave
Sioux Falls,SD57104
20-7317570
Rental Real Estate SD 11,203 2,300,781 Sanford Health
 
(3) Lynx Trust
PO Box 5186
Sioux Falls,SD57117
26-6167201
Investment SD 0 2,706 Sanford Health
 
(4) National Student Housing Trust-SD
PO Box 5186
Sioux Falls,SD57117
20-6831968
Investment SD 2 464 Sanford Health
 
(5) Sanford HealthCare Accessories LLC
3223 32nd Ave SW
Fargo,ND58103
20-2404179
Sales of Durable Medical Equip ND 1,681,951 18,397,482 Sanford North
 
(6) Healthcare Environmental Services LLC
PO Box 2010
Fargo,ND58122
20-5236701
Retail Enterprises ND 939,697 4,581,691 Sanford North
 
(7) North Country Senior Living LLC
1000 Anne St NW
Bemidji,MN56601
26-3862586
Senior Housing CO -665,142 6,611,839 Sanford Health of Northern Minnesota
 
(8) 1527 Broadway LLC
1527 Broadway
Alexandria,MN56308
41-1336392
Real Estate MN 282,646 3,558,845 Sanford Clinic North
 
(9) Shetek Medical Services LLC
251 5th Street E
Tracy,MN56175
41-2004685
Home Health Services MN -237,409 77,978 Sanford Health Network
 
(10) Sanford Health Mobile Med LLC
2603 E Broadway Avenue
Bismarck,ND58501
47-1209528
Mobile Healthcare ND -26,241 0 Sanford Health
 
(11) Southwest MN Radiation Center LLC
1018 6th Avenue
Worthington,MN56187
46-0447693
Radiation Services MN -878,060 8,421 Sanford Health Network
 
(12) B&K Properties LLC
PO Box 5039 Rte 5218
Sioux Falls,SD571175030
83-0614887
Real Estate SD -16,348 20,844,005 Sanford Health
 
Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)Sanford
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
27-1218956
Supporting Organization ND 501(c)(3) 12-II  
 
No
(2)Sanford Health Foundation
P O Box 5039 Rte 5218

Sioux Falls,SD571175039
36-3297853
Foundation SD 501(c)(3) 12-II Sanford Health
 
Yes
 
(3)F-M Ambulance Service Inc
P O Box 5039 Rte 5218

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

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

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

Sioux Falls,SD571175039
45-0397196
Foundation ND 501(c)(3) 7 Sanford Bismarck
 
Yes
 
(7)Sanford Heart of America Health Plan
P O Box 5039 Rte 5218

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sioux Falls,SD571175039
46-0447338
Provide low income housing to seniors and other eligible populations SD 501(c)(3) 10 The Evangelical Lutheran Good Samaritan Society
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


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

100 S Phillips Ave
Sioux Falls,SD57104
20-2129839
Investment SD N/A
        No     No  
(2) RAC Rentals LLC

100 S Phillips Ave
Sioux Falls,SD57104
26-1961077
Investment SD N/A
        No     No  
(3) Ada County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
36-4799439
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(4) Adams County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
38-3896526
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(5) Belington Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
32-0493132
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(6) Collister Drive Housing LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
61-1752929
Low-income housing to seniors and other eligible populations as GP SD N/A
        No     No  
(7) Colorado Good Samaritan Housing GP LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
30-1164681
Low-income housing to seniors and other eligible populations as GP SD N/A
        No     No  
(8) Fargo Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
30-1141316
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(9) Good Samaritan Insurance Plan of North Dakota

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-5020633
Insurance ND N/A
        No     No  
(10) Good Samaritan Insurance Plan LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
81-5051671
Insurance DE N/A
        No     No  
(11) Hastings Village Gardens Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
27-1212511
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(12) HMS Heritage Management Services LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
90-0915850
Provide Home Health Services TX N/A
        No     No  
(13) Indianola Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
30-0755780
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(14) Lilac Way Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
36-4786577
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(15) Millard Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
27-1212324
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(16) Olathe Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
20-5297369
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(17) Olds Hall Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
35-2626242
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(18) Pennington County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
38-4060178
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(19) Prescott Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
27-5115281
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(20) Rapid City Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
35-2466169
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(21) Roseville Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(22) Ruth Street Good Samaritan Housing LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
61-1748321
Low-income housing to seniors and other eligible populations as GP SD N/A
        No     No  
(23) Sioux Falls Downtown Good Samaritan LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
32-0377442
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
(24) Texas Good Samaritan Housing LLC

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
37-1774574
Low-income housing to seniors and other eligible populations as GP SD N/A
        No     No  
(25) Weld County Good Samaritan Housing LP

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
32-0584614
Provide low-income housing to seniors and other eligible populations SD N/A
        No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Sanford Home Medical Equipment Inc

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

300 Cherapa Place
Sioux Falls,SD57103
91-1842494
Insurance SD Sanford Health
 
C 34,533,063 186,369,361 100.000 % Yes  
(3) Sanford Health Plan of MN

300 Cherapa Place
Sioux Falls,SD57103
46-0445852
Insurance MN Sanford Health
 
C 1,629,339 3,703,318 100.000 % Yes  
(4) Sanford Frontiers

1305 W 18th Street PO Box 5039
Sioux Falls,SD571175039
45-5436599
Weight Loss/Fitness SD Sanford Health
 
C -9,514,000 88,754,388 100.000 % Yes  
(5) SOB Inc

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

Sarbah Road Tantri Lorry Station
Cape Coast    
GH
Healthcare GH Sanford World Clinics
 
C -1,187,283 3,408,228 100.000 % Yes  
(7) Shanghai Sanford Healthcare Management Consulting Co Ltd

188 Yesheng Road Room A-862 Guoma
Shanghai    
CH
Healthcare CH Sanford World Clinics
 
C -59,293 502,043 100.000 % Yes  
(8) Sanford International - Munich GmbH

Nymphenburger Strasse 3
Munich    
GM
Healthcare GM Sanford World Clinics
 
C 2,310 11,927,826 100.000 % Yes  
(9) Angels in Waiting Hospice LLC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

P O Box 5039 Rte 5218
Sioux Falls,SD571175039
26-3456679
Provide home and community based services TX N/A
S       Yes  
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
Yes
 
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Sanford Health Foundation

B 6,608,000 Cash Method
(2) Sanford Health Foundation North

B 2,024,586 Cash Method
(3) Sanford Health Foundation of Northern Minnesota

B 615,988 Cash Method
(4) Sanford Health Foundation West

B 1,040,009 Cash Method
(5) The Evangelical Lutheran Good Samaritan Foundation

B 2,105,619 Cash Method
(6) Sanford Frontiers

B 48,028,402 Cash Method
(7) Sanford Health Plan

B 35,000,000 Cash Method
(8) Sanford World Clinics-Ghana

B 1,000,000 Cash Method
(9) Sanford Health Foundation

C 36,125,168 Cash Method
(10) Sanford Health Foundation North

C 726,157 Cash Method
(11) Sanford Health Foundation North

C 365,355 Cash Method
(12) Sanford Health Foundation North

C 1,025,777 Cash Method
(13) Sanford Health Foundation North

C 3,323,643 Cash Method
(14) Sanford Health Foundation North

C 130,153 Cash Method
(15) Sanford Health Foundation of Northern Minnesota

C 657,842 Cash Method
(16) Sanford Health Foundation West

C 483,751 Cash Method
(17) The Evangelical Lutheran Good Samaritan Society

C 139,966 Cash Method
(18) Sanford Home Medical Equipment

F 15,000,000 Cash Method
(19) FM Ambulance

Q 4,204,865 Cash Method
(20) Sanford Health Foundation

R 1,728,936 Cash Method
(21) Sanford Health Foundation Hillsboro

R 50,860 Cash Method
(22) Sanford Health Foundation North

R 1,323,434 Cash Method
(23) Sanford Health Foundation of Northern Minnesota

R 532,038 Cash Method
(24) The Evangelical Lutheran Good Samaritan Society

R 6,293,343 Cash Method
(25) Sanford-Good Samaritan Community Health Services

R 10,724,267 Cash Method
(26) The Evangelical Lutheran Good Samaritan Foundation

S 231,674 Cash Method
(27) The Evangelical Lutheran Good Samaritan Society

S 109,011,881 Cash Method
(28) SOB Inc

S 293,317 Book Value
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020

Additional Data


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