Form990


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
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2022 , and ending 12-31-2022
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 $ 5,327,534,915
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 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 6
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 3,121
6 Total number of volunteers (estimate if necessary) ............. 6 1,254
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 102,695,945
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 2,898,047
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 173,849,939 100,939,514
9 Program service revenue (Part VIII, line 2g) ......... 5,046,555,124 5,209,223,752
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,533,720 9,136,742
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,635,171 2,637,006
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 5,228,573,954 5,321,937,014
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 47,416,673 44,519,605
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) 2,822,078,981 2,907,712,001
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).... 1,964,536,735 2,208,856,104
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 4,834,032,389 5,161,087,710
19 Revenue less expenses. Subtract line 18 from line 12....... 394,541,565 160,849,304
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 3,485,607,781 3,581,478,897
21 Total liabilities (Part X, line 26)............. 1,207,557,219 1,069,495,687
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,278,050,562 2,511,983,210
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
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 $ 4,734,788,301 including grants of $ 44,519,604 ) (Revenue $ 5,064,394,241 )
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. THE MOST RECENT 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 $ 41,001,593 including grants of $ 0 ) (Revenue $ 5,322,741 )
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 $ 36,091,714 including grants of $ 0 ) (Revenue $ 8,433,837 )
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 expensesMediumBullet4,811,881,608
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
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
List of Attached Documents:
// Content
.............
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
List of Attached Documents:
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.........
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 Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
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..
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
List of Attached Documents:
// Content
.........................
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
List of Attached Documents:
// Content
....
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
List of Attached Documents:
// Content
..............
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
List of Attached Documents:
// Content
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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
List of Attached Documents:
// Content
...................
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
.......
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
List of Attached Documents:
// Content
............
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
......................
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
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment
List of Attached Documents:
// Content
.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the 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
List of Attached Documents:
// Content
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
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
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on 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
4,396
b
Enter the number of Forms W-2G included on 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 (2021)
Form 990 (2021)
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
3,121
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 the 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
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
6
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on 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 on 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 on 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 (1024 or 1024-A, if applicable), 990, and 990-T (section 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 EVP CFO & TREASURER2301 EAST 60TH STREET   SIOUX FALLS,SD57104 (605) 333-1000
Form 990 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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 the 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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) WILLIAM BRUNNER MD......................................................................
PHYSICIAN
60.00
.................
0.00
        X   3,406,075 0 39,142
(2) BRYAN NERMOE......................................................................
PRESIDENT & CEO, FARGO-END 3/22
55.00
.................
5.00
      X     0 457,274 37,952
(3) BRYAN NERMOE......................................................................
SEE SCH J, PART III, LINES 4A-4B
55.00
.................
5.00
      X     0 2,719,941 0
(4) BILL GASSEN III......................................................................
TRUSTEE, PRESIDENT & CEO
49.64
.................
10.36
X   X       0 2,683,582 379,583
(5) TOMASZ STYS MD......................................................................
PHYSICIAN
60.00
.................
0.00
        X   2,806,912 0 39,520
(6) RANDY BURY......................................................................
FORMER CHIEF ADMIN OFFICER
0.00
.................
0.00
          X 0 56,688 0
(7) RANDY BURY......................................................................
SEE SCH J, PART III, LINES 4A-4B
0.00
.................
0.00
          X 0 2,769,572 0
(8) ADAM STYS MD......................................................................
PHYSICIAN
60.00
.................
0.00
        X   2,750,489 0 42,510
(9) ERIC BELANGER MD......................................................................
PHYSICIAN
60.00
.................
0.00
        X   2,545,233 0 42,926
(10) MARIAN PETRASKO MD......................................................................
PHYSICIAN
60.00
.................
0.00
        X   2,427,171 0 34,932
(11) MATT HOCKS......................................................................
EVP, CHIEF OPERATING OFFICER
53.85
.................
6.15
      X     0 2,164,525 248,300
(12) MICHELLE BRUHN......................................................................
EVP, CFO & TREASURER
49.64
.................
10.36
    X       0 1,530,538 186,998
(13) JENNIFER GRENNAN......................................................................
EVP, CHIEF ADMIN OFFICER
55.00
.................
5.00
      X     0 1,476,061 183,409
(14) MICHAEL LEBEAU MD......................................................................
SVP, HEALTH SVC OPERATIONS
60.00
.................
0.00
      X     0 1,420,525 182,111
(15) PAUL HANSON......................................................................
PRESIDENT & CEO, SIOUX FALLS
60.00
.................
0.00
      X     0 1,254,502 154,600
(16) MARIA BELL MD......................................................................
TRUSTEE, PHYSICIAN
57.99
.................
2.01
X           1,143,694 0 43,942
(17) TODD SCHAFFER......................................................................
PRESIDENT & CEO, BISMARCK
60.00
.................
0.00
      X     0 948,736 110,906
Form 990 (2021)
Form 990 (2021)
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) TIFFANY LAWRENCE........................................................................
PRESIDENT & CEO, FARGO-BEG 3/22
55.00
.......................5.00
      X     0 924,767 132,767
(19) SUSAN JARVIS........................................................................
PRESIDENT & CEO, BEMIDJI
60.00
.......................0.00
      X     0 805,036 122,025
(20) MICHELLE MICKA........................................................................
SVP, FINANCE, HEALTH SERVICES
55.00
.......................5.00
      X     0 615,816 80,707
(21) MARK LUNDEEN MD........................................................................
TRUSTEE, PHYSICIAN
57.99
.......................2.01
X           343,914 0 13,962
(22) JOANN KUNKEL........................................................................
FORMER CFO-SCH J, PART III, LINES 4A-4B
0.00
.......................0.00
          X 0 339,000 0
(23) ANDY NORTH........................................................................
TRUSTEE, SECRETARY, INDEP CONTRACTOR
9.10
.......................2.01
X   X       316,771 0 0
(24) KIM PATRICK........................................................................
FORMER CLO-SCH J, PART III, LINES 4A-4B
0.00
.......................0.00
          X 0 315,000 0
(25) NATHAN WHITE........................................................................
FORMER COO-SCH J, PART III, LINES 4A-4B
0.00
.......................0.00
          X 0 300,000 0
(26) MARK PAULSON MD........................................................................
TRUSTEE, PHYSICIAN
57.99
.......................2.01
X           239,394 0 38,669
(27) ALLISON WIERDA-SUTTLE MD........................................................................
FORMER SVP, CMO-SCH J PT III, 4A-4B
0.00
.......................0.00
          X 0 264,600 0
(28) NEIL GULSVIG........................................................................
TRUSTEE, CHAIRPERSON
5.10
.......................2.01
X   X       75,772 0 0
(29) LAURIS MOLBERT........................................................................
TRUSTEE, VICE CHAIR
5.10
.......................2.01
X   X       35,500 0 0
(30) MARNIE HERMANN........................................................................
TRUSTEE
5.10
.......................2.01
X           35,500 0 0
(31) DON JACOBS........................................................................
TRUSTEE
5.10
.......................2.01
X           34,500 0 0
(32) JAMES CAIN........................................................................
TRUSTEE
5.10
.......................2.01
X           34,500 0 0
(33) ROBIN SMITH........................................................................
TRUSTEE, TREASURER
5.10
.......................2.01
X   X       34,000 0 0
(34) WESLEY ENGBRECHT........................................................................
TRUSTEE
5.10
.......................2.01
X           34,000 0 0
(35) BRENT TEIKEN........................................................................
TRUSTEE, PAST CHAIR
5.10
.......................2.01
X   X       33,000 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 16,296,425 21,046,163 2,114,961
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 MediumBullet2,308
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
FOCUSONE SOLUTIONS LLC

1010 N 102ND ST STE 300
OMAHA,NE68114
STAFFING SERVICES 300,145,941
MAYO CLINIC LABORATORIES

200 FIRST ST SOUTHWEST
ROCHESTER,MN55905
LAB/MEDICAL SERVICES 10,891,161
MCGOUGH CONSTRUCTION CO LLC

2737 FAIRVIEW AVE N
ST PAUL,MN55113
CONSTRUCTION SERVICES 7,396,303
LOCUMTENENSCOM LLC

2655 NORTHWINDS PKWY
ALPHARETTA,GA30009
STAFFING SERVICES 4,561,600
WAPITI MEDICAL STAFFING

107 FYNN DR SUITE 600
MILBANK,SD57252
STAFFING SERVICES 4,343,061
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet300
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 43,258,143
e Government grants (contributions)1e 42,975,576
f All other contributions, gifts, grants, and similar amounts not included above1f 14,705,795
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 100,939,514
 Program Service RevenueAmt Business Code
2a PATIENT SERVICES 621110 2,359,607,636 2,359,607,636    
b MEDICARE/MEDICAID 621400 1,952,624,035 1,952,624,035    
c PHARMACY 621300 521,232,020 513,313,609 7,918,411  
d RETAIL SALES 456199 187,530,621 166,458,066 21,072,555  
e SUPPORT SERVICES 561439 52,033,841   50,766,776 1,267,065
f All other program service revenue. 136,195,599 86,147,473 22,938,203 27,109,923
g Total. Add lines 2a–2f .....MediumBullet 5,209,223,752
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 5,633,495     5,633,495
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 3,650     3,650
(ii) Personal (i) Real
6a Gross rents   4,659,382 6a
b Less: rental expenses   2,026,026 6b
c Rental income or (loss)   2,633,356 6c
d Net rental income or (loss).......MediumBullet 2,633,356     2,633,356
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 6,007,947 1,067,175 7a
b Less: cost or other basis and sales expenses 2,406,716 1,165,159 7b
c Gain or (loss) 3,601,231 -97,984 7c
d Net gain or (loss).........MediumBullet 3,503,247     3,503,247
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 5,321,937,014 5,078,150,819 102,695,945 40,150,736
Form 990 (2021)
Form 990 (2021)
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 .... 44,383,028 44,383,028
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 126,577 126,577
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 10,000 10,000
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 21,277,779 19,663,681 1,614,098  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 4,129,859   4,129,859  
7 Other salaries and wages........ 2,358,340,963 2,183,257,619 175,083,344  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 96,623,894 88,365,800 8,258,094  
9 Other employee benefits ....... 274,888,369 244,644,216 30,244,153  
10 Payroll taxes ........... 152,451,137 139,476,853 12,974,284  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 2,998,111 294,569 2,703,542  
c Accounting ........... 1,196,513 80,195 1,116,318  
d Lobbying ........... 1,680,186   1,680,186  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 233,703 233,703    
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 439,234,857 407,588,646 31,646,211  
12 Advertising and promotion .... 20,963,774 7,038,078 13,925,696  
13 Office expenses ....... 57,854,805 38,431,076 19,423,729  
14 Information technology ...... 120,195,962 46,677,250 73,518,712  
15 Royalties ..        
16 Occupancy ........... 109,632,057 99,276,820 10,355,237  
17 Travel ............ 20,974,164 18,833,612 2,140,552  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 5,490,097 4,293,797 1,196,300  
20 Interest ........... 24,916,005 24,822,949 93,056  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 171,958,121 150,461,297 21,496,824  
23 Insurance ... 20,230,385 19,840,249 390,136  
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 1,213,605,821 1,206,101,877 7,503,944  
b CONTRACTED BIOMEDICAL S 29,756,264 29,754,082 2,182  
c EMPLOYEE RECRUITMENT 12,228,358 8,133,417 4,094,941  
d OTHER TAXES 10,560,057 10,340,928 219,129  
e All other expenses -54,853,136 19,751,289 -74,604,425  
25 Total functional expenses. Add lines 1 through 24e 5,161,087,710 4,811,881,608 349,206,102 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 (2021)
Form 990 (2021)
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 ........ 87,235,347 1 5,350,099
2 Savings and temporary cash investments ......... 281,391,844 2 230,746,569
3 Pledges and grants receivable, net ......   3 220,673
4 Accounts receivable, net ............. 653,343,333 4 747,066,864
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) ...
  6  
7 Notes and loans receivable, net ........... 50,879,932 7 69,083,286
8 Inventories for sale or use ............ 125,839,955 8 124,928,258
9 Prepaid expenses and deferred charges ...... 65,070,623 9 78,225,069
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 3,815,138,177
b Less: accumulated depreciation 10b 2,025,007,992 1,751,741,875 10c 1,790,130,185
11 Investments—publicly traded securities . 735,389 11 433,579
12 Investments—other securities. See Part IV, line 11 .....   12 33,508,819
13 Investments—program-related. See Part IV, line 11 .. 40,467,353 13 33,414,398
14 Intangible assets ............... 48,008,578 14 47,957,708
15 Other assets. See Part IV, line 11 ........... 380,893,552 15 420,413,390
16 Total assets. Add lines 1 through 15 (must equal line 33)... 3,485,607,781 16 3,581,478,897
Liabilities 17 Accounts payable and accrued expenses ..... 390,495,684 17 321,632,155
18 Grants payable ... 1,595,748 18 5,118,766
19 Deferred revenue ......... 3,159,894 19 4,018,002
20 Tax-exempt bond liabilities ......... 505,134,169 20 479,072,573
21 Escrow or custodial account liability. Complete Part IV of Schedule D 218,589 21 174,332
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 .. 15,455,741 23 11,901,748
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 291,497,394 25 247,578,111
26 Total liabilities. Add lines 17 through 25.. 1,207,557,219 26 1,069,495,687
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 .......... 2,278,043,512 27 2,511,976,110
28 Net assets with donor restrictions ........... 7,050 28 7,100
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 ........... 2,278,050,562 32 2,511,983,210
33 Total liabilities and net assets/fund balances ........ 3,485,607,781 33 3,581,478,897
Form 990 (2021)
Form 990 (2021)
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
5,321,937,014
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
5,161,087,710
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
160,849,304
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
2,278,050,562
5
Net unrealized gains (losses) on investments ...............
5
-7,005,023
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
80,088,367
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
2,511,983,210
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 on
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 (2021)
Form 990 (2021)
Additional Data


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

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
2022
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 ...............................19
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
19
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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
33 1/3% support test—2022. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization .......................right arrow
b
33 1/3% support test—2021. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow
17a
10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
b
10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow
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) 2022

Schedule A (Form 990) 2022
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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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) 2018 (b) 2019 (c) 2020 (d) 2021 (e) 2022 (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 on 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
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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2022. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow
b
33 1/3% support tests—2021. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow
20
Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
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 on 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 on 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) 2022

Schedule A (Form 990) 2022
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 on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on 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 on 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) 2022

Schedule A (Form 990) 2022
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) 2022

Schedule A (Form 990) 2022
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 2022 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-2022
(iii)
Distributable
Amount for 2022
1 Distributable amount for 2022 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2022:
a From 2017.......  
b From 2018.......  
c From 2019.......  
d From 2020.......  
e From 2021.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2022 distributable amount  
i Carryover from 2017 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2022 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2022 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2022, 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 2022. 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 2023. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2018.....  
b Excess from 2019.....  
c Excess from 2020.....  
d Excess from 2021.....  
e Excess from 2022.....  
Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
LIST OF ORGANIZATIONS AND PUBLIC CHARITY STATUS: SANFORD HEALTH 509(A)(3) SANFORD MEDICAL CENTER 170(B)(1)(A)(III) SANFORD CLINIC 509(A)(2) 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 509(A)(2) SANFORD NORTH 509(A)(3) SANFORD MEDICAL CENTER FARGO 170(B)(1)(A)(III) SANFORD CLINIC NORTH 509(A)(2) SANFORD HEALTH NETWORK NORTH 170(B)(1)(A)(III) SANFORD HEALTH OF NORTHERN MINNESOTA 170(B)(1)(A)(III) BAKER PARK, INC. 509(A)(2) SANFORD WEST 509(A)(3) SANFORD BISMARCK 170(B)(1)(A)(III) SANFORD WORLD CLINICS-KLAMATH FALLS 509(A)(2) SANFORD VIRTUAL CARE 509(A)(2)
SCHEDULE A, PART I PART I, LINE 12B - SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST ARE ALL TYPE II SUPPORTING ORGANIZATIONS. DETAIL FOR SCHEDULE A, PART I, LINE 12G LINE 12, COLUMN: (I) SANFORD MEDICAL CENTER; (II) 46-0227855; (III) 3; (IV) YES; (V) $37,525,246 LINE 12, COLUMN: (I) SANFORD CLINIC; (II) 46-0447693; (III) 10; (IV) YES; (V) $2,121,119 LINE 12, COLUMN: (I) SANFORD RESEARCH; (II) 46-0450378; (III) 4; (IV) YES; (V) $584,671 LINE 12, COLUMN: (I) SANFORD RESEARCH NORTH; (II) 45-0274828; (III) 4; (IV) YES; (V) $145,266 LINE 12, COLUMN: (I) SANFORD HOME HEALTH; (II) 46-0282134; (III) 10; (IV) YES; (V) $276,874 LINE 12, COLUMN: (I) SANFORD HEALTH NETWORK; (II) 46-0388596; (III) 3; (IV) YES; (V) $9,696,782 LINE 12, COLUMN: (I) SANFORD CLINIC NORTH; (II) 91-1770748; (III) 10; (IV) YES; (V) $4,364,111 LINE 12, COLUMN: (I) SANFORD MEDICAL CENTER FARGO; (II) 45-0226909; (III) 3; (IV) YES; (V) $46,504,965 LINE 12, COLUMN: (I) SANFORD WORLD CLINICS; (II) 26-2707628; (III) 10; (IV) YES; (V) $196,947 LINE 12, COLUMN: (I) SANFORD WORLD CLINICS-KLAMATH FALLS; (II) (92-0396212 (III) 10; (IV) YES; (V) $119,161 LINE 12, COLUMN: (I) SANFORD HEALTH OF NORTHERN MINNESOTA; (II) 41-1266009; (III) 3; (IV) YES; (V) $10,069,316 LINE 12, COLUMN: (I) BAKER PARK, INC.; (II) 41-1372480; (III) 10; (IV) YES; (V) $18,919 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION NORTH; (II) 45-0398104; (III) 7; (IV) YES; (V) $4,887,544 LINE 12, COLUMN: (I) SANFORD BISMARCK; (II) 45-0226700; (III) 3; (IV) YES; (V) $21,812,183 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION WEST; (II) 45-0397196; (III) 7; (IV) YES; (V) $80,201 LINE 12, COLUMN: (I) SANFORD VIRTUAL CARE; (II) 88-0976483; (III) 10; (IV) YES; (V) $7,634 LINE 12, COLUMN: (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION; (II) 46-0422866; (III) 7; (IV) YES; (V) $214,007 LINE 12, COLUMN: (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY; (II) 45-0228055; (III) 10; (IV) YES; (V) $27,607,528 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA; (II) 41-1389317; (III) 7; (IV) YES; (V) $43,569
SCHEDULE A, PART I, LINE 12G, COLUMN (IV) WE HAVE ANSWERED YES THAT THE ORGANIZATIONS ARE LISTED IN OUR GOVERNING DOCUMENTS BECAUSE THE ARTICLES DESCRIBE THE SPECIFIED SUPPORTED ORGANIZATIONS AND THE OTHER SUPPORTED ORGANIZATIONS BY CLASS (AFFILIATED WITH THE SPECIFIED SUPPORTED ORGANIZATIONS).
SCHEDULE A, PART III LINE 1 - COLUMN: (A) 133,275; (B) 429,804; (C) 9,415,179; (D) (3,426,082); (E) 2,951,560 ; (F) 9,503,736 LINE 2 - COLUMN: (A) 81,522,328; (B) 172,939,530; (C) 177,631,632; (D) 204,250,348; (E) 252,665,915; (F) 889,009,753 LINE 6 - COLUMN: (A) 81,655,603; (B) 173,369,334; (C) 187,046,811; (D) 200,824,266; (E) 255,617,475; (F) 898,513,489 LINE 8 - COLUMN: (F) 898,513,489 LINE 9 - COLUMN: (A) 81,655,603; (B) 173,369,334; (C) 187,046,811; (D) 200,824,266; (E) 255,617,475; (F) 898,513,489 LINE 10A - COLUMN: (A) 1,127,888; (B) 1,216,540; (C) 1,544,624; (D) 1,377,220; (E) 1,111,018; (F) 6,377,290 LINE 10C - COLUMN: (A) 1,127,888; (B) 1,216,540; (C) 1,544,624; (D) 1,377,220; (E) 1,111,018; (F) 6,377,290 LINE 11 - COLUMN: (A) 718,178; (B) 1,230,289; (C) 673,203; (D) 151,437; (E) 789,277; (F) 3,562,384 LINE 13 - COLUMN: (A) 83,501,669; (B) 175,816,163; (C) 189,264,638; (D) 202,352,923; (E) 257,517,770; (F) 908,453,163 LINE 15: 98.91% LINE 16: 98.71% LINE 17: 0.70% LINE 18: 0.85% LINE 19A: X LINE 19B: X PART IV, SECTION A LINE 1: NO LINE 2: NO LINE 3A: NO LINE 4A: NO LINE 5A: YES LINE 5B: YES LINE 5C: NO LINE 6: YES 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
SCHEDULE A, PART IV, SECTION A, LINE 1 THE ARTICLES OF INCORPORATION OF SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK PROVIDE THAT THEY SHALL PROVIDE OVERSIGHT, OPERATE FOR THE BENEFIT OF, TO SUPPORT THE FUNCTIONS OF, AND TO CARRY OUT SOME OR ALL OF THE CHARITABLE PURPOSES OF THE NAMED SUBSIDIARY ORGANIZATIONS WHICH ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ALL OTHER 501(C)(3) ORGANIZATIONS OPERATED, SUPERVISED OR CONTROLLED BY OR SUPERVISED OR CONTROLLED IN CONNECTION WITH, SUCH ORGANIZATIONS. FURTHER, PURSUANT TO THEIR BY-LAWS, THE GOVERNING BODY OF SANFORD (PARENT), SERVES AS THE GOVERNING BODY OF SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK AS WELL AS ALL OF THE NAMED TAX-EXEMPT SUBSIDIARY ORGANIZATIONS. THUS, SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK MEET THE RELATIONSHIP TEST AS A TYPE II ORGANIZATIONS BECAUSE THERE IS COMMON SUPERVISION AND CONTROL BETWEEN SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK AND THEIR NAMED SUPPORTED ORGANIZATIONS. SANFORD HEALTH, SANFORD NORTH, AND SANFORD BISMARCK ALSO SUPPORT ORGANIZATIONS WHICH ARE 501(C)(3) ORGANIZATIONS AFFILIATED WITH THE SUPPORTED ORGANIZATIONS OR ARE 501(C)(3) PUBLIC CHARITIES AFFILIATED WITH THESE AFFILIATED ENTITIES. THEY ARE DESCRIBED BY CLASS. IN ADDITION, THE ARTICLES PROVIDE THAT IN FURTHERANCE OF THEIR PURPOSES, THESE CORPORATIONS MAY ENGAGE IN, ADVANCE, PROMOTE, SUPPORT, AND ADMINISTER CHARITABLE, SCIENTIFIC, AND EDUCATIONAL ACTIVITIES AND PROJECTS OF EVERY KIND AND NATURE WHATSOEVER IN ITS OWN BEHALF OR AS THE AGENT, TRUSTEE, OR REPRESENTATIVE OF OTHERS. THIS INCLUDES TO AID OR ASSIST OTHER ORGANIZATIONS WHOSE ACTIVITIES ARE SUCH AS TO FURTHER, ACCOMPLISH, FOSTER, OR ATTAIN ANY SUCH PURPOSES. ALL POWERS OF THESE CORPORATIONS SHALL BE EXERCISED ONLY SO THAT THESE CORPORATIONS' OPERATIONS SHALL BE EXCLUSIVELY WITHIN THE CONTEMPLATION OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TO QUALIFY AS A SECTION 509(A)(3) SUPPORTING ORGANIZATION, AN ORGANIZATION MUST SUPPORT ONE OR MORE SPECIFIED ORGANIZATIONS. FOR TYPE II SUPPORTING ORGANIZATION'S ARTICLES OF INCORPORATION, THE ARTICLES MUST DESIGNATE THE SUPPORTING ORGANIZATION(S) BY CLASS OR PURPOSE, AND WHICH INCLUDE PUBLICLY SUPPORTED ORGANIZATIONS WHICH ARE CLOSELY RELATED IN PURPOSE OR FUNCTION TO THE PUBLICLY SUPPORTED ORGANIZATION SPECIFIED IN THE ARTICLES. THEREFORE, THE LACK OF INCLUDING THE NAME OF THE AFFILIATED ORGANIZATIONS THAT SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST WILL SUPPORT IN THEIR ARTICLES OF INCORPORATION DOES NOT OTHERWISE DEFEAT THE ORGANIZATIONS STATUSES AS TYPE II SUPPORTING ORGANIZATIONS, BECAUSE THEIR ARTICLES DESCRIBE THESE SUPPORTED ORGANIZATIONS BY CLASS (AFFILIATED WITH THE SPECIFIED SUPPORTED ORGANIZATION) AND REQUIRE THAT THEY BE EXEMPT FROM TAX UNDER IRC SECTION 501(C)(3).
SCHEDULE A, PART IV, SECTION A, LINE 5A (I) SANFORD WORLD CLINICS-KLAMATH FALLS, 92-0396212; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS A NEW ORGANIZATION, AND IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH (I) SANFORD VIRTUAL CARE, 88-0976483; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS A NEW ORGANIZATION, AND IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, 45-0228055; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH (I) SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA, 41-1389317; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH
SCHEDULE A, PART IV, SECTION A, LINE 6 THE ORGANIZATIONS GIVE GRANTS AND PROVIDE SUPPORT TO QUALIFIED 501(C)(3) PUBLIC CHARITIES, GOVERNMENTAL ENTITIES AND VARIOUS LOCAL NONPROFIT ORGANIZATIONS THAT SUPPORT THE MISSIONS OF SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST AND THE ORGANIZATIONS THAT THEY SUPPORT.
SCHEDULE A, PART IV, SECTION C, LINE 1 LINE 1: YES
Schedule A (Form 990) 2022


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
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
2022
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) (2022)
Schedule B (Form 990) (2022) 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) (2022)
Schedule B (Form 990) (2022)
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) (2022)
Schedule B (Form 990) (2022)
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) (2022)
Additional Data


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

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
2021
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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? ...........................................................................................................
Yes
 
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? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
753,600
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
527,817
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
398,769
j
Total. Add lines 1c through 1i ....................................................................................................
1,680,186
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 FOLLOWING ORGANIZATIONS: 340B HEALTH, AMERICAN ACADEMY OF FAMILY PHYSICIANS, AMERICAN ACADEMY OF OPTHALMOLOGY, AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, AMERICAN ACADEMY OF SLEEP MEDICINE, AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES, AMERICAN COLLEGE OF OB/GYN, AMERICAN COLLEGE OF OSTEOPATHIC SURGEONS, AMERICAN COLLEGE OF PHYSICIANS, AMERICAN COLLEGE OF SURGEONS PROFESSIONAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AMERICAN MEDICAL ASSOCIATION, AMERICAN MEDICAL GROUP ASSOCIATION, AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION, AMERICAN OSTEOPATHIC ASSOCIATION, AMERICAN PODIATRIC MEDICAL ASSOCIATION, AMERICAN SOCIETY FOR HEALTH CARE ENGINEERING, AIR MEDICAL OPERATORS ASSOCIATION, ASSOCIATION FOR ADVANCING PHYSICIAN & PROVIDER RECRUITMENT, ASSOCIATION OF COMMUNITY CANCER CENTERS, ASSOCIATION OF CRITICAL CARE TRANSPORT, CANTON ROTARY CLUB, CHAMBER OF COMMERCE GRAND FORKS, CHILDREN'S HOSPITAL ASSOCIATION, DOWNTOWN COMMUNITY PARTNERSHIP, FLORIDA PODIATRIC MEDICAL ASSOCIATION, GREATER ND CHAMBER, GREATER SF CHAMBER OF COMMERCE, HEALTHCARE INFORMATION AND MANAGEMENT SYSTEMS SOCIETY, HEALTH POLICY CONSORTIUM, IOWA HOSPITAL ASSOCIATION, IOWA MEDICAL SOCIETY, LEADINGAGE IA, MEDICAL GROUP MANAGEMENT ASSOCIATION, MIDWEST ASSOCIATION FOR MEDICAL EQUIPMENT & SUPPLIES, MINNESOTA HOSPITAL ASSOCIATION, NATIONAL ASSOCIATION FOR BIOMEDICAL RESEARCH, NATIONAL ASSOCIATION OF SOCIAL WORKERS, NATIONAL ASSOCIATION OF SPECIALTY PHARMACY, NATIONAL RURAL HEALTH ASSOCIATION, NORTH DAKOTA HOSPITAL ASSOCIATION, NORTH DAKOTA LONG TERM CARE ASSOCIATION, NORTH DAKOTA MOTOR CARRIERS ASSOCIATION, NORTH DAKOTA PETROLIUM COUNCIL, RENAL HEALTHCARE ASSOCIATION, SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATION, SD BIOTECH ASSOCIATION, SD CHAMBER OF COMMERCE & INDUSTRY, SD HEALTH CARE ASSOCIATION, SOCIETY OF DIAGNOSTIC MEDICAL SONOGRAPHY, SOUTH DAKOTANS DECIDE HEALTHCARE, SOUTH DAKOTANS FOR FAIR ELECTIONS, AND TRAUMA CENTER ASSOCIATION OF AMERICA. 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) 2021


Additional Data


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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
2021
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) 2021

Schedule D (Form 990) 2021
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 .... 95,588,573 92,002,112 89,216,166 84,843,272 63,648,688
b Contributions ... 3,297,480 3,586,461 3,360,625 4,372,894 21,194,584
c Net investment earnings, gains, and losses -419,011        
d Grants or scholarships ...     574,611    
e Other expenditures for facilities
and programs ...
         
f Administrative expenses .... 180,536   67    
g End of year balance ...... 98,286,506 95,588,573 92,002,112 89,216,166 84,843,272
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 .....   130,555,153 130,555,153
b Buildings ....   1,704,209,799 775,582,059 928,627,740
c Leasehold improvements   93,048,174 57,956,978 35,091,196
d Equipment ....   1,811,002,949 1,157,880,386 653,122,563
e Other .....   76,322,102 33,588,569 42,733,533
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,790,130,185
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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 94,452,433
(2)DEFERRED COMPENSATION ASSETS HELD FOR INVESTMENT 160,807,939
(3)OTHER ASSETS 81,898,286
(4)RIGHT OF USE ASSET 83,254,732
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 420,413,390
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  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 247,578,111
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) 2021

Schedule D (Form 990) 2021
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 OF NORTHERN MINNESOTA, AND SANFORD HEALTH FOUNDATION WEST HOLD ENDOWMENT FUNDS ON BEHALF OF THE FILING ORGANIZATION TO BE USED FOR ASSISTANCE IN ITS ACTIVITIES AND FOR PROVIDING HEALTH CARE, MEDICAL, OR EDUCATIONAL SERVICES.
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, 2022; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES.
Schedule D (Form 990) 2021


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
2022
Open to Public Inspection
Name of the organization
SANFORD GROUP RETURN
 
Employer identification number

45-3791176
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS CHINA INVESTMENTS, BEGINNING IN 2014 523,000
EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES ADMINISTRATIVE EXPENSES (NEW ZEALAND) 106,000
EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICES ADMINISTRATIVE EXPENSES (GERMANY) 3,000
SUB-SAHARAN AFRICA 0 0 PROGRAM SERVICES ADMINISTRATIVE EXPENSES (GHANA), INVESTIGATION OF POTENTIAL RESEARCH PARTNER (SOUTH AFRICA) 2,681,000
EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS GERMANY INVESTMENTS, BEGINNING IN 2015 11,945,000
SUB-SAHARAN AFRICA 0 0 INVESTMENTS GHANA INVESTMENTS, BEGINNING IN 2012 2,337,000
CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES ADMINISTRATIVE EXPENSES (COSTA RICA) 2,317,000
MIDDLE EAST AND NORTH AFRICA 0 0 INVESTMENTS ISRAEL INVESTMENTS, BEGINNING IN 2018 1,300,000
EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS NEW ZEALAND INVESTMENTS, BEGINNING IN 2019 1,600,000
CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT COSTA RICA INVESTMENT, BEGINNING IN 2019 8,000,000
           
           
           
           
           
           
           
3a Sub-total .... 0 0 21,212,000
b Total from continuation sheets to Part I ... 0 0 9,600,000
c Totals (add lines 3a and 3b) 0 0 30,812,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
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)
SUB-SAHARAN AFRICA GENERAL SUPPORT 10,000 BANK TRANSFER 0   COST
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
0
3 Enter total number of other organizations or entities .......................MediumBullet
1
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022Page 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) 2022
Schedule F (Form 990) 2022
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) 2022
Schedule F (Form 990) 2022
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 I, LINE 3: EXPENDITURES ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING.
PART II, LINE 1 ACCOUNTING METHOD: GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS OR ENTITIES OUTSIDE THE UNITED STATES ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING.
PART III ACCOUNTING METHOD:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2022
Additional Data


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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 20a.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
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) . . .
    84,815,767 0 84,815,767 1.640 %
b Medicaid (from Worksheet 3, column a) . . . . .     656,748,729 530,138,370 126,610,359 2.450 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     741,564,496 530,138,370 211,426,126 4.090 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     42,943,092 575,297 42,367,795 0.820 %
f Health professions education (from Worksheet 5) . . .     41,001,594 5,322,741 35,678,853 0.690 %
g Subsidized health services (from Worksheet 6) . . . .     1,535,999,172 1,303,001,747 232,997,425 4.510 %
h Research (from Worksheet 7) .     34,480,838 18,248,016 16,232,822 0.310 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     24,141,891 0 24,141,891 0.470 %
j Total. Other Benefits . .     1,678,566,587 1,327,147,801 351,418,786 6.800 %
k Total. Add lines 7d and 7j .     2,420,131,083 1,857,286,171 562,844,912 10.890 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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     1,335,320 0 1,335,320 0.030 %
2 Economic development     915,172 0 915,172 0.020 %
3 Community support     15,482,007 0 15,482,007 0.300 %
4 Environmental improvements     2,250 0 2,250 0 %
5 Leadership development and
training for community members
    4,789 0 4,789 0 %
6 Coalition building     10,098 0 10,098 0 %
7 Community health improvement advocacy     296,695 0 296,695 0.010 %
8 Workforce development     4,673,493 0 4,673,493 0.090 %
9 Other     59,366 0 59,366 0 %
10 Total     22,779,190   22,779,190 0.450 %
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
73,533,536
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
572,478,356
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
566,666,820
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
5,811,536
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 %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?25Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SANFORD 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
25 SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER
120 LA BREE AVENUE S
THIEF RIVER FALLS,MN56701
WWW.SANFORDHEALTH.ORG
MN 410505
SANFORD HEALTH NETWORK NORTH
450409348
X               BEHAVIORAL HEALTH CENTER-INPATIENT MENTAL HEALTH A
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 21
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 21
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) 2022
Schedule H (Form 990) 2022
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) 2022
Schedule H (Form 990) 2022
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) 2022
Schedule H (Form 990) 2022
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) 2022
Schedule H (Form 990) 2022
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 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, - FACILITY 25: SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH C
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 5: SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 1 -- SANFORD 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 BEHAVIORAL HEALTH 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 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 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: ACCESS TO CAREACCESS TO AFFORDABLE, QUALITY 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 ACCESS TO CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE ACCESS TO AND AWARENESS OF AFFORDABLE CARE OPTIONS AND TO IMPROVE ACCESS THROUGH VIRTUAL CARE OPTIONS. IT IS SANFORD'S GOAL TO IMPROVE COMMUNITY ACCESS SO CARE IS AVAILABLE AND AFFORDABLE FOR ALL. PRIORITY 2: CHRONIC DISEASE PREVENTIONSANFORD MEDICAL CENTER TAKES AN INTEGRATED APPROACH TO DISEASE PREVENTION. SANFORD PROMOTES THE IMPORTANCE OF HAVING A PRIMARY CARE PROVIDER AND OFFERS SCREENING OPPORTUNITIES FOR EARLY DETECTION AND INTERVENTION OF CHRONIC DISEASE.SANFORD HAS MADE CHRONIC DISEASE PREVENTION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO BROADEN COMMUNITY AWARENESS OF THE IMPORTANCE OF PRIMARY AND PREVENTIVE CARE AND IMPROVE CARE FOR CHILDREN AT RISK FOR OBESITY. IT IS SANFORD'S GOAL TO IMPROVE CHRONIC DISEASE MANAGEMENT AND REDUCTION OF OBESITY.PRIORITY 3: MENTAL HEALTH AND ADDICTIONMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH AND ADDICTION SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO EXPAND ACCESS TO TIMELY BEHAVIORAL HEALTH CARE AND REDUCE THE NEGATIVE IMPACT OF ADDICTION AND SUBSTANCE ABUSE ON THE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE CARE MANAGEMENT FOR RESIDENTS SUFFERING FROM SUBSTANCE ABUSE AND MENTAL HEALTH ISSUES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR:ACCESS TO CARESANFORD HEALTH WAS A MEMBER OF A COALITION OF PATIENT ADVOCATES, NURSES, HEALTH CARE PROVIDERS, FARMERS, FAITH LEADERS, AND EDUCATORS THAT WORKED TO PASS MEDICAID EXPANSION IN 2022, EXPANDING ELIGIBILITY TO 40,000 PEOPLE IN SD.HEALTH CARE LITERACY AND FINANCIAL ADVOCACY ARE ONGOING EFFORTS. WE COLLABORATE WITH SANFORD HEALTH PLAN TO HELP PATIENTS FIND AFFORDABLE COVERAGE. THE HOSPITAL ALSO HAS ONSITE FINANCIAL ADVOCATES WHO SPECIALIZE IN HEALTH CARE COVERAGE ENROLLMENT AND HELP PATIENTS NAVIGATE SANFORD'S FINANCIAL ASSISTANCE PROGRAM IF ELIGIBLE. WE CONTINUE TO ENHANCE ACCESS THROUGH VIDEO VISITS, TELEHEALTH, E-VISITS, REMOTE HOME MONITORING AND MY SANFORD NURSE. PCPS ARE ABLE TO REACH MORE PATIENTS TIMELY THROUGH VIRTUAL CARE OPTIONS. IN 2021, SANFORD HEALTH ANNOUNCED A VIRTUAL CARE INITIATIVE AS PART OF OUR COMMITMENT TO TRANSFORM HEALTH CARE FOR PATIENTS LIVING IN RURAL AND UNDERSERVED AREAS. VIRTUAL CARE SERVICES CONTINUED TO GROW IN 2022, BOTH AT THE MEDICAL CENTER AND THROUGHOUT THE REGION WITH 26 REGIONAL NETWORK FACILITIES WITH ACCESS TO VIRTUAL SERVICES FOR EMERGENCY SERVICES AS WELL AS TELE STROKE AND TELE BURN. GI, NEPHROLOGY, RHEUMATOLOGY AND PULMONARY WERE ADDED AS PEDIATRIC VIRTUAL OPTIONS IN 2022. CARESIGNAL HOME MONITORING EXPANDED WITH 7 PATIENTS ENROLLED IN 2022 FOR CONGESTIVE HEART FAILURE; 21 FOR DIABETES; AND 43 FOR DEPRESSION. TOTAL VIDEO VISITS IN THE SF REGION IN CY2022 WERE 24,000 AND E-VISITS WERE 12,800.OUR CALL CENTER, INCLUSIVE OF OUR ONE CALL SYSTEM, THE CLINICAL CALL CENTER, AND THE MY SANFORD NURSE LINE RESPONDS TO HUNDREDS OF THOUSANDS OF CALLS EACH YEAR. IN 2022, MY SANFORD NURSE HAD 47,743 CALLS AND THERE WERE 233,045 ONE CALL SYSTEM CALLS BRINGING THE 2022 TOTAL TO A QUARTER OF A MILLION CALLS.CHRONIC DISEASE PREVENTIONIN 2022, SANFORD MEDICAL CENTER (SMC) JOINED A NEW COLLABORATIVE INITIATED BY THE CITY OF SIOUX FALLS PUBLIC HEALTH DEPT. THIS COMMUNITY HEALTH IMPROVEMENT PLAN IS A COMPLEMENT TO THE CHNA BUT WITH A TARGETED FOCUS ON THE SIOUX FALLS METRO. THE CITY, SANFORD, AVERA, AND COMMUNITY PARTNERS DEVELOPED STRATEGIES TO ADDRESS GAPS IN PREVENTIVE CARE, SCREENINGS AND VACCINATIONS. IN 2022, WE LAUNCHED A MATCH WITH A DOCTOR QUIZ ON OUR WEBSITE TO HELP PEOPLE FIND THE RIGHT PROVIDER FOR THEIR NEEDS. WE ADDED COMMUNITY HEALTH WORKERS (CHWS) AT PRIMARY CARE CLINICS IN SIOUX FALLS. CHWS WORK WITH THE MEDICAID POPULATION TO ENSURE THEY RECEIVE APPROPRIATE CARE, INCLUDING PREVENTIVE CARE AND CONNECT THEM TO COMMUNITY RESOURCES AND SUPPORT SERVICES. IN 2022, CHWS LOGGED 658 ENCOUNTERS WITH THIS POPULATION.SMC DID MARKETING AND AWARENESS CAMPAIGNS IN FEBRUARY FOR HEART MONTH. OUR MOBILE HEART SCREENING TRUCK WAS OUT IN THE COMMUNITY FOR A TOTAL OF 31 DAYS IN 2022. OVERALL (IN CLINIC & MOBILE) WE DID 10,095 SCREENINGS IN 2022 (HEART: 5,509 WITH 1,599 POSITIVE SCREENS AND VASCULAR: 4,586 WITH 105 POSITIVE SCREENS).IN MARCH, WE PROMOTED COLORECTAL CANCER SCREENING AND HEALTHY LIFESTYLE HABITS TO DECREASE RISK. EDUCATIONAL INFORMATION WAS SHARED VIA DIRECT MAIL, SOCIAL MEDIA, OUR WEBSITE, AND OUR SANFORD HEALTH NEWS PODCAST SERIES. PRIMARY CARE STAFF ADVISED PATIENTS AS APPROPRIATE WHEN DUE FOR A SCREENING. SANFORD HEALTH ALSO ISSUED A GENERAL PRESS RELEASE NOTIFYING THE PUBLIC THAT THE SCREEN AGE WAS LOWERED FROM 50 TO 45. SMC SAW AN INCREASE IN COLORECTAL SCREENING RATE FROM 67.1% TO 68.2% IN 2022.LOCAL SCHOOLS HAVE ACCESS TO THE SANFORD FIT PROGRAM WHICH ENGAGES AND EMPOWERS CHILDREN AND FAMILIES TO MAKE HEALTHY LIFESTYLE CHOICES. STUDENTS LEARN ABOUT FOOD, PHYSICAL ACTIVITY, MOOD AND ENERGY NEEDS. IN 2022, OUR REGION HAD 3,700 FIT WEBSITE USERS AND 30,082 PAGE VIEWS. THE FIT TEAM CONDUCTED 35 EVENTS IN SIOUX FALLS TO 4,981 CHILDREN.MENTAL HEALTH AND ADDICTIONWE CONTINUE TO EXPAND BEHAVIORAL HEALTH SERVICES COMMENSURATE TO INCREASING DEMAND. EMBEDDING INTEGRATIVE HEALTH THERAPISTS WITHIN PRIMARY CARE CLINICS ENSURES BROADER ACCESS FOR OUR PATIENT POPULATION SEEKING OUTPATIENT CARE AND ENSURING REGULAR AND CONSISTENT SCREENING AND FOLLOW-UP. SMC HAS TWO PSYCHIATRY AND PSYCHOLOGY CLINIC LOCATIONS IN SIOUX FALLS. THE 49TH AND ELMWOOD LOCATION HAS TEN PROVIDERS. THE 84TH AND LOUISE LOCATION HOUSES PSYCHOLOGY AND NEUROPSYCHOLOGY PROVIDERS. WE CURRENTLY HAVE 5 PHYSICIANS, 5 PSYCHOLOGISTS, 2 NEUROPSYCHOLOGISTS, 7 APPS, 11 BEHAVIORAL HEALTH THERAPISTS. WE ARE ACTIVELY RECRUITING FOR ADDITIONAL PROVIDERS AT THE 49TH STREET LOCATION. WE ADDED 7 PROVIDERS IN 2022. WE HAD 36,505 TOTAL COMPLETED APPOINTMENTS INCLUDING OVER 5,000 NEW REFERRALS IN 2022. OF THE OVER 36,000 VISITS, 2,827 WERE MYCHART TELEMED HOME VISITS, 2,621 WERE TELEMED HOME VISITS (FACETIME), 13,301 WERE IN-CLINIC VISITS, AND OVER 11,000 WERE INDIVIDUAL THERAPY APPOINTMENTS. THE TOTAL ALSO INCLUDES A FEW OTHER VISIT TYPES OF LOWER VOLUMES INCLUDING GROUP THERAPY, MYCHART ADULT NURSE, AND NURSE VISITS FOR INJECTIONS OR BLOOD PRESSURE CHECKS.THE LINK, A COMMUNITY TRIAGE CENTER, IS THE RESULT OF A PARTNERSHIP BETWEEN SANFORD, THE CITY OF SIOUX FALLS, MINNEHAHA COUNTY, AND AVERA HEALTH TO CREATE A SAFE PLACE FOR PEOPLE EXPERIENCING NON-VIOLENT BEHAVIORAL HEALTH CRISIS OR NEEDING CARE FOR SUBSTANCE ABUSE. IT OFFERS ACCESS TO IMMEDIATE TREATMENT AND REFERRAL TO SUPPORT SERVICES FOR COMMUNITY RESIDENTS. SANFORD HEALTH ALSO HAS LICENSED ALCOHOL AND DRUG COUNSELORS AVAILABLE TO PROVIDE EVALUATION, RECOVERY SUPPORT, COUNSELING, AND OTHER RESOURCES. SMC STAFF AND PROVIDERS FOLLOW SANFORD ENTERPRISE BEST PRACTICES REGARDING OPIOID PRESCRIBING AND TREATMENT. THE EMR PROMPTS PROVIDERS TO CHECK 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. THE ONECHART SYSTEM HAS AN OPIOID MANAGEMENT DASHBOARD WHERE PAIN AGREEMENTS, DRUG TESTS, AND NALOXONE COMPLIANCE ARE MONITORED. THERE IS ALSO A CHRONIC OPIOID USE REGISTRY TO SEE WHO HAS AN UPDATED OPIOID RISK TOOL ASSESSING RISK OF OPIOID ABUSE AND PAIN SCREENING TOOL. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE: LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
GROUP A-FACILITY 1 -- SANFORD 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 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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: ACCESS TO AFFORDABLE HEALTH CAREACCESS TO AFFORDABLE, QUALITY 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. NDSU REPORTED HEALTH CARE ACCESSIBILITY AND COST AS TWO SEPARATE HEALTH NEEDS. THE CASS-CLAY WORKING GROUP DETERMINED THAT THE TWO TOPICS ARE MOST APPROPRIATELY ADDRESSED AS A COMBINED TOPIC FOR PURPOSES OF THE LOCAL CHNA PROCESS.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND HEALTHCARE ACCESS AND ACCESS TO PRIMARY CARE SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE THAT PATIENTS WILL HAVE GREATER EASE TO ACCESS PRIMARY CARE PROVIDERS FOR VIRTUAL OR IN-PERSON VISITS, HOME VISITS AND INCREASED EXPANDED HOURS. PATIENTS MAY EXPERIENCE LESS FREQUENT UTILIZATION OF EMERGENCY CARE, WHICH IS OFTEN MORE EXPENSIVE THAN PREVENTATIVE AND SCREENING SERVICES.PRIORITY 2: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT PROVIDERS, INCREASE ACCESS TO CARE AND MENTAL HEALTH PROMOTION. IT IS SANFORD'S GOAL TO HAVE BETTER ACCESS TO AND UTILIZATION OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES DUE TO SERVICES BEING PROVIDED AT THE RIGHT TIME AND RIGHT PLACE. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: ACCESS TO AFFORDABLE HEALTH CARESANFORD FARGO ESTABLISHED TWO GOALS IN SUPPORT OF THE PRIORITY, ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EXPAND HEALTHCARE ACCESS AND SUPPORT RESOURCES FOR VULNERABLE AND UNDERSERVED POPULATIONS. THE SECOND IS TO EXPAND PLATFORM AND ACCESS TO PRIMARY CARE SERVICES.ONE STRATEGY IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROGRAM IS TO MAKE VIRTUAL VISITS AVAILABLE FOR ALL PRIMARY CARE PROVIDERS. AS OF THE END OF 2022, ACCESS TO TELEHEALTH IS AVAILABLE FOR ALL FAMILY MEDICINE PROVIDERS, WHICH ALLOWS PATIENTS TO RECEIVE CARE WITHIN THEIR HOMES IF THEY DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION OR CANNOT TRAVEL FOR APPOINTMENTS. TO INCREASE PRIMARY CARE AVAILABILITY, THE FAMILY MEDICINE RESIDENCY PROGRAM HAS BEGUN OUTREACH TO JEFFERSON ELEMENTARY (FARGO PUBLIC SCHOOLS) AND WILL BE EXPANDING TO YOUTHWORKS. JEFFERSON ELEMENTARY HAS APPROXIMATELY 288 STUDENTS, 231 OF WHICH ARE ELIGIBLE TO PARTICIPATE IN THE FREE LUNCH AND REDUCED-PRICE LUNCH PROGRAMS, ACCORDING TO THE NATIONAL CENTER FOR EDUCATION STATISTICS. YOUTHWORKS IS A "501C3 NON-PROFIT DEDICATED TO PROVIDING YOUTH AND FAMILY SERVICES THROUGHOUT NORTH DAKOTA. THEIR FOCUS AND EXPERTISE IS IN WORKING WITH TEENS, PARENTS, AND YOUNG ADULTS UNDER 22 YEARS OF AGE. OUR SERVICES INCLUDE PROGRAMS FOR RUNAWAY, HOMELESS AND STREET YOUTH; JUVENILE OFFENDERS; YOUTH FAILING IN SCHOOL; YOUTH SUSPENDED OR EXPELLED FROM SCHOOL; YOUNG PARENTS AND PREGNANT MOMS (UNDER 22); YOUTH ARRESTED AND UNABLE TO IMMEDIATELY RETURN HOME; YOUTH NEEDING EMERGENCY CARE; YOUTH NEEDING PEER SUPPORT OR CROSS-AGE MENTORING; AND YOUTH WITH ANGER ISSUES." THIS STRATEGY WILL HELP IMPROVE ACCESS FOR VULNERABLE AND UNDERSERVED RESIDENTS OF THE FARGO/MOORHEAD METRO AREA.A NEW PRIMARY CARE CLINIC IS UNDER CONSTRUCTION IN HORACE, ND AND IS SET TO OPEN IN 2023. THIS WILL SERVE THE NEEDS OF THE RAPIDLY GROWING TOWN OF HORACE AS WELL AS PORTIONS OF WEST FARGO TO ALLOW FOR INCREASED SPEED OF ACCESS TO INDIVIDUALS ACROSS ALL CLINICS. THREE NEW PROVIDERS WERE RECRUITED TO PRIMARY CARE. THE NEW PROVIDERS TOTALED 148 VISITS UPON STARTING IN THE FOURTH QUARTER OF 2022.MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE THREE GOALS SUPPORT THE MENTAL HEALTH AND SUBSTANCE ABUSE GOAL. THE FIRST IS RECRUITING PROVIDERS AND INCREASING ACCESS TO CARE. THE SECOND IS TO DEVELOP A COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION. THE THIRD IS TO DECREASE SUBSTANCE ABUSE.TO INCREASE ACCESS TO MENTAL HEALTH CARE, SANFORD FARGO EXPANDED ITS PARTNERSHIP WITH REGIONAL SCHOOLS TO PROVIDE STUDENT PLACEMENT FOR MASTER'S LEVEL THERAPISTS INTO THE INTERNAL MEDICINE DEPARTMENT. COORDINATION OF CARE WITH PRIMARY CARE, EMERGENCY DEPARTMENT, AND HOSPITAL CARE COORDINATION HAS RESULTED IN THE WAIT LIST FOR BEHAVIORAL HEALTH AND PSYCHIATRY APPOINTMENTS DECREASING FROM 2,000 PATIENTS TO 180 PATIENTS WAITING TO BE SCHEDULED. FURTHERMORE, ACCESS TO SUPPORTIVE BEHAVIORAL HEALTH SERVICES AND RESOURCES HAVE IMPROVED IN THE HOSPITAL WITH THE CREATION OF A DEDICATED UNIT AT THE SANFORD MEDICAL CENTER FARGO FOR PATIENTS ADMITTED FOR MEDICAL CARE WHO REQUIRE ADDITIONAL BEHAVIORAL HEALTH SUPPORT. IN 2022, SANFORD FARGO COMPLETED 10,083 COMPLETED VIDEO VISITS, 144 TRADITIONAL TELEMEDICINE AND 90 VERBAL VISITS.SANFORD FARGO CONDUCTED A DEPRESSION SCREENING INITIATIVE THROUGHOUT SANFORD-FARGO CLINICS TO SUPPORT COMMUNITY MENTAL HEALTH PROMOTION. THE PROMOTION RESULTED IN 40,000 DEPRESSION SCREENINGS COMPLETED BY INTERNAL MEDICINE, FAMILY MEDICINE, AND OB/GYN PROVIDERS AND RESIDENCY CLINICS. FOR ALL POSITIVE DEPRESSION SCREENINGS, THERE WAS A DOCUMENTED FOLLOW-UP PLAN WITHIN 14 DAYS OF THE SCREENING. SANFORD AMBULANCE REPORTED 1,200 PATIENTS RECEIVING CARE RELATED TO ALCOHOL USE, 1,350 RELATED TO BEHAVIORAL HEALTH/PSYCHIATRIC EPISODE. SANFORD FARGO IS ACTIVELY RECRUITING A NEW PROVIDER TO SUPPORT SUBOXONE CLINIC FOR PATIENTS WORKING ON ADDICTION AND RECOVERY TO DECREASE SUBSTANCE ABUSE. FURTHER SUPPORT IS PROVIDED THROUGH HOSPITAL PEER COACHING, WITH CONTINUED WORK WITH F5 AND THE LOTUS CENTER THROUGHOUT 2022 TO PROVIDE PEER COACHING IN THE HOSPITAL. SANFORD FARGO ALSO ENGAGES IN A PARTNERSHIP WITH CASS COUNTY'S WITHDRAWAL MANAGEMENT UNIT TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONSENIOR HOUSING AND LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSING, EMPLOYMENT, ECONOMIC DEVELOPMENTDIVERSITY, INCLUSION, HEALTH EQUITYCHILDCAREHEALTH LITERACY AND NAVIGATIONSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: ACCESS TO AFFORDABLE HEALTH CARE ACCESS TO AFFORDABLE, QUALITY 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. NDSU REPORTED HEALTH CARE ACCESSIBILITY AND COST AS TWO SEPARATE HEALTH NEEDS. THE CASS-CLAY WORKING GROUP DETERMINED THAT THE TWO TOPICS ARE MOST APPROPRIATELY ADDRESSED AS A COMBINED TOPIC FOR PURPOSES OF THE LOCAL CHNA PROCESS.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND HEALTHCARE ACCESS AND ACCESS TO PRIMARY CARE SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE THAT PATIENTS WILL HAVE GREATER EASE TO ACCESS PRIMARY CARE PROVIDERS FOR VIRTUAL OR IN-PERSON VISITS, HOME VISITS AND INCREASED EXPANDED HOURS. PATIENTS MAY EXPERIENCE LESS FREQUENT UTILIZATION OF EMERGENCY CARE, WHICH IS OFTEN MORE EXPENSIVE THAN PREVENTATIVE AND SCREENING SERVICES.PRIORITY 2: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT PROVIDERS, INCREASE ACCESS TO CARE AND MENTAL HEALTH PROMOTION. IT IS SANFORD'S GOAL TO HAVE BETTER ACCESS TO AND UTILIZATION OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES DUE TO SERVICES BEING PROVIDED AT THE RIGHT TIME AND RIGHT PLACE. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: ACCESS TO AFFORDABLE HEALTH CARESANFORD FARGO ESTABLISHED TWO GOALS IN SUPPORT OF THE PRIORITY, ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EXPAND HEALTHCARE ACCESS AND SUPPORT RESOURCES FOR VULNERABLE AND UNDERSERVED POPULATIONS. THE SECOND IS TO EXPAND PLATFORM AND ACCESS TO PRIMARY CARE SERVICES.ONE STRATEGY IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROGRAM IS TO MAKE VIRTUAL VISITS AVAILABLE FOR ALL PRIMARY CARE PROVIDERS. AS OF THE END OF 2022, ACCESS TO TELEHEALTH IS AVAILABLE FOR ALL FAMILY MEDICINE PROVIDERS, WHICH ALLOWS PATIENTS TO RECEIVE CARE WITHIN THEIR HOMES IF THEY DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION OR CANNOT TRAVEL FOR APPOINTMENTS. TO INCREASE PRIMARY CARE AVAILABILITY, THE FAMILY MEDICINE RESIDENCY PROGRAM HAS BEGUN OUTREACH TO JEFFERSON ELEMENTARY (FARGO PUBLIC SCHOOLS) AND WILL BE EXPANDING TO YOUTHWORKS. JEFFERSON ELEMENTARY HAS APPROXIMATELY 288 STUDENTS, 231 OF WHICH ARE ELIGIBLE TO PARTICIPATE IN THE FREE LUNCH AND REDUCED-PRICE LUNCH PROGRAMS, ACCORDING TO THE NATIONAL CENTER FOR EDUCATION STATISTICS. YOUTHWORKS IS A "501C3 NON-PROFIT DEDICATED TO PROVIDING YOUTH AND FAMILY SERVICES THROUGHOUT NORTH DAKOTA. THEIR FOCUS AND EXPERTISE IS IN WORKING WITH TEENS, PARENTS, AND YOUNG ADULTS UNDER 22 YEARS OF AGE. OUR SERVICES INCLUDE PROGRAMS FOR RUNAWAY, HOMELESS AND STREET YOUTH; JUVENILE OFFENDERS; YOUTH FAILING IN SCHOOL; YOUTH SUSPENDED OR EXPELLED FROM SCHOOL; YOUNG PARENTS AND PREGNANT MOMS (UNDER 22); YOUTH ARRESTED AND UNABLE TO IMMEDIATELY RETURN HOME; YOUTH NEEDING EMERGENCY CARE; YOUTH NEEDING PEER SUPPORT OR CROSS-AGE MENTORING; AND YOUTH WITH ANGER ISSUES." THIS STRATEGY WILL HELP IMPROVE ACCESS FOR VULNERABLE AND UNDERSERVED RESIDENTS OF THE FARGO/MOORHEAD METRO AREA.A NEW PRIMARY CARE CLINIC IS UNDER CONSTRUCTION IN HORACE, ND AND IS SET TO OPEN IN 2023. THIS WILL SERVE THE NEEDS OF THE RAPIDLY GROWING TOWN OF HORACE AS WELL AS PORTIONS OF WEST FARGO TO ALLOW FOR INCREASED SPEED OF ACCESS TO INDIVIDUALS ACROSS ALL CLINICS. THREE NEW PROVIDERS WERE RECRUITED TO PRIMARY CARE. THE NEW PROVIDERS TOTALED 148 VISITS UPON STARTING IN THE FOURTH QUARTER OF 2022.MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSETHREE GOALS SUPPORT THE MENTAL HEALTH AND SUBSTANCE ABUSE GOAL. THE FIRST IS RECRUITING PROVIDERS AND INCREASING ACCESS TO CARE. THE SECOND IS TO DEVELOP A COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION. THE THIRD IS TO DECREASE SUBSTANCE ABUSE.TO INCREASE ACCESS TO MENTAL HEALTH CARE, SANFORD FARGO EXPANDED ITS PARTNERSHIP WITH REGIONAL SCHOOLS TO PROVIDE STUDENT PLACEMENT FOR MASTER'S LEVEL THERAPISTS INTO THE INTERNAL MEDICINE DEPARTMENT. COORDINATION OF CARE WITH PRIMARY CARE, EMERGENCY DEPARTMENT, AND HOSPITAL CARE COORDINATION HAS RESULTED IN THE WAIT LIST FOR BEHAVIORAL HEALTH AND PSYCHIATRY APPOINTMENTS DECREASING FROM 2,000 PATIENTS TO 180 PATIENTS WAITING TO BE SCHEDULED. FURTHERMORE, ACCESS TO SUPPORTIVE BEHAVIORAL HEALTH SERVICES AND RESOURCES HAVE IMPROVED IN THE HOSPITAL WITH THE CREATION OF A DEDICATED UNIT AT THE SANFORD MEDICAL CENTER FARGO FOR PATIENTS ADMITTED FOR MEDICAL CARE WHO REQUIRE ADDITIONAL BEHAVIORAL HEALTH SUPPORT. IN 2022, SANFORD FARGO COMPLETED 10,083 COMPLETED VIDEO VISITS, 144 TRADITIONAL TELEMEDICINE AND 90 VERBAL VISITS.SANFORD FARGO CONDUCTED A DEPRESSION SCREENING INITIATIVE THROUGHOUT SANFORD-FARGO CLINICS TO SUPPORT COMMUNITY MENTAL HEALTH PROMOTION. THE PROMOTION RESULTED IN 40,000 DEPRESSION SCREENINGS COMPLETED BY INTERNAL MEDICINE, FAMILY MEDICINE, AND OB/GYN PROVIDERS AND RESIDENCY CLINICS. FOR ALL POSITIVE DEPRESSION SCREENINGS, THERE WAS A DOCUMENTED FOLLOW-UP PLAN WITHIN 14 DAYS OF THE SCREENING. SANFORD AMBULANCE REPORTED 1,200 PATIENTS RECEIVING CARE RELATED TO ALCOHOL USE, 1,350 RELATED TO BEHAVIORAL HEALTH/PSYCHIATRIC EPISODE. SANFORD FARGO IS ACTIVELY RECRUITING A NEW PROVIDER TO SUPPORT SUBOXONE CLINIC FOR PATIENTS WORKING ON ADDICTION AND RECOVERY TO DECREASE SUBSTANCE ABUSE. FURTHER SUPPORT IS PROVIDED THROUGH HOSPITAL PEER COACHING, WITH CONTINUED WORK WITH F5 AND THE LOTUS CENTER THROUGHOUT 2022 TO PROVIDE PEER COACHING IN THE HOSPITAL. SANFORD FARGO ALSO ENGAGES IN A PARTNERSHIP WITH CASS COUNTY'S WITHDRAWAL MANAGEMENT UNIT TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONSENIOR HOUSING AND LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSING, EMPLOYMENT, ECONOMIC DEVELOPMENTDIVERSITY, INCLUSION, HEALTH EQUITYCHILDCAREHEALTH LITERACY AND NAVIGATIONSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE ACCESS TO BEHAVIORAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN IMPROVED CONTINUUM OF CARE APPROACH TO ADDRESSING MENTAL AND BEHAVIORAL HEALTH NEEDS AND SUBSTANCE USE DISORDERS. PRIORITY 2: IMPROVE ACCESS TO AFFORDABLE CAREACCESS TO AFFORDABLE, QUALITY 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. IMPROVING ACCESS TO HEALTHCARE SERVICES HAS BOTH FINANCIAL AND QUALITY OF LIFE IMPLICATIONS ON THE COMMUNITY. BY HELPING COMMUNITY MEMBERS ACCESS THE RIGHT CARE AT THE RIGHT TIME IN THE RIGHT PLACE, THEY ARE BETTER ABLE TO PREVENT AND MANAGE CHRONIC DISEASE AND ENJOY A BETTER QUALITY OF LIFE. FROM A FINANCIAL PERSPECTIVE, BETTER ACCESS TO CARE CAN BE MEASURED IN REDUCED UNNECESSARY EMERGENCY VISITS AND HOSPITALIZATIONS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICESTWO GOALS WERE IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS TO IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, A VITAL NEED FOR THE COMMUNITIES SERVED BY SANFORD HEALTH. THE FIRST GOAL ADVANCES SCHOOL-BASED SERVICES FOR PEDIATRIC PATIENTS WHILE THE SECOND GOAL EXPANDS BEHAVIORAL HEALTH SERVICES AVAILABLE THROUGH THE EMERGENCY DEPARTMENT. SANFORD HEALTH HAS PARTNERED WITH NUMEROUS SCHOOLS IN THE BISMARCK PUBLIC SCHOOLS DISTRICT TO PROVIDE ONSITE BEHAVIORAL HEALTH SERVICES AS PART OF A COMPREHENSIVE TIERED-SYSTEM APPROACH TO PROVIDING RESILIENCY TRAINING AND INTERVENTIONS TO HELP STUDENTS BE SUCCESSFUL. FOR THOSE STUDENTS WHO MAY BENEFIT FROM SERVICES PROVIDED BY A LICENSED BEHAVIORAL HEALTH PROVIDER, SANFORD HEALTH'S ROLE IN THIS PARTNERSHIP IS TO PROVIDE ONSITE CARE. FURTHER, SANFORD'S THERAPIST MEETS WEEKLY WITH THE SCHOOLS' LEADERSHIP TEAMS TO BETTER COORDINATE SUPPORT SERVICES FOR HIGH-RISK STUDENTS. TO ENSURE ACCESS, SANFORD PROVIDED TELEHEALTH VISIT OPTIONS AND CONTINUED CARING FOR THE STUDENTS DURING THE SUMMER BREAK. THIS PROJECT BEGAN AS A PILOT PROGRAM WITH SIMLE MIDDLE SCHOOL. IN 2022, SANFORD PROVIDED 341 VISITS WITH SIMLE STUDENTS AND THEIR FAMILIES AND EXTENDED THE SERVICE EIGHT ADDITIONAL SCHOOLS, PROVIDING A TOTAL OF 989 VISITS IN 2022. SANFORD PARTNERS WITH HEARTVIEW FOUNDATION, A SUBSTANCE USE DISORDER TREATMENT CENTER, TO CO-LOCATE A COUNSELOR IN SANFORD'S EMERGENCY ROOM. THE COUNSELOR MET WITH 159 PATIENTS, 93 OF WHOM WERE REFERRED TO TREATMENT AT HEARTVIEW OR ELSEWHERE. HEARTVIEW OFFERS A 16-BED RESIDENTIAL FACILITY IN BISMARCK AMONG OTHER SERVICES. THE ORGANIZATION HAS ADDITIONAL RESIDENTIAL FACILITIES IN CANDO, ND, AND DICKINSON, ND.SANFORD EXPANDED ITS PARTNERSHIP WITH HEARTVIEW BY COLLABORATING WITH HEARTVIEW AND THE BISMARCK POLICE DEPARTMENT ON A GRANT APPLICATION TO PROVIDE TREATMENT FOR PATIENTS WITH CHRONIC SUD AND/OR OPIOID OVERDOSE. THE GRANT WAS APPROVED JANUARY 2022, AND THE PROGRAM BEGAN AUGUST 2022. SANFORD HAS REFERRED 13 PATIENTS TO HEARTVIEW FOR SUD MEDICATION-ASSISTED TREATMENT OPPORTUNITIES. AS PART OF THE PROGRAM TO HELP PATIENTS WHO EXPERIENCE AN OVERDOSE BE SUCCESSFUL IN SEEKING TREATMENT, SANFORD PHYSICIANS PRESCRIBE BUPRENORPHINE TO HELP PATIENTS SAFELY TRANSITION TO A MEDICATION-ASSISTED THERAPY PROGRAM. IMPROVE ACCESS TO AFFORDABLE CARESANFORD BISMARCK IS ADDRESSING THE PRIORITY THROUGH TWO GOALS: REDUCING HEALTHCARE COSTS BY REDUCING AVOIDABLE VISITS AND INCREASING HEALTHCARE COVERAGE IN THE COMMUNITY. RESIDENTS OF THE CHNA AREA CONDUCTED 3,378 SEARCHES ON THE FINDHELP PLATFORM IN 2022. A QUARTER OF THEM WERE HEALTH RELATED.COMMUNITY HEALTH WORKERS (CHWS) ARE ONE OF THE STRATEGIES DEPLOYED BY THE REGION TO REDUCE AVOIDABLE VISITS. CHWS ARE TRAINED PUBLIC HEALTH WORKERS WHO SERVE AS A BRIDGE BETWEEN COMMUNITIES AND THE HEALTHCARE SYSTEM. THEY ARE NON-LICENSED PROVIDERS WITH SPECIFIC TRAINING TO HELP PATIENTS ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH OUTSIDE THE CLINIC SETTING.SANFORD HEALTH BISMARCK ADDED A COMMUNITY HEALTH WORKER TO HELP ADDRESS PATIENT NEEDS OUTSIDE THE FOUR WALLS OF A CLINIC OR A HOSPITAL. THE CHW WORKS WITH PATIENTS TO IMPROVE HEALTH OUTCOMES BY HELPING THOSE WHO MIGHT OTHERWISE HAVE TROUBLE ACCESSING THE HEALTH SYSTEM AND BY CONNECTING PATIENTS TO COMMUNITY SERVICES SUCH AS HOUSING, TRANSPORTATION, AND FOOD. THE CHW PLAYS AN IMPORTANT ROLE WITH HEALTH SYSTEM CARE TEAMS AND HAS A UNIQUE KNOWLEDGE OF BARRIERS TO ACCESS AND ARE EXPERTS IN OVERCOMING THOSE BARRIERS.IN 2022, SANFORD BISMARCK'S CHW HELPED 164 PATIENTS. BY HELPING PATIENTS CONNECT TO NEEDED COMMUNITY SERVICES AND OTHER HEALTH-RELATED LIVING FACTORS, THE CHW HELPED REDUCE AVOIDABLE ER VISITS AND AVOIDABLE HOSPITALIZATIONS FOR THESE PATIENTS BY 56 PERCENT AND 68 PERCENT, RESPECTIVELY. BOTH THE HEALTH IMPROVEMENT AND COST SAVINGS FOR BOTH THE PATIENT AND THE HEALTHCARE SYSTEM ARE TREMENDOUS. TO INCREASE HEALTHCARE COVERAGE IN THE COMMUNITY, SANFORD HEALTH HAS INTEGRATED FULLTIME, ONSITE FINANCIAL ADVOCATES WHO SPECIALIZE IN HEALTHCARE COVERAGE ENROLLMENT TO HELP COMMUNITY MEMBERS WHO ARE UNINSURED AND UNDERINSURED SECURE ACCESS TO HEALTHCARE SERVICES. THEY HELP SANFORD PATIENTS AS WELL AS COMMUNITY REFERRALS.HEALTH INSURANCE COVERAGE: SANFORD BISMARCK'S FINANCIAL ADVOCATES HELPED 3,363 UNINSURED AND UNDERINSURED PATIENTS AND THEIR FAMILIES SECURE HEALTH CARE COVERAGE, HELPING PATIENTS PAY FOR MUCH-NEEDED HEALTHCARE SERVICES AND ONGOING CARE.THE SANFORD HEALTH FOUNDATION ALSO SUPPORTS PATIENTS THAT MAY BE TEMPORARILY UNABLE TO AFFORD THE MEDICATIONS THEY NEED DUE TO EXTENUATING CIRCUMSTANCES, E.G., SUDDEN LOSS OF EMPLOYMENT, SANFORD'S FOUNDATION ESTABLISHED A FUND TO HELP COMMUNITY MEMBERS. ESTABLISHED INTERNAL WORKFLOW PROCESSES TO HELP INDIVIDUALS UNABLE TO AFFORD PRESCRIPTIONS RECEIVE THE MEDICATION FREE OF CHARGE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:HEALTHY LIVING ACCESS TO HEALTH CARE PROVIDERSLONG-TERM CARE PUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: ACCESS TO HEALTH CARE: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ADD ADDITIONAL BEHAVIORAL HEALTH PROVIDERS, PROGRAMS, IMPROVED ACCESS, AND ALTERNATE WAYS TO ENGAGE WITH BEHAVIORAL HEALTH PROVIDERS. IT IS SANFORD'S GOAL TO PROVIDE ACCESS TO QUALITY AND TIMELY HEALTH CARE RELATED TO MENTAL HEALTH AND SUBSTANCE ABUSE. PRIORITY 2: HEALTHY LIVINGIN THE UNITED STATES, MANY OF THE LEADING CAUSES OF DEATH AND DISEASE ARE ATTRIBUTED TO UNHEALTHY BEHAVIORS. FOR EXAMPLE, POOR NUTRITION AND LOW LEVELS OF PHYSICAL ACTIVITY ARE ASSOCIATED WITH HIGHER RISK OF CARDIOVASCULAR DISEASE, TYPE 2 DIABETES, AND OBESITY. TOBACCO USE IS ASSOCIATED WITH HEART DISEASE, CANCER, AND POOR PREGNANCY OUTCOMES IF THE MOTHER SMOKES DURING PREGNANCY. EXCESSIVE ALCOHOL USE IS ASSOCIATED WITH INJURIES, CERTAIN TYPES OF CANCERS, AND CIRRHOSIS. SANFORD HAS MADE HEALTHY LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN OPTIONS AND ASSISTANCE FOR HEALTHY LIVING. IT IS SANFORD'S GOAL TO FOCUS ON HEALTHY LIVING TO INCLUDE ASSESSMENT AND TREATMENT OF CHRONIC HEALTH ISSUES, LEVELS OF PHYSICAL ACTIVITY AND FOOD INSECURITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE: MENTAL HEALTHWE IDENTIFIED FOUR GOALS TO ADDRESS MENTAL HEALTH ACCESS. THE FIRST IS TO DEVELOP A FULLY INTEGRATED BEHAVIORAL HEALTH SYSTEM, RESULTING IN INCREASED ACCESS AND QUALITY CARE AND BECOME A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC). THE SECOND GOAL IS TO INCREASE ACCESS TO URGENT AND EMERGENT BEHAVIORAL HEALTH SERVICES FOR COMMUNITY MEMBERS IN BEHAVIORAL HEALTH CRISIS. SANFORD BEMIDJI ALSO SEEKS THE GOALS OF INCREASING ACCESS TO CULTURALLY SENSITIVE SUBSTANCE ABUSE PREVENTION AND TREATMENT AND INCREASING ACCESS TO CHILDREN'S BEHAVIORAL HEALTH SERVICES. WE ANTICIPATE BECOMING A CCBHC, CERTIFIED BY THE MINNESOTA DEPARTMENT OF HEALTH, IN MARCH 2023. A 2-YEAR FEDERAL GRANT FOR CCBHC IMPLEMENTATION WILL END IN FEBRUARY 2023 AND INCLUDED 1,360 PATIENT INTAKES. SANFORD IS RECRUITING FOR ADDITIONAL PROVIDERS, WHICH RESULTED IN SIGNING TWO PSYCHIATRISTS AND THREE APPS. ADDITIONAL NEEDS WERE SUPPORTED THROUGH FURTHER DEVELOPMENT OF SCHOLARSHIPS AND INTERNSHIPS PROGRAMMING WITH EIGHT INTERNS ADDED IN 2022. THIS SUPPORTS THE NEEDS OF BOTH THE SYSTEM AND THE STUDENTS SEEKING A CAREER IN THE MEDICAL FIELD.IN ADDITION TO THE NEEDS WITHIN THE CHNA COMMUNITY, SANFORD IS EXPLORING THE EXPANSION OF BEHAVIORAL HEALTH SERVICES INTO SECONDARY MARKETS IN MULTIPLE COMMUNITIES ADJACENT TO THE CURRENT SERVICE FOOTPRINT. BEHAVIORAL HEALTH SERVICES WERE EXPANDED INTO PARK RAPIDS THROUGH THE ACQUISITION OF A BETTER CONNECTION COMPLETED 12/2021. THE ADDITION TO THE SANFORD ORGANIZATION INCREASED SERVICES BY 20% WITH A 1.0 CARE COORDINATOR, AND 1.0 BHC.HEARTLAND LAKES DEVELOPMENT (HLD) HAS SECURED THE LAND TO BUILD A SUPPORTIVE HOUSING COMPLEX. NEXT STEPS IN THE PLANNING/CONSTRUCTION HAVE NOT STARTED. WE CONTINUE TO COMMUNICATE WITH HLD AS PLANS ARE DEVELOPED.CONSTRUCTION WAS COMPLETED ON THE BEHAVIORAL HEALTH CRISIS CENTER HOSPITAL AND EMPATH UNITS. A SOFT ROLL-OUT FOR EMPATH STARTED DECEMBER 2022 AND THE IP UNIT OPENED IN FEBRUARY 2023. ACCESS TO MOBILE CRISIS SERVICES WAS EXPANDED BY INCREASING FULL-TIME FTES.TO INCREASE ACCESS TO CULTURALLY SENSITIVE SUBSTANCE ABUSE PREVENTION AND TREATMENT, BEHAVIORAL HEALTH'S SUD PROGRAM BECAME A WELLBRIETY CERTIFIED TREATMENT CENTER IN 2022. MEETING THIS CRITERIA ENSURES ALL COUNSELORS ARE TRAINED IN AND INCORPORATE CULTURALLY BASED CURRICULUM, PROVIDES ACCESS TO A NATIVE AMERICAN ELDER WHO CONDUCTS CEREMONIES AND PROVIDES TEACHINGS, AND INCORPORATES TRADITIONAL NATIVE AMERICAN HEALING PRACTICES (SMUDGING, PIPE CEREMONY, SWEAT LODGE, ETC.) INTO THE PROGRAM.THE MEDICATION ASSISTED TREATMENT PROGRAM MOVED TO THE 1705 CLINIC AND TRANSITIONED TO THE BH UMBRELLA.EXPANDING BH SERVICES INTO SECONDARY IS BEING EXPLORED IN MULTIPLE COMMUNITIES ADJACENT TO THE CURRENT SERVICE FOOTPRINT TO INCREASE ACCESS TO CHILDREN'S BH SERVICES.CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS EXPANDED WITH CONTINUED PLANNING FOR MORE IN-HOME SERVICES. HOWEVER, IN-SCHOOL SERVICE NEEDS HAVE DRAMATICALLY INCREASED. THE SCHOOL LINKED MENTAL HEALTH GRANT REQUEST WAS INCREASED BY $300,000, TO SUPPORT AN INCREASE OF FIVE FTES TO SERVE ADDITIONAL SCHOOLS. WE WILL BE OFFERING CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS TO ALL BEMIDJI SCHOOLS.HEALTHY LIVINGWE ESTABLISHED FOUR GOALS WITHIN THE PRIORITY: ASSESSMENT AND TREATMENT OF CHRONIC HEALTH ISSUES, ASSESSMENT AND TREATMENT OF CHRONIC HEALTH ISSUES, FOOD INSECURITY, AND EXPAND SUPPORT OF HUBBARD COUNTY AND PARK RAPIDS THROUGH LOCAL COMMUNITY PARTNERS AND FOCUS ON THE ISSUES OF HEALTHY LIFESTYLES, BEHAVIORAL HEALTH, AFFORDABLE HOUSING, AND WORKFORCE DEVELOPMENT.WE STARTED 2022 COMMITTED TO IMPROVING DEPRESSION SCREENING IN PRIMARY CARE. DURING THE YEAR, WE ADDED DEPRESSION SCREENING TO SEVERAL SPECIALTY DEPARTMENTS AND THE WALK-IN CLINIC. THE RESULTS WERE EXCELLENT. IN A 1-MONTH PERIOD, FALL 2022, THE WALK-IN CLINIC ALONE SCREENED OVER 1,000 PATIENTS THAT LIKELY WOULD HAVE BEEN MISSED. AT YEAR END, THE PRIMARY CARE CLINICS SCREENED 65.7% OF ELIGIBLE PATIENTS, AN IMPROVEMENT FROM 48.3% IN 2021. THIS RATE PLACES OUR PRIMARY CARE IN THE TOP 30% OF ALL CLINICIANS NATIONWIDE. ADDING THE SPECIALTY AND WALK-IN CLINICS IMPROVED THE REGIONAL SCREENING FROM 42.9% TO 49.3% OF ELIGIBLE PATIENTS AND RANKS BETTER THAN 50% NATIONWIDE. DEPRESSION REMISSION RATES ALSO IMPROVED IN PRIMARY CARE AND THE REGION. PRIMARY CARE IMPROVED FROM 14% TO 16%, AND ALTHOUGH THESE NUMBERS SEEM LOW, THEY ARE ALSO IN THE TOP 30% NATIONWIDE. THE REGION IS IN TOP HALF.THE PRIMARY CARE GOAL OF REDUCING UNCONTROLLED DIABETES TO BETTER THAN 23.5% WAS REALIZED, MOVING FROM 24.6% OF PATIENTS UNCONTROLLED TO 22.1% (TOP 20% NATIONWIDE). REFERRALS TO SELF-CARE IMPROVED FROM 0-2 PER MONTH IN AUGUST 2021 TO 15 PATIENTS/MONTH BY AUGUST 2022 THROUGH PROMOTION EFFORTS. PATIENTS WHO ATTEND THE BETTER CHOICES/BETTER HEALTH CLASS HAVE A 12% IMPROVEMENT IN MEDICATION COMPLIANCE.THE PEDIATRIC CLINIC IMPLEMENTED THE FOOD PANTRY IN JUNE 2022. DUE TO STAFFING CONSTRAINTS THE CLINIC WAS UNABLE TO SCREEN EACH FAMILY AS ORIGINALLY PLANNED. STAFFING CONSTRAINTS ARE DECREASING, THE PANTRY HAD A RESET JAN. 2023. IN THE MONTH OF JANUARY IT WAS ESTIMATED THAT APPROXIMATELY 350-400 LBS OF FOOD WAS GIVEN OUT. THIS IMPACTED 6 FAMILIES, INCLUDING A FAMILY OF 12. THE GOAL MOVING FORWARD IS TO SCREEN EACH FAMILY AT WELL-CHILD CHECKS. STAFF WILL MONITOR THE NUMBER OF PATIENTS SCREENED COMPARED TO THE NUMBER OF WELL-CHILD CHECKS. OVER TIME WE WILL LOOK TO EXPAND THIS TO OTHER VISIT TYPES. SANFORD STAFF ATTEND QUARTERLY ACTION PARK RAPIDS NON-PROFIT AGENCY NETWORKING MEETINGS TO LISTEN TO THE NEEDS/CONCERNS OF THE NON-PROFIT COMMUNITY INCLUDING SOCIAL ISSUES, EDUCATION AND EXPANDED BEHAVIORAL HEALTH NEEDS. COLLABORATION WITH UNITED WAY TO FIND INITIATIVE IN HUBBARD COUNTY.SANFORD PARTICIPATED IN THE CHI ST. JOSEPH HEALTH CARE/HUBBARD CHNA SURVEY AND STAKEHOLDERS MEETING.WE SURVEYED OUR STAFF WHO HAVE DEPENDENTS ON THEIR CHILDCARE NEEDS. QUESTIONS INCLUDED THE TIMES THEY NEEDED CARE, AS WELL AS NUMBER OF KIDS AND NUMBER OF HOURS PER WEEK. THE RESPONSE RATE WAS APPROXIMATELY 40%. THE HIGHEST NEEDS OF OUR STAFF INCLUDE DROP IN AND BACKUP CHILD CARE (FOR THE TIMES THEIR REGULAR DAYCARE BECOMES SICK OR TAKES VACATION), AND INFANT SPOTS. CONVERSATIONS CONTINUE WITH COMMUNITY PARTNERS ON HOW ADDITIONAL CHILDCARE IN OUR COMMUNITY CAN BE SUPPORTED.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:EMPLOYMENT AND INCOMEACCESS TO AFFORDABLE HEALTH CAREAFFORDABLE HOUSINGPUBLIC TRANSPORTATIONCHILD CARE QUALITYCOMMUNITY SAFETYSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR MENTAL HEALTH PROMOTION, SUICIDE PREVENTION AND EDUCATION FOR PARENTING RELATED SKILLS. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES, IN PARTICULAR FOR AT RISK YOUTH AND TO DECREASE THE NUMBER OF SUICIDES.PRIORITY 2: ACCESS TO HEALTHCARE PROVIDERSACCESS TO AFFORDABLE, QUALITY 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 ACCESS TO HEALTHCARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO DEVELOP A FULLTIME DERMATOLOGY CLINIC AND TO EXPAND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH. IT IS SANFORD'S GOAL TO INCREASE THE NUMBER OF LOCAL PROVIDERS SERVICING THIEF RIVER FALLS THROUGH LOCALLY BASED PROVIDERS, OUTREACH FROM OTHER SANFORD FACILITIES, OR TELEHEALTH/VIRTUAL CARE PLATFORMS. INCREASED PROVIDERS WILL EXPAND THE NUMBER OF AVAILABLE SERVICES AND APPOINTMENTS AVAILABLE TO THE LOCAL COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SANFORD THIEF RIVER FALLS AND SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER ESTABLISHED TWO GOALS WITHIN THE MENTAL HEALTH PRIORITY. THE FIRST IS TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION. THE SECOND GOAL IS TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS.IN LATE 2021, AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION, SANFORD BEHAVIORAL HEALTH IDENTIFIED A CORE TEAM OF STAFF AND DEVELOPED A STRATEGY TO GROW A COMMUNITY COALITION FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION IN OUR COMMUNITY. IN JANUARY OF 2022, SANFORD BEHAVIORAL HEALTH BEGAN MEETING MONTHLY WITH COMMUNITY PARTNERS FROM TEN PUBLIC AND PRIVATE ENTITIES INCLUDING PUBLIC HEALTH, LAW ENFORCEMENT, FAITH COMMUNITY, EDUCATION, EMPLOYERS, HEALTH CARE, AND YOUTH ACTIVITIES. OVER THE PAST YEAR, SIX ADDITIONAL PARTNERS WERE ADDED, INCLUDING SCHOOL COUNSELORS, VIP, ADDITIONAL SCHOOL DISTRICT, MENTAL HEALTH PROVIDER, HIGH SCHOOL STUDENT, AND A SUICIDE LOSS SURVIVOR. THROUGHOUT THE YEAR, THIS GROUP BECAME KNOWN AS "COMMUNITY STRONG," DEFINED OUR COMMUNITY AS PENNINGTON COUNTY, AND IDENTIFIED OUR FOCUS ON YOUTH AND FAMILY EDUCATION. COMMUNITY STRONG ESTABLISHED A VISION STATEMENT TO BE "A COMMUNITY THAT STRIVES, PROMOTES AND SEEKS OUT MENTAL AND EMOTIONAL WELLBEING AND A MISSION STATEMENT "TO EMPOWER A HEALTHY COMMUNITY IN PENNINGTON COUNTY THROUGH EDUCATION, OUTREACH AND SUPPORT THAT RESHAPES THINKING AND AWARENESS AROUND MENTAL WELL-BEING AND SUICIDE PREVENTION." IN 2022, IN PARTNERSHIP WITH COMMUNITY STRONG, SANFORD BEHAVIORAL HEALTH PROVIDED FOUR EDUCATIONAL EVENTS IN PENNINGTON COUNTY, WITH ADDITIONAL OUTREACH EVENTS.IN EARLY 2022, SANFORD BEHAVIORAL HEALTH IDENTIFIED KEY PERSONNEL TO DEVELOP A STRATEGY FOR IMPLEMENTING PARENTING RELATED SKILLS IN THE COMMUNITY AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS. IN MAY OF 2022, SANFORD BEHAVIORAL HEALTH USED ESTABLISHED RELATIONSHIPS THROUGH THE JUVENILE DIVERSION PROGRAM TO IDENTIFY PARTNERS WHO COULD JOIN IN THE EFFORT TO IMPLEMENT AND PROMOTE THIS TYPE OF EDUCATIONAL GROUP FOR PARENTS. THROUGH WORK WITH THE TRF POLICE DEPARTMENT, PENNINGTON COUNTY SOCIAL SERVICES, PENNINGTON COUNTY COURT AND COUNTY ATTORNEY, AND TRF SCHOOL DISTRICT, IT WAS IDENTIFIED THAT THE INITIAL TARGETED POPULATION OF THIS PARENTING SKILLS EDUCATION WOULD BE PARENTS OF CHILDREN IN THE JUVENILE DIVERSION PROGRAM, OR THOSE THAT THE AGENCIES INVOLVED ARE IDENTIFYING AS ESCALATING IN CRIMINAL JUSTICE SYSTEM AND AT AN INCREASED NEED FOR SERVICES. IN LATE MAY, THE CURRICULUM TO BE USED WAS IDENTIFIED AS THE INCREDIBLE YEARS AND LOVE & LOGIC CURRICULUM. FACILITATORS WERE ALSO IDENTIFIED FROM SANFORD BEHAVIORAL HEALTH AND PENNINGTON COUNTY SOCIAL SERVICES. THE FIRST SIX-WEEK SESSION OF THE PARENTING SKILLS GROUP BEGAN IN OCTOBER OF 2022 WITH SIX FAMILIES COMPLETING THE TRAINING.ACCESS TO HEALTHCARE PROVIDERSTWO GOALS WERE ESTABLISHED TO SUPPORT THE PRIORITY, INCLUDING THE DEVELOPMENT OF A FULLTIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, AND EXPANDING THE PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH.TO SUPPORT THE GOAL OF DEVELOPING A FULL-TIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, SANFORD HEALTH TRF HIRED A FULL-TIME DERMATOLOGY NURSE PRACTITIONER IN APRIL OF 2021. THE DERMATOLOGIST STARTED IN THIEF RIVER FALLS AFTER SIX MONTHS OF TRAINING WITH A DERMATOLOGIST IN GRAND FORKS, SO THE COMMUNITY NOW HAS A FULL-TIME DERMATOLOGY SERVICE. CY2022 FOCUSED ON BUILDING THE PRACTICE TO INCLUDE RESOURCES NEEDED FOR SKIN TESTING, SKIN CHECKS, BIOPSIES, AND PROCEDURES ALONG WITH STAFFING AND SCHEDULING RESOURCES TO BEST ACCOMMODATE PATIENT NEEDS. AVAILABLE LOCAL DERMATOLOGY APPOINTMENTS WENT FROM MONTHLY OUTREACH, ROUGHLY 40 APPOINTMENTS, TO FULL-TIME COMMUNITY CLINIC, ROUGHLY 140 APPOINTMENTS PER MONTH. PATIENT UTILIZATION OF DERMATOLOGY SERVICES WAS BUILT AND SUSTAINED EARLY IN 2022. HELPING WITH THE PRACTICE AWARENESS AND PATIENT EDUCATION INCLUDED MARKETING THE NEW NURSE PRACTITIONER TO THE PUBLIC VIA TRADITIONAL AND SOCIAL MEDIA SOURCES, HOSTING FREE PUBLIC SKIN CHECK EVENTS, COMMUNITY OUTREACH WITH EMPLOYERS AND THE SCHOOL DISTRICT, AND PRODUCING AND DISTRIBUTING SKIN PREVENTION EDUCATIONAL MATERIALS. THIEF RIVER FALLS DERMATOLOGY IS OFFERING ROBUST GEOGRAPHICAL OFFERINGS IN OUR PRIMARY SERVICE AREA BY SPENDING TWO DAYS OF OUTREACH DERMATOLOGY TIME IN COMMUNITIES HALLOCK AND CROOKSTON, GIVING THEM 16 PATIENT APPOINTMENTS OF DERMATOLOGY ACCESS NOT PREVIOUSLY HAD. IN CY2023, THE FOCUS WILL BE ON GROWING AVAILABLE ACCESS BY INCREASING APPOINTMENTS EACH CLINIC DAY.AS PART OF THE EXPANDED PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH GOAL, SANFORD BEHAVIORAL HEALTH PROVIDES PATIENTS THE FLEXIBILITY OF SCHEDULING THEIR APPOINTMENT IN THE MANNER THAT BEST SUITS THEIR NEEDS, PROVIDED THAT WE ARE ABLE TO MEET REGULATORY REQUIREMENTS AND IT IS IN THE PATIENT'S BEST INTEREST CLINICALLY. AS A RESULT, MORE THAN 40% OF APPOINTMENTS ARE CURRENTLY SCHEDULED AS TELEHEALTH APPOINTMENTS. THIS DATA DOES NOT REFLECT ANY NEW PATIENT ASSESSMENTS WHO MAY BE SEEN VIA TELEHEALTH DUE TO THE INABILITY TO CAPTURE THE DATA WITHOUT A MANUAL PROCESS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO QUALITY HEALTHCAREAFFORDABLE HOUSINGLONG-TERM CAREPUBLIC TRANSPORTATIONSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE. SANFORD HAS MADE PHYSICAL ACTIVITY AND NUTRITION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND IMPROVE CARE OF PATIENTS WITH OBESITY DIAGNOSIS AND TO PROVIDE EDUCATION TO SCHOOLS REGARDING PHYSICAL ACTIVITY AND NUTRITION. IT IS SANFORD'S GOAL TO IMPROVE PHYSICAL ACTIVITY AND NUTRITION FOR THE COMMUNITY. PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCORDING TO THE COUNTY HEALTH RANKINGS FOR CLINICAL CARE, ACCESS TO 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 AND EDUCATION. IT IS SANFORD'S GOAL THAT ALL PATIENTS REQUIRING ACCESS TO HEALTHCARE ARE SUCCESSFUL IN SECURING TIMELY APPOINTMENTS AND IMPROVING MENTAL HEALTH SERVICES IN THE COMMUNITY. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPHYSICAL ACTIVITY AND NUTRITIONSANFORD ABERDEEN SUPPORTED THE PRIORITY THROUGH A COMBINATION OF VOLUNTEER SUPPORT AND OUTREACH BY ITS REGISTERED DIETICIAN. THE NEED FOR CONTINUED FOCUS ON THE GOAL IS VISIBLE WITHIN THE RESULTS OF THE FINDHELP SEARCH TOOL NOTED WITHIN THE SYSTEM SUMMARY IN THE PREVIOUS SECTION. RESIDENTS OF THE CHNA-DEFINED SANFORD ABERDEEN MEDICAL CENTER COMMUNITY CONDUCTED 783 SEARCHES IN 2022 ACROSS THE PLATFORM, 25% OF THE SEARCHES WERE RELATED TO FOOD ISSUES, SUCH AS PANTRIES, PAYING FOR FOOD, AND MEALS. COMMUNITY RESIDENTS ENGAGED WITH FOOD RESOURCES ON THE SANFORD FINDHELP TOOL 14 TIMES IN 2022. BY ONE MEASURE, BROWN COUNTY OBESITY RATES ARE 35.5% FOR FEMALES AND 35.1% FOR MALES PER DATA FROM THE INSTITUTE FOR HEALTH METRICS AND EVALUATION.VOLUNTEER EFFORTS FOCUSED ON GETTING HEALTHY FOOD IN THE HANDS OF THOSE THAT NEED IT. TO THAT END SANFORD VOLUNTEERED TEN HOURS TO MEALS ON WHEELS IN 2022, EXTENDING CARE BEYOND THE HOSPITAL WALLS TO PARTNER WITH A LOCAL COMMUNITY PARTNER TO DELIVER FOOD TO LOCAL SENIORS. SANFORD ABERDEEN PARTNERED WITH ANOTHER COMMUNITY PARTNER, THE SALVATION ARMY, TO DONATE ITEMS TO HOST A HEALTH FOOD DRIVE FOR YOUTH. IN TOTAL, 800 POUNDS OF FOOD AND $700 IN MONETARY DONATIONS WERE COLLECTED THROUGH THE EFFORT.SANFORD ABERDEEN EMPLOYS A REGISTERED DIETICIAN. IN ADDITION TO THEIR WORK WITHIN THE HEALTH SYSTEM, THE REGISTERED DIETICIAN COMPLETED A HEALTHY COOKING CLASS FOR AGING ADULTS AT THE ABERDEEN SENIOR CENTER. THE DIETITIAN ALSO ANALYZED LOCAL RESTAURANT MENUS TO PROVIDE INFORMATION TO CONSUMERS ON HEALTH OPTIONS AS PART OF PARTICIPATION IN HUB CITY HEALTHY EATS. ACCESS TO HEALTH CARE PROVIDERSSANFORD ABERDEEN IS SUPPORTING THE PRIORITY BY AUGMENTING LOCAL RESOURCES VIA TELEMEDICINE OUTREACH TO THE COMMUNITY FROM RESOURCES AVAILABLE THROUGH SANFORD HEALTH IN SIOUX FALLS, THROUGH INTEGRATED HEALTH THERAPISTS INTEGRATED INTO PRIMARY CARE SETTINGS, AND STANDARDIZING WORKFLOW TO ALL HEALTH COACHES AND PANEL SPECIALISTS WITHIN THE HOSPITAL AND CLINIC THROUGH EDUCATIONAL EFFORTS. SANFORD ABERDEEN HAD 180 REFERRALS FOR INTEGRATED HEALTH THERAPISTS (IHT) FROM VARIOUS SERVICE LINES, INCLUDING 139 FROM FAMILY PRACTICE, 11 FROM ORTHOPEDICS, 3 FROM ONCOLOGY, 9 FROM OBGYN, 7 FROM ENT, 3 FROM CHILDREN'S, AND 7 FROM CARDIOLOGY. IHT VISITS TOTALED 393 IN 2022 AND TOTAL 92 THROUGH THE FIRST TWO MONTHS OF 2023. REFERRALS TO BEHAVIORAL HEALTH/PSYCHOLOGY WERE 130 IN 2022 INCLUDING 123 FROM FAMILY PRACTICE, 3 FROM OBGYN, AND 4 FROM CHILDREN'S. BEHAVIORAL HEALTH THERAPISTS (BHT) BEGAN SEEING PATIENTS IN OCTOBER 2022 AND HAD 79 VISITS THROUGH THE END OF THE YEAR. BHT VISITS TOTALED 135 THROUGH THE FIRST TWO MONTHS OF 2023. COMMUNITY HEALTH WORKERS HAD 56 VISITS DURING THE PAST YEAR.SANFORD ABERDEEN COMPLETED WORKFLOW EDUCATION TO ALL PROVIDERS AND NURSING STAFF FOR REFERRALS. SANFORD ABERDEEN HAS HIRED A PMHNP, CNP WHO WILL BE ABLE TO COMPLETE LOCAL PSYCH REFERRALS AND MEDICATION MANAGEMENT.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: ACCESS TO PROVIDERS (BILINGUAL MENTAL HEALTH AND PEDIATRIC DENTAL CARE)ACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE SCREENING OF MENTAL HEALTH AND REFERRAL SOURCES FOR MENTAL HEALTH SUPPORT AND TO INCREASE ACCESS TO PEDIATRIC DENTAL CARE FOR AT-RISK PATIENTS. IT IS SANFORD'S GOAL THAT MORE AREA RESIDENTS WILL HAVE ACCESS TO PROVIDERS OF BILINGUAL MENTAL HEALTH AND PEDIATRIC DENTAL CARE.PRIORITY 2: TEEN PREGNANCYTEEN PREGNANCY RESULTS IN SUBSTANTIAL SOCIAL, ECONOMIC, AND HEALTH COSTS THROUGH IMMEDIATE AND LONG-TERM IMPACTS ON TEEN PARENTS AND THEIR CHILDREN. STUDIES SHOW THAT THE CHILDREN OF TEENAGE MOTHERS ARE MORE LIKELY TO HAVE LOWER SCHOOL ACHIEVEMENT AND TO DROP OUT OF HIGH SCHOOL, HAVE MORE HEALTH PROBLEMS, BE INCARCERATED AT SOME TIME DURING ADOLESCENCE, AND FACE UNEMPLOYMENT AS A YOUNG ADULT, THAN CHILDREN BORN TO OLDER MOTHERS.SANFORD HAS MADE TEEN PREGNANCY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE LINKAGES BETWEEN TEEN PREGNANCY PREVENTION PROGRAMS AND COMMUNITY-BASED CLINICAL SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WILL BENEFIT FROM STRONG LOCAL PARTNERSHIPS THROUGH SANFORD'S FOCUS ON THIS ISSUE. FAMILY PRACTICE AND PEDIATRIC PROVIDERS WILL PROVIDE PATIENT EDUCATION, RECOMMEND, AND SUPPORT SPECIALTY REFERRALS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO PROVIDERS (BILINGUAL MENTAL HEALTH AND PEDIATRIC DENTAL CARE)SANFORD WORTHINGTON ESTABLISHED TWO GOALS FOR THE PRIORITY, INCLUDING INCREASING ACCESS TO PEDIATRIC DENTAL CARE FOR AT-RISK PATIENTS, IN ADDITION TO INCREASED SCREENING OF MENTAL HEALTH AND REFERRAL SOURCES FOR MENTAL HEALTH SUPPORT. DENTAL CARE WAS THE EIGHTH MOST SEARCHED TERM ON THE FINDHELP PLATFORM. IN TOTAL COMMUNITY MEMBERS CONDUCTED 434 SEARCHES IN 2022 WITH 28% BEING HEALTH-RELATED TOPICS.THE ORGANIZATION COMPLETED A PROFORMA FOR A DENTAL THERAPIST IN THE CLINIC SETTING. THE PROFORMA INDICATED THAT IT WAS NOT A FEASIBLE OPPORTUNITY. HOWEVER, SANFORD WORTHINGTON EDUCATED CLINICAL STAFF ON LOCAL DENTAL DISPARITIES AND IS SHARING LOCAL DATA. DATA IS SHARED BI-ANNUALLY WITH STAFF. STAFF ALSO EXPLORED THE OPPORTUNITY FOR PARTNERSHIP WITH HIGHER EDUCATION AND DENTAL PROGRAMS TO COMPLETE A ROTATION OF DENTAL SERVICE PRACTICE IN AMBULATORY SETTING. THIS WAS ALSO DETERMINED TO NOT BE FEASIBLE.THE ORGANIZATION IS COLLABORATING TO DETERMINE A LOCAL STRATEGY TO ASSIST PATIENTS IN GREATEST NEED. LAST YEAR, SANFORD SHARED OPPORTUNITIES FOR LOCAL PROJECTS AND SERVICES IN THE COMMUNITY SETTING FOR REFERRAL OF AT-RISK PATIENTS AND CONTINUES TO STRENGTHEN RELATIONSHIPS WITH LOCAL DENTAL PROVIDERS, PUBLIC HEALTH, AND OTHER COMMUNITY STAKEHOLDERS TO ENSURE THOSE IN GREATEST NEED GET CONNECTED TO THE RESOURCES NEEDED TO TREAT AND PREVENT PEDIATRIC DENTAL ISSUES.FOR MENTAL HEALTH, THE ORGANIZATION WAS ABLE TO SUCCESSFULLY RECRUIT AN INTEGRATED HEALTH THERAPIST (IHT) AFTER THE POSITION WAS POSTED FOR MORE THAN 600 DAYS. THE IHT JOINED THE ORGANIZATION IN OCTOBER 2022. TWO BILINGUAL SPANISH COMMUNITY HEALTH WORKERS (CHWS) COMPLETED APPROXIMATELY 50 SOCIAL DETERMINANTS OF HEALTH ASSESSMENTS (SDOH) ON TARGETED PATIENTS REFERRED TO CHWS AFTER THE SDOH ASSESSMENT WAS INTRODUCED AND IMPLEMENTED INTO CHW WORKFLOW IN JUNE OF 2022. THE SDOH SCREENING CONTAINS QUESTIONS REGARDING MENTAL HEALTH AND STRESS. IF PATIENTS RESPOND TO THOSE QUESTIONS WITH A CONCERN, THE CHWS FURTHER ASSESS AND REFER TO INTERNAL AND/OR EXTERNAL COMMUNITY MENTAL HEALTH RESOURCES AS NEEDED. IN NOVEMBER, A SHORTENED VERSION OF THE SDOH ASSESSMENT WAS DEPLOYED TO ALL PATIENTS CHECKING IN FOR THEIR APPOINTMENT AT REGISTRATION WHICH INCREASES LIKELIHOOD OF IDENTIFYING MENTAL HEALTH CONCERNS TO BE ADDRESSED WITH THE PROVIDER AND OPPORTUNITY FOR APPROPRIATE REFERRAL AND FOLLOW UP.SANFORD WORTHINGTON IS WORKING TO IMPROVE PATIENT COMPLETION RATE OF APPROPRIATE MENTAL HEALTH SCREENING IN AMBULATORY SETTINGS THROUGH STAFF WORKFLOW IMPROVEMENTS. THE CMS QUALITY GOAL FOR DEPRESSION SCREENING IS 95% AND WORTHINGTON WAS AT 26% IN JANUARY 2021. HOWEVER, THIS HAS IMPROVED TO 67.7% AS OF THE END OF 2022. THE SIGNIFICANT IMPROVEMENT WAS THE RESULT OF FOCUSED WORK BY STAFF. THE PANEL ASSISTANT RAN A REGISTRY OF PATIENTS THAT WERE MISSING THE DEPRESSION SCREEN OR HAD AN OUTDATED SCREENING TO COMPLETE. SOME OF THOSE WITH A MISSING SCREED WERE UPDATED VIA TELEPHONE OUTREACH WHILE OTHERS WERE FLAGGED AND COMPLETED DURING A SCHEDULED APPOINTMENT. WORTHINGTON WAS ABLE TO INCREASE ACCESS TO MENTAL HEALTH TELEMEDICINE SERVICES WITH THE ADDITION OF A CREDENTIALED LICENSED MENTAL HEALTH SERVICE PROVIDER TO COVER WORTHINGTON CLINIC PATIENTS IN MARCH 2022.TEEN PREGNANCYSANFORD WORTHINGTON WORKED TOGETHER WITH NOBLES COUNTY PUBLIC HEALTH AND SMOC FAMILY PLANNING TO ORGANIZE A BRAINSTORMING MEETING WITH COMMUNITY STAKEHOLDERS REGARDING TEEN PREGNANCY. SMOC FAMILY PLANNING IS THE LEAD FOR THIS PROJECT. ORGANIZATIONS AND COMMUNITY MEMBERS REPRESENTED AT THE INITIAL BRAINSTORM MEETING ON MARCH 22, 2022, INCLUDED LOCAL PUBLIC HEALTH, SMOC FAMILY PLANNING, SANFORD WORTHINGTON, WELLSHARE INTERNATIONAL, SMOC HEAD START, AND COMMUNITY HEALTH WORKERS. THE MEETING WAS HELD AT THE SANFORD WORTHINGTON HOSPITAL WITH DISCUSSION THAT COVERED CURRENT STATISTICS FOR NOBLES COUNTY, AN INFORMAL ASSESSMENT OF SERVICES OFFERED, A GAP ANALYSIS, AND A LIST OF COMMUNITY REPRESENTATIVES THAT SHOULD BE AT THE TABLE FOR AN OFFICIAL WORK GROUP. A SECOND BRAINSTORM MEETING WAS HELD ON APRIL 27TH WITH A FEW ADDITIONAL STAKEHOLDERS THAT WERE UNABLE TO ATTEND THE FIRST BRAINSTORM SESSION. NEW ATTENDEES INCLUDED COMMUNITY ADVOCATE/JBS, SOUTHWEST CRISIS CENTER, COUNSELOR, WORTHINGTON HIGH SCHOOL, AND CHILD PROTECTION NOBLES COUNTY COMMUNITY SERVICES. WITH THE ADDITIONAL FEEDBACK AND INPUT, IT WAS DECIDED TO OFFICIALLY EXTEND AN INVITE TO THOSE THE GROUP LISTED AND KICK OFF A TEEN PREGNANCY WORK GROUP WITH THE EXPANDED GROUP.IN MAY, SMOC FAMILY PLANNING PRESENTED TO THE SANFORD PATIENT AND FAMILY ADVISORY COUNCIL REGARDING THE NEW WORKGROUP AND PLANS TO MOVE FORWARD WITH REGULAR MEETINGS.OTHER FAMILY PLANNING PRIORITIES TOOK PRECEDENCE FOR THE REMAINDER OF 2022. THE WORKGROUP WILL RECONVENE IN 2023 TO DETERMINE THE NEXT STEPS FOR ADDRESSING TEEN PREGNANCY IN NOBLES COUNTY. SANFORD WORTHINGTON IS A WILLING AND ENGAGED PARTNER TO CONTINUE THIS IMPORTANT WORK. THERE IS MUCH ENTHUSIASM AMONG OTHER COMMUNITY PARTNERS TO CONTINUE MOMENTUM WITH TEEN PREGNANCY PREVENTION EFFORTS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:INCOME AND POVERTYPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGACCESS TO AFFORDABLE HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONCHILDCARE QUALITYLONG-TERM CARESANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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: ACCESS TO AFFORDABLE HEALTH CARE ACCESS TO AFFORDABLE, QUALITY 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 ACCESS TO AFFORDABLE HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EDUCATE THE COMMUNITY ON THE FULL SCOPE OF LOCALLY AVAILABLE SERVICES AND OFFER COMMUNITY EDUCATIONAL AND SCREENING EVENTS TO ENHANCE PREVENTATIVE CARE AND REDUCE OUT-OF-POCKET COSTS. IT IS SANFORD'S GOAL TO INCREASE THE PUBLIC EDUCATION ON THE PROMOTION OF SERVICES AVAILABLE IN SHELDON, REDUCING OUT-OF-POCKET COSTS DUE TO TRAVEL TIME AND TIME AWAY FROM THEIR EMPLOYMENT.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ENHANCE MARKETING AND PROMOTIONAL ACTIVITIES TO IMPROVE ACCESS AND TO PROMOTE VIRTUAL CARE TO AUGMENT ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE. IT IS SANFORD'S GOAL TO ENHANCE ACCESS TO CARE FOR RESIDENTS OF SHELDON AND THE SURROUNDING AREA.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HEALTH CARESANFORD SET TWO GOALS IN AN EFFORT TO INCREASE ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EDUCATE THE COMMUNITY ON THE FULL SCOPE OF SERVICES AVAILABLE LOCALLY. THE SECOND GOAL IS TO OFFER COMMUNITY EDUCATIONAL AND SCREENING EVENTS TO ENHANCE PREVENTATIVE CARE AND REDUCE OUT-OF-POCKET COSTS.SANFORD HEALTH LAUNCHED TWO CAMPAIGNS FOCUSING ON PRIMARY CARE IN THE CALENDAR YEAR 2022. "CARE CLOSE TO HOME" ADVERTISEMENTS WERE CREATED FOR ALL SANFORD CLINIC LOCATIONS AND UTILIZED WITHIN THE SHELDON MARKET. THE BOYDEN, SHELDON, SANBORN, HARTLEY, AND LAKE PARK CLINICS LISTED THEIR SPECIFIC HOURS AND AVAILABLE PROVIDERS WITHIN THE CAMPAIGN. "HERE FOR ALL. HERE FOR GOOD" WAS THE SECOND CAMPAIGN THAT WAS DIGITALLY LAUNCHED WITHIN THE SHELDON MARKET. DUE TO COVID POSITIVITY RATES SANFORD SHELDON DID NOT HOLD ANY IN HOUSE COMMUNITY EDUCATION EVENTS IN 2022. THE ORGANIZATION CONTINUED TO ASSIST O'BRIEN COUNTY PUBLIC HEALTH WITH VACCINE ASSISTANCE. IN CALENDAR YEAR 2022 APPROXIMATELY 130 INDIVIDUALS RECEIVED A VACCINE AT EVENTS. ADDITIONALLY, SANFORD SHELDON STAFF TRAVELED TO SIOUX CITY IA TO ASSIST WITH NATIONAL GUARD COVID TESTING FOR APPROXIMATELY 110 TROOPS THAT WERE BEING DEPLOYED.SANFORD SHELDON DID HOST HEART AND VASCULAR SCREENS WHICH CORRELATED WITH HEART MONTH IN FEBRUARY 2022 AT REDUCED COSTS FOR THE PATIENT.ACCESS TO HEALTH CARE PROVIDERSSANFORD SHELDON EXPANDED MENTAL HEALTH SERVICES IN JULY 2022 WITH THE ADDITION OF CYNTHIA KANTOS, INTEGRATED HEALTH THERAPIST. KANTOS BRINGS THE TOTAL NUMBER OF MENTAL HEALTH PROVIDERS AVAILABLE AT SANFORD SHELDON TO FIVE. CYNTHIA KANTOS JOINS JASON CHESTER, LISW AND STACEY JUMBECK PMHNP, APRN, CNP AS IN HOUSE PROVIDERS. MATTHEW EGGERS, DO AND MARK DANIELS, PHD PROVIDE MENTAL HEALTH SERVICES VIA TELEMED.IN ORDER TO PROVIDE ADDITIONAL CLINIC SERVICES TO PATIENTS IN NORTHWEST IOWA, SANFORD SHELDON BEGAN A CLINIC EXPANSION PROJECT WHICH WILL INCLUDE EIGHT ADDITIONAL EXAM ROOMS PLUS FOUR PROCEDURE ROOMS. ESTIMATED COMPLETION DATE IS JULY 2023.AS NOTED IN THE PREVIOUS GOAL, SANFORD HEALTH LAUNCHED TWO CAMPAIGNS FOCUSING ON PRIMARY CARE IN THE CALENDAR YEAR 2022. "CARE CLOSE TO HOME" ADVERTISEMENTS WERE CREATED FOR ALL SANFORD CLINIC LOCATIONS AND UTILIZED WITHIN THE SHELDON MARKET. THE BOYDEN, SHELDON, SANBORN, HARTLEY, AND LAKE PARK CLINICS LISTED THEIR SPECIFIC HOURS AND AVAILABLE PROVIDERS WITHIN THE CAMPAIGN. "HERE FOR ALL. HERE FOR GOOD" WAS THE SECOND CAMPAIGN THAT WAS DIGITALLY LAUNCHED WITHIN THE SHELDON MARKET. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONAFFORDABLE HOUSINGPUBLIC TRANSPORTATIONLONG-TERM CAREENVIRONMENTAL HEALTHSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: ACCESS TO AFFORDABLE HEALTH CAREACCESS TO AFFORDABLE, QUALITY 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 VERMILLION HAS MADE ACCESS TO AFFORDABLE HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ENSURE PATIENTS AND COMMUNITY PARTNERS ARE AWARE OF ITS FINANCIAL ASSISTANCE PROGRAM AND OTHER PROGRAMS AVAILABLE TO ELIGIBLE PATIENTS TO ASSIST WITH MEDICATIONS AND PREVENTATIVE CARE. IT IS SANFORD'S GOAL TO SEE LESS ACCOUNTS GOING TO COLLECTIONS OR WRITTEN OFF TO BAD DEBT AND A GREATER SHARE WRITTEN OFF TO OUR FINANCIAL ASSISTANCE PROGRAM. THERE ARE OTHER ASSISTANCE PROGRAMS FOR MEDICATIONS AND WOMEN'S PREVENTATIVE CARE THAT WE CAN HELP PATIENTS GET SIGNED UP FOR AS WELL.PRIORITY 2: HEALTH CARE ACCESS: MENTAL HEALTH/BEHAVIORAL HEALTHACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE HEALTH CARE ACCESS: MENTAL HEALTH/BEHAVIORAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE ALTERNATIVE VISIT TYPES AND TO ALLOW OPEN SCHEDULING AND EXPANSION OF WEEKEND HOURS. IT IS SANFORD'S GOAL TO OFFER THE ALTERNATIVE VISITS, ADDING OPEN SCHEDULING AND EXPANSION OF OUR WEEKEND HOURS, THUS ALLOWING GREATER ACCESS TO OUR PROVIDERS FOR THE COMMUNITY AND WILL ADVERTISE THESE SO THE COMMUNITY IS AWARE.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HEALTH CARESANFORD VERMILLION ESTABLISHED TWO GOALS TO SUPPORT IMPROVED ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST GOAL CENTERED ON BUILDING UPON CURRENT EFFORTS TO PROMOTE THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM TO REDUCE BAD DEBT AND INCREASE UTILIZATION BY POPULATIONS THAT WOULD BENEFIT. THE SECOND GOAL IS TO PROMOTE AWARENESS OF OTHER ASSISTANCE PROGRAMS FOR MEDICATIONS AND PREVENTATIVE CARE. ONE ILLUSTRATION OF THE NEED IS THROUGH THE 436 SEARCHES CONDUCTED WITHIN THE COMMUNITY ON THE FINDHELP PLATFORM IN 2022. OVER A QUARTER OF SEARCHES (28%) WERE FOR HEALTH-RELATED TOPICS WITH SEVERAL RELATED TO COST APPEARING ON THE MOST-SEARCHED LIST, INCLUDING "DISCOUNTED HEALTHCARE," "HELP PAY FOR HEALTHCARE, AND "MEDICAL BILLS."THE HOSPITAL PROVIDED A FINANCIAL ASSISTANCE PROGRAM PATIENT BROCHURE TO ALL ADMITTED PATIENTS IN 2022. THE PLAN IS TO DISPLAY THIS BROCHURE AT THE CENTRAL REGISTRATION AREA, CLINIC AND OUTPATIENT WAITING ROOMS. THE CLINIC PROVIDED THE BILLING OFFICE'S BUSINESS CARDS WITH THEIR PHONE NUMBER TO PATIENTS WHO WISHED TO CALL ABOUT THE FINANCIAL ASSISTANCE PROGRAM OR HAD OTHER BILLING INQUIRIES. FINANCIAL ASSISTANCE PACKETS WERE ALSO PROVIDED TO PATIENTS AS REQUESTED AT THE CLINIC. THE CLINIC ALSO HAS THE MEDDATA PATIENT BROCHURE IN THEIR LOBBY FOR PATIENTS TO ACCESS ON THEIR PROGRAM TO ASSIST WITH MEDICAL BILLS FOR UNINSURED AND/OR GAPS IN COVERAGE.THE CLINIC DIRECTOR ENSURED EDUCATION WAS PROVIDED AT ORIENTATION FOR STAFF AND PROVIDERS ON PATIENT ASSISTANCE PROGRAMS FOR MEDICATIONS AND PREVENTATIVE CARE SUCH AS NEEDYMEDS.COM AND ALL WOMEN COUNT. THE CLINIC HEALTH COACH AND NEW COMMUNITY HEALTH CARE WORKER (OCTOBER 2022) ASSISTED PATIENTS WITH ACCESSING THESE RESOURCES FOR THOSE APPLICABLE. THE FINANCIAL ASSISTANCE PROGRAM APPLICATION FORM IS AVAILABLE AT THE CLINIC OR HOSPITAL AND ON THE SANFORD WEBSITE FOR PATIENTS TO ACCESS. THE OTHER ASSISTANCE PROGRAMS ARE ALSO ON THE WEBSITE AND BROCHURES FOR EACH ARE IN THE CLINIC LOBBY AND ARE PROVIDED TO APPLICABLE PATIENTS. THE HOSPITAL HAS A LIST OF RESOURCES CREATED BY THE SOCIAL WORKER THAT IS REVIEWED WITH AND GIVEN TO APPLICABLE PATIENTS AT DISCHARGE. THE WRITE OFFS FOR BAD DEBT (ACCOUNTS SENT TO COLLECTIONS) IN 2022 DECREASED FROM 2021 BY OVER $389,000 WHICH WAS ONE OF THE GOALS. TOTAL WRITTEN OFF TO THE FINANCIAL ASSISTANCE PROGRAM IN 2022 WAS DOWN APPROXIMATELY $15,000 FROM 2021.CLINIC STAFF AND PROVIDERS HAVE ALSO PROMOTED DIRECT ACCESS LABS TO PATIENTS WHO MAY BENEFIT FROM THEM, SUCH AS THOSE WITH HIGH DEDUCTIBLES. FOR THESE LABS, PATIENTS CAN COME IN AND GET LAB SERVICES WITHOUT SEEING A PROVIDER AND PAY A REDUCED COST AT TIME OF SERVICE; NO INSURANCE IS BILLED. SANFORD VERMILLION IS ALSO LISTED AS A SITE ON SANFORD HEALTH'S WEBSITE THAT OFFERS DIRECT ACCESS LABS. IN 2021 VERMILLION CONDUCTED 77 DIRECT ACCESS LABS AND IN 2022 IT INCREASED TO 219.HEALTH CARE ACCESS: MENTAL HEALTH/BEHAVIORAL HEALTH TWO GOALS WERE ESTABLISHED VIA THE CHNA TO INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH; PROMOTE ALTERNATIVE VISIT TYPES TO INCREASE ACCESS-VERBAL, VIDEO, TELEHEALTH, AND DIRECT ACCESS LABORATORY VISITS AND ALLOW OPEN SCHEDULING AND EXPANSION OF WEEKEND HOURS.ALL BEHAVIORAL HEALTH VISITS WERE OPENED UP TO VIRTUAL VISITS AT THE END OF 2022. THE INTEGRATED HEALTH THERAPIST (IHT) OFFERS ALL VISIT TYPES INCLUDING IN-PERSON, VIDEO, TELEHEALTH, AND PHONE VISITS. THE OUTREACH PSYCHOLOGY PROVIDER WHO COMES TO VERMILLION OFFERS TELEHEALTH WHEN THERE'S INCLEMENT WEATHER AND THE OTHER MENTAL HEALTH COUNSELOR ONLY OFFERS IN-PERSON VISITS. THE NUMBER OF BEHAVIORAL/MENTAL HEALTH VISITS INCREASED AT THE CLINIC FROM 2,149 TO 2,412 IN 2022 COMPARED TO 2021. HOWEVER, THE NUMBER AND % OF CANCELED VISITS AND NO-SHOW APPOINTMENTS DID NOT DECREASE BUT REMAINED ABOUT 5%, IN LINE WITH THE INDUSTRY AVERAGE.BEHAVIORAL/MENTAL HEALTH PROVIDERS EACH HAVE A PAGE DESCRIPTION ON THE SANFORD CLINIC VERMILLION WEBSITE FOR PATIENTS TO ACCESS INFORMATION ABOUT THEM. THEY WERE ALSO FEATURED AND PROMOTED AT THE 4/12/22 DHF EVENING FOR WOMEN, "MENTAL HEALTH AND EMOTIONAL RESILIENCY." THE ALTERNATE VISIT TYPES ARE PROMOTED BY CLINIC STAFF AND PROVIDERS, THROUGH THE SANFORD WEBSITE, WITH OUR OUTREACH PROVIDER ADS AND WITH OUR MYCHART APP WHERE THEY CAN SELF-SCHEDULE APPOINTMENTS. THE ACCESSIBILITY FOR PATIENTS TO COME IN AND GET LABS ON THEIR OWN WITHOUT SEEING A DOCTOR THROUGH THE DIRECT ACCESS LABS WAS UTILIZED BY MORE PATIENTS IN 2022 WITH 219 LABS COMPLETED COMPARED TO 77 IN 2021.OPEN SCHEDULING OF APPOINTMENTS WAS AVAILABLE TO PATIENTS IN 2022 VIA THE MYCHART APP. FOR 2022, 6% OF OUR CLINIC APPOINTMENTS WERE SCHEDULED ONLINE BY SANFORD VERMILLION PATIENTS. UNFORTUNATELY, WEEKEND BEHAVIORAL HEALTH APPOINTMENTS WERE UNABLE TO BE OFFERED IN 2022.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:AFFORDABLE HOUSINGPUBLIC TRANSPORTATIONSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ADD ADDITIONAL MENTAL HEALTH RESOURCES IN THE COMMUNITY AND TO INCREASE ACCESSIBILITY TO MENTAL HEALTH CARE FOR YOUTH. IT IS SANFORD'S GOAL TO INCREASE MENTAL HEALTH COUNSELING AND SUBSTANCE ABUSE COUNSELING OPTIONS IN THE COMMUNITY. PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS SPECIALTY CAREACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.SANFORD HAS MADE ACCESS TO SPECIALTY HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE NEW SPECIALTY CARE SERVICES INCLUDING OPHTHALMOLOGY AND ORTHOPEDICS AND CREATE AWARENESS OF VIRTUAL CARE OPTIONS FOR SPECIALTY SERVICES. IT IS SANFORD'S GOAL TO PROVIDE ENHANCED ACCESS TO A VARIETY OF SPECIALTY CARE SERVICES IN THE COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH AND SUBSTANCE ABUSETHE SANFORD CHAMBERLAIN MEDICAL CENTER IS SUPPORTING THE PRIORITY THROUGH ITS GOAL OF ADDING ADDITIONAL MENTAL HEALTH RESOURCES TO THE COMMUNITY AND INCREASING ACCESSIBILITY FOR MENTAL HEALTH CARE FOR YOUTH, SPECIFICALLY, THROUGH ITS PARTNERSHIP WITH THE CHAMBERLAIN SCHOOL DISTRICT. THE SANFORD CHAMBERLAIN MEDICAL CENTER PROVIDES MENTAL HEALTH SERVICES AND SUBSTANCE ABUSE PREVENTION EDUCATION TO STUDENTS IN THE CHAMBERLAIN SCHOOL DISTRICT. MENTAL HEALTH SERVICES INCLUDE AN EMBEDDED LICENSED MENTAL HEALTH COUNSELOR WITHIN THE MIDDLE SCHOOL AND HIGH SCHOOL. THE COUNSELOR ALSO PROVIDES SERVICES TO THE ELEMENTARY SCHOOL. THE COUNSELOR IS IN THE ELEMENTARY SCHOOL ONE HALF DAY PER WEEK AND THE MIDDLE SCHOOL/HIGH SCHOOL ONE HALF DAY PER WEEK.SANFORD CHAMBERLAIN MADE PLANS TO PROVIDE YOUTH MENTAL HEALTH FIRST AID TRAINING TO THE CHAMBERLAIN COMMUNITY FOR THE FIRST TIME. THIS PROGRAM IS SCHEDULED TO TAKE PLACE IN FEBRUARY 2023. PLANS WERE DEVELOPED IN 2022 FOR ADDITIONAL SERVICES, INCLUDING LIFE AFTER LOSS, A WHOLE FAMILY GRIEF COUNSELING PROGRAM, WERE ALSO DEVELOPED AND ARE SCHEDULED TO START AS AN ONGOING PROGRAM BEGINNING IN JANUARY 2023.ACCESS TO HEALTH CARE PROVIDERS SPECIALTY CARESANFORD CHAMBERLAIN PRIORITIZED OPHTHALMOLOGY AND ORTHOPEDICS AS TWO SPECIALTIES FOR ADDITIONAL PROMOTION LOCALLY AS PART OF THE PRIORITY IN ADDITION TO INCREASED PROMOTION OF VIRTUAL CARE OPTIONS FOR THOSE THAT QUALITY BASED UPON THEIR NEEDED TYPE OF CARE. RESIDENTS OF THE THREE COUNTIES INCLUDED IN THE CHNA-DEFINED COMMUNITY CONDUCTED 326 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 19% FOR HEALTH-RELATED TOPICS.UNFORTUNATELY, SANFORD HAD TO CANCEL OPHTHALMOLOGY OUTREACH TO CHAMBERLAIN DUE TO PROVIDER AVAILABILITY. THE LOCAL MEDICAL CENTER IS EXPLORING OPTIONS FOR THE SERVICE DUE TO THE IDENTIFIED NEED FOR LOCAL CATARACTS SURGERY SERVICES. ORTHOPEDIC PROCEDURES WERE RE-ESTABLISHED LOCALLY IN NOVEMBER 2022 WITH CLINT BENGE, MD PROVIDING OUTREACH SERVICES. DR. BENGE IS AN ORTHOPEDIC SURGEON BASED IN SIOUX FALLS, SD AND OFFERS ACL RECONSTRUCTION, CARTILAGE RESTORATION, HIP ARTHROSCOPY, KNEE ARTHROSCOPY, MENISCAL REPAIR AND TRANSPLANTATION, AND SHOULDER ARTHROSCOPY AND ARTHROPLASTY.SANFORD CHAMBERLAIN, AND THE SYSTEM GENERALLY, UTILIZES TELE/VIRTUAL HEALTH AS AN OPTION TO AUGMENT SOME SERVICES THAT ARE PROVIDED IN THE LOCAL COMMUNITY. SANFORD CHAMBERLAIN SET A GOAL OF INCREASING THE PROMOTION OF TELE/VIRTUAL HEALTH TO INCREASE AWARENESS OF THE OPTION WITHIN THE COMMUNITY. THE FIRST INSTALLMENT OF TELEHEALTH EDUCATION WAS PRESENTED TO THE LOCAL ADVISORY BOARD IN OCTOBER 2022.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONSEXUAL ACTIVITYCOMMUNITY SAFETYCHILDCARE QUALITYAFFORDABLE HOUSINGPUBLIC TRANSPORTATION AND THE INTERNETSANFORD 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 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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND MENTAL HEALTH OPPORTUNITIES AND DECREASE SUBSTANCE ABUSE IN THE COMMUNITY. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE EXPANDED ACCESS TO MENTAL HEALTH SERVICES WITHIN THE COMMUNITY.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE ACCESS TO PRIMARY CARE AND EXPAND TELEHEALTH AND DENTAL ACCESS. IT IS SANFORD'S GOAL TO PROVIDE GREATER ACCESS TO CARE USING THE VISIT STYLE PREFERRED BY THE PATIENT. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD LUVERNE IS ADDRESSING THE PRIORITY WITH THE GOALS OF EXPANDING MENTAL HEALTH OPPORTUNITIES AND DECREASING SUBSTANCE ABUSE IN THE COMMUNITY. MENTAL HEALTH IS TOP OF MIND FOR AREA RESIDENTS AS COMMUNITY RESIDENTS CONDUCTED 289 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 19% ON HEALTH-RELATED TOPICS. "PSYCHIATRIC EMERGENCY SERVICES" APPEARED IN THE TOP FIVE MOST SEARCHED LIST.ROCK COUNTY VOTED AT END OF 2022 TO NOT RENEW THE CONTRACT WITH SW MENTAL HEALTH, THUS CREATING A NEED FOR MORE MENTAL HEALTH SERVICES IN ROCK COUNTY. THE LOCAL SANFORD TEAM MET WITH COUNTY LEADERSHIP TO DISCUSS TRANSITION AND SUBSEQUENTLY RECEIVED APPROVAL TO POST FOR A FULL TIME LICSW BEHAVIORAL HEALTH THERAPIST AND ARE CURRENTLY WAITING FOR APPLICATIONS.SANFORD'S CURRENT INTEGRATED HEALTH THERAPIST (IHT) HAS BEEN ACTIVELY ENGAGED WITHIN THE COMMUNITY THIS PAST YEAR. MENTAL HEALTH PROVIDERS ENGAGE THE 6TH GRADE CLASS OF 80-90 STUDENTS ON ISSUES SURROUNDING MENTAL HEALTH, INCLUDING MINDFULNESS, HEALTHY RELATIONSHIPS, SUBSTANCE USE, TAKING CARE OF YOUR BRAIN, BRAIN HEALTH BASICS, AND BULLYING. SANFORD'S IHT COORDINATES AND IS A PRESENTER. ALL LOCAL MENTAL HEALTH PROVIDERS MEET ONCE PER MONTH IN BRAIN HEALTH GROUP MEETINGS TO EXPLORE GAPS IN CARE, COMMUNITY ENGAGEMENT, AND AVAILABILITY. SANFORD'S IHT LEADS THESE MEETINGS OF APPROXIMATELY 20 INDIVIDUALS. THIS GROUP ORGANIZED AMERICAN FOUNDATION FOR SUICIDE PREVENTION CLASSES AND HAD APPROXIMATELY 20 PEOPLE BETWEEN THE TWO CLASSES.ORGANIZED BY SANFORD'S IHT, THE OUT OF THE DARKNESS SUICIDE PREVENTION WALK TOOK PLACE SEPT 2022 AND DREW 200-300 WALKERS.GOAL: SUBSTANCE ABUSESANFORD HEALTH HAS BEEN ACTIVELY INVOLVED IN THE COMMUNITY'S OPIOID GRANT WORK AS WELL AS WITH COMMUNITY EDUCATION. THROUGH THE OPIOID GRANT WORK, THERE HAVE BEEN TWO BILLBOARDS PUT UP WITHIN THE COMMUNITY FOR AWARENESS. IN ADDITION, ANGELA KENNECKE PRESENTED EMILY'S HOPE IN FEBRUARY 2022 AND THE 3RD GRADE HAD EMILY'S HOPE CURRICULUM PRESENTED. LOCAL SUBSTANCE USE COUNSELORS HAVE BEEN ACTIVELY INVOLVED WITH COMMUNITY EDUCATION EVENTS FOCUSING AROUND NARCAN TRAINING THROUGH THE STEVE RUMMLER HOPE FOUNDATION.ADDITIONAL EVENTS INCLUDE A JANUARY 6TH GRADE BRAIN HEALTH PRESENTATION ON SUBSTANCE USE AND ABUSE WITH 80 KIDS, A FEBRUARY OPIOID PANEL WITH 150 PEOPLE AT LUVERNE HIGH SCHOOL, SUBSTANCE USE AND ABUSE EDUCATION WITH 80 KIDS WITHIN LUVERNE HIGH SCHOOL HEALTH CLASSES, AN APRIL EDUCATION SESSION TO SANFORD LUVERNE LAB STAFF ON ADDICTION AND STIGMA WITH SEVEN PEOPLE, AND A WOMEN'S ECUMENICAL BRUNCH IN MAY WITH 100 PEOPLE COVERING EDUCATION, ADDICTION, AND FAITH.IN THE FALL, 100 PEOPLE ATTENDED AN OCTOBER PRESENTATION ON ADDICTION AND FAITH, 10 PEOPLE ATTENDED A SANFORD LUVERNE LUNCH AND LEARN ON ADDICTION AND STIGMA IN NOVEMBER, 15 LADIES ATTENDED ANOTHER NOVEMBER EVENT ON THE TOPIC WITH PINK LADIES SANFORD LUVERNE, AND 45 PEOPLE ATTENDED A COMMUNITY NALOXONE TRAINING IN DECEMBER.ACCESS TO HEALTH CARE PROVIDERSACCESS TO HEALTH CARE PROVIDERS IS ADDRESSED THROUGH INCREASING ACCESS TO FAMILY MEDICINE AND EXPANDING TELEHEALTH AND DENTAL ACCESS. DR. KAT DAHL JOINED THE LUVERNE FAMILY MEDICINE TEAM IN FEBRUARY 2022 TO EXPAND ACCESS AND HAS BUILT A FULL CASELOAD. IN THE FALL OF 2022, LUVERNE HAD A TRANSITION FROM ONE NURSE PRACTITIONER TO ANOTHER NURSE PRACTITIONER WHO ADDED AN ADDITIONAL DAY EVERY TWO WEEKS, PROVIDING GREATER ACCESS. ENCOUNTER NUMBERS CONTINUE TO INCREASE WITH THE EXPANDED ACCESS.AFTER HOURS CARE IS AVAILABLE THROUGH A VIRTUAL VISIT WITHIN THE MYCHART APP. AFTER HOURS ACUTE CARE IS NOT AVAILABLE AT LUVERNE, BUT PATIENTS CAN BE DIRECTED TO WORTHINGTON, ROCK RAPIDS, OR SIOUX FALLS. TELEHEALTH EXPANSION HAS BEEN MINIMAL THIS YEAR DUE TO LIMITED OFFERINGS. TELEPSYCH IS FREQUENTLY USED AND PRESENTLY HAS WAIT TIMES OF SEVERAL WEEKS. THIS AREA CONTINUES TO BE A FOCUS OF THE SYSTEM AND WILL EXPAND AS THE VIRTUAL HEALTH INITIATIVE GROWS.CLINIC PROVIDERS CONTINUE TO PARTNER WITH THE MOBILE DENTAL UNIT THAT COMES TO LUVERNE. THE MOBILE DENTAL UNIT COMES 1-2 DAYS PER MONTH. THE ORGANIZATION HAS ALSO PARTNERED WITH CARING HANDS CLINIC IN PIPESTONE FOR MEDICAID PATIENTS. HOWEVER, CARING HANDS NOW HAS A SEVERAL WEEK WAIT TIME.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONAFFORDABLE HOUSINGCHILDCARE/DAYCARE SERVICESSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 THIEF RIVER FALLS BEHAVIORAL HEALTH 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 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 MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO FOCUS ON TWO PRIMARY GOALS: EXPANDING AWARENESS OF THE SANFORD CANBY AMBULATORY CARE MANAGER'S ROLE IN MENTAL HEALTH AND PROVIDING AND/OR SUPPORTING MENTAL HEALTH RESOURCES TO AREA YOUTH. IT IS SANFORD'S GOAL TO MAKE THE COMMUNITY MORE AWARE OF MENTAL HEALTH RESOURCES THAT ARE AVAILABLE IN THEIR LOCAL COMMUNITY.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS ACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS TO PROVIDERS, SPECIFICALLY TO INCREASE ACCESS TO PRIMARY CARE PROVIDERS AND IMPROVE MARKETING AROUND SPECIALTY OUTREACH SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD FEEL EMPOWERED TO TAKE OWNERSHIP OF PREVENTATIVE HEALTH MAINTENANCE AND SEE PROGRESS TOWARDS AN OVERALL HEALTHIER POPULATION. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD CANBY SUPPORTS THIS PRIORITY THROUGH A DUAL FOCUS ON EXPANDING AWARENESS OF AMBULATORY CARE MANAGER'S ROLE IN MENTAL HEALTH WITHIN THE COMMUNITY AND PROVIDING MENTAL HEALTH RESOURCES TO AREA YOUTH. A TOTAL OF 91 MENTAL HEALTH APPOINTMENTS TOOK PLACE FOR THE 2022 YEAR.ONE OF THE TACTICS IDENTIFIED BY THE HOSPITAL ROLE TO INCREASE COMMUNITY AWARENESS LEVELS WAS TO PRESENT FOUR EDUCATION SESSIONS ANNUALLY ON THE ROLE OF THE AMBULATOR CARE MANAGER. THE AMBULATORY CARE MANAGER PRESENTED TO SEVERAL STAKEHOLDER GROUPS IN 2022 IN ORDER TO EXPAND AWARENESS OF HER ROLE IN MENTAL HEALTH. THE CANBY ROTARY CLUB (OCTOBER 13) DISCUSSED WHAT MENTAL HEALTH CONDITIONS ARE AND HOW TO RECOGNIZE THEM, IN ADDITION TO COMMUNITY RESOURCES AND LOCAL SERVICES. SANFORD CANBY'S PATIENT ADVISORY AND PATIENT AND FAMILY ENGAGEMENT COUNCIL RECEIVED A SIMILAR PRESENTATION ON APRIL 27. MENTAL HEALTH AMONG THE ELDERLY, INCLUDING SIGNS AND SYMPTOMS, WAS THE TOPIC FOR NOVEMBER 11 AND DECEMBER 6 PRESENTATIONS TO THE SYLVAN PLACE RESIDENT COUNCIL AND SYLVAN COURT FAMILY COUNCIL, RESPECTIVELY. THE DISCUSSION INCLUDED INFORMATION ON THE AVAILABILITY OF LOCAL RESOURCES. THE SEVEN MEMBERS OF THE SYLVAN COURT FAMILY COUNCIL ALSO REVIEWED A VIDEO ON DEPRESSION ON MARCH 7.MENTAL HEALTH EDUCATION WAS PROVIDED BY THE AMBULATORY CARE MANAGER TO SANFORD CANBY STAFF VIA AN ARTICLE IN THE AUGUST 2022 SANFORD CANBY EMPLOYEE NEWSLETTER ON THE 988 SUICIDE & CRISIS LIFELINE. THE SAME INFORMATION WAS ALSO POSTED ON SANFORD CANBY WELLNESS CENTER'S FACEBOOK PAGE ON OCTOBER 17, 2022. IN THE COMING YEAR, INFORMATION ON DEPRESSION/MENTAL HEALTH EDUCATION AND AWARENESS WILL BE PRESENTED TO THE EMR CANBY HIGH SCHOOL STUDENTS ON MAY 8, 2023. STAFF ALSO SUPPORTED THE NATIONAL NIGHT OUT FOR AREA YOUTH ON JULY 26, 2022. REHAB, WELLNESS CENTER, AND AMBULANCE STAFF MEMBERS FROM SANFORD CANBY PARTICIPATED IN THE EVENT.ACCESS TO HEALTH CARE PROVIDERSTO SUPPORT THE PRIORITY, THE HOSPITAL IS WORKING TO INCREASE PREVENTATIVE HEALTH AND WELLNESS VISITS AND EXPAND KNOWLEDGE AND AWARENESS OF SANFORD-PROVIDED SPECIALTY OUTREACH SERVICES AVAILABLE LOCALLY. YELLOW MEDICINE COUNTY RESIDENTS AND STAFF ENGAGED THE FINDHELP PLATFORM IN 2022 WITH 114 SEARCHES, 24% OF WHICH WERE FOR HEALTH-RELATED TERMS. SANFORD CANBY HAD A TOTAL OF 969 PREVENTATIVE CARE PROVIDER ENCOUNTERS IN 2022.SANFORD PROVIDERS CONDUCTED A NUMBER OF PUBLIC ENGAGEMENTS TO INTERACT WITH THE PUBLIC IN SUPPORT OF INCREASED PREVENTATIVE CARE VISITS. DR. AYBAR AND DR. LOPEZ WERE THE GRAND MARSHALLS OF THE CANBY HAT DAZE PARADE ON JUNE 18TH. A COMMUNITY RETIREMENT PARTY WAS HELD FOR DR. AYBAR AND DR. LOPEZ WITH SANFORD'S PA-C KAHLEY MEYER IN ATTENDANCE. DR. FUHRMAN, DR. AYBAR, DR. HANSON, AND MICHELLE DANIELSON, CNP PARTICIPATED IN ADDITIONAL COMMUNITY EVENTS THROUGHOUT THE YEAR. DR. FUHRMAN AND HANSON PARTICIPATED IN THE CANBY TRUNK OR TREAT ON OCTOBER 31, 2022, WHILE DRS. FUHRMAN AND DANIELSON PARTICIPATED IN THE CANBY HOMETOWN HOLIDAY PARADE IN DECEMBER. AYBAR AND HANSON PRESENTED A MATURATION CLASS AT CANBY ELEMENTARY SCHOOL ON APRIL 27. AYBAR PROVIDED WEIGHT CERTIFICATIONS FOR MINNESOTA HIGH SCHOOL WRESTLERS IN DECEMBER 2022.SANFORD CANBY IS EXPANDING ITS MARKETING OF DIRECT ACCESS LABORATORY TESTING. DIRECT ACCESS LABORATORY TESTING BROCHURES HAVE BEEN DISPLAYED AT THE SANFORD CANBY CLINIC FRONT DESK SINCE JANUARY 2022 AND WAS EXTENDED TO THE ELECTRONIC DISPLAY TV IN THE SANFORD CANBY CLINIC WAITING AREA IN FEBRUARY 2023. DIRECT ACCESS LABS RECEIVED $7,150 IN TESTING REVENUE IN 2022.A CAMPAIGN TO EXPAND AWARENESS OF SANFORD-PROVIDED SPECIALTY AND OUTREACH SERVICES STARTED IN 2023. EFFORTS INCLUDE POSTING ONE OUTREACH PROVIDER'S INFORMATION ON THE SANFORD CANBY WELLNESS CENTER FACEBOOK PAGE EACH MONTH BEGINNING MARCH 2023 AND THE SAME INFORMATION WILL BE DISPLAYED ON THE ELECTRONIC DISPLAY TV IN THE SANFORD CANBY CLINIC WAITING AREA. 2022 VOLUMES FOR SPECIALTY AND OUTREACH SERVICES INCLUDE UROLOGY 91, CARDIOLOGY 466, NEPHROLOGY 145, GASTROENTEROLOGY 177, PODIATRY 221, AND VASCULAR 49. ADDITIONAL EDUCATION TO SANFORD CANBY EMPLOYEES WILL TAKE PLACE VIA THE EMPLOYEE NEWSLETTER EACH MONTH BEGINNING IN APRIL 2023. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:AFFORDABLE HOUSINGEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ADVANCE INTEGRATED HEALTHCARE IN THE COMMUNITY AND TO INCREASE AWARENESS AND EDUCATION ON SUICIDE PREVENTION. IT IS SANFORD'S GOAL TO INCREASE THE NUMBER OF PATIENTS THAT SANFORD PROVIDES INTEGRATED HEALTH THERAPIST SERVICES TO IN THE JACKSON AREA. PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE COMMUNITY AWARENESS OF LOCAL PROVIDERS AND INCREASE ACCESS TO SPECIALTY CARE AT SANFORD JACKSON MEDICAL CENTER. IT IS SANFORD'S GOAL TO INCREASE AWARENESS OF PRIMARY CARE PROVIDERS AND SPECIALTY CARE.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD JACKSON IS WORKING ON THE GOALS OF ADVANCING INTEGRATED HEALTHCARE IN THE COMMUNITY AND INCREASING AWARENESS AND PROVIDING EDUCATION ON SUICIDE PREVENTION IN SUPPORT OF THE PRIORITY. SANFORD JACKSON MEDICAL CENTER'S INTEGRATED HEALTH THERAPIST (IHT) 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 MONTHLY TO DISCUSS BEHAVIORAL HEALTH ISSUES OF ALL AGES, AVAILABLE RESOURCES, AND THE IMPACT ON OUR COMMUNITY. THE IHT AND OTHER STAFF MEMBERS WERE ALSO INVOLVED IN A STRATEGIC PLANNING SUICIDE PREVENTION COHORT FACILITATED BY MINNESOTA DEPARTMENT OF PUBLIC HEALTH ALONGSIDE DES MOINES VALLEY HEALTH AND HUMAN SERVICES (PUBLIC HEALTH) AND VARIOUS OTHER LOCAL COMMUNITY STAKEHOLDERS. THIS SPECIFIC GROUP BEGAN MEETING MONTHLY IN SEPTEMBER 2021 AND CONTINUED TO DO SO THROUGH 2022 CALENDAR YEAR. THE GOAL OF THIS COHORT IS TO GAIN SKILLS TO DEVELOP A COMPREHENSIVE PLAN TO PRIORITIZE PREVENTION EFFORTS RELATED TO DEATH BY SUICIDE.IN MAY OF 2022 SANFORD JACKSON MEDICAL CENTER'S INTEGRATED HEALTH THERAPIST ALONG WITH A FAMILY NURSE PRACTITIONER COMPLETED A BEHAVIORAL HEALTH EDUCATION, AWARENESS AND RESPONSE DEVELOPMENT COURSE. THIS COURSE HELPS INCREASE KNOWLEDGE, SKILLS, AND CONFIDENCE TO SUPPORT PEOPLE WITH BEHAVIORAL HEALTH CONCERNS. ITS FOCUS IS TO ASSIST ATTENDEES TO SUPPORT PATIENTS STRUGGLING WITH A WIDE RANGE OF BEHAVIORAL HEALTH CONCERNS. IN 2022 SANFORD JACKSON MEDICAL CENTER SOUGHT TO MAINTAIN AND FILL OPEN INTEGRATED HEALTH THERAPIST POSITIONS. STAFF MEMBERS WORKED TIRELESSLY WITH SANFORD TALENT ADVISORS AND OTHER INTERNAL CONTACTS TO ATTRACT CANDIDATES AND MAINTAIN RELATIONSHIPS.SANFORD JACKSON MEDICAL CENTER STAFF IS A STRONG PRESENCE IN THE LOCAL POSITIVE COMMUNITY NORMS PROGRAM PATH, (POSITIVE ACTIONS TOWARDS HEALTH) BY ATTENDING MONTHLY AND OCCASIONAL BIMONTHLY MEETINGS. THE OVERALL GOAL IS TO CULTIVATE LASTING CULTURAL TRANSFORMATION BY INVOLVING THE STUDENTS, PARENTS, TEACHERS, AND THE ENTIRE COMMUNITY IN UNDERSTANDING NOT JUST WHAT IS CONCERNING, BUT ALSO WHAT IS HELPFUL. THEY ENCOURAGED ATTENDANCE TO MOTIVATIONAL SPEAKER, CORY GREENWOOD IN A FEBRUARY 18, 2022, PRESENTATION. THIS SPEAKER WAS BROUGHT TO OUR COMMUNITY AND SCHOOL SYSTEMS BY FUNDING PROVIDED BY PATH. ON DECEMBER 2, 2022, THE SANFORD JACKSON MEDICAL CENTER ADMINISTRATOR SIGNED THE STIGMA FREE RESOLUTION TO RECOGNIZE THE COMMUNITY NEEDS AND AGREE TO JOIN THE COLLABORATE CAMPAIGN AGAINST THE STIGMA OF MENTAL ILLNESS. SANFORD JACKSON MEDICAL CENTER WAS ESTABLISHED AS A STIGMA-FREE ZONE AND WILL CONTINUE TO HELP RAISE AWARENESS OF RESOURCES AND ENCOURAGE PATIENTS, RESIDENTS, AND FELLOW STAFF MEMBERS TO ENGAGE IN CARE AS SOON AS THE NEED IS IDENTIFIED SO RECOVERY CAN BEGIN.ACCESS TO HEALTH CARE PROVIDERSTO INCREASE ACCESS TO HEALTH CARE PROVIDERS, THE MEDICAL CENTER IS WORKING TO CREATE COMMUNITY AWARENESS OF PROVIDER OFFERING LOCAL CARE AND WORKING TO INCREASE SPECIALTY CARE ACCESS AT THE SANFORD JACKSON MEDICAL CENTER.TO INCREASE AWARENESS, SANFORD JACKSON MEDICAL CENTER PROVIDED BIOMETRIC SCREENINGS TO SIX AREA EMPLOYERS AND SCREENED 188 PEOPLE. THE RESULTS WERE GIVEN TO PATIENTS WITH INSTRUCTIONS TO FOLLOW UP WITH THEIR PRIMARY CARE PROVIDER (PCP) OR SEEK MEDICAL CARE IF ANY OF THE MEASURES FELL OUTSIDE OF THE NORMAL RANGE. ADDITIONALLY IN MARCH 2022 SANFORD JACKSON MEDICAL CENTER PARTICIPATED IN THE MARTIN COUNTY STAR HEALTH AND WELLNESS EDITION. THE MEDICAL CENTER PROVIDED A "HERE FOR YOUR HEALTH IN JACKSON" AD AND ARTICLE "WHEN SHOULD I FIND A PRIMARY CARE PROVIDER?" TO HELP GENERATE AWARENESS ABOUT THE IMPORTANCE OF HAVING A PCP. SANFORD JACKSON MEDICAL CENTER ALSO CONTINUED TO RECEIVE FEEDBACK AND COMMUNITY INPUT FROM BOTH OUR ADVISORY BOARD AND PATIENT ADVISORY BOARD. IN 2022 SANFORD JACKSON MEDICAL CENTER DESIGNED AND STARTED CONSTRUCTION ON A NEW STATE OF THE ART TELEHEALTH SUITE FOR AN IMPROVED TELEHEALTH EXPERIENCE. THE NEW TELEHEALTH SUITE IS EQUIPPED WITH A LARGE SCREEN TELEVISION, MICROPHONE, AND SPEAKERS TO ENHANCE OUR PATIENT'S TELEMEDICINE EXPERIENCE AT THE MEDICAL CENTER. THE ADDITION OF THE TELEHEALTH SUITE HAS IMPROVED THE QUALITY OF CARE FOR CURRENT TELEMEDICINE PATIENTS THAT WAS ALREADY TAKING PLACE WITH DR. EGGERS, A PEDIATRIC PSYCHIATRIST. IT ALSO PAVED THE WAY FOR EXPLORATION OF OTHER OPPORTUNITIES FOR TELEHEALTH PROVIDERS AND SPECIALTY SERVICES THAT ARE SCHEDULED TO BEGIN IN EARLY 2023. THOSE SERVICES CURRENTLY SCHEDULED TO BEGIN ARE VASCULAR HEALTH (MARCH) AND NEPHROLOGY (APRIL). IN 2022 WE ALSO SAW THE ADDITION OF AN UPGRADED ULTRASOUND MACHINE THAT IMPROVED THE ULTRASOUND OB/GYN CAPABILITIES LOCALLY, SO PATIENTS DID NOT HAVE TO TRAVEL TO RECEIVE THESE SCANS.SANFORD JACKSON MEDICAL CENTER WAS FORTUNATE TO ADD TWO TALENTED PROFESSIONALS TO ITS STAFF IN 2022. IN JANUARY OF 2022, KAITLIN JOHNSON ACCEPTED THE ROLE AS THE NEW SUPERVISOR OVER THERAPY AND REHABILITATION. KAITLIN BRINGS WITH HER A BACKGROUND THAT SPECIALIZES IN WOMEN'S HEALTH, PARKINSON'S, PEDIATRICS, GERIATRICS, CONTINENCE, POST-SURGERY, AS WELL AS SPORTS, AND ORTHOPEDIC INJURIES. SHE ALSO BRINGS WITH HER NEW THERAPIES THAT ARE NOW AVAILABLE LOCALLY SUCH AS DRY NEEDLING, CUPPING, TAPING, BALANCE THERAPY, MANUAL/HANDS ON THERAPY AND THE GRASTON TECHNIQUE. IN NOVEMBER OF 2022 SANFORD JACKSON MEDICAL CENTER INCREASED THEIR SURGICAL STAFF AND AVAILABLE SURGICAL SERVICES WITH THE ADDITION OF DR. RODNEY DYNES, MD. HE IS CURRENTLY PERFORMING COLONOSCOPIES, ENDOSCOPIES, VASECTOMIES, HEMORRHOIDECTOMY, AND LIPOMA REMOVALS, WITH PLANS TO EXPAND SERVICES IN 2023. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONHUMAN IMMUNODEFICIENCY VIRUS (HIV)ALCOHOL-RELATED DRIVING DEATHSAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE THE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE.SANFORD HEALTH TRACY HAS MADE PHYSICAL ACTIVITY AND NUTRITION SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO CONTINUE THE RN HEALTH COACH PROGRAM AND TO BEGIN A DIABETIC EDUCATION PROGRAM. IN ADDITION, SANFORD HAS DEVELOPED A STRATEGY TO PROVIDE AN ALTERNATIVE OPTION FOR THOSE COMMUNITY MEMBERS WHO ARE HUNGRY AND/OR LACKING FOOD OPTIONS. IT IS SANFORD'S GOAL TO PROVIDE A POSITIVE IMPACT ON PHYSICAL WELLBEING SPECIFICALLY RELATED TO OBESITY AND CHRONIC ILLNESS LIKE HIGH BLOOD PRESSURE AND DIABETES, AS WELL AS A POSITIVE IMPACT ON THE LACK OF NUTRITIONAL FOOD ACCESS.PRIORITY 2: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE SCREENING FOR DEPRESSION AND TO PROMOTE AND IMPROVE ACCESS TO SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE A LOWERED NUMBER OF MENTAL HEALTH DAYS FROM COMMUNITY MEMBERS AND A POSITIVE INCREASE IN AWARENESS OF MENTAL HEALTH SERVICES IN THE COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPHYSICAL ACTIVITY AND NUTRITIONSANFORD TRACY HAS THE GOAL OF USING THE RN HEALTH COACH AND DIABETIC EDUCATION PROGRAMS TO INCREASE AWARENESS OF DIABETES AND IMPROVE KEY MEASURES, SUCH AS A1C IN DIABETICS. SANFORD TRACY ALSO SEEKS TO SUPPORT COMMUNITY MEMBERS WHO ARE HUNGRY AND/OR LACK FOOD OPTIONS THROUGH A PANTRY LOCATION IN THE CLINIC.THE FOOD PANTRY PROGRAM BEGAN IN 2022 WITH SIX INDIVIDUALS/FAMILIES RECEIVING BOXES. DUE TO THE RESIGNATION OF BEHAVIORAL HEALTH ON-SITE STAFF IN 2022, THE PROGRAM SLOWED. IT IS MORE DIFFICULT FOR PCPS AND NURSES TO IDENTIFY THESE INDIVIDUALS AND FAMILIES IN NEED AT TIMES. THE ORGANIZATION IS EXPLORING OPTIONS TO RENEW THE PROGRAM IN 2023.REGARDING SANFORD'S RN HEALTH COACH, A1C IMPROVED QUARTERLY RATES FROM 16.6% IN Q1 2022 TO 14.4% IN Q4 OF 2022. HYPERTENSION CONTROL INCREASED FROM 84.3% IN Q1 2022 TO 87.5% IN Q4 2022. BMI DATA UNAVAILABLE DUE TO INACCURACIES IN DATA. PROVIDERS CONTINUE TO REVIEW BMI WITH PATIENTS, BUT DATA IS NO LONGER MONITORED OR MEASURED FOR QUALITY PURPOSES. THE DIABETIC EDUCATION PROGRAM STARTED 2022 SLOW DUE TO A MATERNITY LEAVE WITH STAFF. UPON RETURN IN APRIL, THE PROGRAM SAW 11 PATIENTS. COMMUNITY EDUCATION EVENTS WERE POSTPONED IN 2022 DUE TO THE MATERNITY LEAVE AND LIMITED AVAILABILITY OF STAFF. EDUCATION PROGRAMS ARE BEING CONSIDERED FOR 2023 BASED UPON STAFF AVAILABILITY.MENTAL HEALTHTHE PRIORITY WILL BE ADDRESSED BY SANFORD TRACY THROUGH TWO GOALS. THE FIRST GOAL IS TO INCREASE SCREENING FOR DEPRESSION AND REFERRALS TO BEHAVIORAL HEALTH SPECIALISTS. THE SECOND GOAL IS TO RAISE AWARENESS OF MENTAL HEALTH AND BEHAVIORAL HEALTH PROVIDERS AND SERVICES AT SANFORD TRACY.BEHAVIORAL HEALTH SCREENINGS AVERAGED APPROXIMATELY 68% FOR 2022. THE STRETCH GOAL IS TO ACHIEVE 100% SCREENING OF ALL PATIENTS TWELVE YEARS AND OLDER WITH A PRIOR HISTORY OF DEPRESSION OR ANXIETY. STAFF EDUCATION WILL CONTINUE TO HELP INCREASE THIS SCREENING NUMBER IN 2023. MENTAL HEALTH REFERRAL EFFORTS TO OUTSIDE PROVIDERS AND FACILITIES WERE PUT ON HOLD IN 2022 DUE TO THE RESIGNATION OF IN-HOUSE BEHAVIORAL HEALTH PROVIDERS AT SANFORD TRACY. THE STAFFING UPDATE ALSO PAUSED THE PROMOTION OF IN-HOUSE BEHAVIORAL HEALTH SERVICES FOR 2022. CURRENT UTILIZATION REMAINS LIMITED DUE TO AVAILABILITY CONSTRAINTS FROM HAVING ONE OUTREACH TELEMEDICINE PSYCHIATRIST. HOWEVER, THE PSYCHIATRIST SAW 197 PATIENTS VIA TELEMEDICINE VISITS IN 2022, AN INCREASE FROM 99 IN 2021.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE HEALTH CAREEMPLOYMENT AND ECONOMIC OPPORTUNITIESPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH SERVICES A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS, USE OF INTEGRATED HEALTH THERAPISTS AND IMPROVE SCREENING PROCEDURES. IT IS SANFORD'S GOAL TO REDUCE THE SEVERITY OF DEPRESSION THROUGH SCREENING AND CARE DELIVERY EFFORTS. PRIORITY 2: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTH CARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH HILLSBORO HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED A STRATEGY TO WORK IN COLLABORATION WITH CITY AND COUNTY LEADERSHIP TO EXPLORE OPTIONS FOR THE LOCAL COMMUNITY AND COUNTY MEMBERS. IT IS SANFORD'S GOAL TO IMPROVE THE AVAILABILITY OF PUBLIC TRANSPORTATION THROUGH BOTH THE PROMOTION OF CURRENT RESOURCES WITHIN THE HOSPITAL AND CLINIC SETTINGS, BUT ALSO IN WORKING TO ESTABLISH NEW RESOURCES THAT EXPAND OPPORTUNITIES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SERVICES SANFORD HILLSBORO HAS ESTABLISHED TWO GOALS FOR THE MENTAL HEALTH SERVICES PRIORITY. THE FIRST IS IMPROVING PHQ-9 SCORES FOR PATIENTS WITH DEPRESSION. THE SECOND IS TO PROVIDE FOR IMPROVED ACCESS TO MENTAL HEALTH/BEHAVIORAL HEALTH SERVICES. ALTHOUGH THE FINDHELP TOOL IS NOT SPECIFIC TO MENTAL HEALTH, RESIDENTS OF THE CHNA COMMUNITY CONDUCTED 298 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 29% ON HEALTH-RELATED TOPICS.SANFORD HILLSBORO HAD IMPLEMENTED INTEGRATED HEALTH THERAPISTS (IHTS) INTO THE CLINICS, PRIMARILY VIA TELEHEALTH, BUT THE IHT RESIGNED, AND THE ORGANIZATION IS IN THE PROCESS OF RECRUITING A REPLACEMENT. PATIENTS AND PROVIDERS FELT THAT THE PROGRAM WAS GOING WELL, AND IT IS USED QUITE FREQUENTLY.HILLSBORO'S GO LIVE FOR SENIOR LIFE SOLUTIONS OUTPATIENT GROUP THERAPY PROGRAM RESTARTED EARLY 2023 AND WE HAVE 4-10 PATIENTS PER DAY PARTICIPATING IN THE PROGRAM. THE SERVICE PREVIOUSLY OPERATED VIRTUALLY BEGINNING IN JANUARY 2021.TRANSPORTATIONSANFORD SEEKS TO ADDRESS TRANSPORTATION PRIORITIES BY PROVIDING A COMPREHENSIVE DIRECTION OF OPTIONS AVAILABLE WITHIN THE COUNTY. COMMUNITY RESIDENTS CONDUCTED 298 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 11% ON TRANSIT-RELATED TOPICS. SEARCH TERMS INCLUDE "HELP PAY FOR TRANSIT," "TRANSPORTATION, AND "HELP PAY FOR GAS."A LIST OF TRANSPORTATION OPTIONS IS AVAILABLE ACROSS THE COUNTY BY SANFORD HILLSBORO IN COORDINATION WITH TRAILL COUNTY. THE COMMUNITY HAS A BUS/VAN AVAILABLE FOR USE AND INDICATIONS ARE IT IS WELL-RECEIVED IN THE COMMUNITY. A LIMITATION TO THE PROGRAM IS DRIVER AVAILABILITY.SANFORD SUPPORTS THE USE OF VIRTUAL CARE AS AN ALTERNATIVE TO IN PERSON VISITS FOR SEVERAL TYPES OF CARE. AS SUCH, SANFORD HILLSBORO PROMOTES VIRTUAL CARE INCLUDING VIDEO VISITS, TELEHEALTH, AND E-VISITS TO PATIENTS AS APPROPRIATE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONACCESS TO QUALITY CHILDCARE AND AFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE THE SEVERITY OF DEPRESSION THROUGH USE OF INTEGRATED HEALTH THERAPISTS AND IMPROVE SCREENING PROCEDURES REDUCE MORTALITY AND MORBIDITY FROM MENTAL HEALTH AND BEHAVIORAL HEALTH AND SUBSTANCE ABUSE. IT IS SANFORD'S GOAL TO REDUCE THE SEVERITY OF DEPRESSION THROUGH SCREENING AND CARE DELIVERY EFFORTS.PRIORITY 2: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTH CARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH MAYVILLE HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED A STRATEGY TO WORK IN COLLABORATION WITH CITY AND COUNTY LEADERSHIP TO EXPLORE OPTIONS FOR THE LOCAL COMMUNITY AND COUNTY MEMBERS. IT IS SANFORD'S GOAL TO IMPROVE AVAILABILITY OF PUBLIC TRANSPORTATION THROUGH BOTH THE PROMOTION OF CURRENT RESOURCES WITHIN THE HOSPITAL AND CLINIC SETTINGS, BUT ALSO IN WORKING TO ESTABLISH NEW RESOURCES THAT EXPAND OPPORTUNITIES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SERVICESSANFORD MAYVILLE CHANGED TO USING THE PHQ2 FOR ALL PATIENT HEALTH QUESTIONNAIRE ON INITIAL APPOINTMENTS 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. SANFORD HILLSBORO WILL START THE SAME PROCESS IN QUARTER TWO OF 2023.SANFORD MAYVILLE HAD IMPLEMENTED INTEGRATED HEALTH THERAPISTS (IHTS) INTO THE CLINICS, PRIMARILY VIA TELEHEALTH, BUT THE IHT RESIGNED, AND THE ORGANIZATION IS IN THE PROCESS OF RECRUITING A REPLACEMENT. PATIENTS AND PROVIDERS FELT THAT THE PROGRAM WAS GOING WELL, AND IT IS USED QUITE FREQUENTLY.TRANSPORTATIONSANFORD SEEKS TO ADDRESS TRANSPORTATION PRIORITIES BY PROVIDING A COMPREHENSIVE DIRECTION OF OPTIONS AVAILABLE WITHIN THE COUNTY. COMMUNITY RESIDENTS CONDUCTED 298 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 11% ON TRANSIT-RELATED TOPICS. SEARCH TERMS INCLUDE "HELP PAY FOR TRANSIT," "TRANSPORTATION, AND "HELP PAY FOR GAS."A LIST OF TRANSPORTATION OPTIONS IS AVAILABLE ACROSS THE COUNTY BY SANFORD MAYVILLE IN COORDINATION WITH TRAILL COUNTY. THE COMMUNITY HAS A BUS/VAN AVAILABLE FOR USE AND INDICATIONS ARE IT IS WELL-RECEIVED IN THE COMMUNITY. A LIMITATION TO THE PROGRAM IS DRIVER AVAILABILITY.SANFORD SUPPORTS THE USE OF VIRTUAL CARE AS AN ALTERNATIVE TO IN PERSON VISITS FOR SEVERAL TYPES OF CARE. AS SUCH, SANFORD HILLSBORO PROMOTES VIRTUAL CARE INCLUDING VIDEO VISITS, TELEHEALTH, AND E-VISITS TO PATIENTS AS APPROPRIATE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONACCESS TO QUALITY CHILDCARE AND AFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE THE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE.SANFORD HAS MADE PHYSICAL ACTIVITY AND NUTRITION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE THE NUMBER OF PATIENTS ENGAGING WITH DIETICIANS TO IMPROVE NUTRITION AND TO CREATE A COMPREHENSIVE APPROACH TO CARE MANAGEMENT. IT IS SANFORD'S GOAL TO SEE IMPROVED HEALTH AND WELLNESS AND BETTER OVERALL MANAGEMENT OF CHRONIC DISEASES.PRIORITY 2: COMMUNITY SAFETYACCIDENTS AND VIOLENCE AFFECT HEALTH AND QUALITY OF LIFE IN THE SHORT- AND LONG-TERM, FOR THOSE BOTH DIRECTLY AND INDIRECTLY AFFECTED, AND LIVING IN UNSAFE NEIGHBORHOODS CAN IMPACT HEALTH IN A MULTITUDE OF WAYS. SANFORD HAS MADE COMMUNITY SAFETY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND LEVERAGE RESOURCES TO ADDRESS SUBSTANCE ABUSE ISSUES AND EXPAND ACCESS TO MENTAL HEALTH AND BEHAVIORAL HEALTH CARE. IT IS SANFORD'S GOAL TO INCREASE GREATER AWARENESS OF RESOURCES AVAILABLE TO MITIGATE COMMUNITY SAFETY ISSUES. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPHYSICAL ACTIVITY AND NUTRITIONSANFORD WEBSTER IS ADDRESSING THE PRIORITY THROUGH THE GOALS OF CREATING A COMPREHENSIVE APPROACH TO CARE MANAGEMENT AND INCREASING THE NUMBER OF PATIENTS ENGAGING WITH DIETICIANS TO IMPROVE NUTRITION. THE NEED FOR PHYSICAL ACTIVITY AND NUTRITION GOAL IS SHOWN THROUGH THE FINDHELP TOOL. IN 2022, 37% OF THE LOCAL SEARCHES ON FINDHELP WERE FOR FOOD-RELATED TOPICS.THE SANFORD WEBSTER MEDICAL CENTER HAD 173 DIETICIAN REFERRALS IN 2022. SANFORD STAFF PROMOTED DISEASE MANAGEMENT AND NUTRITION PROGRAMS WITHIN THE COMMUNITY THROUGHOUT THE YEAR TO GENERATE THE REFERRALS. MEDICAL STAFF WERE INVOLVED IN THE REFERRALS OF THESE PATIENTS TO MAKE SURE ACCESS TO NUTRITION AND PATIENT/COMMUNITY ENGAGEMENT WERE A TOP PRIORITY. THE SANFORD WEBSTER MEDICAL CENTER ENGAGED WITH 18-28 PATIENTS A MONTH WITH THE ORGANIZATION'S CHRONIC CARE MANAGEMENT PROGRAM. PROVIDERS REVIEW THE PLAN OF CARE AND THE NURSES LEADING THE PROGRAMS CONNECT WITH THE PATIENTS TO HELP IMPROVE OVERALL HEALTHCARE. THE COLLABORATION BETWEEN THE PATIENT, MEDICAL STAFF, AND NURSES INCREASED THE OVERALL PARTICIPATION IN THE PROGRAM. STAFF WERE ALSO ABLE TO REFER TO THE DIETICIAN AND CARE TEAM, CREATING GREATER OVERALL COMMUNITY ENGAGEMENT AND BETTER HEALTH WITHIN THE COMMUNITY.COMMUNITY SAFETYSANFORD WEBSTER SET TWO GOALS TO PROMOTE AND LEVERAGE RESOURCES TO ADDRESS SUBSTANCE ABUSE ISSUES AND EXPANDED ACCESS TO MENTAL HEALTH AND BEHAVIORAL HEALTH CARE TO IMPROVE COMMUNITY SAFETY.THE SANFORD WEBSTER MEDICAL CENTER PROVIDES ACCESS TO PSYCHIATRY SERVICES THROUGH TELEMEDICINE. THE WEBSTER MEDICAL STAFF WORK CLOSELY WITH DR. NUSS AND DR. EGGERS ON A FULL RANGE OF SERVICES INCLUDING SUBSTANCE ABUSE. THE WEBSTER CLINIC ASSISTED WITH 183 VISITS IN 2022 TO HELP ADDRESS SUBSTANCE ABUSE ISSUES WITHIN THE COMMUNITY. THE SANFORD WEBSTER MEDICAL CENTER PROVIDES ACCESS TO AN INTEGRATED HEALTH THERAPIST. THE ENGAGEMENT AND ACCESS ARE DRIVEN BY THE MEDICAL STAFF TO PROVIDE REFERRALS AND ACCESS INTO THIS SERVICE LINE. INTEGRATED HEALTH PROVIDERS HAD 222 IHT APPOINTMENTS IN 2022. INTEGRATED HEALTH THERAPISTS ARE AVAILABLE DURING CLINIC HOURS FOR AVAILABLE APPOINTMENT WITH DR. DANIELS. THE UTILIZATION AND ACCESS WERE IDENTIFIED AND HAS BEEN UTILIZED BY THE COMMUNITY AND MEDICAL STAFF.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 AND SUBSTANCE ABUSE MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS TO SERVICES. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO PSYCHOLOGY AND PSYCHIATRY AND TO EXPAND TELEHEALTH SERVICES. PRIORITY 2: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE THE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE.SANFORD HAS MADE PHYSICAL ACTIVITY AND NUTRITION SIGNIFICANT PRIORITIES HAS DEVELOPED STRATEGIES IMPROVE ACCESS TO NUTRITION AND TO PROMOTE AND SUPPORT OPPORTUNITIES FOR PHYSICAL ACTIVITY. IT IS SANFORD'S GOAL TO HAVE ADDITIONAL FOOD SOURCES AND AVAILABILITY FOR FOOD OPTIONS AND TO IMPROVE AND EXPAND COMMUNITY AREAS FOR PHYSICAL ACTIVITY.ADDRESSING OF SIGNIFICANT NEEDS DURING THE CURRENT YEARMENTAL HEALTH AND SUBSTANCE ABUSESANFORD MEDICAL CENTER WHEATON IS WORKING TO IMPROVE ACCESS TO SERVICES BY ADVANCING TELEHEALTH SERVICES, EXPANDING PSYCHOLOGY SERVICES, AND COORDINATING WITH GOVERNMENTAL ENTITIES TO EXPAND ACCESS WITHIN THEIR PROGRAMS AND FACILITIES. IN 2022, SANFORD WHEATON HAD 28 ADULT AND ONE PEDIATRIC BEHAVIORAL HEALTH REFERRALS FROM A PATIENT BASE OF 3,447. THE REFERRALS ALL OCCURRED VIA THE TELEHEALTH SERVICE. SANFORD WHEATON IS WORKING WORTH SANFORD HEALTH LEADERSHIP TO EXPLORE OPTIONS WITHIN THE ORGANIZATION FOR EXPANDED TELEHEALTH SERVICES WITH THIEF RIVER FALLS-BASED PROVIDERS AS PSYCHOLOGY CONTINUES TO BE A SERVICE WITH LIMITED LOCAL CAPACITY. SANFORD WHEATON CONTINUES TO WORK ON DEVELOPING PARTNERSHIP AND PLANNING WITH CURRENT PARTNERS TO FILL THE NEED WITHIN THE REGION AND COMMUNITY. FOR EXAMPLE, HORIZON PUBLIC HEALTH ALSO RECOGNIZES THE PRIORITY OF MENTAL CARE AND MENTAL ILLNESS AS A TOP PRIORITY IN THEIR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP).PHYSICAL ACTIVITY AND NUTRITIONSANFORD MEDICAL CENTER WHEATON SET TWO GOALS FOR THE PHYSICAL ACTIVITY AND NUTRITION PRIORITY. THE FIRST GOAL IS TO IMPROVE ACCESS TO NUTRITION THROUGH SUPPORT OF THE COMMUNITY BACKPACK PROGRAM. THE TOP FOUR SEARCHES FROM THE COMMUNITY ON FINDHELP WERE BASED UPON FOOD INSECURITY, INCLUDING "HELP PAY FOR FOOD," "FOOD DELIVERY," "FOOD PANTRY, AND "EMERGENCY FOOD." THE SECOND GOAL IS PROMOTING AND SUPPORTING OPPORTUNITIES FOR PHYSICAL ACTIVITY.SANFORD WHEATON PARTICIPATES IN THE LOCAL BACKPACK PROGRAM PROVIDING FOOD TO CHILDREN IN THE LOCAL SCHOOLS. THE PROGRAM PROVIDES FOOD FOR CHILDREN EVERY OTHER WEEKEND BY PLACING ENTREES, CEREAL, AND SNACKS IN THEIR LOCKER. THERE ARE 51 STUDENTS THAT PARTICIPATE IN GRADES K-12 OUT OF A TOTAL STUDENT BASE OF 359. SANFORD STAFF PACK AND DELIVER THE BAGS TO A VOLUNTEER AT THE SCHOOL.SANFORD WHEATON ALSO SUPPORTS DEVELOPMENT OF BALL PARKS IN THE COMMUNITY TO PROMOTE PHYSICAL ACTIVITY. IN SUPPORT, SANFORD HAS OFFERED $10,000 OVER THE NEXT 3 YEARS FOR THE BALLPARK IMPROVEMENT PROGRAM. THE HOSPITAL IS ALSO ACTIVELY PARTICIPATING IN AN ACTIVE TRANSPORTATION GRANT WITH THE MINNESOTA DEPARTMENT OF TRANSPORTATION, COLLABORATING WITH THE LOCAL CITY AND PARK BOARD. WE ARE ALSO EXPLORING HAVING AN OPEN TIME FOR THE HOSPITAL CARDIAC REHAB SPACE AND WORKING TOWARDS A HEALTHIER COMMUNITY.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN:ACCESS TO HEALTH CARE PROVIDERSEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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: ACCESS TO HEALTH CARE PROVIDERSACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE. SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON ACCESS TO AFFORDABLE, QUALITY HEALTHCARE WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS. THE FIRST GOAL IS TO HAVE INCREASED ACCESS TO PRIMARY AND SPECIALTY CARE AND THE SECOND GOAL IS TO HAVE INCREASED UTILIZATION OF TELEMEDICINE SERVICES.PRIORITY 2: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON BEHAVIORAL HEALTH SERVICES WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS. THE FIRST GOAL IS TO PROVIDE ADDITIONAL BEHAVIORAL HEALTH SERVICES WITHIN SANFORD BAGLEY. THE SECOND GOAL IS THE ASSESSMENT AND TREATMENT OF BEHAVIORAL HEALTH CONCERNS WITHIN PRIMARY CARE VISITS.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE PROVIDERSSANFORD BAGLEY HAS SET THE GOALS OF INCREASING ACCESS TO PRIMARY AND SPECIALTY CARE WITHIN THE COMMUNITY AND TO INCREASE UTILIZATION OF TELEMEDICINE SERVICES AS A CARE DELIVERY MECHANISM. RESIDENTS OF CLEARWATER COUNTY CONDUCTED 206 SEARCHES ON THE FINDHELP PLATFORM IN 2022. NEARLY 14% OF SEARCHES WERE FOR HEALTH-RELATED SUPPORT.EFFORTS PROGRESSED IN 2022 TO INCREASE PRIMARY AND SPECIALTY CARE WITHIN SANFORD BAGLEY CLINICS. DR. COLLEEN SWANK, MD BEGAN OFFERING PEDIATRIC CARE OUTREACH AT THE BAGLEY CLINIC ONE DAY A MONTH. DR. SWANK IS BASED IN BEMIDJI, MN. DR. SWANK HAD A TOTAL OF 18 PATIENTS SCHEDULED AND 13 VISITS COMPLETED. IN 2022, THE EPIC BUILD (PROGRAMMING NEEDED FOR SCHEDULING, DOCUMENTATION, AND BILLING) WAS COMPLETED FOR DERMATOLOGY SERVICES WITHIN THE BAGLEY CLINIC. IN DECEMBER 2022, DR. CHET MAINGI, EXPRESSED INTEREST IN PROVIDING OUTREACH DERMATOLOGY SERVICES AT THE BAGLEY CLINIC STARTING THE SPRING OF 2023. DR. MAINGI WILL BE AVAILABLE TO SEE PATIENTS APPROXIMATELY TWICE A MONTH.EFFORTS HAVE BEEN MADE TO PROMOTE UTILIZATION TELEHEALTH SERVICES FOR PRIMARY CARE APPOINTMENTS. SANFORD PROMOTED ON-DEMAND VISITS FOR PATIENTS IN 2022. THE SANFORD HEALTH PLAN PROMOTED ZERO DOLLAR ON-DEMAND URGENT CARE VIDEO VISITS 24 HOURS A DAY AND SEVEN DAYS A WEEK IN ADDITION PROMOTIONS CENTERED ON SCHEDULED VIRTUAL CARE APPOINTMENTS FOR PRIMARY CARE. THE PRIMARY CARE VIRTUAL VISITS ALLOWED EXISTING SANFORD PATIENTS TO VISIT WITH A PROVIDER IN THE PLACE OF A CLINIC VISIT. THIS OPTION WAS EXPANDED TO NOT ONLY SANFORD HEALTH PLAN PATIENTS, BUT TO ANYONE WHO WAS AN ESTABLISHED PATIENT. IN 2022, SANFORD BAGLEY CLINIC PROVIDERS HAVE BEEN TRAINED ON HOW TO CONDUCT TELEHEALTH VISITS AND EQUIPMENT WAS PROCURED (WEBCAMS-SPEAKERS). A TOTAL OF 212 TELEHEALTH VISITS WERE PERFORMED IN FAMILY MEDICINE, 17 TELEHEALTH VISITS FOR INTERNAL MEDICINE, AND 429 TELEHEALTH VISITS FOR BEHAVIORAL HEALTH.MENTAL HEALTHSIGNIFICANT WORK HAS BEEN PERFORMED IN 2022 TO INCREASE BEHAVIORAL HEALTH SERVICES AND SUPPORT IN THE SANFORD BAGLEY COMMUNITY. SANFORD CONTRACTED WITH A SENOR LIFE SOLUTIONS FOR BEHAVIORAL HEALTH SERVICES. SENIOR LIFE SOLUTIONS IS AN INTENSIVE OUTPATIENT GROUP THERAPY PROGRAM DESIGNED TO MEET THE NEEDS OF INDIVIDUALS TYPICALLY 65 AND OLDER, EXPERIENCING DEPRESSION OR ANXIETY RELATED TO LIFE CHANGES THAT ARE OFTEN ASSOCIATED WITH AGING. THE PARTICIPANTS MEET UP TO THREE TIMES PER WEEK IN A SUPPORTIVE, ENCOURAGING GROUP SETTING. THE SENIOR LIFE SOLUTION PROGRAM WAS ESTABLISHED IN 2022 AND BEGAN SEEING PATIENTS IN DECEMBER OF 2022. THE PROGRAM PERFORMED 27 THERAPY SESSIONS IN 2022.SANFORD BAGLEY CLINIC MADE DEPRESSION SCREENING AT ROUTINE PRIMARY CARE VISITS A FOCUS FOR 2022. DEPRESSION IS A SERIOUS MEDICAL ILLNESS ASSOCIATED WITH HIGHER RATES OF CHRONIC DISEASE, INCREASED HEALTH CARE UTILIZATION, AND IMPAIRED FUNCTIONING. SANFORD BAGLEY CLINIC DEPRESSION SCREENING RATE WAS AT 65.2% IN JANUARY 2022. A SCREENING RATE GOAL OF 87.4 % WAS ESTABLISHED AND STEADY PROGRESS WAS MADE THROUGHOUT THE YEAR TO MEET THIS TARGET. THE DEPARTMENT EXCEEDED THE GOAL IN NOVEMBER (87.7%) AND MET THE GOAL AGAIN IN DECEMBER (87.3%). THE DEPARTMENT WILL FOCUS ON MAINTAINING THIS AND THEIR STRETCH GOAL WILL CONTINUE TO BE 95%. DEPRESSION REMISSION AT 12 MONTHS WAS AT 17.56%. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:LONG-TERM CARE, NURSING HOMES, AND SENIOR HOUSINGAFFORDABLE HOUSINGCOMMUNITY SAFETY ACCESS TO AFFORDABLE HEALTH CAREPUBLIC TRANSPORTATIONACCESS TO QUALITY HEALTH CARESANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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: ACCESS TO AFFORDABLE HOUSINGTHERE IS A STRONG AND GROWING EVIDENCE BASE LINKING STABLE AND AFFORDABLE HOUSING TO HEALTH. AS HOUSING COSTS HAVE OUTPACED LOCAL INCOMES, HOUSEHOLDS NOT ONLY STRUGGLE TO ACQUIRE AND MAINTAIN ADEQUATE SHELTER, BUT ALSO FACE DIFFICULT TRADE-OFFS IN MEETING OTHER BASIC NEEDS. WHEN THE MAJORITY OF A PAYCHECK GOES TOWARD THE RENT OR MORTGAGE, IT CAN BE DIFFICULT TO AFFORD DOCTOR VISITS, HEALTHY FOODS, UTILITY BILLS, AND RELIABLE TRANSPORTATION TO WORK OR SCHOOL. THIS CAN, IN TURN, LEAD TO INCREASED STRESS LEVELS AND EMOTIONAL STRAIN. SANFORD HAS MADE ACCESS TO AFFORDABLE HOUSING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE HOUSING OPTIONS WHICH WOULD SEE AN INCREASE IN POPULATION AND ABILITY FOR CITIZENS TO AGE IN PLACE VERSUS MOVING OUT OF TOWN DUE TO NO OPTIONS. THIS WORK WILL PROVIDE A MUCH NEEDED ECONOMIC STIMULUS TO THE COMMUNITY, AS WELL AS INCREASED ACCESS TO AFFORDABLE HOUSING OPTIONS. IT IS SANFORD'S GOAL TO WORK WITH THE CANTON ECONOMIC DEVELOPMENT CORPORATION (CEDC) TO RECRUIT A DEVELOPER TO CANTON TO BUILD AFFORDABLE MULTI-FAMILY AND SINGLE-FAMILY HOMES.PRIORITY 2: ACCESS TO SENIOR LIVINGLONG-TERM CARE REFERS TO A BROAD RANGE OF SERVICES AND SUPPORTS TO MEET THE NEEDS OF FRAIL OLDER ADULTS AND OTHER PEOPLE WHO ARE LIMITED IN THEIR ABILITIES FOR SELF-CARE BECAUSE OF CHRONIC ILLNESS, DISABILITY, AGE, OR OTHER HEALTH-RELATED CONDITIONS. THESE SERVICES HELP PEOPLE LIVE AS INDEPENDENTLY AND SAFELY AS POSSIBLE WHEN THEY CAN NO LONGER PERFORM EVERYDAY ACTIVITIES ON THEIR OWN. CARE CAN BE PROVIDED IN THE HOME, A NURSING HOME, OR IN A VARIETY OF OTHER SETTINGS.SANFORD HAS MADE ACCESS TO SENIOR LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPLORE ADDITIONAL OPTIONS FOR SENIOR CARE, INCLUDING HOME-BASED CARE AND HOUSING ALTERNATIVES. IT IS SANFORD'S GOAL TO DO A HOME HEALTH FEASIBILITY STUDY AND EXPAND SENIOR HOUSING OPTIONS IN THE COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HOUSINGSANFORD CANTON-INWOOD MEDICAL CENTER SEEKS TO INCREASE ACCESS TO AFFORDABLE HOUSING THROUGH ITS MEMBERSHIP IN AND SUPPORT OF THE CANTON ECONOMIC DEVELOPMENT CORPORATION (CEDC). THE CEDC IS WORKING TO INCREASE THE NUMBER OF AFFORDABLE HOUSING AND CUSTOM-BUILT HOMES AVAILABLE IN THE COMMUNITY. AN EXAMPLE OF THE NEED IS SHOWN THROUGH THE SANFORD FINDHELP TOOL. RESIDENTS OF THE CHNA AREA, EXCLUDING SIOUX FALLS, HARRISBURG, AND TEA CONDUCTED 326 SEARCHES IN 2022 WITH HALF ORIGINATING FROM THE CANTON, SD ZIP CODE. HOUSING-RELATED TERMS WERE ONE-FOURTH OF ALL SEARCHES, WITH TERMS SUCH AS "HELP PAY FOR HOUSING AND "HOUSING VOUCHERS" COMMONLY USED.THE CANTON ECONOMIC DEVELOPMENT CORPORATION (CEDC) PURCHASED THE 64.12-ACRE PARCEL FROM THE CANTON INWOOD AREA HEALTH FOUNDATION ON SEPTEMBER 1, 2022. AN AGREEMENT WAS LATER SIGNED WITH EXP GROUP TO CREATE A LIMITED LIABILITY COMPANY (LLC) CALLED MONARCH DEVELOPMENT PARTNERS ON OCTOBER 17, 2022. THIS AGREEMENT WILL BRING EXP GROUP AND CANTON ECONOMIC DEVELOPMENT CORPORATION TOGETHER TO DESIGN A LAYOUT OF THE HOUSING DEVELOPMENT TO COVER MULTI-FAMILY AND SINGLE-FAMILY HOUSING IN ADDITION TO GREEN SPACES AND A BIKE/WALKING TRAIL. ENGINEERS ARE CURRENTLY CONDUCTING THE NECESSARY SURVEYS SO THAT THE ARCHITECT AND DESIGNER CAN MAP THE DEVELOPMENT. ONCE MAPPED, THE PROJECT WILL SEEK APPROVAL FROM THE CITY OF CANTON.AN AREA OF INTEREST TO THE ORGANIZATION IS LEGISLATION RECENTLY PASSED BY THE SOUTH DAKOTA LEGISLATURE. SB41 WILL PROVIDE $200 MILLION DOLLARS TO INFRASTRUCTURE PROJECTS, LIKE THE ONE TAKING PLACE IN CANTON. THE BILL HAS THE POTENTIAL TO SPEED UP THE PROJECT, SHOULD IT BE SELECTED AS PART OF THE PROCESS. ACCESS TO SENIOR LIVING SANFORD IS WORKING TO EXPAND ACCESS TO SENIOR LIVING THROUGH A COMBINED EFFORT OF EXPANDED LOCAL SENIOR HOUSING OPTIONS AND VIA POTENTIAL DEVELOPMENT OF HOME HEALTH SERVICES IN THE COMMUNITY. SANFORD CANTON PROVIDES HOME HEALTH SERVICES TO THE COMMUNITY ON AN AS-NEEDED BASIS. ADDITIONALLY, SANFORD HOME HEALTH AND COMMUNITY SERVICES IN SIOUX FALLS SENDS SANFORD NURSES TO CANTON PATIENTS WHO QUALIFY FOR AND NEED HOME HEALTH SERVICES. SANFORD CANTON CLINIC STAFF AND PROVIDERS ARE AWARE THAT HOME HEALTH IS AN OPTION IN CANTON FOR THOSE THAT QUALIFY.THE LOCAL RN CARE MANAGER FOR THE CANTON AND BERESFORD CLINICS PROVIDES ASSISTANCE TO MANY OF OUR CHRONIC PATIENTS AND ELDERLY THAT LACK THE RESOURCES TO PROVIDE THE NECESSARY TREATMENTS ON THEIR OWN. THE CARE MANAGER HELPS THEM FIND HOUSING, FOOD, AND UTILITY ASSISTANCE. ADDITIONALLY, SHE WORKS WITH DRUG COMPANIES TO GET MEDICATION VOUCHERS FOR PATIENTS AND WILL HELP PATIENTS GET SET UP ON THEIR DIABETIC TREATMENTS. THE CARE MANAGER WILL HELP MONITOR DIABETIC PATIENTS AND WILL PROVIDE EDUCATION TO PATIENTS AS NEEDED. SHE HAS SUPPORTED PROVIDERS IN THE CLINIC BY TAKING PATIENTS THAT ARE NOT ALWAYS COMPLIANT AT HOME AND NEED ADDITIONAL HELP. SHE HELPS PROVIDE SUPPORT AND HELPS NURTURE THEM SO THAT THEY CAN, AT SOME POINT, SUPPORT THEMSELVES IN THEIR OWN HOME.SANFORD CANTON-INWOOD HAS WHAT SANFORD CALLS THE RURAL HEALTH COOP. THE RURAL HEALTH COOP COMES TO CANTON ON MONDAYS FROM 11-1 P.M. TO HELP THOSE 18 AND OVER WITH NO INSURANCE, MEDICAID, OR MEDICARE. THEY HAVE TWO RN'S AND A PHARMACIST THAT ASSIST WITH THESE PATIENTS. THEY ALSO HAVE ACCESS TO A NURSE PRACTITIONER AND A DIETICIAN.WE CONTINUE TO EVALUATE OPTIONS TO EXPAND SENIOR CARE SERVICES IN THE COMMUNITY AS RESOURCES ALLOW.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREMENTAL HEALTH AND SUBSTANCE ABUSEPUBLIC TRANSPORTATION SANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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: ACCESS TO HEALTH CARE PROVIDERS/AFFORDABLE HEALTH CAREACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.ACCESS TO AFFORDABLE, QUALITY 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 HEALTH CLEAR LAKE HAS MADE ACCESS TO HEALTH CARE PROVIDERS AND AFFORDABLE HEALTH CARE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT AN ADDITIONAL PRIMARY CARE PROVIDER AND TO INCREASE ANNUAL WELLNESS VISITS. IT IS SANFORD'S GOAL TO INCREASE MEDICAL STAFF RESULTING IN INCREASED APPOINTMENT AVAILABILITY, AS WELL AS A GREATER PATIENT CHOICE IN PROVIDERS. PRIORITY 2: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTHCARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH CLEAR LAKE HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO DEVELOP A SUSTAINABLE PUBLIC TRANSPORTATION SERVICE IN THE CLEAR LAKE COMMUNITY AND TO ESTABLISH AN INFRASTRUCTURE IMPROVEMENT PLAN TO ALLOW FOR ENHANCED WALKABILITY IN THE CLEAR LAKE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE THE AVAILABILITY OF TRANSPORTATION OPTIONS FOR COMMUNITY MEMBERS UNABLE TO KEEP APPOINTMENTS DUE TO LACK OF PERSONAL TRANSPORTATION OPTIONS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE PROVIDERS/AFFORDABLE HEALTH CARESANFORD CLEAR LAKE MEDICAL CENTER IDENTIFIED A NEED FOR ADDITIONAL PRIMARY CARE AVAILABILITY AND INCREASED USE OF WELLNESS VISITS THROUGH ITS CHNA PROGRAM. TO ADDRESS THIS PRIORITY, SANFORD CLEAR LAKE SET THE GOALS OF RECRUITING TWO PRIMARY CARE PROVIDERS AND INCREASING WELLNESS VISITS BY 10% BY THE END OF 2024.SANFORD CLEAR LAKE WAS ABLE TO HIRE TWO NEW PRIMARY CARE ADVANCED PRACTICE PROVIDERS (APPS) IN THE LAST YEAR. AS A RESULT, THE CLINIC IS NOW STAFFED MONDAY THROUGH FRIDAY BY TWO PA-CS AND ONE CNP. ONE PROVIDER ALSO DOES OUTREACH SERVICES TO THE SANFORD CANBY CLINIC.TO INCREASE WELLNESS VISITS, SANFORD CLEAR LAKE IS WORKING INTERNALLY WITH THE ORGANIZATION'S MARKETING DEPARTMENT AND PHYSICIANS ON EXPANDED COMMUNITY CAMPAIGNS. DURING THE PAST YEAR, THE MARKETING DEPARTMENT COMPLETED VIDEOS ON ALL NEW PROVIDERS HIGHLIGHTING THEIR BIOGRAPHIES. THE VIDEOS ARE AVAILABLE ON SANFORDHEALTH.ORG. THE NEW PROVIDERS WERE INTRODUCED TO THE COMMUNITY THROUGH COORDINATED SOCIAL MEDIA AND NEWSPAPER CAMPAIGNS. THE NEW PROVIDER SOCIAL MEDIA POSTS SHOWED SIGNIFICANT ENGAGEMENT WITH OUR MARKET WITH HUNDREDS OF VIEWS AND SHARED VIDEOS. FOR REFERENCE, THE POPULATION OF DEUEL COUNTY, THE CHNA COMMUNITY, IS 1,220 AS PROVIDED IN THE CHNA REPORT. ADDITIONALLY, DEUEL COUNTY RESIDENTS CONDUCTED 67 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 13% FOR HEALTH-RELATED TOPICS.PROVIDER ENGAGEMENT WITH THE COMMUNITY INCLUDED OUTREACH TO THE CRYSTAL SPRINGS RODEO, THE ST PATRICK'S DAY PIE AUCTION, AND THE COMMUNITY'S THURSDAYS ON THIRD MUSIC NIGHT. TWO PROVIDERS ATTENDED THE DEUEL COUNTY COMMUNITY FOUNDATION'S TOUR OF TABLES IN OCTOBER 2022. ALL OF THESE ACTIVITIES PROMOTE PRIMARY CARE PROVIDERS ENGAGING WITH THE COMMUNITY.TRANSPORTATION SANFORD CLEAR LAKE ESTABLISHED TWO GOALS FOR THE PRIORITY, INCLUDING THE DEVELOPMENT OF A SUSTAINABLE PUBLIC TRANSPORTATION SERVICE FOR THE CLEAR LAKE COMMUNITY BY 2024 AND ESTABLISHING AN INFRASTRUCTURE IMPROVEMENT PLAN TO ALLOW FOR ENHANCED WALKABILITY IN THE CLEAR LAKE COMMUNITY. ONE IN TEN FINDHELP SEARCHES FROM THE COUNTY IN 2022 WERE TRANSIT-RELATED TOPICS. TRANSIT SEARCH TERMS INCLUDED "TRANSPORTATION FOR HEALTHCARE AND "HELP PAY FOR TRANSIT."UPON STUDY, THE DEUEL COUNTY COMMUNITY TRANSIT DETERMINED THAT RIDERSHIP WITHIN THE COMMUNITY OF CLEAR LAKE WAS LIMITED AND WOULD NOT SUPPORT A PUBLIC TRANSIT OPTION WITHIN THE CITY. AS SUCH, THE TRANSIT PROJECT WAS PUT ON HOLD AS NEXT STEPS ARE EVALUATED. SANFORD HEALTH DOES COORDINATE WITH A VOLUNTEER THAT CAN PROVIDE TRANSPORTATION TO COMMUNITY MEMBERS AND HOSPITALIZED PATIENTS BASED UPON THE VOLUNTEER'S SCHEDULE.THE MEDICAL CENTER PARTICIPATES IN THE HEALTHY HOMETOWN COMMITTEE. HEALTHY HOMETOWN IS A PROGRAM THAT ASSISTS COMMUNITIES IN IMPLEMENTING CHANGES THAT PROMOTE HEALTHY LIVING BY FOCUSING ON THREE AREAS; MOVE MORE, EAT WELL, AND FEEL BETTER. THE COMMITTEE IS WORKING WITH THE SOUTH DAKOTA DEPARTMENT OF TRANSPORTATION FOR A FLASHING CROSS WALK AND PAINTED BUMP OUTS AT HIGHWAY 15. THIS INTERSECTION IS A BUSY LOCATION WHERE MANY STUDENTS CROSS TO WALK TO AND FROM SCHOOL. INTERNALLY, SANFORD CLEAR LAKE HAD BUCKLED CONCRETE SIDEWALKS AROUND THE BUILDING THAT WERE REPAIRED IN THE SUMMER OF 2022 TO PROVIDE SAFER WALKING CONDITIONS FOR PATIENTS AND STAFF. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:MENTAL HEALTHAFFORDABLE HOUSING PHYSICAL ACTIVITY AND NUTRITIONSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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 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 HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH WESTBROOK HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND THE USE OF TELEMEDICINE AND IN-HOUSE MENTAL HEALTH SERVICES AND INCREASE THE NUMBER OF SCREENINGS AND REFERRALS TO BEHAVIORAL HEALTH PROVIDERS. IT IS SANFORD'S GOAL TO SEE A LOWERED NUMBER OF MENTAL HEALTH DAYS FROM COMMUNITY MEMBERS AND A POSITIVE INCREASE IN AWARENESS OF MENTAL HEALTH SERVICES IN THE COMMUNITY.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND OUTREACH SERVICES AND TO ADDRESS THE NEED FOR LIMITED ACCESS TO DENTAL CARE. REDUCE MORTALITY AND MORBIDITY FROM MENTAL HEALTH AND BEHAVIORAL HEALTH AND SUBSTANCE ABUSE. IT IS SANFORD'S GOAL TO INCREASE THE AVAILABILITY OF SPECIALTY SERVICES LOCALLY THROUGH OUTREACH AND/OR TELEHEALTH.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHTHE MENTAL HEALTH PRIORITY IS BEING ADDRESSED THROUGH EXPANDED USE OF CURRENT TELEMEDICINE AND IN-HOUSE MENTAL HEALTH SERVICES AND THE ADDITIONAL GOAL OF INCREASING THE NUMBER OF SCREENINGS AND REFERRALS TO BEHAVIORAL HEALTH PROVIDERS. SANFORD WESTBROOK BEHAVIORAL HEALTH PROVIDERS RESIGNED IN 2022. AS SUCH, PROMOTION OF IN-HOUSE PROVIDERS WAS PLACED ON HOLD UNTIL A SOLUTION IS DEVELOPED TO ADDRESS THE CAPACITY NEED. UTILIZATION HAS BEEN LIMITED TO ACCESS TO ONE OUTREACH TELEMEDICINE PSYCHIATRIST. THIS PSYCHIATRIST SAW 158 PATIENTS VIA TELEMEDICINE VISITS IN 2022: UP FROM 134 IN 2021. SIMILARLY, REFERRAL EFFORTS TO OUTSIDE PROVIDERS AND FACILITIES HAVE BEEN PUT ON HOLD.BEHAVIORAL HEALTH SCREENINGS AVERAGED APPROXIMATELY 80.73% FOR 2022. THE STRETCH GOAL IS TO ACHIEVE 100% SCREENING OF ALL PATIENTS TWELVE YEARS AND OLDER WITH A PRIOR HISTORY OF DEPRESSION OR ANXIETY. STAFF EDUCATION WILL CONTINUE TO HELP INCREASE THIS SCREENING NUMBER IN 2023.ACCESS TO HEALTH CARE PROVIDERSSANFORD WESTBROOK SET A GOAL OF EXPANDED OUTREACH SERVICES TO ADDRESS THE ACCESS NEED. THE HOSPITAL CONTINUES TO RECRUIT AN ORTHOPEDIC OUTREACH SPECIALIST AND AN ADDITIONAL GENERAL SURGEON. SANFORD WORTHINGTON DOES HAVE A POSSIBLE ORTHOPEDIC AND GENERAL SURGEON THAT MAY BEGIN OUTREACH SERVICES AT SANFORD WESTBROOK IN 2023. OUTREACH TELEHEALTH APPOINTMENTS CONTINUE TO BE OFFERED WITH 2022 SEEING SEVEN ONCOLOGY TELEMED VISITS (UP FROM 0 IN 2021); 87 NEPHROLOGY TELEMED VISITS (UP FROM 79 IN 2021); FIVE INFECTIOUS DISEASE TELEMED VISITS (DOWN FROM 12 IN 2021) AND 158 PSYCH TELEMED VISITS (UP FROM 134 IN 2021). THE GOAL OF ADDRESSING THE NEED FOR LIMITED ACCESS TO DENTAL CARE, MEETINGS WITH SCHOOL PROGRAM DIRECTORS AND SCHOOL NURSE WAS COMPLETED IN 2022. THE APPLICATION AND A SUCCESSFUL RECEIPT OF A MDH COMMUNITY CLINIC GRANT TO FUND THE WESTBROOK WALNUT GROVE ELEMENTARY AND JUNIOR HIGH SCHOOLS DENTAL HEALTH PROGRAM WERE ALSO COMPLETED IN 2022. BY SEPTEMBER, THE SUPPLIES FOR THE PROGRAM WERE PURCHASED, WHICH INCLUDE TOOTHBRUSHES, TOOTHPASTE, FLOSSERS, AND FLUORIDE RINSES THAT STUDENTS RECEIVE EVERY MONTH. DENTAL EDUCATION INFORMATION FOR PROVIDERS WAS SHARED AT PROVIDER MEETINGS IN 2022. PROVIDERS AND CLINIC NURSES SHARE DENTAL INFORMATION WITH PARENTS AT ALL WELL CHILD VISITS, AS WELL AS OFFER FLUORIDE VARNISH IF APPROPRIATE AT WELL CHILD VISITS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:COMMUNITY SAFETYENVIRONMENTAL HEALTHAFFORDABLE HOUSINGPUBLIC TRANSPORTATIONPHYSICAL ACTIVITY AND NUTRITIONEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD 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 AND STAKEHOLDERS.
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 HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 6A: SANFORD 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 BEHAVIORAL HEALTH 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-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CAREACCESS TO AFFORDABLE, QUALITY 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. NDSU REPORTED HEALTH CARE ACCESSIBILITY AND COST AS TWO SEPARATE HEALTH NEEDS. THE CASS-CLAY WORKING GROUP DETERMINED THAT THE TWO TOPICS ARE MOST APPROPRIATELY ADDRESSED AS A COMBINED TOPIC FOR PURPOSES OF THE LOCAL CHNA PROCESS.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND HEALTHCARE ACCESS AND ACCESS TO PRIMARY CARE SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE THAT PATIENTS WILL HAVE GREATER EASE TO ACCESS PRIMARY CARE PROVIDERS FOR VIRTUAL OR IN-PERSON VISITS, HOME VISITS AND INCREASED EXPANDED HOURS. PATIENTS MAY EXPERIENCE LESS FREQUENT UTILIZATION OF EMERGENCY CARE, WHICH IS OFTEN MORE EXPENSIVE THAN PREVENTATIVE AND SCREENING SERVICES.PRIORITY 2: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT PROVIDERS, INCREASE ACCESS TO CARE AND MENTAL HEALTH PROMOTION. IT IS SANFORD'S GOAL TO HAVE BETTER ACCESS TO AND UTILIZATION OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES DUE TO SERVICES BEING PROVIDED AT THE RIGHT TIME AND RIGHT PLACE. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: ACCESS TO AFFORDABLE HEALTH CARESANFORD FARGO ESTABLISHED TWO GOALS IN SUPPORT OF THE PRIORITY, ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EXPAND HEALTHCARE ACCESS AND SUPPORT RESOURCES FOR VULNERABLE AND UNDERSERVED POPULATIONS. THE SECOND IS TO EXPAND PLATFORM AND ACCESS TO PRIMARY CARE SERVICES.ONE STRATEGY IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROGRAM IS TO MAKE VIRTUAL VISITS AVAILABLE FOR ALL PRIMARY CARE PROVIDERS. AS OF THE END OF 2022, ACCESS TO TELEHEALTH IS AVAILABLE FOR ALL FAMILY MEDICINE PROVIDERS, WHICH ALLOWS PATIENTS TO RECEIVE CARE WITHIN THEIR HOMES IF THEY DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION OR CANNOT TRAVEL FOR APPOINTMENTS. TO INCREASE PRIMARY CARE AVAILABILITY, THE FAMILY MEDICINE RESIDENCY PROGRAM HAS BEGUN OUTREACH TO JEFFERSON ELEMENTARY (FARGO PUBLIC SCHOOLS) AND WILL BE EXPANDING TO YOUTHWORKS. JEFFERSON ELEMENTARY HAS APPROXIMATELY 288 STUDENTS, 231 OF WHICH ARE ELIGIBLE TO PARTICIPATE IN THE FREE LUNCH AND REDUCED-PRICE LUNCH PROGRAMS, ACCORDING TO THE NATIONAL CENTER FOR EDUCATION STATISTICS. YOUTHWORKS IS A "501C3 NON-PROFIT DEDICATED TO PROVIDING YOUTH AND FAMILY SERVICES THROUGHOUT NORTH DAKOTA. THEIR FOCUS AND EXPERTISE IS IN WORKING WITH TEENS, PARENTS, AND YOUNG ADULTS UNDER 22 YEARS OF AGE. OUR SERVICES INCLUDE PROGRAMS FOR RUNAWAY, HOMELESS AND STREET YOUTH; JUVENILE OFFENDERS; YOUTH FAILING IN SCHOOL; YOUTH SUSPENDED OR EXPELLED FROM SCHOOL; YOUNG PARENTS AND PREGNANT MOMS (UNDER 22); YOUTH ARRESTED AND UNABLE TO IMMEDIATELY RETURN HOME; YOUTH NEEDING EMERGENCY CARE; YOUTH NEEDING PEER SUPPORT OR CROSS-AGE MENTORING; AND YOUTH WITH ANGER ISSUES." THIS STRATEGY WILL HELP IMPROVE ACCESS FOR VULNERABLE AND UNDERSERVED RESIDENTS OF THE FARGO/MOORHEAD METRO AREA.A NEW PRIMARY CARE CLINIC IS UNDER CONSTRUCTION IN HORACE, ND AND IS SET TO OPEN IN 2023. THIS WILL SERVE THE NEEDS OF THE RAPIDLY GROWING TOWN OF HORACE AS WELL AS PORTIONS OF WEST FARGO TO ALLOW FOR INCREASED SPEED OF ACCESS TO INDIVIDUALS ACROSS ALL CLINICS. THREE NEW PROVIDERS WERE RECRUITED TO PRIMARY CARE. THE NEW PROVIDERS TOTALED 148 VISITS UPON STARTING IN THE FOURTH QUARTER OF 2022.MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE THREE GOALS SUPPORT THE MENTAL HEALTH AND SUBSTANCE ABUSE GOAL. THE FIRST IS RECRUITING PROVIDERS AND INCREASING ACCESS TO CARE. THE SECOND IS TO DEVELOP A COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION. THE THIRD IS TO DECREASE SUBSTANCE ABUSE.TO INCREASE ACCESS TO MENTAL HEALTH CARE, SANFORD FARGO EXPANDED ITS PARTNERSHIP WITH REGIONAL SCHOOLS TO PROVIDE STUDENT PLACEMENT FOR MASTER'S LEVEL THERAPISTS INTO THE INTERNAL MEDICINE DEPARTMENT. COORDINATION OF CARE WITH PRIMARY CARE, EMERGENCY DEPARTMENT, AND HOSPITAL CARE COORDINATION HAS RESULTED IN THE WAIT LIST FOR BEHAVIORAL HEALTH AND PSYCHIATRY APPOINTMENTS DECREASING FROM 2,000 PATIENTS TO 180 PATIENTS WAITING TO BE SCHEDULED. FURTHERMORE, ACCESS TO SUPPORTIVE BEHAVIORAL HEALTH SERVICES AND RESOURCES HAVE IMPROVED IN THE HOSPITAL WITH THE CREATION OF A DEDICATED UNIT AT THE SANFORD MEDICAL CENTER FARGO FOR PATIENTS ADMITTED FOR MEDICAL CARE WHO REQUIRE ADDITIONAL BEHAVIORAL HEALTH SUPPORT. IN 2022, SANFORD FARGO COMPLETED 10,083 COMPLETED VIDEO VISITS, 144 TRADITIONAL TELEMEDICINE AND 90 VERBAL VISITS.SANFORD FARGO CONDUCTED A DEPRESSION SCREENING INITIATIVE THROUGHOUT SANFORD-FARGO CLINICS TO SUPPORT COMMUNITY MENTAL HEALTH PROMOTION. THE PROMOTION RESULTED IN 40,000 DEPRESSION SCREENINGS COMPLETED BY INTERNAL MEDICINE, FAMILY MEDICINE, AND OB/GYN PROVIDERS AND RESIDENCY CLINICS. FOR ALL POSITIVE DEPRESSION SCREENINGS, THERE WAS A DOCUMENTED FOLLOW-UP PLAN WITHIN 14 DAYS OF THE SCREENING. SANFORD AMBULANCE REPORTED 1,200 PATIENTS RECEIVING CARE RELATED TO ALCOHOL USE, 1,350 RELATED TO BEHAVIORAL HEALTH/PSYCHIATRIC EPISODE. SANFORD FARGO IS ACTIVELY RECRUITING A NEW PROVIDER TO SUPPORT SUBOXONE CLINIC FOR PATIENTS WORKING ON ADDICTION AND RECOVERY TO DECREASE SUBSTANCE ABUSE. FURTHER SUPPORT IS PROVIDED THROUGH HOSPITAL PEER COACHING, WITH CONTINUED WORK WITH F5 AND THE LOTUS CENTER THROUGHOUT 2022 TO PROVIDE PEER COACHING IN THE HOSPITAL. SANFORD FARGO ALSO ENGAGES IN A PARTNERSHIP WITH CASS COUNTY'S WITHDRAWAL MANAGEMENT UNIT TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONSENIOR HOUSING AND LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSING, EMPLOYMENT, ECONOMIC DEVELOPMENTDIVERSITY, INCLUSION, HEALTH EQUITYCHILDCAREHEALTH LITERACY AND NAVIGATIONSANFORD 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 AND STAKEHOLDERS.
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
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 5: SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 6A: SANFORD USD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 7D: SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA 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 HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR MENTAL HEALTH PROMOTION, SUICIDE PREVENTION AND EDUCATION FOR PARENTING RELATED SKILLS. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES, IN PARTICULAR FOR AT RISK YOUTH AND TO DECREASE THE NUMBER OF SUICIDES.PRIORITY 2: ACCESS TO HEALTHCARE PROVIDERSACCESS TO AFFORDABLE, QUALITY 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 ACCESS TO HEALTHCARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO DEVELOP A FULLTIME DERMATOLOGY CLINIC AND TO EXPAND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH. IT IS SANFORD'S GOAL TO INCREASE THE NUMBER OF LOCAL PROVIDERS SERVICING THIEF RIVER FALLS THROUGH LOCALLY BASED PROVIDERS, OUTREACH FROM OTHER SANFORD FACILITIES, OR TELEHEALTH/VIRTUAL CARE PLATFORMS. INCREASED PROVIDERS WILL EXPAND THE NUMBER OF AVAILABLE SERVICES AND APPOINTMENTS AVAILABLE TO THE LOCAL COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SANFORD THIEF RIVER FALLS AND SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER ESTABLISHED TWO GOALS WITHIN THE MENTAL HEALTH PRIORITY. THE FIRST IS TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION. THE SECOND GOAL IS TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS.IN LATE 2021, AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION, SANFORD BEHAVIORAL HEALTH IDENTIFIED A CORE TEAM OF STAFF AND DEVELOPED A STRATEGY TO GROW A COMMUNITY COALITION FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION IN OUR COMMUNITY. IN JANUARY OF 2022, SANFORD BEHAVIORAL HEALTH BEGAN MEETING MONTHLY WITH COMMUNITY PARTNERS FROM TEN PUBLIC AND PRIVATE ENTITIES INCLUDING PUBLIC HEALTH, LAW ENFORCEMENT, FAITH COMMUNITY, EDUCATION, EMPLOYERS, HEALTH CARE, AND YOUTH ACTIVITIES. OVER THE PAST YEAR, SIX ADDITIONAL PARTNERS WERE ADDED, INCLUDING SCHOOL COUNSELORS, VIP, ADDITIONAL SCHOOL DISTRICT, MENTAL HEALTH PROVIDER, HIGH SCHOOL STUDENT, AND A SUICIDE LOSS SURVIVOR. THROUGHOUT THE YEAR, THIS GROUP BECAME KNOWN AS "COMMUNITY STRONG," DEFINED OUR COMMUNITY AS PENNINGTON COUNTY, AND IDENTIFIED OUR FOCUS ON YOUTH AND FAMILY EDUCATION. COMMUNITY STRONG ESTABLISHED A VISION STATEMENT TO BE "A COMMUNITY THAT STRIVES, PROMOTES AND SEEKS OUT MENTAL AND EMOTIONAL WELLBEING AND A MISSION STATEMENT "TO EMPOWER A HEALTHY COMMUNITY IN PENNINGTON COUNTY THROUGH EDUCATION, OUTREACH AND SUPPORT THAT RESHAPES THINKING AND AWARENESS AROUND MENTAL WELL-BEING AND SUICIDE PREVENTION." IN 2022, IN PARTNERSHIP WITH COMMUNITY STRONG, SANFORD BEHAVIORAL HEALTH PROVIDED FOUR EDUCATIONAL EVENTS IN PENNINGTON COUNTY, WITH ADDITIONAL OUTREACH EVENTS.IN EARLY 2022, SANFORD BEHAVIORAL HEALTH IDENTIFIED KEY PERSONNEL TO DEVELOP A STRATEGY FOR IMPLEMENTING PARENTING RELATED SKILLS IN THE COMMUNITY AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS. IN MAY OF 2022, SANFORD BEHAVIORAL HEALTH USED ESTABLISHED RELATIONSHIPS THROUGH THE JUVENILE DIVERSION PROGRAM TO IDENTIFY PARTNERS WHO COULD JOIN IN THE EFFORT TO IMPLEMENT AND PROMOTE THIS TYPE OF EDUCATIONAL GROUP FOR PARENTS. THROUGH WORK WITH THE TRF POLICE DEPARTMENT, PENNINGTON COUNTY SOCIAL SERVICES, PENNINGTON COUNTY COURT AND COUNTY ATTORNEY, AND TRF SCHOOL DISTRICT, IT WAS IDENTIFIED THAT THE INITIAL TARGETED POPULATION OF THIS PARENTING SKILLS EDUCATION WOULD BE PARENTS OF CHILDREN IN THE JUVENILE DIVERSION PROGRAM, OR THOSE THAT THE AGENCIES INVOLVED ARE IDENTIFYING AS ESCALATING IN CRIMINAL JUSTICE SYSTEM AND AT AN INCREASED NEED FOR SERVICES. IN LATE MAY, THE CURRICULUM TO BE USED WAS IDENTIFIED AS THE INCREDIBLE YEARS AND LOVE & LOGIC CURRICULUM. FACILITATORS WERE ALSO IDENTIFIED FROM SANFORD BEHAVIORAL HEALTH AND PENNINGTON COUNTY SOCIAL SERVICES. THE FIRST SIX-WEEK SESSION OF THE PARENTING SKILLS GROUP BEGAN IN OCTOBER OF 2022 WITH SIX FAMILIES COMPLETING THE TRAINING.ACCESS TO HEALTHCARE PROVIDERSTWO GOALS WERE ESTABLISHED TO SUPPORT THE PRIORITY, INCLUDING THE DEVELOPMENT OF A FULLTIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, AND EXPANDING THE PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH.TO SUPPORT THE GOAL OF DEVELOPING A FULL-TIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, SANFORD HEALTH TRF HIRED A FULL-TIME DERMATOLOGY NURSE PRACTITIONER IN APRIL OF 2021. THE DERMATOLOGIST STARTED IN THIEF RIVER FALLS AFTER SIX MONTHS OF TRAINING WITH A DERMATOLOGIST IN GRAND FORKS, SO THE COMMUNITY NOW HAS A FULL-TIME DERMATOLOGY SERVICE. CY2022 FOCUSED ON BUILDING THE PRACTICE TO INCLUDE RESOURCES NEEDED FOR SKIN TESTING, SKIN CHECKS, BIOPSIES, AND PROCEDURES ALONG WITH STAFFING AND SCHEDULING RESOURCES TO BEST ACCOMMODATE PATIENT NEEDS. AVAILABLE LOCAL DERMATOLOGY APPOINTMENTS WENT FROM MONTHLY OUTREACH, ROUGHLY 40 APPOINTMENTS, TO FULL-TIME COMMUNITY CLINIC, ROUGHLY 140 APPOINTMENTS PER MONTH. PATIENT UTILIZATION OF DERMATOLOGY SERVICES WAS BUILT AND SUSTAINED EARLY IN 2022. HELPING WITH THE PRACTICE AWARENESS AND PATIENT EDUCATION INCLUDED MARKETING THE NEW NURSE PRACTITIONER TO THE PUBLIC VIA TRADITIONAL AND SOCIAL MEDIA SOURCES, HOSTING FREE PUBLIC SKIN CHECK EVENTS, COMMUNITY OUTREACH WITH EMPLOYERS AND THE SCHOOL DISTRICT, AND PRODUCING AND DISTRIBUTING SKIN PREVENTION EDUCATIONAL MATERIALS. THIEF RIVER FALLS DERMATOLOGY IS OFFERING ROBUST GEOGRAPHICAL OFFERINGS IN OUR PRIMARY SERVICE AREA BY SPENDING TWO DAYS OF OUTREACH DERMATOLOGY TIME IN COMMUNITIES HALLOCK AND CROOKSTON, GIVING THEM 16 PATIENT APPOINTMENTS OF DERMATOLOGY ACCESS NOT PREVIOUSLY HAD. IN CY2023, THE FOCUS WILL BE ON GROWING AVAILABLE ACCESS BY INCREASING APPOINTMENTS EACH CLINIC DAY.AS PART OF THE EXPANDED PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH GOAL, SANFORD BEHAVIORAL HEALTH PROVIDES PATIENTS THE FLEXIBILITY OF SCHEDULING THEIR APPOINTMENT IN THE MANNER THAT BEST SUITS THEIR NEEDS, PROVIDED THAT WE ARE ABLE TO MEET REGULATORY REQUIREMENTS AND IT IS IN THE PATIENT'S BEST INTEREST CLINICALLY. AS A RESULT, MORE THAN 40% OF APPOINTMENTS ARE CURRENTLY SCHEDULED AS TELEHEALTH APPOINTMENTS. THIS DATA DOES NOT REFLECT ANY NEW PATIENT ASSESSMENTS WHO MAY BE SEEN VIA TELEHEALTH DUE TO THE INABILITY TO CAPTURE THE DATA WITHOUT A MANUAL PROCESS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO QUALITY HEALTHCAREAFFORDABLE HOUSINGLONG-TERM CAREPUBLIC TRANSPORTATIONSANFORD 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 AND STAKEHOLDERS.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 13H: OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA 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) 2022
Schedule H (Form 990) 2022
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?251
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
1656 CENTRAL ST W
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 EYE CENTER & OPTICAL
1611 ANNE ST NW
BEMIDJI,MN56601
EYE CARE CENTER
16 16 - SANFORD BEMIDJI DOWNTOWN EYE CENTER & OP
506 BELTRAMI AVE NW
BEMIDJI,MN56601
EYE CARE CENTER
17 17 - SANFORD BEMIDJI HOME CARE & HOSPICE
3201 PINE RIDGE AVE NW
BEMIDJI,MN56601
HOME CARE AND HOSPICE
18 18 - SANFORD BEMIDJI MAIN CLINIC
1233 34TH ST NW
BEMIDJI,MN56601
MEDICAL CLINIC
19 19 - SANFORD BEMIDJI OTHOPEDICS & SPORTS MEDI
1300 ANNE STREET NW
BEMIDJI,MN56601
MEDICAL CLINIC
20 20 - SANFORD DIALYSIS BEMIDJI
1300 ANNE STREET NW
BEMIDJI,MN56601
DIALYSIS
21 21 - SANFORD HEALTH NEILSON PLACE
1000 ANNE ST NW
BEMIDJI,MN56601
SKILLED NURSING FACILITY
22 22 - SANFORD HEALTH TRILLIUM
930 ANNE STREET NW
BEMIDJI,MN56601
ASSISTED LIVING CENTER
23 23 - SANFORD HEALTH WINDSONG
1000 ANNE ST NW
BEMIDJI,MN56601
ASSISTED LIVING CENTER
24 24 - SANFORD JOE LUEKEN CANCER CENTER
1233 34TH ST NW
BEMIDJI,MN56601
CANCER CENTER
25 25 - SANFORD BEHAVIORAL HEALTH HEADWATERS ACT
1705 ANNE ST NW
BEMIDJI,MN56601
BEHAVIORAL HEALTH TREATMENT CENTER
26 26 - SANFORD HEALTH PRIMEWEST RESIDENTIAL
3124 HANNAH AVE NW
BEMIDJI,MN56601
BEHAVIORAL HEALTH & ADDICTION CENTER
27 27 - SANFORD CLINIC BERESFORD
600 W CEDAR STREET
BERESFORD,SD57004
RURAL HEALTH CLINIC
28 28 - BISMARCK CANCER CENTER
500 N 8TH STREET
BISMARCK,ND58501
CANCER CENTER
29 29 - SANFORD BIRTH CENTER
300 N 7TH STREET
BISMARCK,ND58501
BIRTH CENTER
30 30 - SANFORD CANCER CENTER BISMARCK
300 N 7TH STREET
BISMARCK,ND58501
CANCER CENTER
31 31 - SANFORD CHILDREN'S NORTH CLINIC
765 W INTERSTATE AVE
BISMARCK,ND58503
CHILDREN'S CLINIC
32 32 - SANFORD CLINIC
222 N 7TH STREET
BISMARCK,ND58501
MEDICAL CLINIC
33 33 - SANFORD EAST INTERSTATE AVE CLINIC
1800 E INTERSTATE AVE
BISMARCK,ND58503
MEDICAL CLINIC
34 34 - SANFORD FIFTH & BROADWAY CLINIC
515 E BROADWAY AVE
BISMARCK,ND58501
MEDICAL CLINIC
35 35 - SANFORD HEALTH CHIROPRACTICOCC MED CLIN
2603 E BROADWAY AVE
BISMARCK,ND58501
MEDICAL CLINIC
36 36 - SANFORD NORTH CLINIC
2830 N WASHINGTON STREET
BISMARCK,ND58503
MEDICAL CLINIC
37 37 - SANFORD ORTHOPEDIC & SPORTS MEDICINE
225 N 7TH STREET
BISMARCK,ND58501
MEDICAL CLINIC
38 38 - SANFORD SEVENTH & BROADWAY CLINIC
715 E BROADWAY AVE
BISMARCK,ND58501
MEDICAL CLINIC
39 39 - SANFORD SEVENTH & ROSSER CLINIC
414 N 7TH STREET
BISMARCK,ND58501
MEDICAL CLINIC
40 40 - SANFORD SEVENTH & THAYER CLINIC
209 N 7TH STREET
BISMARCK,ND58501
MEDICAL CLINIC
41 41 - SANFORD SOUTH CLINIC
1040 TACOMA AVE
BISMARCK,ND58504
MEDICAL CLINIC
42 42 - SANFORD STATE SREET CLINIC
3318 N 14TH STREET
BISMARCK,ND58503
MEDICAL CLINIC
43 43 - SANFORD TOM & FRANCES LEACH BISMARCK DIA
209 N 7TH STREET
BISMARCK,ND58501
DIALYSIS CENTER
44 44 - SANFORD BEMIDJI BLACKDUCK CLINIC
81 1ST ST NW
BLACKDUCK,MN56630
MEDICAL CLINIC
45 45 - SANFORD BOYDEN CLINIC
3971 320TH ST
BOYDEN,IA51234
MEDICAL CLINIC
46 46 - SANFORD BRANDON ACUTE CARE & ORTHO FAST
1105 E HOLLY BLVD
BRANDON,SD57005
MEDICAL CLINIC
47 47 - SANFORD BRANDON FAMILY MEDICINE & CHILDR
1105 E HOLLY BLVD
BRANDON,SD57005
MEDICAL CLINIC
48 48 - SANFORD HEALTH BROOKINGS CLINIC
922 - 22ND AVENUE S
BROOKINGS,SD57006
MEDICAL CLINIC
49 49 - SANFORD CANBY CLINIC
112 ST OLAF AVENUE S
CANBY,MN56220
MEDICARE CERTIFIED RURAL HEALTH CLINIC
50 50 - SANFORD CANBY DENTAL CLINIC
11 ST OLAF AVENUE S
CANBY,MN56220
DENTAL CLINIC
51 51 - SANFORD CANBY DIALYSIS UNIT
112 ST OLAF AVENUE S
CANBY,MN56220
MEDICARE CERTIFIED END STAGE RENAL DIALYSIS
52 52 - SANFORD CANBY HOME CARE
213 ST OLAF AVENUE N
CANBY,MN56220
MEDICARE CERTIFIED HOME HEALTH AGENCY
53 53 - SANFORD CANBY MEDICAL CENTER
112 ST OLAF AVENUE S
CANBY,MN56220
CLASS F HOME CARE PROVIDER
54 54 - SANFORD DIALYSIS CANBY
112 ST OLAF AVENUE S
CANBY,MN56220
DIALYSIS
55 55 - SANFORD HEALTH CANBY SYLVAN PLACE
212 ST OLAF AVENUE S
CANBY,MN56220
HOUSING WITH SERVICES
56 56 - SANFORD HEALTH CANISTOTAUSD CLINIC
320 W MAIN ST
CANISTOTA,SD57012
RURAL HEALTH CLINIC
57 57 - SANFORD CANTON CLINIC
400 N HIAWATHA DRIVE
CANTON,SD57013
RURAL HEALTH CLINIC
58 58 - SANFORD HEALTH CANTON HIAWATHA HEIGHTS
398 N HIAWATHA DRIVE
CANTON,SD57013
ASSISTED LIVING CENTER
59 59 - SANFORD BEMIDJI CASS LAKE CLINIC
219 GRANT UTLEY AVE NW
CASS LAKE,MN56633
MEDICAL CLINIC
60 60 - SANFORD CHAMBERLAIN CLINIC
300 S BYRON BLVD
CHAMBERLAIN,SD57325
RURAL HEALTH CLINIC
61 61 - SANFORD DIALYSIS
300 S BYRON BLVD
CHAMBERLAIN,SD57325
DIALYSIS
62 62 - SANFORD HEALTH CHAMBERLAIN CARE CENTER
300 S BYRON BLVD
CHAMBERLAIN,SD57325
NURSING FACILITY
63 63 - SANFORD HOME HEALTH & HOSPICE CHAMBERLAI
110 W BEEBE AVE
CHAMBERLAIN,SD57325
HOME HEALTH CARE & HOSPICE
64 64 - SANFORD HEALTH CLARK CLINIC
211 N COMMERCIAL STREET
CLARK,SD57225
RURAL HEALTH CLINIC
65 65 - SANFORD CLEAR LAKE CLINIC
701 3RD AVENUE S
CLEAR LAKE,SD57226
RURAL HEALTH CLINIC
66 66 - SANFORD CLEAR LAKE MEDICAL CENTER
701 3RD AVENUE S
CLEAR LAKE,SD57226
HOME HEALTH CARE
67 67 - SANFORD BAGLEY CLEARBROOK CLINIC
22 ELM STREET
CLEARBROOK,MN56634
RURAL HEALTH CLINIC
68 68 - SANFORD HEALTH DAKOTA DUNES CLINIC
350 OAK TREE LN
DAKOTA DUNES,SD57049
MEDICAL CLINIC
69 69 - SANFORD HEALTH DELL RAPIDS ORCHARD HILLS
200 W 10TH STREET
DELL RAPIDS,SD57022
ASSISTED LIVING CENTER
70 70 - SANFORD DIALYSIS
1234 WASHINGTON AVE SUITE B
DETROIT LAKES,MN56501
DIALYSIS CENTER
71 71 - SANFORD HEALTH DETROIT LAKES CLINC & SAM
1245 WASHINGTON AVENUE
DETROIT LAKES,MN56501
AMBULATORY SURGERY CENTER/CLINIC
72 72 - SANFORD HEALTH DETROIT LAKES EYE CENTER
1234 WASHINGTON AVE SUITE A
DETROIT LAKES,MN56501
EYE CARE CENTER
73 73 - SANFORD HEALTH WEST DICKINSON CLINIC
2615 FAIRWAY STREET
DICKINSON,ND58601
MEDICAL CLINIC
74 74 - SANFORD HEALTH EAST DICKINSON CLINIC
33 9TH ST W
DICKINSON,ND58601
MEDICAL CLINIC
75 75 - SANFORD HEALTH HEARING CENTER DICKINSON
1531 W VILLARD ST
DICKINSON,ND58601
HEARING CENTER
76 76 - SANFORD DERMATOLOGY CLINIC
625 DEMERS AVE NW
EAST GRAND FORKS,MN56721
MEDICAL CLINIC
77 77 - SANFORD HEALTH 621 DEMERS AVE CLINIC
621 DEMERS AVE NW
EAST GRAND FORKS,MN56721
MEDICAL CLINIC
78 78 - SANFORD HEALTH 929 CENTRAL AVE CLINIC
929 CENTRAL AVE
EAST GRAND FORKS,MN56721
MEDICAL CLINIC
79 79 - SANFORD HEALTH 625 DEMERS AVE CLINIC
625 DEMERS AVE NW
EAST GRAND FORKS,MN56721
MEDICAL CLINIC
80 80 - SANFORD HOME CARE EAST GRAND FORKS
404 DEMERS AVE
EAST GRAND FORKS,MN56721
HOME HEALTH CARE
81 81 - SANFORD HEALTH EDGELEY CLINIC
506 2ND ST
EDGELEY,ND58433
MEDICAL CLINIC
82 82 - SANFORD LUVERNE EDGERTON CLINIC
733 MAIN AVE
EDGERTON,MN56128
RURAL HEALTH CLINIC
83 83 - SANFORD HEALTH ELLENDALE CLINIC
141 MAIN ST
ELLENDALE,ND58436
RURAL HEALTH CLINIC
84 84 - SANFORD HEALTH ENDERLIN CLINIC
201 4TH AVENUE
ENDERLIN,ND58027
RURAL HEALTH CLINIC
85 85 - SANFORD CLINIC ESTELLINE
305 HOSPITAL DRIVE
ESTELLINE,SD57234
RURAL HEALTH CLINIC
86 86 - EDITH SANFORD BREAST CENTER FARGO
737 BROADWAY N
FARGO,ND58102
WOMEN'S HEALTH
87 87 - SANFORD 1711 MEDICAL BUILDING
1711 UNIVERSITY DRIVE S
FARGO,ND58103
MEDICAL CLINIC
88 88 - SANFORD 2801 MEDICAL BUILDING
2801 S UNIVERSITY DRIVE
FARGO,ND58122
MEDICAL CLINIC
89 89 - SANFORD BRAIN & SPINE CENTER FARGO
2301 25TH ST S
FARGO,ND58103
MEDICAL CLINIC
90 90 - SANFORD BROADWAY CLINIC
801 BROADWAY N
FARGO,ND58102
MEDICAL CLINIC
91 91 - SANFORD BROADWAY MEDICAL BUILDING
736 BROADWAY N
FARGO,ND58102
MEDICAL CLINIC
92 92 - SANFORD CHILDREN'S BROADWAY CLINIC
737 BROADWAY N
FARGO,ND58102
CHILDREN'S CLINIC
93 93 - SANFORD CHILDREN'S CARE CLINIC
100 4TH STREET S
FARGO,ND58103
CHILDREN'S CLINIC
94 94 - SANFORD CHILDREN'S SOUTHWEST CLINIC
2701 13TH AVE S
FARGO,ND58103
CHILDREN'S CLINIC
95 95 - SANFORD DERMATOLOGY & LASER CLINIC
4656 40TH AVE S
FARGO,ND58104
MEDICAL CLINIC
96 96 - SANFORD DIALYSIS FARGO
2801 S UNIVERSITY DRIVE
FARGO,ND58122
DIALYSIS
97 97 - SANFORD FOOT AND ANKLE CLINIC
1720 S UNIVERSITY DR
FARGO,ND58103
MEDICAL CLINIC
98 98 - SANFORD HOME CARE FARGO
100 4TH STREET S
FARGO,ND58103
HOME HEALTH AGENCY
99 99 - SANFORD I-94 CLINIC
5225 23RD AVENUE SOUTH
FARGO,ND58104
MEDICAL CLINIC
100 100 - SANFORD NEUROSCIENCE CLINIC
700 1ST AVE S
FARGO,ND58103
MEDICAL CLINIC
101 101 - SANFORD NORTH FARGO CLINIC
2601 BROADWAY N
FARGO,ND58102
MEDICAL CLINIC
102 102 - SANFORD ORTHOPEDIC WALK-IN CLINIC FARGO
1720 S UNIVERSITY DR
FARGO,ND58103
MEDICAL CLINIC
103 103 - SANFORD PAIN CENTER FARGO
2301 25TH ST S
FARGO,ND58103
MEDICAL CLINIC
104 104 - SANFORD REPRODUCTIVE MEDICINE CLINIC
1111 HARWOOD DRIVE S
FARGO,ND58104
MEDICAL CLINIC
105 105 - SANFORD ROGER MARIS CANCER CENTER
820 4TH STREET N
FARGO,ND58102
CANCER CENTER
106 106 - SANFORD SOUTH UNIVERSITY CLINIC
1717 S UNIVERSITY DR
FARGO,ND58103
MEDICAL CLINIC
107 107 - SANFORD SOUTH UNIVERSITY EYE CENTER & OP
1717 S UNIVERSITY DR
FARGO,ND58103
EYE CARE CENTER
108 108 - SANFORD SOUTHPOINTE CLINIC
2400 32ND AVE S
FARGO,ND58103
MEDICAL CLINIC
109 109 - SANFORD SOUTHPOINTE EYE CENTER & OPTICAL
2400 32ND AVE S
FARGO,ND58103
EYE CARE CENTER
110 110 - SANFORD VETERANS SQUARE CLINIC
3955 56TH ST S
FARGO,ND58104
MEDICAL CLINIC
111 111 - SANFORD HEALTH FINLEY CLINIC
407 WASHINGTON AVE E
FINLEY,ND58230
RURAL HEALTH CLINIC
112 112 - SANFORD HEALTH FORMAN CLINIC
336 MAIN ST
FORMAN,ND58032
RURAL HEALTH CLINIC
113 113 - SANFORD DIALYSIS FORT YATES
10 N RIVER ROAD
FORT YATES,ND58538
DIALYSIS CENTER
114 114 - SANFORD HEALTH FOSSTON EYE CENTER & OPTI
111 2ND ST NE
FOSSTON,MN56542
EYE CARE CENTER
115 115 - SANFORD ROCK RAPIDS GEORGE CLINIC
101 N MAIN
GEORGE,IA51237
RURAL HEALTH CLINIC
116 116 - SANFORD HEALTH GRAND FORKS CLINIC
1750 47TH AVE S
GRAND FORKS,ND58201
MEDICAL CLINIC
117 117 - SANFORD HEALTH GWINNER CLINIC
69 HIGHWAY 13 W
GWINNER,ND58040
MEDICAL CLINIC
118 118 - SANFORD HEALTH HALSTAD CLINIC
445 1ST STREET E
HALSTAD,MN56548
RURAL HEALTH CLINIC
119 119 - SANFORD HEALTH HARTFORD CLINIC
905 N OAKS AVE
HARTFORD,SD57033
MEDICAL CLINIC
120 120 - SANFORD SHELDON HARTLEY CLINIC
512 3RD ST NE
HARTLEY,IA51346
MEDICAL CLINIC
121 121 - SANFORD HAWLEY CLINIC
1412 MAIN ST
HAWLEY,MN56549
MEDICAL CLINIC
122 122 - SANFORD HEALTH COMSTOCK CORNER
12 3RD STREET SE
HILLSBORO,ND58045
ASSISTED LIVING CENTER
123 123 - SANFORD HILLSBORO CARE CENTER
12 3RD STREET SE
HILLSBORO,ND58045
HOSPITAL BASED-NURSING FACILITIES LTC
124 124 - SANFORD HEALTH HILLSBORO CLINIC
315 EAST CALEDONIA
HILLSBORO,ND58045
RURAL HEALTH CLINIC
125 125 - SANFORD HEALTH DIALYSIS HOSPERS
112 SUNRISE DRIVE
HOSPERS,IA51238
END STAGE RENAL DIALYSIS
126 126 - SANFORD HEALTH INTL FALLS EYE CENTER
1400 HIGHWAY 71
INTERNATIONAL FALLS,MN56649
EYE CARE CENTER
127 127 - SANFORD HEALTH INWOOD CLINIC
303 E JEFFERSON ST
INWOOD,IA51240
MEDICAL CLINIC
128 128 - SANFORD CLINIC IPSWICH
110 5TH AVENUE
IPSWICH,SD57451
RURAL HEALTH CLINIC
129 129 - SANFORD JACKSON CLINIC
1430 NORTH HIGHWAY
JACKSON,MN56143
MEDICARE CERTIFIED RURAL HEALTH CLINIC
130 130 - SANFORD DIALYSIS JAMESTOWN
300 2ND AVENUE NE
JAMESTOWN,ND58401
DIALYSIS CENTER
131 131 - SANFORD HEALTH HEARING CENTER JAMESTOWN
904 5TH AVE NE
JAMESTOWN,ND58401
HEARING CENTER
132 132 - SANFORD HEALTH JAMESTOWN 2ND AVE CLINIC
300 2ND AVENUE NE
JAMESTOWN,ND58401
MEDICAL CLINIC
133 133 - SANFORD DIALYSIS JAMESTOWN
300 2ND AVENUE NE
JAMESTOWN,ND58401
DIALYSIS
134 134 - SANFORD HEALTH JAMESTOWN CLINIC
904 5TH AVE NE
JAMESTOWN,ND58401
MEDICAL CLINIC
135 135 - SANFORD HEALTH KELLIHER CLINIC
243 CLARK AVE N
KELLIHER,MN56650
MEDICAL CLINIC
136 136 - SANFORD HEALTH KIMBALL CLINIC
101 S MAIN ST
KIMBALL,SD57355
RURAL HEALTH CLINIC
137 137 - SANFORD CHILDREN'S CLINIC
3001 DAGGETT ST
KLAMATH FALLS,OR97601
MEDICAL CLINIC
138 138 - SANFORD HEALTH LAKE NORDEN CLINIC
512 MAIN AVE
LAKE NORDEN,SD57248
RURAL HEALTH CLINIC
139 139 - SANFORD JACKSON LAKEFIELD CLINIC
209 MAIN STREET
LAKEFIELD,MN56150
MEDICARE CERTIFIED RURAL HEALTH CLINIC
140 140 - SANFORD HEALTH LAKE PARK CLINIC
215 N MARKET ST
LAKE PARK,IA51347
MEDICAL CLINIC
141 141 - SANFORD HEALTH LAMOURE CLINIC
100 1ST AVE SW
LAMOURE,ND58458
RURAL HEALTH CLINIC
142 142 - SANFORD HEALTH LENNOX CLINIC
108 S MAIN
LENNOX,SD57039
RURAL HEALTH CLINIC
143 143 - SANFORD HEALTH LIDGERWOOD CLINIC
21 WILEY AVE S
LIDGERWOOD,ND58053
MEDICAL CLINIC
144 144 - SANFORD HEALTH LISBON CLINIC
102 10TH AVE W
LISBON,ND58054
MEDICAL CLINIC
145 145 - SANFORD HOME CARE LISBON
404 FOREST ST
LISBON,ND58054
HOME HEALTH CARE
146 146 - SANFORD HOME HEALTH LUVERNE
304 N MCKENZIE ST
LUVERNE,MN56156
HOME HEALTH CARE
147 147 - SANFORD LUVERNE CLINIC
1601 SIOUX VALLEY DR
LUVERNE,MN56156
MEDICAL CLINIC
148 148 - SANFORD LUVERNE HOSPICE
217 N OAKLEY ST
LUVERNE,MN56156
MEDICARE CERTIFIED HOSPICE
149 149 - SANFORD DIALYSIS
323 SW 10TH STREET
MADISON,SD57042
END STAGE RENAL DIALYSIS
150 150 - SANFORD HOSPICE MADISON
900 2ND AVENUE
MADISON,MN56256
HOSPICE (LICENSED IN SD)
151 151 - SANFORD HEALTH MAHNOMEN CLINIC
410 W 4TH ST
MAHNOMEN,MN56557
RURAL HEALTH CLINIC
152 152 - SANFORD HOME CARE MAHNOMEN
414 W JEFFERSON AVE
MAHNOMEN,MN56557
HOME HEALTH CARE
153 153 - SANFORD HOME CARE BISMARCK
910 18TH STREET NW
MANDAN,ND58554
HOME HEALTH AGENCY
154 154 - SANFORD EAST MANDAN CLINIC
102 MANDAN AVE
MANDAN,ND58554
MEDICAL CLINIC
155 155 - SANFORD NORTH MANDAN CLINIC
910 18TH STREET NW
MANDAN,ND58554
MEDICAL CLINIC
156 156 - SANFORD HOME CARE MAYVILLE
49 7TH AVE SE
MAYVILLE,ND58257
HOME HEALTH CARE
157 157 - SANFORD MAYVILLE CLINIC
600 1ST ST SE
MAYVILLE,ND58257
MEDICAL CLINIC
158 158 - SANFORD HEALTH HIGHWAY 2 CLINIC
801 21ST AVE SE
MINOT,ND58701
MEDICAL CLINIC
159 159 - SANFORD HEALTH NORTHWEST CLINIC
1500 21ST AVE NW
MINOT,ND58701
MEDICA
160 160 - SANFORD HEALTH MINNEOTA CLINIC
700 N MONROE ST
MINNEOTA,MN56264
RURAL HEALTH CLINIC
161 161 - SANFORD HEALTH MITCHELL CLINIC
2100 HIGHLAND WAY
MITCHELL,SD57301
MEDICAL CLINIC
162 162 - SANFORD MOORHEAD CAMPUS
4000 28TH AVE S
MOORHEAD,MN56560
MEDICAL CLINIC
163 163 - SANFORD DIALYSIS MORRIS
400 1ST STREET EAST
MORRIS,MN56267
DIALYSIS
164 164 - SANFORD HEALTH MOUNTAIN LAKE CLINIC
308 N 8TH STREET
MOUNTAIN LAKE,MN56159
MEDICARE CERTIFIED RURAL HEALTH CLINIC
165 165 - SANFORD HEALTH OAKES CLINIC
420 7TH ST S
OAKES,ND58474
MEDICAL CLINIC
166 166 - SANFORD CHILDREN'S CLINIC
3605 VISTA WAY
OCEANSIDE,CA92056
CHILDREN'S CLINIC
167 167 - SANFORD HEALTH PARK RAPIDS CLINIC
110 7TH ST W
PARK RAPIDS,MN56470
MEDICAL CLINIC
168 168 - SANFORD HEALTH PARKERS PRAIRIE CLINIC
115 E SOO STREET
PARKERS PRAIRIE,MN56361
MEDICAL CLINIC
169 169 - SANFORD HEALTH PELICAN RAPIDS CLINIC
211 EAST MILL STREET
PELICAN RAPIDS,MN56572
RURAL HEALTH CLINIC
170 170 - SANFORD HOME CARE PELICAN RAPIDS
211 EAST MILL STREET
PELICAN RAPIDS,MN56572
HOME HEALTH CARE
171 171 - SANFORD HEALTH PIERRE CLINIC
521 E SIOUX AVE
PIERRE,SD57501
MEDICAL CLINIC
172 172 - SANFORD VERMILLION PONCA CLINIC
111 E 2ND STREET
PONCA,NE68770
MEDICAL CLINIC
173 173 - SANFORD DIALYSIS RED LAKE
24760 HOSPITAL DRIVE
RED LAKE,MN56671
DIALYSIS
174 174 - SANFORD ROCK RAPIDS CLINIC
104 BUNCOMBE DRIVE
ROCK RAPIDS,IA51246
RURAL HEALTH CLINIC
175 175 - SANFORD SHELDON SANBORN CLINIC
321 MAIN STREET
SANBORN,IA51248
MEDICAL CLINIC
176 176 - SANFORD HEALTH SHELDON CARE CENTER
118 NORTH SEVENTH AVENUE PO BOX 250
SHELDON,IA51201
HOSPITAL BASED-NURSING FACILITIES
177 177 - SANFORD SHELDON CLINIC
800 OAK STREET
SHELDON,IA51201
RURAL HEALTH CLINIC
178 178 - SANFORD SHELDON HOME HEALTH & HOSPICE
118 NORTH SEVENTH AVENUE PO BOX 250
SHELDON,IA51201
HOME HEALTH AGENCY AND HOSPICE
179 179 - AVA'S HOUSE
1320 W 17TH STREET
SIOUX FALLS,SD57104
HOSPICE
180 180 - SANFORD 10TH & PHILLIPS ACUTE CARE & ORT
136 S PHILLIPS AVE
SIOUX FALLS,SD57104
MEDICAL CLINIC
181 181 - SANFORD 26TH & SYCAMORE FAMILY MEDICINE
4405 E 26TH ST
SIOUX FALLS,SD57103
MEDICAL CLINIC
182 182 - SANFORD 32ND & ELLIS CLINIC
2601 S ELLIS ROAD
SIOUX FALLS,SD57106
MEDICAL CLINIC
183 183 - SANFORD 49TH & OXBOW FAMILY MEDICINE
3401 W 49TH STREET
SIOUX FALLS,SD57106
MEDICAL CLINIC
184 184 - SANFORD 4TH & SYCAMORE FAMILY MEDICINE
600 N SYCAMORE AVE
SIOUX FALLS,SD57110
MEDICAL CLINIC
185 185 - SANFORD 69TH & LOUISE FAMILY MEDICINE
6101 S LOUISE AVE
SIOUX FALLS,SD57108
MEDICAL CLINIC
186 186 - SANFORD 69TH & MINNESOTA FAMILY MEDICINE
6110 S MINNESOTA AVE
SIOUX FALLS,SD57108
MEDICAL CLINIC
187 187 - SANFORD CANCER CENTER
1309 W 17TH ST
SIOUX FALLS,SD57104
CANCER CENTER
188 188 - SANFORD CARDIOVASCULAR INSTITUTE
1301 W 18TH STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
189 189 - SANFORD CHILDREN'S MB2 CLINIC
1205 S GRANGE AVE
SIOUX FALLS,SD57105
CHILDREN'S CLINIC
190 190 - SANFORD CHILDREN'S RESIDENCY CLINIC
6101 S LOUISE AVE
SIOUX FALLS,SD57108
CHILDREN'S CLINIC
191 191 - SANFORD CHILDREN'S SPECIALTY CLINIC
1600 W 22ND STREET
SIOUX FALLS,SD57117
CHILDREN'S CLINIC
192 192 - SANFORD DERMATOLOGY CLINIC
1310 W 22ND STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
193 193 - SANFORD DIABETES & THYROID CLINIC
1305 W 18TH STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
194 194 - SANFORD DIALYSIS SIOUX FALLS
1321 W 22ND STREET
SIOUX FALLS,SD57117
DIALYSIS CENTER
195 195 - SANFORD EAR NOSE AND THROAT CLINIC
1310 W 22ND STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
196 196 - SANFORD EYE CENTER & OPTICAL
1621 S MINNESOTA AVE
SIOUX FALLS,SD57105
EYE CARE CENTER
197 197 - SANFORD HEALTH EYE CLINIC
2310 S MARION RD 140
SIOUX FALLS,SD57106
EYE CARE CENTER
198 198 - SANFORD HEALTH MB2 CLINIC
1205 S GRANGE AVE
SIOUX FALLS,SD57105
MEDICAL CLINIC
199 199 - SANFORD HOME HEALTH SIOUX FALLS
2710 WEST 12TH STREET
SIOUX FALLS,SD57104
HOME HEALTH CARE
200 200 - SANFORD HOSPICE SIOUX FALLS
2710 WEST 12TH STREET
SIOUX FALLS,SD57104
HOSPICE (LICENSED IN MN AND SD)
201 201 - SANFORD IMAGENETICS
1321 W 22ND STREET
SIOUX FALLS,SD57117
GENETICS
202 202 - SANFORD INTERNAL MEDICINE CLINIC
1321 W 22ND STREET
SIOUX FALLS,SD57117
MEDICAL CLINIC
203 203 - SANFORD MATERNAL-FETAL MEDICINE
1500 W 22ND STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
204 204 - SANFORD OBSTETRICS & GYNECOLOGY CLINIC
1500 W 22ND STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
205 205 - SANFORD PSYCHIATRY & PSYCHOLOGY CLINIC
2400 W 49TH STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
206 206 - SANFORD SURGICAL ASSOCIATES
1508 W 22ND STREET
SIOUX FALLS,SD57105
AMBULATORY SURGERY CENTER/CLINIC
207 207 - SANFORD USD 34TH & KIWANIS FAMILY MEDICI
2701 S KIWANIS AVE
SIOUX FALLS,SD57105
MEDICAL CLINIC
208 208 - SANFORD VAN DEMARK CLINIC
1210 W 18TH STREET
SIOUX FALLS,SD57104
MEDICAL CLINIC
209 209 - SANFORD VASCULAR ASSOCIATES
1305 W 18TH STREET
SIOUX FALLS,SD57105
MEDICAL CLINIC
210 210 - SANFORD WOMEN'S PRIMARY CARE CLINIC
5019 S WESTERN AVE
SIOUX FALLS,SD57108
MEDICAL CLINIC
211 211 - THE BIRTH PLACE
1500 W 22ND STREET
SIOUX FALLS,SD57105
BIRTH CENTER
212 212 - NORTHERN LIGHTS COMMUNITY RESIDENCE
921 ATLANTIC AVE N
THIEF RIVER FALLS,MN56701
RESIDENTIAL BEHAVIORAL HEALTH
213 213 - SANFORD BEHAVIORAL HEALTH OUTPATIENT CLI
120 LABREE AVENUE S
THIEF RIVER FALLS,MN56701
BEHAVIORAL HEALTH TREATMENT CENTER
214 214 - SANFORD DIALYSIS THIEF RIVER FALLS
120 LABREE AVENUE S
THIEF RIVER FALLS,MN56701
DIALYSIS
215 215 - SANFORD HEALTH THIEF RIVER FALLS EYE CEN
1720 HIGHWAY 59 S
THIEF RIVER FALLS,MN56701
EYE CARE CENTER
216 216 - SANFORD HEALTH THIEF RIVER FALLS SOUTHEA
1720 HIGHWAY 59 S
THIEF RIVER FALLS,MN56701
MEDICAL CLINIC
217 217 - SANFORD THIEF RIVER FALLS CLINIC
3001 SANFORD PKWY
THIEF RIVER FALLS,MN56701
MEDICAL CLINIC
218 218 - SANFORD HEALTH TRACY O'BRIEN COURT
410 STATE STREET
TRACY,MN56175
HOUSING WITH SERVICES
219 219 - SANFORD TRACY CLINIC
249 FIFTH STREET E
TRACY,MN56175
MEDICARE CERTIFIED RURAL HEALTH CLINIC
220 220 - SHETEK HOME CARE SERVICES
251 5TH ST E
TRACY,MN56175
HOME HEALTH CARE
221 221 - SANFORD HEALTH TWIN VALLEY CLINIC
501 2ND ST NW
TWIN VALLEY,MN56584
RURAL HEALTH CLINIC
222 222 - SANFORD HEALTH ULEN CLINIC
108 VIKING AVENUE W
ULEN,MN56585
RURAL HEALTH CLINIC
223 223 - SANFORD HEALTH VALLEY CITY CLINIC
520 CHAUTAUQUA BLVD
VALLEY CITY,ND58072
MEDICAL CLINIC
224 224 - SANFORD HEALTH VERMILLION CARE CENTER
125 WALKER STREET
VERMILLION,SD57069
NURSING FACILITY
225 225 - SANFORD HEALTH VERMILLION DAKOTA GERDENS
126 S PLUM STREET
VERMILLION,SD57069
RESIDENTIAL LIVING CENTER
226 226 - SANFORD HOSPICE VERMILLION
848 EAST CHERRY STREET
VERMILLION,SD57069
HOSPICE
227 227 - SANFORD VERMILLION CLINIC
20 S PLUM STREET
VERMILLION,SD56069
MEDICAL CLINIC
228 228 - SANFORD DIALYSIS
111 WASHINGTON AVE NW
WAGNER,SD57380
DIALYSIS CENTER
229 229 - SANFORD HEALTH WAHPETON CLINIC
332 2ND AVE N
WAHPETON,ND58075
MEDICAL CLINIC
230 230 - SANFORD HEALTH WAHPETON EYE CENTER & OPT
332 2ND AVE N
WAHPETON,ND58075
EYE CARE CENTER
231 231 - SANFORD HEALTH WAHPETON PT & PSYCHOLOGY
123 2ND AVE N
WAHPETON,ND58075
MEDICAL CLINIC
232 232 - SANFORD HEALTH WALKER CLINIC
614 MICHIGAN AVENUE
WALKER,MN56484
RURAL HEALTH CLINIC
233 233 - SANFORD HEALTH WALKER REHAB
106 5TH ST S
WALKER,MN56484
REHABILITATIVE SERVICES
234 234 - SANFORD TRACY WALNUT GROVE CLINIC
810 8TH ST
WALNUT GROVE,MN56180
MEDICARE CERTIFIED RURAL HEALTH CLINIC
235 235 - SANFORD HEALTH WATERTOWN CLINIC
901 4TH STREET NW
WATERTOWN,SD57201
MEDICAL CLINIC
236 236 - SANFORD HEALTH HEARING CENTER
116 8TH STREET NE
WATFORD CITY,ND58854
HEARING CENTER
237 237 - SANFORD HEALTH WATFORD CITY CLINIC
709 4TH AVE NE
WATFORD CITY,ND58854
MEDICAL CLINIC
238 238 - SANFORD WEBSTER CLINIC
101 PEABODY DRIVE
WEBSTER,SD57274
RURAL HEALTH CLINIC
239 239 - SANFORD HEALTH WESTROOK PETERSON ESTATES
1012 9TH STREET
WESTBROOK,MN56183
HOUSING WITH SERVICES
240 240 - SANFORD WESTBROOK CLINIC
920 BELL AVENUE
WESTBROOK,MN56183
MEDICARE CERTIFIED RURAL HEALTH CLINIC
241 241 - SANFORD WEST FARGO CLINIC
1220 SHEYENNE STREET
WEST FARGO,ND58078
MEDICAL CLINIC
242 242 - SANFORD HOME CARE WHEATON
405 12TH ST N
WHEATON,MN56926
HOME HEALTH CARE
243 243 - SANFORD WHEATON CLINIC
401 12TH ST N
WHEATON,MN56926
RURAL HEALTH CLINIC
244 244 - SANFORD CLINIC WINDOM
591 2ND AVENUE N
WINDOM,MN56101
MEDICARE CERTIFIED RURAL HEALTH CLINIC
245 245 - SANFORD HOSPICE WINNER
745 E 8TH STREET
WINNER,SD57580
HOSPICE
246 246 - SANFORD DIALYSIS
1018 SIXTH AVENUE
WORTHINGTON,MN56187
DIALYSIS CENTER
247 247 - SANFORD HEALTH CANCER CENTER
1018 SIXTH AVENUE
WORTHINGTON,MN56187
CANCER CENTER
248 248 - SANFORD HOSPICE WORTHINGTON
1935 WOODLAND CT
WORTHINGTON,MN56187
HOSPICE (LICENSED IN SD)
249 249 - SANFORD WORTHINGTON CLINIC
1680 DIAGONAL ROAD
WORTHINGTON,MN56187
MEDICAL CLINIC
250 250 - SANFORD WORTHINGTON MEDICAL CENTER
1018 SIXTH AVENUE
WORTHINGTON,MN56187
MEDICARE CERTIFIED END STAGE RENAL DIALYSIS
251 251 - SANFORD WORTHINGTON OBGYN CLINIC
1018 SIXTH AVENUE
WORTHINGTON,MN56187
MEDICAL CLINIC
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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 2022, 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:HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
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 2022, SUBSIDIZED HEALTH SERVICES PROVIDED THROUGH CLINIC PHYSICIAN PRACTICES GENERATED LOSSES OF $232,997,424.11.
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 (AFS) OF SANFORD INCLUDE A BAD DEBT FOOTNOTE. SEE FOOTNOTE 3 ON PAGES 17 - 19 OF THE AFS. 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 $585,268,604. 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 HEALTH REGULARLY UTILIZES A BROAD ARRAY OF RESOURCES AND PARTNERS TO ASSESS AND DELIVER CARE TO THE COMMUNITIES SERVED BY THE SYSTEM. ASSESSMENT AND, BY EXTENSION, COMMUNITY ENGAGEMENT, IS A COMPOSITE, PARTNER-DRIVEN APPROACH.WITHIN THE CONTEXT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, THE SYSTEM RELIES UPON A MULTI-STEP, MULTI-MODAL APPROACH THAT MINIMIZES THE INHERENT LIMITATIONS OF ANY GIVEN ASSESSMENT TOOL AND INCREASES THE POINTS OF CONTACT FOR COMMUNITY MEMBERS TO SHARE DIRECT INSIGHTS INTO THE PROCESS. STEP ONE OF THE CHNA IS ENGAGEMENT WITH OTHER HEALTH SYSTEMS IN THE COMMUNITIES IN WHICH SANFORD AND ANOTHER HEALTH SYSTEM BOTH OPERATE. ADDITIONALLY, SANFORD ENGAGES PUBLIC HEALTH ORGANIZATIONS AND OTHER CARE PROVIDERS IN THE DEVELOPMENT OF ASSESSMENT STRATEGIES AND TOOLS. THE COOPERATION BETWEEN THE ORGANIZATIONS ENSURES INFORMATION IS COLLECTED THAT WILL BENEFIT NOT ONLY THE CHNA PROGRAM, BUT ALSO THE STRATEGIES AND OPERATIONS OF THE RESPECTIVE ORGANIZATIONS. THE SYSTEMS ALSO COLLABORATE IN THE DEVELOPMENT OF THEIR RESPECTIVE IMPLEMENTATION PLANS TO FURTHER THE POSITIVE IMPACT TO THE COMMUNITY. AS NOTED ABOVE, THE CHNA ASSESSMENT INCLUDES A MULTI-MODAL PROCESS, WHICH BEGINS WITH A SURVEY TO COMMUNITY MEMBERS SENT VIA MULTIPLE PATHWAYS, WHICH INCLUDE THE PURCHASE OF A LOCAL SURVEY PANEL AND THE DEVELOPMENT OF A COMMUNITY STAKEHOLDER LIST. STAKEHOLDERS ARE ASKED TO COMPLETE THE SURVEY AND THEN FORWARD THE TOOL TO THEIR CONTACTS TO AMPLIFY THE COLLECTION OPPORTUNITIES. AN INDEPENDENT THIRD PARTY WITH SURVEY ANALYSIS EXPERTISE IS RETAINED TO EVALUATE THE RESULTS AND DEVELOP AN INITIAL LIST OF NEEDS WITH ADDITIONAL AUGMENTATION FROM COUNTYHEALTHRANKINGS.COM, CENSUS DATA, AND OTHER SECONDARY DATA SOURCES. LOCAL STAKEHOLDER MEETINGS THAT INCLUDE HEALTH CARE LEADERS, ELECTED OFFICIALS, REPRESENTATIVES OF UNDERSERVED COMMUNITIES, NONPROFIT LEADERS, AND OTHER COMMUNITY PARTNERS THEN REVIEW THE FINDINGS, PROVIDE INPUT, AND DEVELOP THE FINAL PRIORITIES FOR INCLUSION IN THE IMPLEMENTATION PLAN.DATA GATHERED FROM THE CHNA PROGRAM, PARTICULARLY SURVEY RESPONSES, IS MADE AVAILABLE TO LOCAL COMMUNITY ORGANIZATIONS THAT REQUEST THE INFORMATION. SANFORD VIEWS THE FINDINGS AS A COMMUNITY ASSET THAT CAN FURTHER THE POSITIVE IMPACT ON COMMUNITY HEALTH OUTSIDE THE WALLS OF THE SYSTEM.RECENTLY, SANFORD HAS ADDED MORE RESOURCES TO ADVANCE COMMUNITY HEALTH. FINDHELP IS AN ONLINE PLATFORM THAT CONNECTS LOCAL ORGANIZATIONS, FUNDING OPPORTUNITIES, AND OTHER RESOURCES CONNECTED TO SOCIAL DETERMINANTS OF HEALTH WITH INDIVIDUALS IN NEED. SANFORD INTEGRATED THE FINDHELP PLATFORM INTO THE ORGANIZATION'S WEBSITE, ELECTRONIC MEDICAL RECORD, AND POST-VISIT PAPERS. THE INTEGRATION NOT ONLY ALLOWS USERS TO SELF-SEARCH FOR LOCAL RESOURCES BASED UPON THEIR NEED, BUT ALSO ALLOWS SANFORD'S CARE MANAGEMENT TEAM TO DIRECTLY REFER PATIENTS TO LOCAL ORGANIZATIONS AND MONITOR ENGAGEMENT. FINDHELP IS PUBLIC TO ANY RESIDENT AND IS NOT RESERVED SPECIFICALLY FOR PATIENTS OF THE SYSTEM. THE SERVICES OFFERED ON THE NEW WEBSITE ARE EITHER FREE OR REDUCED COST AND COVER OPTIONS THAT MIGHT NOT BE INCLUDED WITH MEDICARE OR MEDICAID. THIS PARTNERSHIP ALLOWS SANFORD TO ADDRESS INEQUITY IN THE COMMUNITIES WE SERVE WITH EXISTING SERVICES THAT MEET THE NEEDS OF PATIENTS.ADDITIONAL EXTERNAL SOURCES ARE REGULARLY ENGAGED WITHIN THE STRATEGIC PLANNING, OPERATIONAL, AND CHNA PROCESS. THE ADVISORY BOARD IS REPRESENTATIVE OF THESE ASSESSMENT CAPABILITIES. THE ADVISORY BOARD (AB) OFFERS A WEALTH OF SECONDARY INFORMATION, SUCH AS INDUSTRY TRENDS, CONSUMER ASSESSMENTS, AND OTHER INFORMATION. AB ALSO INCLUDES DATA TOOLS, INCLUDING THE MARKET INNOVATION CENTER AND THE POST-ACUTE PATHWAYS EXPLORER THAT PROVIDES LINE OF SIGHT INTO DEMOGRAPHIC DATA, VOLUME PROJECTIONS, CARE COORDINATION PATTERNS, AND CARE DRIVERS BEYOND THE INTERNAL DATA SOURCES WITHIN SANFORD. OTHER ENGAGEMENTS AND ASSESSMENTS INCLUDE LEADERSHIP AND MEMBERSHIP IN STATE HEALTHCARE ASSOCIATIONS AND VIZIENT. THE DEVELOPMENT OF PATIENT FAMILY ADVISORY AND DIVERSITY, EQUITY AND INCLUSION COUNCILS WITHIN SYSTEM FACILITIES PROMOTES TWO-WAY COMMUNICATION WITH THE COMMUNITIES SERVED. THESE TOOLS ARE INCORPORATED THROUGHOUT THE PLANNING PROCESS AND ARE EMBEDDED WITHIN OPERATIONS. TO ENSURE CARE PROVIDED ENCOMPASSES THE WHOLE PERSON, SANFORD HEALTH EMPLOYS COMMUNITY HEALTH WORKERS (CHWS), FIRST ESTABLISHING THE ROLE IN 2014. THESE NON-CLINICAL STAFF PROVIDE FRONTLINE PUBLIC HEALTH SERVICES AND SERVE AS A LIAISON BETWEEN HEALTH CARE AND THE COMMUNITY TO FACILITATE ACCESS TO RESOURCES. THESE CARE TEAM MEMBERS PROVIDE A RANGE OF SERVICES AND ACTIVITIES FOR AT-RISK POPULATIONS INCLUDING OUTREACH, COMMUNITY EDUCATION, INFORMAL COUNSELING, SOCIAL SUPPORT, AND ADVOCACY.ANOTHER IMPORTANT SUPPORT/LIAISON ROLE IS THAT OF HEALTH GUIDES. THESE INDIVIDUALS IDENTIFY GAPS IN CARE PREVENTING RISING-RISK PATIENTS FROM ACHIEVING THEIR HEALTH GOALS. GUIDES ADDRESS BARRIERS PATIENTS ARE FACING IN ACCESSING THE RESOURCES THEY NEED TO BE SUCCESSFUL. HEALTH GUIDES HELP PATIENTS NAVIGATE THE HEALTH SYSTEM AND VARIOUS COMMUNITY RESOURCES, EMPOWERING PATIENTS TO TAKE MORE OWNERSHIP OF THEIR HEALTH AND BE AN ACTIVE PARTICIPANT IN THEIR CARE.MANY SANFORD HEALTH CLINIC FACILITIES OFFER A BROAD RANGE OF ROBUST, INTEGRATED CARE OPTIONS. FROM DIETICIANS TO PHARMACISTS TO SOCIAL WORKERS, AMBULATORY RN CARE MANAGERS AND INTEGRATED HEALTH THERAPISTS (IHTS), PATIENTS SEEN FOR PRIMARY CARE HAVE CLOSE PROXIMITY TO OTHER ANCILLARY SUPPORT SERVICES AND CARE OPTIONS. PATIENTS STRUGGLING WITH MENTAL HEALTH OR SUBSTANCE DEPENDENCY ISSUES, FOR EXAMPLE, CAN OFTEN IMMEDIATELY SEE A SUPPORT PROFESSIONAL ON-SITE VERSUS HAVING TO WAIT TO SEE A SPECIALIST VIA A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. SANFORD ALSO SCREENS FOR SOCIAL DETERMINANTS OF HEALTH AND HAVE "WELLNESS PANTRIES" EMBEDDED IN OUR PEDIATRIC CLINICS ACROSS MINNESOTA, NORTH DAKOTA AND SOUTH DAKOTA. WE ARE CURRENTLY COLLECTING DATA TO BETTER UNDERSTAND HOW ADDRESSING FOOD INSECURITY HELPS REDUCE ANXIETY AND DEPRESSION IN CHILDREN. THE TIMELINESS OF THESE KEY SERVICES HELPS TO ENSURE THAT PATIENT NEEDS ARE NOT FALLING THROUGH THE CRACKS OR THAT CARE IS DELAYED.
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-POLICY
PART VI, LINE 4: SANFORD HEALTH IS AN INTEGRATED HEALTH SYSTEM HEADQUARTERED IN THE DAKOTAS. IT IS ONE OF THE LARGEST RURAL HEALTH SYSTEMS IN THE NATION WITH 46 MEDICAL CENTERS AND 222 CLINIC LOCATIONS IN NINE STATES AND THREE COUNTRIES. SANFORD HEALTH'S APPROXIMATELY 44,000 EMPLOYEES, INCLUDING 2,827 PHYSICIANS AND 7,944 REGISTERED NURSES DELIVERING CARE IN MORE THAN 80 SPECIALTY AREAS, 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 2022 U.S. CENSUS BUREAU ESTIMATES A TOTAL POPULATION OF 203,971 FOR SIOUX FALLS. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF MINNEHAHA COUNTY IS 81.1% WHITE, 6.4% AFRICAN AMERICAN, 2.9% AMERICAN INDIAN, 2.2% ASIAN AND 5.4% 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 $66,502.SANFORD MEDICAL CENTER FARGO - FARGO, NORTH DAKOTAFARGO IS THE LARGEST CITY IN NORTH DAKOTA, ACCOUNTING FOR 17% OF THE STATE'S POPULATION. FARGO IS ALSO THE COUNTY SEAT OF CASS COUNTY. THE 2022 UNITED STATES CENSUS ESTIMATES THE POPULATION OF FARGO WAS 131,444. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF CASS COUNTY IS 84.1% WHITE, 6.3% AFRICAN AMERICAN, 1.5% AMERICAN INDIAN, 3.3% ASIAN AND 2.9% HISPANIC. ONLY 1% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $68,718. 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 2022 UNITED STATES CENSUS ESTIMATES, THE POPULATION OF BEMIDJI IS 15,424. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF BELTRAMI COUNTY IS 71.9% WHITE, 0.7% AFRICAN AMERICAN, 22% AMERICAN INDIAN, 0.8% ASIAN AND 2.5% HISPANIC. 0% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $55,910.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 74,445. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF BURLEIGH COUNTY IS 88.2% WHITE, 2.2 AFRICAN AMERICAN, 4.5% AMERICAN INDIAN, 0.9% ASIAN AND 2.7% HISPANIC. 0% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $76,043.SANFORD NETWORK HOSPITALSSANFORD HEALTH NETWORK HOSPITALS IS A NETWORK OF RURAL HOSPITALS LOCATED THROUGHOUT SOUTH DAKOTA, NORTH DAKOTA, AND MINNESOTA.SANFORD CLINICSSANFORD CLINIC IS A MULTI-SPECIALTY CLINIC COMPRISED OF APPROXIMATELY 2,827 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 13 MEMBERS AT THE END OF THE CALENDAR YEAR, INCLUDING 9 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 RURAL HEALTH SYSTEMS IN THE NATION WITH 46 MEDICAL CENTERS AND 222 CLINIC LOCATIONS IN NINE STATES AND THREE COUNTRIES. SANFORD HEALTH'S APPROXIMATELY 44,000 EMPLOYEES, INCLUDING 2,827 PHYSICIANS AND 7,944 REGISTERED NURSES DELIVERING CARE IN MORE THAN 80 SPECIALTY AREAS, 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, OR NEBRASKA. FILING IN MINNESOTA IS VOLUNTARY.
Schedule H (Form 990) 2022
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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
2022
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 AREA CHAMBER OF COMM
PO BOX 1179
ABERDEEN,SD574021179
46-0103710 501(C)(6) 7,750 0     ECONOMIC DEVELOPMENT
(2) ABERDEEN DEVELOPMENT CORP
416 PRODUCTION ST N
ABERDEEN,SD57401
46-6011831 501(C)(6) 10,000 0     ECONOMIC DEVELOPMENT,COMMUNITY HEALTH IMPROVEMENT
(3) ABERDEEN FAMILY YMCA
5 S STATE ST
ABERDEEN,SD57401
46-0255779 501(C)(3) 25,000 0     COMMUNITY HEALTH IMPROVEMENT
(4) ABERDEEN PUBLIC SCHOOLS FOUNDA
1224 S 3RD ST
ABERDEEN,SD57401
46-0423109 501(C)(3) 40,000 0     PROGRAM SUPPORT
(5) ALZHEIMERS ASSOC
225 N MICHIGAN AVE FLOOR 17
CHICAGO,IL60601
13-3039601 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(6) AMER CANCER ACTION SOC NETWORK
555 11TH ST NW
WASHINGTON,DC20004
52-2340031 501(C)(4) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(7) AMERICAN CANCER SOCIETY
250 WILLIAMS ST 4TH FL
ATLANTA,GA30303
13-1788491 501(C)(3) 514,000 0     RESEARCH
(8) AMERICAN GOLD GYMNASTICS INC
2001 17TH AVE S
FARGO,ND58103
45-0333196 501(C)(3) 40,000 0     PROGRAM SUPPORT
(9) AMERICAN HEART ASSOCIATION INC
7272 GREENVILLE AVENUE
DALLAS,TX75231
13-5613797 501(C)(3) 34,500 0     COMMUNITY HEALTH IMPROVEMENT
(10) ARTS PARTNERSHIP
1104 2ND AVE S STE 315
FARGO,ND58104
23-7108936 501(C)(3) 15,000 0     PROGRAM SUPPORT
(11) AUGUSTANA UNIVERSITY
2001 S SUMMIT AVE
SIOUX FALLS,SD57197
46-0224588 501(C)(3) 5,058,150 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(12) BECKER COUNTY HISTORICAL SOC
714 SUMMIT AVE
DETROIT LAKES,MN56501
41-0873609 501(C)(3) 6,000 0     ECONOMIC DEVELOPMENT
(13) BEEF LOGIC INC
316 S COTEAU AVE
PIERRE,SD57501
87-2043795 501(C)(3) 75,000 0     ECONOMIC DEVELOPMENT
(14) BEMIDJI AREA SCHOOLS
502 MINNESOTA AVE
BEMIDJI,MN56619
41-6000181 115 98,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(15) BEMIDJI BLUE OX MARATHON
PO BOX 633
BEMIDJI,MN56619
46-1700357 501(C)(3) 15,000 0     ECONOMIC DEVELOPMENT
(16) BEMIDJI COMMUNITY ARENA CORP
PO BOX 1726
BEMIDJI,MN566191726
81-3622011 501(C)(3) 69,060 0     ECONOMIC DEVELOPMENT
(17) BEMIDJI STATE UNIVERSITY
1500 BIRCHMONT DR NE
BEMIDJI,MN56601
41-1687554 115 112,200 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(18) BEMIDJI SYMPHONY ORCHESTRA
PO BOX 3136
BEMIDJI,MN56619
39-2017074 501(C)(3) 14,500 0     PROGRAM SUPPORT
(19) BEMIDJI YOUTH SOCCER
PO BOX 265
BEMIDJI,MN56619
41-1870778 501(C)(3) 6,500 0     PROGRAM SUPPORT
(20) BIO GIRLS INC
4151 38TH ST STE A
FARGO,ND58104
81-0792142 501(C)(3) 17,000 0     COMMUNITY HEALTH IMPROVEMENT
(21) BISHOP DUDLEY HOSPITALITY HOUS
101 N INDIANA AVE
SIOUX FALLS,SD57103
91-1836526 501(C)(3) 16,000 0     COMMUNITY HEALTH IMPROVEMENT
(22) BISMARCK CANCER CENTER FDTN
500 N 8TH ST
BISMARCK,ND58501
26-0466647 501(C)(3) 11,464 0     COMMUNITY HEALTH IMPROVEMENT
(23) BISMARCK MANDAN CHAMBER EDC
1640 BURNT BOAT DR
BISMARCK,ND58503
45-0116753 501(C)(6) 17,725 0     ECONOMIC DEVELOPMENT
(24) BISMARCK MANDAN CHAMBER FOUNDATION
1640 BURNT BOAT DR
BISMARCK,ND58503
26-3807225 501(C)(3) 25,000 0     ECONOMIC DEVELOPMENT
(25) BISMARCK PUBLIC SCHOOL DISTRICT #1
806 N WASHINGTON ST
BISMARCK,ND58501
45-6000242 115 67,004 2,747 FMV T-SHIRTS EDUCATION/WORKFORCE DEVELOPMENT,PROGRAM SUPPORT
(26) BISMARCK PUBLIC SCHOOLS FDTN
806 N WASHINGTON ST
BISMARCK,ND58501
45-0442960 501(C)(3) 70,000 0     EDUCATION/WORKFORCE DEVELOPMENT,PROGRAM SUPPORT
(27) BISMARCK STATE COLLEGE FOUND
PO BOX 5587
BISMARCK,ND585065587
45-0358929 501(C)(3) 104,842 0     EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(28) BOY SCOUTS VOYAGEURS COUNCIL
3877 STEBNER ROAD
HERMANTOWN,MN55811
41-0695583 501(C)(3) 10,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(29) BOYS & GIRLS CLUB ABERDEEN
1121 1ST AVE SE
ABERDEEN,SD57401
23-7062273 501(C)(3) 6,500 0     COMMUNITY HEALTH IMPROVEMENT
(30) BOYS & GIRLS CLUB BEMIDJI AREA
1600 MINNESOTA AVE NW
BEMIDJI,MN56601
81-0599601 501(C)(3) 11,540 0     COMMUNITY HEALTH IMPROVEMENT
(31) BOYS & GIRLS CLUBS OF THE RED RIVER VALLEY
2500 18TH ST S
FARGO,ND58103
45-0316132 501(C)(3) 20,000 0     COMMUNITY HEALTH IMPROVEMENT
(32) BRANDON VALLEY BOOSTER CLUB
PO BOX 572
BRANDON,SD57005
46-0393971 501(C)(3) 95,300 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(33) BRANDON VALLEY SCHOOL DISTRICT 49-2
300 S SPLITROCK BLVD
BRANDON,SD57005
46-6002577 115 10,000 0     PROGRAM SUPPORT
(34) BUTTERFLY HOUSE & AQUARIUM
4320 S OXBOW AVE
SIOUX FALLS,SD57106
52-2370420 501(C)(3) 16,000 0     ECONOMIC DEVELOPMENT
(35) CALL TO FREEDOM INC
1915 E 8TH ST STE 100
SIOUX FALLS,SD57103
47-5469817 501(C)(3) 22,500 0     COMMUNITY HEALTH IMPROVEMENT
(36) CANTON SCHOOLS
800 N MAIN ST
CANTON,SD57013
46-6002143 115 18,764 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
(37) CHAD GREENWAYS LEAD WAY FDTN
59 CAVALIER BLVD STE 310
FLORENCE,KY41042
26-1782419 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(38) CHAMBER OF COMMERCE FMWF
PO BOX 2443
FARGO,ND581082443
45-0448041 501(C)(6) 15,920 0     ECONOMIC DEVELOPMENT
(39) CHARIS MINISTRY PARTNERS
1300 E 10TH ST
SIOUX FALLS,SD57103
38-3775128 501(C)(3) 7,000 0     COMMUNITY HEALTH IMPROVEMENT
(40) CHRISTIAN YOUTH ACTIVITY LEAGUE
47644 273RD ST
HARRISBURG,SD57032
46-4964311 501(C)(3) 5,427 0     PROGRAM SUPPORT
(41) CITY OF WEBSTER
PO BOX 539
WEBSTER,SD57274
46-6000530 115 7,143 0     COMMUNITY HEALTH IMPROVEMENT
(42) CITY OF YANKTON
PO BOX 176
YANKTON,SD57078
46-6000567 115 10,000 0     ECONOMIC DEVELOPMENT
(43) COMMUNITY MEMORIAL HOSPITAL
814 JACKSON ST
BURKE,SD57523
46-0219795 501(C)(3) 25,000 0     COMMUNITY HEALTH IMPROVEMENT
(44) CONCORDIA COLLEGE
901 8TH STREET S
MOORHEAD,MN565609981
41-0693977 501(C)(3) 3,306,500 369,883 APPRAISAL LAND EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(45) CREIGHTON UNIVERSITY
2500 CALIFORNIA PLAZA
OMAHA,NE68178
47-0376583 501(C)(3) 250,000 0     SCHOLARSHIP ENDOWMENT
(46) CRIBS FOR KIDS INC
5450 SECOND AVE
PITTSBURGH,PA15207
25-1442806 501(C)(3) 5,036 0     PROGRAM SUPPORT
(47) DAKOTA ALLIANCE SOCCER CLUB
401 W 39TH ST
SIOUX FALLS,SD57105
46-0359817 501(C)(3) 74,250 0     PROGRAM SUPPORT
(48) DAKOTA MEDICAL FOUNDATION
4141 28TH AVE SOUTH
FARGO,ND58104
45-6012318 501(C)(3) 12,050 0     COMMUNITY HEALTH IMPROVEMENT
(49) DAKOTA STATE UNIVERSITY
820 N WASHINGTON AVE
MADISON,SD57042
46-6000364 115 617,500 0     EDUCATION/WORKFORCE DEVELOPMENT,PROGRAM SUPPORT
(50) DEADWOOD CHAMBER OF COMMERCE
501 MAIN ST
DEADWOOD,SD57732
46-0118544 501(C)(6) 20,000 0     ECONOMIC DEVELOPMENT
(51) DOWNTOWN COMMUNITY PARTNERSHIP
210 BROADWAY STE 202
FARGO,ND58102
46-4472309 501(C)(6) 5,500 0     ECONOMIC DEVELOPMENT
(52) DOWNTOWN SIOUX FALLS INC
230 S PHILIPS AVE STE 306
SIOUX FALLS,SD57104
36-3627217 501(C)(4) 29,104 0     ECONOMIC DEVELOPMENT
(53) DSU HERITAGE FDTN
230 8TH AVE W
DICKINSON,ND58601
47-5378718 501(C)(3) 144,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(54) ELEVATE RAPID CITY
525 UNIVERSITY LOOP STE 102
RAPID CITY,SD57701
46-0118545 501(C)(6) 50,000 0     ECONOMIC DEVELOPMENT
(55) FAMILY ADVOCACY CNTR OF NORTH
800 BEMIDJI AVE N STE 4
BEMIDJI,MN566013072
20-2102302 501(C)(3) 18,000 0     COMMUNITY HEALTH IMPROVEMENT
(56) FAMILY FEST
PO BOX 90646
SIOUX FALLS,SD57109
81-2254064 501(C)(3) 7,500 0     COMMUNITY HEALTH IMPROVEMENT
(57) FARGO PARK DISTRICT
701 MAIN AVE
FARGO,ND58103
45-6002070 501(C)(6) 3,553,103 0     COMMUNITY HEALTH IMPROVEMENT
(58) FARGO PUBLIC SCHOOLS
415 4TH ST N
FARGO,ND57192
45-6012318 501(C)(3) 187,500 0     PROGRAM SUPPORT
(59) FARGO YOUTH BASEBALL
1892 17TH AVE S
FARGO,ND58103
45-0370089 501(C)(3) 17,700 0     PROGRAM SUPPORT
(60) FARGO YOUTH HOCKEY ASSOC
831 17TH AVE N
FARGO,ND58102
36-3548649 501(C)(3) 12,000 0     PROGRAM SUPPORT
(61) FIRST CITY OF LIGHTS FOUNDATION
PO BOX 1991
BEMIDJI,MN56619
85-4069354 501(C)(3) 6,500 0     ECONOMIC DEVELOPMENT
(62) FIRST TEE OF SOUTH DAKOTA
PO BOX 88938
SIOUX FALLS,SD57109
46-0449824 501(C)(3) 36,000 0     PROGRAM SUPPORT
(63) FIRSTLINK
4357 13TH AVE S STE 107L
FARGO,ND58103
45-0419491 501(C)(3) 25,000 0     COMMUNITY HEALTH IMPROVEMENT
(64) FITNESS ON MAIN
901 MAIN STREET
BURKE,SD57523
26-4125455 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(65) FOLDS OF HONOR SOUTH DAKOTA
5800 N PATRIOT DR
OWASSO,OK74055
75-3240683 501(C)(3) 60,800 0     PROGRAM SUPPORT
(66) FORWARD SIOUX FALLS
PO BOX 907
SIOUX FALLS,SD57101
46-0396647 501(C)(6) 250,000 0     ECONOMIC DEVELOPMENT
(67) FRESH START SURGICAL GIFTS
2011 PALOMAR AIRPORT RD STE 206
CARLSBAD,CA92011
33-0460177 501(C)(3) 75,000 0     PROGRAM SUPPORT
(68) GATEWAY TO SCIENCE
1810 SCHAFER STREET STE 1
BISMARCK,ND58501
45-0443517 501(C)(3) 10,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(69) GLORY HOUSE OF SIOUX FALLS
4000 S WEST AVE
SIOUX FALLS,SD57105
46-0308425 501(C)(3) 15,000 0     COMMUNITY HEALTH IMPROVEMENT
(70) GREAT NORTH POLE
675 13TH AVE E STE 101
WEST FARGO,ND58078
82-1969429 501(C)(3) 20,000 0     COMMUNITY HEALTH IMPROVEMENT
(71) GREATER SF CHAMBER OF COMMERCE
200 N PHILLIPS AVE STE 200
SIOUX FALLS,SD571046058
46-0189300 501(C)(6) 6,200 0     ECONOMIC DEVELOPMENT
(72) GROUND WORKS
102 N KROHNS PL STE 116
SIOUX FALLS,SD57103
47-5498537 501(C)(3) 10,000 0   ' COMMUNITY HEALTH IMPROVEMENT
(73) HARRISBURG HIGH SCHOOL
1300 E WILLOW ST
HARRISBURG,SD57032
46-6002218 501(C)(3) 8,050 0     PROGRAM SERVICES
(74) HARRISBURG SCHOOL DISTRICT
200 WILLOW ST
HARRISBURG,SD57032
46-6002218 115 229,800 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
(75) HARTFORD AREA DEVELOPMENT FDTN
125 N MAIN AVE
HARTFORD,SD57033
46-0354618 501(C)(3) 10,000 0     ECONOMIC DEVELOPMENT
(76) HELPLINE CENTER INC
1000 N WEST AVE STE 310
SIOUX FALLS,SD571041314
23-7424387 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(77) HOPE HAVEN INC
PO BOX 70
ROCK VALLEY,IA51247
42-0890017 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(78) HUETHER FAMILY MATCH POINTE
4210 N BOBHALLA DR
SIOUX FALLS,SD57107
45-2784394 501(C)(3) 12,000 0     PROGRAM SUPPORT
(79) INDEPENDENT SCHOOL DIST #2184
709 NORTH KNISS AVE
LUVERNE,MN56156
41-1784004 115 10,250 6,147     EDUCATION/WORKFORCE DEVELOPMENT
(80) INDEPENDENT SCHOOL DISTRICT518
1117 MARINE AVE
WORTHINGTON,MN561871610
41-6008522 115 112,000 0     PROGRAM SUPPORT
(81) JUNIOR ACHIEVEMENT OF SD
300 S PHILLIPS AVE STE L102
SIOUX FALLS,SD57104
46-0306352 501(C)(3) 15,200 0     EDUCATION/WORKFORCE DEVELOPMENT
(82) LAKOTA NATION INVITATIONAL
PO BOX 3140
RAPID CITY,SD57709
46-1310975 501(C)(3) 7,500 0     ECONOMIC DEVELOPMENT
(83) LEGENDS OF GOLD
PO BOX 287
BERESFORD,SD57004
27-3794971 501(C)(3) 20,000 0     PROGRAM SUPPORT
(84) LEVITT AT THE FALLS
524 N MAIN AVE 106
SIOUX FALLS,SD57104
61-1699910 501(C)(3) 75,000 464 COST SIGNAGE ECONOMIC DEVELOPMENT
(85) LIFESCAPE
2501 WEST 26TH ST
SIOUX FALLS,SD57105
46-0233030 501(C)(3) 41,898 0     PROGRAM SUPPORT
(86) LINK
132 N DAKOTA AVE
SIOUX FALLS,SD57104
84-4806781 501(C)(3) 400,000 0     COMMUNITY HEALTH IMPROVEMENT
(87) LUVERNE AREA COMMUNITY FOUND
102 E MAIN ST
LUVERNE,MN56156
41-1512905 501(C)(3) 6,000 7 COST AED ACCESSORIES COMMUNITY HEALTH IMPROVEMENT
(88) MAKE A WISH FOUNDATION OF SOUTH DAKOTA & MONTANA
1400 W 17TH ST
SIOUX FALLS,SD57104
46-0375953 501(C)(3) 12,400 0     COMMUNITY HEALTH IMPROVEMENT
(89) MANDAN PUBLIC SCHOOL DISTRICT1
901 DIVISION ST NW
MANDAN,ND58554
45-6001098 115 12,500 0     PROGRAM SUPPORT
(90) MAYVILLE STATE UNIVERSITY
330 THIRD ST NE
MAYVILLE,ND58257
45-6002485 501(C)(3) 30,000 0     PROGRAM SUPPORT,SCHOLARSHIP ENDOWMENT
(91) MCCROSSAN BOYS RANCH
47135 260TH STREET
SIOUX FALLS,SD57107
46-0311913 501(C)(3) 7,500 0     PROGRAM SUPPORT
(92) MCKENZIE COUNTY HEALTHCARE SYS
709 4TH AVE NE
WATFORD CITY,ND58854
77-0637498 501(C)(3) 100,000 0     COMMUNITY HEALTH IMPROVEMENT
(93) METRO AREA TOURNAMENT COMM
415 NORTH 4TH ST
FARGO,ND58102
45-0458883 501(C)(3) 20,000 0     PROGRAM SUPPORT
(94) MINNESOTA STATE UNIVERSITY MOORHEAD
1104 7TH AVE SOUTH
MOORHEAD,MN56563
41-1687554 115 102,250 0     PROGRAM SUPPORT
(95) MINNETONKA TOUCHDOWN CLUB
18301 HWY 7
MINNETONKA,MN55435
46-0496128 501(C)(3) 10,000 0     PROGRAM SUPPORT
(96) MITCHELL PARKS & RECREATION
612 NORTH MAIN STREET
MITCHELL,SD57301
46-6000305 115 17,000 0     COMMUNITY HEALTH IMPROVEMENT
(97) MN STATE UNIV MANKATO FDTN
236 WIGLEY ADMINISTRATION CTR
MANKOTA,MN56001
41-6033423 501(C)(3) 200,000 0     SCHOLARSHIP ENDOWMENT
(98) MN WEST FOUNDATION
1593 11TH AVENUE
GRANITE FALLS,MN56241
36-3266500 501(C)(3) 10,000 0     SCHOLARSHIP ENDOWMENT
(99) MO RIVER BASEBALL CLUB
540 CRESTLAND PLACE
BISMARCK,ND58503
87-2686828 501(C)(3) 7,500 0     PROGRAM SUPPORT
(100) MO SLOPE AREAWIDE UNITED WAY
515 N 4TH ST
BISMARCK,ND58501
45-0387741 501(C)(3) 18,500 0     COMMUNITY HEALTH IMPROVEMENT, ECONOMIC DEVELOPMENT
(101) MOORHEAD AREA PUBLIC SCHOOLS
2410 14TH ST S
MOORHEAD,MN56560
81-2603701 115 140,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(102) MOORHEAD YOUTH HOCKEY ASSOC
707 SE MAIN AVE
MOORHEAD,MN56560
23-7221429 501(C)(3) 50,500 0     PROGRAM SUPPORT
(103) NAMELESS COALITION FOR THE HOMELESS
PO BOX 353
BEMIDJI,MN566010353
47-2472053 501(C)(3) 10,000 0     ECONOMIC SUPPORT
(104) NAMI SD
PO BOX 89213
SIOUX FALLS,SD57109
36-3593641 501(C)(3) 6,500 0     COMMUNITY HEALTH IMPROVEMENT
(105) NATIONAL KIDNEY FOUNDATION
30 EAST 33RD STREET
NEW YORK,NY10016
13-1673104 501(C)(3) 27,000 0     COMMUNITY HEALTH IMPROVEMENT
(106) NATL MULTIPLE SCLEROSIS SOC
733 THIRD AVENUE FLOOR 3
NEW YORK,NY10017
13-5661935 501(C)(3) 11,500 0     COMMUNITY HEALTH IMPROVEMENT
(107) ND ASSISTIVE
3240 15TH ST S SUITE B
FARGO,ND58104
27-0260522 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(108) ND SAFETY COUNCIL
1710 CANARY AVE SUITE A
BISMARCK,ND58501
45-0353009 501(C)(3) 0 13,000 COST WATER COMMUNITY HEALTH IMPROVEMENT
(109) ND STATE COLLEGE OF SCIENCE
800 N 6TH ST
WAHPETON,ND580760002
45-0407617 501(C)(3) 7,500 0     COMMUNITY HEALTH IMPROVEMENT
(110) NDSU
PO BOX 6050
FARGO,ND581086050
45-6002439 501(C)(3) 668,088 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
(111) NDSU FOUNDATION & ALUMNI ASSOC
1241 UNIVERSITY DR N
FARGO,ND58102
23-7120898 501(C)(3) 2,430,000 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(112) NICKLAUS CHILDRENS HOSP FDTN
3100 SW 62ND AVE
MIAMI,FL33155
46-1784918 501(C)(3) 3,000,000 0     COMMUNITY HEALTH IMPROVEMENT
(113) NORTHERN DENTAL ACCESS CENTER
1405 ANNE ST NW
BEMIDJI,MN56601
84-1711812 501(C)(3) 20,000 0     COMMUNITY HEALTH IMPROVEMENT
(114) NORTHERN LIGHTS COUNCIL
4200 19TH AVE S
FARGO,ND581037207
45-0226415 501(C)(3) 7,250 0     COMMUNITY HEALTH IMPROVEMENT
(115) NORTHERN STATE UNIVERSITY
1200 S JAY ST
ABERDEEN,SD574017198
46-6000364 115 792,000 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
(116) NORTHERN SUN INTERCOLLEGIATE
2999 COUNTY RD 42 W
BURNSVILLE,MN55306
41-1783486 501(C)(3) 100,000 0     SCHOLARSHIP ENDOWMENT,PROGRAM SUPPORT
(117) NORTHWEST INDIAN CMTY DEV CTR
520 4TH ST NW
BEMIDJI,MN56601
36-3505641 501(C)(3) 6,000 0     COMMUNITY HEALTH IMPROVEMENT
(118) NORTHWEST MN FOUNDATION
201 3RD ST NW
BEMIDJI,MN56601
41-1556013 501(C)(3) 28,550 0     PROGRAM SUPPORT
(119) OAK GROVE LUTHERAN SCHOOL
124 N TERRACE
FARGO,ND58102
45-0226473 501(C)(3) 24,000 0     PROGRAM SUPPORT
(120) OUTDOOR ADVENTURE FOUNDATION
415 38TH ST S STE E
FARGO,ND58103
27-0192316 501(C)(3) 7,500 0     COMMUNITY HEALTH IMPROVEMENT
(121) PERHAM AREA COMMUNITY CENTER
620 3RD AVE SE
PERHAM,MN56573
41-1565457 115 40,500 0     COMMUNITY HEALTH IMPROVEMENT
(122) PREMIERE PLAYHOUSE
315 N PHILLIPS AVE
SIOUX FALLS,SD57104
80-0074622 501(C)(3) 7,500 0     EDUCATION/WORKFORCE DEVELOPMENT
(123) PROFESSIONAL PATIENT ADVOCATES IN LIFE SCIENCES
94 HILLANDALE RD
DANBURY,CT06811
47-2878879 501(C)(3) 20,000 0     COMMUNITY HEALTH IMPROVEMENT
(124) RAPID CITY CLUB FOR BOYS INC
320 N 4TH ST
RAPID CITY,SD57701
46-0277778 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(125) REINBOWS INC OF WINDOM MN
43341 480TH AVE
WINDOM,MN56101
20-8775427 501(C)(3) 7,000 0     COMMUNITY HEALTH IMPROVEMENT
(126) RONALD MCDONALD HOUSE
4757 AGASSIZ XING S
FARGO,ND58104
45-0365598 501(C)(3) 105,000 0     COMMUNITY HEALTH IMPROVEMENT
(127) RONALD MCDONALD HOUSE CHARITY
825 S LAKE ROAD
SIOUX FALLS,SD57104
46-0371152 501(C)(3) 25,000 0     COMMUNITY HEALTH IMPROVEMENT
(128) SAMARITANS FEET
PO BOX 78992
CHARLOTTE,NC282717045
14-1880905 501(C)(3) 2,540,000 0     COMMUNITY HEALTH IMPROVEMENT
(129) SD BASKETBALL COACHES ASSOCIATION
1404 YOSEMITE LANE
BROOKINGS,SD57006
81-1379554 501(C)(3) 6,232 0     PROGRAM SUPPORT
(130) SD COMMUNITY FOUNDATION
1714 N LINCOLN AVE
PIERRE,SD57501
46-0398115 501(C)(3) 1,266,000 0     SCHOLARSHIP ENDOWMENT
(131) SD GOLF ASSOCIATION JUNIOR GOLF FOUNDATION
PO BOX 88938
SIOUX FALLS,SD57109
46-0449824 501(C)(3) 25,000 0     PROGRAM SUPPORT
(132) SD HALL OF FAME
1480 SOUTH MAIN
CHAMBERLAIN,SD57325
46-0324210 501(C)(3) 50,000 0     ECONOMIC DEVELOPMENT
(133) SD HIGH SCHOOL ACTIVITIES
PO BOX 1217
PIERRE,SD575011217
46-0226882 501(C)(3) 125,000 0     PROGRAM SUPPORT
(134) SD LAW ENFORCEMENT CHARITIES
101 SOUTH MAIN AVE STE 100
SIOUX FALLS,SD57104
46-0440378 501(C)(3) 10,000 0     SCHOLARSHIP ENDOWMENT
(135) SD MILITARY HERITAGE ALLIANCE
1600 W RUSSELL ST
SIOUX FALLS,SD57104
83-2381925 501(C)(3) 250,000 0     MILITARY AND VETERANS SERVICES
(136) SD SCHOOL OF MINES AND TECHN
501 EAST ST JOSEPH STREET
RAPID CITY,SD577013995
46-6000364 115 18,000 0     PROGRAM SUPPORT
(137) SD STATE UNIV FOUNDATION
815 MEDARY AVE
BROOKINGS,SD57007
46-0273801 501(C)(3) 1,167,000 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(138) SD SYMPHONY ORCHESTRA
300 NORTH DAKOTA AVE STE 116
SIOUX FALLS,SD57104
46-6017026 501(C)(3) 43,000 0     ECONOMIC DEVELOPMENT
(139) SD YOUTH SOCCER ASSOC
2127 S MINNESOTA AVE STE 201
SIOUX FALLS,SD57105
23-7183054 501(C)(3) 25,000 0     PROGRAM SUPPORT
(140) SF AREA COMMUNITY FOUNDATION
200 N CHERAPA PL
SIOUX FALLS,SD57103
31-1748533 501(C)(3) 50,000 0     COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
(141) SF CHRISTIAN HIGH SCHOOL
6120 S CHARGER CIRCE
SIOUX FALLS,SD57108
46-0340024 501(C)(3) 114,460 0     SCHOLARSHIP ENDOWMENT,PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
(142) SF SWIM TEAM INC
PO BOX 758
SIOUX FALLS,SD57101
46-0343732 501(C)(3) 25,000 0     PROGRAM SUPPORT
(143) SF YOUTH HOCKEY ASSOC
5000 S MINNESOTA AVE
SIOUX FALLS,SD57108
46-0427805 501(C)(3) 65,000 0     PROGRAM SUPPORT
(144) SHELDON COMM SCHOOL DISTRICT
1700 E 4TH STREET
SHELDON,IA51201
42-6038825 115 30,000 0     PROGRAM SUPPORT
(145) SIGN FRACTURE CARE INTERNATIONAL
451 HILLS ST STE B
RICHLAND,WA99354
91-1952283 501(C)(3) 250,000 0     COMMUNITY HEALTH IMPROVEMENT
(146) SIOUX COUNCIL BOY SCOUTS
800 N WEST AVE
SIOUX FALLS,SD57104
46-0224599 501(C)(3) 25,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(147) SIOUX EMPIRE UNITED WAY
1000 N W AVE 120
SIOUX FALLS,SD571041314
46-0233701 501(C)(3) 150,000 0     COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
(148) SIOUX FALLS AREA CASA PROGRAM
PO BOX 1901
SIOUX FALLS,SD57101
46-0430647 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(149) SIOUX FALLS LUTHERAN SCHOOL
308 W 37TH ST
SIOUX FALLS,SD57105
46-0343381 501(C)(3) 1,000,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(150) SIOUX FALLS POWER HOCKEY
5808 S PRAIRIE VIEW CT
SIOUX FALLS,SD57108
47-1795011 501(C)(3) 40,000 0     PROGRAM SUPPORT
(151) SIOUX FALLS SCHOOL DISTRICT
201 E 38TH ST
SIOUX FALLS,SD57105
46-6002586 501(C)(3) 336,852 0     PROGRAM SUPPORT, EDUCATION/WORKFORCE DEVELOPMENT
(152) SIOUX FALLS SPORTS AUTHORITY
200 N PHILLIPS AVE SUITE 304
SIOUX FALLS,SD57104
20-5850491 501(C)(3) 7,500 0     ECONOMIC DEVELOPMENT
(153) SIOUX FALLS WOMEN RUN TRAINING
5235 S SWEETBRIAR CT
SIOUX FALLS,SD57108
81-3518734 501(C)(6) 15,000 0     COMMUNITY HEALTH IMPROVEMENT
(154) SIOUX FALLS YMCA
230 S MINNESOTA AVE
SIOUX FALLS,SD57104
46-0225021 501(C)(3) 61,090 0     COMMUNITY HEALTH IMPROVEMENT
(155) SMSU FOUNDATION
1501 STATE ST
MARSHALL,MN56258
23-7108470 501(C)(3) 100,000 0     PROGRAM SUPPORT
(156) SOUTH DAKOTA STATE UNIVERSITY
815 MEDARY AVE PO BOX 525
BROOKINGS,SD57007
46-0273801 115 1,121,500 0     PROGRAM SUPPORT
(157) SPECIAL OLYMPICS SOUTH DAKOTA
800 E I-90 LANE
SIOUX FALLS,SD57104
46-0359776 501(C)(3) 10,100 0     COMMUNITY HEALTH IMPROVEMENT
(158) ST JOHN PAUL II CATHOLIC SCHLS
5600 25TH ST S
FARGO,ND581047123
45-0403317 501(C)(3) 20,000 0     PROGRAM SUPPORT
(159) SUMMIT LEAGUE INC
4000 N HERCULES AVE STE 200
SIOUX FALLS,SD571071401
39-1417116 501(C)(3) 1,600,000 0     PROGRAM SUPPORT
(160) TEAM FOUNDATION
105 PARK AVE NW
BAGLEY,MN56621
06-1696861 501(C)(3) 7,500 0     PROGRAM SUPPORT
(161) TEAM MAKERS CLUB INC
3309 FLECHTNER DR S STE G
FARGO,ND58103
45-6014085 501(C)(3) 131,000 0     PROGRAM SUPPORT
(162) THIEF RIVER FALLS SCHOOLS
230 LABREE AVENUE SOUTH
THIEF RIVER FALLS,MN56701
41-6003126 115 21,500 0     PROGRAM SUPPORT
(163) UND ALUMNI ASSOC & FOUNDATION
3501 UNIVERSITY AVE STOP 8157
GRAND FORKS,ND58202
45-0348296 501(C)(3) 112,500 0     SCHOLARSHIP ENDOWMENT
(164) UNITED WAY OF BEMIDJI AREA
PO BOX 27
BEMIDJI,MN56619
41-1567744 501(C)(3) 93,760 0     ECONOMIC DEVELOPMENT
(165) UNITED WAY OF CASS-CLAY
PO BOX 1609
FARGO,ND581071609
41-0810008 501(C)(3) 126,900 0     COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
(166) UNITED WAY OF NORTHEASTERN SD
PO BOX 1065
ABERDEEN,SD574021065
23-7086355 501(C)(3) 10,450 0     COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
(167) UNIV OF MARY
7500 UNIVERSITY DR
BISMARCK,ND58504
45-0273403 501(C)(3) 210,000 0     EDUCATION/WORKFORCE DEVELOPMENT
(168) UNIV OF NE FOUNDATION
1010 LINCOLN MALL STE 300
LINCOLN,NE68508
47-0379839 501(C)(3) 250,000 0     SCHOLARSHIP ENDOWMENT
(169) UNIV OF SD FOUNDATION
1110 N DAKOTA ST
VERMILLION,SD57069
46-6018891 501(C)(3) 3,143,333 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(170) UNIV OF WI FOUNDATION
1848 UNIVERSITY AVE
MADISON,WI537264090
39-0743975 501(C)(3) 110,000 0     PROGRAM SUPPORT
(171) UNIVERSITY OF COLORAD
13001 E 17TH PLACE
AURORA,CO80045
84-6000555 115 250,000 0     RESEARCH
(172) UNIVERSITY OF JAMESTOWN
6085 COLLEGE LANE
JAMESTOWN,ND58405
45-0231180 501(C)(3) 70,300 0     PROGRAM SUPPORT
(173) UPPER MIDWEST ELITE LEAGUE
PO BOX 385970
BLOOMINGTON,MN55438
04-3644163 501(C)(3) 6,250 0     PROGRAM SUPPORT
(174) USD SCHOOL OF MEDICINE
414 EAST CLARK ST
VERMILLION,SD57069
46-6000364 115 52,004 0     PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
(175) VALLEY CITY STATE UNIVERSITY
101 COLLEGE ST SW
VALLEY CITY,ND58072
45-6002482 115 5,500 129 FMV BIKE DONATION FOR AUCTION EDUCATION/WORKFORCE DEVELOPMENT
(176) VERMILLION CHAMBER OF COMMERCE
2 E MAIN ST STE 101
VERMILLION,SD57069
46-0284795 501(C)(3) 22,500 0     ECONOMIC DEVELOPMENT
(177) DEPARTMENT OF VETERAN AFFAIRS
2501 WEST 22ND ST
SIOUX FALLS,SD57105
46-0227571 115 0 3,051,485 COST PGX TESTING COMMUNITY HEALTH IMPROVEMENT
(178) VETERANS COMMUNITY PROJECT
88900 TROOST AVE
KANSAS CITY,MO64131
47-4960735 501(C)(3) 17,000 0     MILITARY AND VETERANS SERVICES
(179) VILLAGE FAMILY SERVICE CENTER
808 3RD AVE S STE 101
FARGO,ND58103
45-0226423 501(C)(3) 102,000 0     COMMUNITY HEALTH IMPROVEMENT
(180) VILLAGE NORTHWEST UNLIMITED
330 VILLAGE CIRCLE
SHELDON,IA51201
42-1044017 501(C)(3) 27,500 0     COMMUNITY HEALTH IMPROVEMENT
(181) VOLUNTEERS OF AMERICA DAKOTAS
PO BOX 89306
SIOUX FALLS,SD57109
23-7353508 501(C)(3) 10,000 0     COMMUNITY HEALTH IMPROVEMENT
(182) WARNER SCHOOL DIST 6-5 FNDN
PO BOX 20
WARNER,SD57479
20-4606639 501(C)(3) 10,000 0     ECONOMIC DEVELOPMENT
(183) WATERTOWN COMMUNITY FOUNDATION
211 E KEMP AVE
WATERTOWN,SD57201
46-0350319 501(C)(3) 20,000 0     ECONOMIC DEVELOPMENT
(184) WATERTOWN DEVELOPMENT COMPANY
PO BOX 332
WATERTOWN,SD57201
47-0813269 501(C)(3) 15,000 0     ECONOMIC DEVELOPMENT
(185) WEST CENTRAL SCHOOL DISTRICT
PO BOX 252
HARTFORD,SD57033
46-0284421 115 25,050 0     PROGRAM SUPPORT
(186) WESTERN REGION ECONOMIC DEV
PO BOX 1306
WILLISTON,ND58802
36-3803598 501(C)(6) 10,000 0     ECONOMIC DEVELOPMENT
(187) WINGS OF VALOR INC
45618 278TH ST
PARKER,SD57053
84-3711088 501(C)(3) 51,942 0     MILITARY AND VETERANS SERVICES
(188) WINNER REGIONAL HEALTHCARE CTR
745 E 8TH ST
WINNER,SD57580
46-0274380 501(C)(3) 100,000 0     COMMUNITY HEALTH IMPROVEMENT
(189) YELLOW JACKET FOUNDATION
1200 UNIVERSITY ST UNIT 9506
BELLE FOURCHE,SD57717
51-0151319 501(C)(3) 110,000 0     PROGRAM SUPPORT
(190) YOUNG MENS CHRISTIAN ASSOC SF
606 E TAN TARA CIR
SIOUX FALLS,SD57106
46-4887667 501(C)(3) 30,000 0     PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
174
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
17
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

Schedule I (Form 990) 2022
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) GENERAL SUPPORT FOR COMMUNITY PROGRAMS   25 30,577 COST $25 GIFT CARDS SANFORD CARES CHRISTMAS PROGRAM; YOUTH SPORTS PROGRAM ASSISTANCE
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: PRIOR TO DISBURSEMENT ALL GRANT FUND REQUESTS ARE REVIEWED TO ENSURE THE RECEIVING ORGANIZATION AND PROPOSED USE OF FUNDS ALIGN WITH SANFORD'S MISSION.
Schedule I (Form 990) 2022



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
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) 2022

Schedule J (Form 990) 2022
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, 1099-MISC compensation, and/or 1099-NEC (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
1WILLIAM BRUNNER MD
PHYSICIAN
(i)

(ii)
3,264,442
-------------
0
0
-------------
0
141,633
-------------
0
15,250
-------------
0
23,892
-------------
0
3,445,217
-------------
0
0
-------------
0
2BRYAN NERMOE
PRESIDENT & CEO, FARGO-END 3/22
(i)

(ii)
0
-------------
175,719
0
-------------
252,724
0
-------------
28,831
0
-------------
30,585
0
-------------
7,367
0
-------------
495,226
0
-------------
0
3BRYAN NERMOE
SEE SCH J, PART III, LINES 4A-4B
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
2,719,941
0
-------------
0
0
-------------
0
0
-------------
2,719,941
0
-------------
688,398
4BILL GASSEN III
TRUSTEE, PRESIDENT & CEO
(i)

(ii)
0
-------------
1,818,239
0
-------------
582,757
0
-------------
282,586
0
-------------
378,828
0
-------------
755
0
-------------
3,063,165
0
-------------
0
5TOMASZ STYS MD
PHYSICIAN
(i)

(ii)
2,655,388
-------------
0
0
-------------
0
151,524
-------------
0
15,250
-------------
0
24,270
-------------
0
2,846,432
-------------
0
0
-------------
0
6RANDY BURY
FORMER CHIEF ADMIN OFFICER
(i)

(ii)
0
-------------
36,400
0
-------------
0
0
-------------
20,288
0
-------------
0
0
-------------
0
0
-------------
56,688
0
-------------
0
7RANDY BURY
SEE SCH J, PART III, LINES 4A-4B
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
2,769,572
0
-------------
0
0
-------------
0
0
-------------
2,769,572
0
-------------
0
8ADAM STYS MD
PHYSICIAN
(i)

(ii)
2,617,365
-------------
0
0
-------------
0
133,124
-------------
0
15,250
-------------
0
27,260
-------------
0
2,792,999
-------------
0
0
-------------
0
9ERIC BELANGER MD
PHYSICIAN
(i)

(ii)
2,543,991
-------------
0
0
-------------
0
1,242
-------------
0
15,250
-------------
0
27,676
-------------
0
2,588,159
-------------
0
0
-------------
0
10MARIAN PETRASKO MD
PHYSICIAN
(i)

(ii)
2,270,184
-------------
0
0
-------------
0
156,987
-------------
0
6,240
-------------
0
28,692
-------------
0
2,462,103
-------------
0
0
-------------
0
11MATT HOCKS
EVP, CHIEF OPERATING OFFICER
(i)

(ii)
0
-------------
1,448,268
0
-------------
482,335
0
-------------
233,922
0
-------------
219,455
0
-------------
28,845
0
-------------
2,412,825
0
-------------
0
12MICHELLE BRUHN
EVP, CFO & TREASURER
(i)

(ii)
0
-------------
1,012,253
0
-------------
350,000
0
-------------
168,285
0
-------------
160,681
0
-------------
26,317
0
-------------
1,717,536
0
-------------
0
13JENNIFER GRENNAN
EVP, CHIEF ADMIN OFFICER
(i)

(ii)
0
-------------
989,176
0
-------------
330,001
0
-------------
156,884
0
-------------
157,092
0
-------------
26,317
0
-------------
1,659,470
0
-------------
0
14MICHAEL LEBEAU MD
SVP, HEALTH SVC OPERATIONS
(i)

(ii)
0
-------------
968,405
0
-------------
285,000
0
-------------
167,120
0
-------------
154,419
0
-------------
27,692
0
-------------
1,602,636
0
-------------
0
15PAUL HANSON
PRESIDENT & CEO, SIOUX FALLS
(i)

(ii)
0
-------------
835,062
0
-------------
277,997
0
-------------
141,443
0
-------------
134,455
0
-------------
20,145
0
-------------
1,409,102
0
-------------
0
16MARIA BELL MD
TRUSTEE, PHYSICIAN
(i)

(ii)
1,020,094
-------------
0
54,000
-------------
0
69,600
-------------
0
15,250
-------------
0
28,692
-------------
0
1,187,636
-------------
0
0
-------------
0
17TODD SCHAFFER
PRESIDENT & CEO, BISMARCK
(i)

(ii)
0
-------------
664,040
0
-------------
153,130
0
-------------
131,566
0
-------------
108,543
0
-------------
2,363
0
-------------
1,059,642
0
-------------
0
18TIFFANY LAWRENCE
PRESIDENT & CEO, FARGO-BEG 3/22
(i)

(ii)
0
-------------
729,385
0
-------------
68,796
0
-------------
126,586
0
-------------
105,250
0
-------------
27,517
0
-------------
1,057,534
0
-------------
0
19SUSAN JARVIS
PRESIDENT & CEO, BEMIDJI
(i)

(ii)
0
-------------
531,338
0
-------------
180,184
0
-------------
93,514
0
-------------
91,858
0
-------------
30,167
0
-------------
927,061
0
-------------
0
20MICHELLE MICKA
SVP, FINANCE, HEALTH SERVICES
(i)

(ii)
0
-------------
414,734
0
-------------
146,250
0
-------------
54,832
0
-------------
61,109
0
-------------
19,598
0
-------------
696,523
0
-------------
0
21MARK LUNDEEN MD
TRUSTEE, PHYSICIAN
(i)

(ii)
332,590
-------------
0
0
-------------
0
11,324
-------------
0
11,832
-------------
0
2,130
-------------
0
357,876
-------------
0
0
-------------
0
22JOANN KUNKEL
FORMER CFO-SCH J, PART III, LINES 4A
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
339,000
0
-------------
0
0
-------------
0
0
-------------
339,000
0
-------------
0
23ANDY NORTH
TRUSTEE, SECRETARY, INDEP CONTRACTOR
(i)

(ii)
316,771
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
316,771
-------------
0
0
-------------
0
24KIM PATRICK
FORMER CLO-SCH J, PART III, LINES 4A
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
315,000
0
-------------
0
0
-------------
0
0
-------------
315,000
0
-------------
0
25NATHAN WHITE
FORMER COO-SCH J, PART III, LINES 4A
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
300,000
0
-------------
0
0
-------------
0
0
-------------
300,000
0
-------------
0
26MARK PAULSON MD
TRUSTEE, PHYSICIAN
(i)

(ii)
221,637
-------------
0
13,500
-------------
0
4,257
-------------
0
10,612
-------------
0
28,057
-------------
0
278,063
-------------
0
0
-------------
0
27ALLISON WIERDA-SUTTLE MD
FORMER SVP, CMO-SCH J PT III, 4A-4B
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
264,600
0
-------------
0
0
-------------
0
0
-------------
264,600
0
-------------
0
Schedule J (Form 990) 2022

Schedule J (Form 990) 2022
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 OFFERED FOR CERTAIN MEETINGS AND EVENTS. THESE COSTS ARE INCLUDED IN THE 1099'S OF THE INDIVIDUALS. SANFORD USED THE SIFL (STANDARD INDUSTRY FARE LEVEL) RATE METHOD TO IMPUTE THE FRINGE BENEFIT TO THE LISTED PERSON. 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 2022.
PART I, LINES 4A-B LINE 4A-SEVERANCE OR CHANGE OF CONTROL PAYMENT 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. EXECUTIVES MAY ALSO QUALIFY FOR A PAYMENT FOR SATISFYING A NON-COMPETE. FINAL SEPARATION PAYMENTS MIGHT VARY FROM THE AMOUNT PROVIDED IN THE AGREEMENT AS A RESULT OF NEGOTIATIONS SURROUNDING POST-SEPARATION OBLIGATIONS AND INCENTIVES (THE "SEPARATION" PAYMENT). LINE 4B-SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS SANFORD SPONSORS NONQUALIFIED RETIREMENT PLANS FOR SELECT OFFICERS OR KEY EMPLOYEES. CERTAIN OF THE BELOW OFFICERS OR KEY EMPLOYEES WERE PAID AS A RESULT OF A VESTING EVENT. LINE 4A AND 4B-PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS AND/OR SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: BRYAN NERMOE: SEPARATION..................................$2,011,302 NONQUALIFIED RETIREMENT PLAN.................$708,639 TOTAL.......................................$2,719,941 RANDY BURY: SEPARATION..................................$2,769,572 JOANN KUNKEL: NON-COMPETE PAYMENT...........................$339,000 KIM PATRICK: NON-COMPETE PAYMENT...........................$315,000 NATHAN WHITE: NON-COMPETE PAYMENT...........................$300,000 ALLISON WIERDA-SUTTLE: NON-COMPETE PAYMENT...........................$264,600
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) 2022

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
2021
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 CHAMBERLAIN
 
46-0000094 000000000 12-30-2010 4,000,000 2010 CHAMB: NEW CONSTRUCTION OF LONG-TERM CARE FACILITIES   X   X   X
C 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
D 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 .................. 57,490,000 2,959,679 35,040,000 19,220,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 4,000,000 66,185,000 45,000,000
4 Gross proceeds in reserve funds ............. 74,550 3,605 3,685  
5 Capitalized interest from proceeds .............   31,874    
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 1,906,127 24,356 150,032
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 4,000,000 110,529,233 45,000,000
11 Other spent proceeds ............. 52,083,720   66,160,644  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2010 2012 2012
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   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   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 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 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
  X   X   X   X
Part
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) 2021

Schedule K (Form 990) 2021
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: 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 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 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) 2021

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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
2021
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 CHAMBERLAIN
 
46-0000094 000000000 12-30-2010 4,000,000 2010 CHAMB: NEW CONSTRUCTION OF LONG-TERM CARE FACILITIES   X   X   X
C 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
D 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 .................. 57,490,000 2,959,679 35,040,000 19,220,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 71,581,953 4,000,000 66,185,000 45,000,000
4 Gross proceeds in reserve funds ............. 74,550 3,605 3,685  
5 Capitalized interest from proceeds .............   31,874    
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 764,068 1,906,127 24,356 150,032
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 70,817,885 4,000,000 110,529,233 45,000,000
11 Other spent proceeds ............. 52,083,720   66,160,644  
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2006 2010 2012 2012
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X   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   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 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 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
  X   X   X   X
Part
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) 2021

Schedule K (Form 990) 2021
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: 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 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 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) 2021

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990)
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
2021
Open to Public Inspection
Name of the organization
SANFORD GROUP RETURN
 
Employer identification number

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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
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) MELINDA ANDERSON FAMILY RELATIONSHIP - MARK PAULSON 169,960 EMPLOYMENT   No
(2) KATHRYN NERMOE FAMILY RELATIONSHIP - BRYAN NERMOE 150,884 EMPLOYMENT   No
(3) KACEY DOYLE FAMILY RELATIONSHIP - MARNIE HERMANN 65,433 EMPLOYMENT   No
(4) KRISTI BENZ FAMILY RELATIONSHIP - LAURIS MOLBERT 60,298 EMPLOYMENT   No
(5) NICHOLE HESTER FAMILY RELATIONSHIP - ANDY NORTH 58,844 INDEPENDENT CONTRACTOR ARRANGEMENT   No
(6) MALLORY NERMOE FAMILY RELATIONSHIP - BRYAN NERMOE 54,485 EMPLOYMENT   No
(7) MEGAN HEMMELGARN FAMILY RELATIONSHIP - MARK PAULSON 17,259 EMPLOYMENT   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990)

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
2021
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, SANFORD HEALTH NETWORK NORTH, 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: BILL GASSEN, BRYAN NERMOE, JENNIFER GRENNAN, MARIA BELL, MARK LUNDEEN, MARK PAULSON, MICHAEL LEBEAU, MICHELLE BRUHN, MICHELLE MICKA, PAUL HANSON, MATT HOCKS, SUSAN JARVIS, TODD SCHAFFER, & TIFFANY LAWRENCE.
FORM 990, PART VI, SECTION A, LINE 6 SANFORD IS GOVERNED BY A BOARD OF TRUSTEES (BOT) THAT HAS ULTIMATE STRATEGIC AND DECISION MAKING AUTHORITY. THE BOT DELEGATES CERTAIN ACTIVITIES AND RESPONSIBILITIES TO BOARDS OF EACH OF SANFORD'S PRIMARY OPERATING SUBSIDIARIES. THE UNIQUE NATURE AND COMPLEXITY OF THE SUBSIDIARIES REQUIRES EACH TO HAVE A DELEGATED BOARD WITH A SINGULAR ENTITY FOCUS. SUCH BODIES, REFERRED TO AS BOARDS OF DIRECTORS AND BOARDS OF GOVERNORS, ADDRESS MATTERS SUCH AS CREDENTIALING, ACCREDITATION STANDARDS, DEVELOPING BUDGETS, PROGRAMS AND FACILITIES ON AN ENTITY-SPECIFIC BASIS, AND GENERALLY CONSIST OF INDIVIDUALS DISTINCT FROM THE BOT. THESE BOARDS FUNCTION MUCH LIKE COMMITTEES IN A TRADITIONAL CORPORATE STRUCTURE. THE BOT THEN ACTS AS A HOLDING COMPANY BOARD, SYNTHESIZING AND RECONCILING EACH ENTITY'S PROGRAMS AND BUDGETS INTO A SYSTEM-WIDE STRATEGIC PLAN. THIS STRUCTURE OF GOVERNANCE PRODUCES A SIGNIFICANT NUMBER OF TRUSTEES, GOVERNORS AND DIRECTORS. SUBSIDIARIES INCLUDED WITHIN THIS GROUP TAX RETURN CONSIST OF SANFORD HEALTH, SANFORD NORTH, SANFORD MEDICAL CENTER, SANFORD MEDICAL CENTER FARGO, SANFORD CLINIC, SANFORD CLINIC NORTH, SANFORD HEALTH NETWORK, SANFORD HEALTH NETWORK NORTH, SANFORD HOME HEALTH, SANFORD RESEARCH, SANFORD RESEARCH NORTH, SANFORD WORLD CLINICS, SANFORD HEALTH OF NORTHERN MINNESOTA, BAKER PARK, INC., SANFORD WEST, SANFORD BISMARCK, SANFORD VIRTUAL CARE, AND SANFORD WORLD CLINICS - KLAMATH FALLLS. 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 THEIR 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 DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR FINANCE SENIOR LEADERSHIP. BEFORE THE RETURN IS FILED, A COMPLETE COPY OF THE RETURN 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 2022. PART VI, LINE 16A: 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 TABLE REPORTS THE COMPENSATION OF THE SANFORD OFFICERS, DIRECTORS/TRUSTEES, SYSTEM KEY EMPLOYEES, AND FIVE HIGHEST COMPENSATED EMPLOYEES AND INDEPENDENT CONTRACTORS. THE SANFORD BOARD OF TRUSTEES HAS ULTIMATE GOVERNANCE RESPONSIBILITIES FOR EACH SUBORDINATE ORGANIZATION.
FORM 990, PART VII, SECTION B WE ARE REPORTING ONE GROUP OF TOP FIVE EMPLOYEES AND INDEPENDENT CONTRACTORS FOR THE ENTIRE GROUP. AMOUNTS LISTED AS COMPENSATION FOR THE FIVE HIGHEST COMPENSATED INDEPENDENT CONTRACTORS INCLUDE PAYMENTS FOR BOTH MATERIALS AND SERVICES.
FORM 990, PART XI, LINE 9: NET PAYROLL PAID BY PARENT NET OF OTHER EXPENSES PAID FOR AFFILIATES 62,167,718. PENSION PLAN ACTURIAL GAIN/LOSS 18,822,320. CAPITAL CONTRIBUTIONS TO SUBSIDIARIES -901,671.
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 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 WORLD CLINICS - KLAMATH FALLS 3001 DAGGETT AVE KLAMATH FALLS, OR 97601 92-0396212 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 VIRTUAL CARE 1305 W 18TH STREET, PO BOX 5039 SIOUX FALLS, SD 57117-5039 EIN: 88-0976483
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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
2021
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) 1527 BROADWAY LLC
1527 BROADWAY
ALEXANDRIA,MN56308
41-1336392
REAL ESTATE MN 0 151,829 SANFORD CLINIC NORTH
 
(2) B&K PROPERTIES LLC
PO BOX 5039 RTE 5218
SIOUX FALLS,SD571175030
83-0614887
REAL ESTATE SD 0 0 SANFORD HEALTH
 
(3) HEALTHCARE ENVIRONMENTAL SERVICES LLC
PO BOX 2010
FARGO,ND58122
20-5236701
RETAIL ENTERPRISES ND 1,143,510 3,806,618 SANFORD NORTH
 
(4) LINCOLN COUNTY REAL ESTATE TRUST
100 S PHILLIPS AVE
SIOUX FALLS,SD57104
46-6126929
REAL ESTATE SD     SANFORD HEALTH
 
(5) LYNX TRUST
PO BOX 5186
SIOUX FALLS,SD57117
26-6167201
INVESTMENT SD     SANFORD HEALTH
 
(6) NATIONAL STUDENT HOUSING TRUST-SD
PO BOX 5186
SIOUX FALLS,SD57117
20-6831968
INVESTMENT SD 0 0 SANFORD HEALTH
 
(7) NORTH COUNTRY SENIOR LIVING LLC
1000 ANNE ST NW
BEMIDJI,MN56601
26-3862586
SENIOR HOUSING CO 3,839,877 5,143,010 SANFORD HEALTH OF NORTHERN MINNESOTA
 
(8) PPK FAMILY TRUST
100 S PHILLIPS AVE
SIOUX FALLS,SD57104
20-7317570
RENTAL REAL ESTATE SD 34,580 2,247,575 SANFORD HEALTH
 
(9) SANFORD HEALTHCARE ACCESSORIES LLC
3223 32ND AVE SW
FARGO,ND58103
20-2404179
SALES OF DURABLE MEDICAL EQUIP ND 0 0 SANFORD HEALTH
 
(10) SHETEK MEDICAL SERVICES LLC
251 5TH STREET E
TRACY,MN56175
41-2004685
HOME HEALTH SERVICES MN 166,282 246 SANFORD HEALTH NETWORK
 
(11) SOUTHWEST MN RADIATION CENTER LLC
1018 6TH AVENUE
WORTHINGTON,MN56187
46-0447693
RADIATION SERVICES MN     SANFORD HEALTH NETWORK
 
Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)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
 
(2)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
 
(3)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
 
(4)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
 
(5)F-M AMBULANCE SERVICE INC
P O BOX 5039 RTE 5218

SIOUX FALLS,SD571175039
45-0344371
EMT ND 501(C)(4)   SANFORD NORTH
 
Yes
 
(6)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
 
(7)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
 
(8)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
 
(9)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
 
(10)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
 
(11)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
 
(12)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
 
(13)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
 
(14)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
 
(15)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
 
(16)SANFORD
P O BOX 5039 RTE 5218

SIOUX FALLS,SD571175039
27-1218956
SUPPORTING ORGANIZATION ND 501(C)(3) 12-II  
 
No
(17)SANFORD HEALTH FOUNDATION
P O BOX 5039 RTE 5218

SIOUX FALLS,SD571175039
36-3297853
FOUNDATION SD 501(C)(3) 12-II SANFORD HEALTH
 
Yes
 
(18)SANFORD HEALTH FOUNDATION NORTH
P O BOX 5039 RTE 5218

SIOUX FALLS,SD571175039
45-0398104
FOUNDATION ND 501(C)(3) 7 SANFORD NORTH
 
Yes
 
(19)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
 
(20)SANFORD HEALTH FOUNDATION WEST
P O BOX 5039 RTE 5218

SIOUX FALLS,SD571175039
45-0397196
FOUNDATION ND 501(C)(3) 7 SANFORD BISMARCK
 
Yes
 
(21)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
 
(22)THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
P O BOX 5039 RTE 5218

SIOUX FALLS,SD571175039
46-0422866
FOUNDATION MN 501(C)(3) 12-I SANFORD HEALTH
 
Yes
 
(23)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) 10 SANFORD
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 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  
(2) 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  
(3) 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  
(4) 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  
(5) 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  
(6) 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  
(7) NATIONAL STUDENT HOUSING-SOUTH DAKOTA LLC

100 S PHILLIPS AVE
SIOUX FALLS,SD57104
20-2129839
INVESTMENT SD N/A
        No     No  
(8) 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  
(9) 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  
(10) 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  
(11) RAC RENTALS LLC

100 S PHILLIPS AVE
SIOUX FALLS,SD57104
26-1961077
INVESTMENT SD N/A
        No     No  
(12) 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  
(13) 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  
(14) 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  
(15) 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  
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) GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA INC

P O BOX 5039 RTE 5218
SIOUX FALLS,SD571175039
81-5037667
INSURANCE NE N/A
C         No
(2) GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA

P O BOX 5039 RTE 5218
SIOUX FALLS,SD571175039
81-5020633
INSURANCE ND N/A
C         No
(3) GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA INC

P O BOX 5039 RTE 5218
SIOUX FALLS,SD571175039
81-4989242
INSURANCE SD N/A
C         No
(4) GOOD SAMARITAN SOCIETY INSURANCE LTD

P O BOX 5039 RTE 5218
SIOUX FALLS,SD571175039
98-0379099
INSURANCE CJ N/A
C         No
(5) 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         No
(6) 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         No
(7) 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         No
(8) 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         No
(9) 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         No
(10) SANFORD FRONTIERS

1305 W 18TH STREET PO BOX 5039
SIOUX FALLS,SD571175039
45-5436599
WEIGHT LOSS/FITNESS SD N/A
C         No
(11) SANFORD HEALTH PLAN

300 CHERAPA PLACE
SIOUX FALLS,SD57103
91-1842494
INSURANCE SD N/A
C         No
(12) SANFORD HEALTH PLAN OF MN

300 CHERAPA PLACE
SIOUX FALLS,SD57103
46-0445852
INSURANCE MN N/A
C         No
(13) SANFORD INTERNATIONAL - MUNICH GMBH

NYMPHENBURGER STRASSE 3
MUNICH    
GM
HEALTHCARE GM N/A
C         No
(14) SANFORD WORLD CLINICS - GHANA

SARBAH ROAD TANTRI LORRY STATION
CAPE COAST    
GH
HEALTHCARE GH N/A
C         No
(15) SHANGHAI SANFORD HEALTHCARE MANAGEMENT CONSULTING CO LTD

188 YESHENG ROAD ROOM A-862 GUOMA
SHANGHAI    
CH
HEALTHCARE CH N/A
C         No
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) FM AMBULANCE

R 133,088 CASH METHOD
(2) SANFORD (PARENT)

R 146,935,197 CASH METHOD
(3) SANFORD FRONTIERS

B 36,733,574 CASH METHOD
(4) SANFORD HEALTH FOUNDATION

S 476,075 CASH METHOD
(5) SANFORD HEALTH FOUNDATION

P 4,682,184 CASH METHOD
(6) SANFORD HEALTH FOUNDATION

C 35,269,345 CASH METHOD
(7) SANFORD HEALTH FOUNDATION NORTH

S 525,796 CASH METHOD
(8) SANFORD HEALTH FOUNDATION NORTH

P 2,249,273 CASH METHOD
(9) SANFORD HEALTH FOUNDATION NORTH

C 5,107,410 CASH METHOD
(10) SANFORD HEALTH FOUNDATION NORTHERN MN

P 623,005 CASH METHOD
(11) SANFORD HEALTH FOUNDATION NORTHERN MN

C 1,515,432 CASH METHOD
(12) SANFORD HEALTH FOUNDATION NORTHERN MN

S 3,109,854 CASH METHOD
(13) SANFORD HEALTH FOUNDATION WEST

P 943,446 CASH METHOD
(14) SANFORD HEALTH FOUNDATION WEST

C 1,191,151 CASH METHOD
(15) SANFORD HEALTH FOUNDATION WEST

S 1,441,680 CASH METHOD
(16) SANFORD WORLD CLINICS - GHANA

B 876,672 CASH METHOD
(17) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION

R 696,358 CASH METHOD
(18) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION

P 1,361,596 CASH METHOD
(19) THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

S 6,391,581 CASH METHOD
(20) SANFORD HEALTH PLAN

B 15,000,000 CASH METHOD
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


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