TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) AMY HART...................................................................... CEO	40.00 .................	X	X		481,422	35,545
(2) DR JOSHUA HOROWITZ...................................................................... DIRECTOR/PHYSICIAN	1.00 .................	X			0	0
(3) DR PAIGE HOLMGREN...................................................................... DIRECTOR/PHYSICIAN	1.00 .................	X			0	0
(4) JAMIE SKJEVELAND...................................................................... DIRECTOR	1.00 .................	X			0	0
(5) JOEL STAEHLING...................................................................... DIRECTOR UNTIL 2/4/24	1.00 .................	X			0	0
(6) JULIE MOHS...................................................................... DIRECTOR	1.00 .................	X			0	0
(7) LORI BURGSTALER...................................................................... DIRECTOR	1.00 .................	X			0	0
(8) KENT FELTZ...................................................................... DIRECTOR UNTIL 8/15/23	1.00 .................	X			0	0
(9) GRETCHEN ROGERS...................................................................... DIRECTOR START 12/19/23	1.00 .................	X			0	0
(10) WADE LEONARD...................................................................... VICE CHAIR	1.00 .................	X	X		0	0
(11) BART TAYLOR...................................................................... CHAIR	1.00 .................	X	X		0	0
(12) KATIE BERG...................................................................... CFO	40.00 .................		X		315,554	19,852
(13) FAWN ATCHISON...................................................................... ANESTHESIOLOGIST	40.00 .................			X	632,356	30,783
(14) LEAH KIPPES...................................................................... ANESTHESIOLOGIST	40.00 .................			X	569,905	55,935
(15) KYLE MOORE...................................................................... PHYSICIAN	40.00 .................			X	514,084	45,659
(16) KYLE DURGIN...................................................................... PHYSICIAN	40.00 .................			X	489,335	44,772
(17) CHRISTOPHER KACZMARCZYK...................................................................... PHYSICIAN	40.00 .................			X	498,904	17,537

(A) Name and business address	(B) Description of services	(C) Compensation
PREMIER SURGICAL ASSOCIATES PA 318 E MAIN STREET CROSBY,MN56441	PHYSICIAN FEES	14,373,293
CENTRAL LAKES PHYSICIANS PA 318 E MAIN STREET CROSBY,MN56441	PHYSICIAN FEES	5,739,216
MEDICAL SOLUTIONS INC PO BOX 850737 MINNEAPOLIS,MN554850737	PHYSICIAN FEES	3,233,421
CENTRAL MN DIAGNOSTIC INC PO BOX 158 MILACA,MN56353	RADIOLOGY SERVICES	2,826,894
MINNESOTA INTERVENTIONAL SPINE CONSULTAN 23080 CROSS DR DEERWOOD,MN56444	PHYSICIAN FEES	2,331,575
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 26

- TIN:

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

2023

Open to Public
Inspection

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. 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—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.)..

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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990) 2023

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

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer 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).

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

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

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).

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

Did one or more disqualified persons (as defined 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.

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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

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

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.

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

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

By reason of the relationship described in 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.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2023

Page 6

Part V

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

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

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

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

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

Schedule A (Form 990) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2023

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization CUYUNA REGIONAL MEDICAL CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization CUYUNA REGIONAL MEDICAL CENTER		Employer identification number 41-1724637

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization CUYUNA REGIONAL MEDICAL CENTER			Employer identification number 41-1724637
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

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

right arrow

Complete if the organization is described below. 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

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

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

1,999

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

1,999

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	CUYUNA REGIONAL MEDICAL CENTER PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING.

Schedule C (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
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

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

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

Number of states where property subject to conservation easement is located right arrow

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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

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

Yes

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

3a(i)

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

3a(ii)

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

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 .....	304,340		304,340
b	Buildings ....	86,837,980	47,340,200	39,497,780
c	Leasehold improvements
d	Equipment ....	67,923,487	55,266,429	12,657,058
e	Other .....	4,906,492	1,397,280	3,509,212
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				55,968,390

Schedule D (Form 990) 2022

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.)

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.)

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)DUE FROM AFFILIATES				977,573
(2)RIGHT-OF-USE LEASE ASSETS				10,783,218
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				11,760,791

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
DUE TO AFFILIATE	2,954,847
CRM DUE TO MEDICARE	29,263,195
RIGHT-OF-USE LEASE LIABILITIES	11,121,852
FINANCE LEASE LIABILITIES	31,940





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	43,371,834
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) 2022

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:	THE HOSPITAL IS A CUSTODIAN OF FUNDS FOR RESIDENTS. THE HOSPITAL HOLDS THESE FUNDS FOR PURCHASES MADE BY THE RESIDENTS.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .			3,068,399		3,068,399	1.520 %
b	Medicaid (from Worksheet 3, column a) . . . . .			29,279,020	16,184,519	13,094,501	6.470 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			32,347,419	16,184,519	16,162,900	7.990 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	16	6,989	202,381		202,381	0.100 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			446,006		446,006	0.220 %
j	Total. Other Benefits . .	16	6,989	648,387		648,387	0.320 %
k	Total. Add lines 7d and 7j .	16	6,989	32,995,806	16,184,519	16,811,287	8.310 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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
2	Economic development	1		4,305		4,305	0 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	1		13,312		13,312	0.010 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	2		17,617		17,617	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

7,604,515

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. ......

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

Section B. Medicare

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

31,758,452

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

32,270,247

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

-511,795

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2023

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?1Name, 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)						Other (describe)
1	CUYUNA REGIONAL MEDICAL CENTER 320 EAST MAIN STREET CROSBY,MN56441 410629	X	X	X	X	N/A

Schedule H (Form 990) 2023

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)

	CUYUNA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 23

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): SEE PART V, PAGE 8

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23

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

Yes

If "Yes" (list url): SEE PART V, PAGE 8

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

10b

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

12a

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

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CUYUNA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 250.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

HTTPS://CUYUNAMED.ORG/PATIENT-INFORMATION/BILLING

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

HTTPS://CUYUNAMED.ORG/PATIENT-INFORMATION/BILLING

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://CUYUNAMED.ORG/PATIENT-INFORMATION/BILLING

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	CUYUNA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	CUYUNA REGIONAL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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
CUYUNA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 5: IN COLLABORATION WITH ESSENTIA HEALTH/ST. JOSEPH MEDICAL CENTER, CUYUNA REGIONAL MEDICAL CENTER (CRMC) TOOK A PROACTIVE APPROACH TO UNDERSTAND AND ADDRESS THE HEALTHCARE NEEDS OF CROW WING COUNTY. HERE IS AN OVERVIEW OF OUR COMPREHENSIVE SURVEY INITIATIVES:1) COMMUNITY HEALTH NEEDS SURVEY (SUMMER 2021):CRMC, IN PARTNERSHIP WITH ESSENTIA HEALTH/ST. JOSEPH MEDICAL CENTER, CONDUCTED A THOROUGH SURVEY IN THE SUMMER OF 2021 TO ASSESS THE HEALTH NEEDS OF CROW WING COUNTY. THIS COLLABORATIVE EFFORT AIMED TO GATHER INSIGHTS INTO THE SPECIFIC CHALLENGES AND REQUIREMENTS OF THE COMMUNITY, LAYING THE FOUNDATION FOR TARGETED AND EFFECTIVE HEALTHCARE INITIATIVES.2) PATIENT SURVEY (FEBRUARY 2023):IN FEBRUARY 2023, CRMC CONDUCTED A SURVEY AMONG ITS PATIENTS TO OBTAIN DIRECT FEEDBACK ON THEIR HEALTHCARE EXPERIENCES. THIS INITIATIVE WAS CRUCIAL IN UNDERSTANDING THE PERSPECTIVES OF THOSE RECEIVING MEDICAL SERVICES, ALLOWING US TO IDENTIFY AREAS FOR IMPROVEMENT AND BETTER CATER TO THE NEEDS OF OUR PATIENT POPULATION.3) STAKEHOLDER SURVEY (MARCH 2023):RECOGNIZING THE IMPORTANCE OF ENGAGING WITH KEY COMMUNITY STAKEHOLDERS, CRMC CONDUCTED A SURVEY IN MARCH 2023. REPRESENTATIVES FROM VARIOUS ORGANIZATIONS, INCLUDING CROSBY-IRONTON SCHOOL DISTRICT, SMILES FOR JAKE, HALLETT COMMUNITY CENTER, POPULATION HEALTH NURSES, CENTRAL MINNESOTA COUNCIL ON AGING, NORTHLAND ARBORETUM, CROW WING COUNTY PUBLIC HEALTH, CITY OF CROSBY, YMCA, AND CROW WING COUNTY AGING SERVICES, PROVIDED VALUABLE INSIGHTS. THIS COLLABORATIVE EFFORT ENSURED A COMPREHENSIVE UNDERSTANDING OF THE DIVERSE PERSPECTIVES AND PRIORITIES WITHIN THE COMMUNITY.4) DATA COMPILATION FROM CROW WING COUNTY PUBLIC HEALTH AND LOCAL SCHOOLS:TO ENHANCE THE DEPTH OF OUR RESEARCH, CRMC GATHERED ADDITIONAL DATA FROM CROW WING COUNTY PUBLIC HEALTH AND LOCAL SCHOOLS. THIS MULTI-FACETED APPROACH ALLOWED US TO CROSS-REFERENCE INFORMATION, ENSURING A COMPREHENSIVE AND ACCURATE REPRESENTATION OF THE COMMUNITY'S HEALTH NEEDS.BY SYNTHESIZING DATA FROM DIVERSE SOURCES AND ENGAGING WITH COMMUNITY STAKEHOLDERS, CRMC IS WELL-POSITIONED TO DEVELOP AND IMPLEMENT TARGETED HEALTHCARE INITIATIVES THAT ADDRESS THE UNIQUE NEEDS OF CROW WING COUNTY. WE REMAIN COMMITTED TO FOSTERING A HEALTHIER COMMUNITY THROUGH INFORMED, COLLABORATIVE, AND PATIENT-CENTRIC APPROACHES TO HEALTHCARE.
CUYUNA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6A: ESSENTIA HEALTH/ST. JOSEPH'S MEDICAL CENTER IN BRAINERD
CUYUNA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 6B: CROW WING COUNTY HUMAN SERVICES, CENTRAL MINNESOTA COUNCIL ON AGING, CITY OF CROSBY, HALLETT CENTER OF CROSBY, BRAINERD YMCA, CROSBY-IRONTON SCHOOLS, CROW WING COUNTY PUBLIC HEALTH, NORTHLAND ARBORETUM, CTC, AND SMILES FOR JAKE.
CUYUNA REGIONAL MEDICAL CENTER	PART V, SECTION B, LINE 11: MENTAL HEALTH INITIATIVES AT CUYUNA REGIONAL MEDICAL CENTER (CRMC)CUYUNA REGIONAL MEDICAL CENTER (CRMC) HAS IMPLEMENTED A COMPREHENSIVE AND PROACTIVE STRATEGY TO ADDRESS SIGNIFICANT MENTAL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CRMC'S MENTAL HEALTH INITIATIVES EMPHASIZE TREATMENT, PREVENTION, EDUCATION, AND COMMUNITY ENGAGEMENT, REFLECTING A BROAD COMMITMENT TO FOSTERING A SUPPORTIVE ENVIRONMENT FOR MENTAL WELLNESS.1. PARTNERSHIP WITH SMILES FOR JAKE:CRMC COLLABORATES WITH SMILES FOR JAKE, A SUICIDE PREVENTION INITIATIVE, PROMOTING THE S.M.I.L.E. ADVOCATE PROGRAM. THIS PROGRAM INCREASES AWARENESS OF MENTAL HEALTH RISK FACTORS, PROTECTIVE FACTORS, WARNING SIGNS, AND AVAILABLE RESOURCES. BY FOCUSING ON EDUCATION AND PEER SUPPORT, CRMC AIMS TO EQUIP COMMUNITY MEMBERS WITH TOOLS TO SUPPORT EACH OTHER EFFECTIVELY.2. COMMUNITY MENTAL HEALTH INITIATIVES:CRMC'S PARTNERSHIP WITH SMILES FOR JAKE EXTENDS TO A VARIETY OF COMMUNITY ENGAGEMENT ACTIVITIES. THESE INCLUDE THE CREATION OF A HOPE WALKING PATH AT IMMANUEL LUTHERAN CHURCH, SPONSORSHIP OF EVENTS LIKE PAINT THE TOWN BLUE FOR MENTAL HEALTH, AND ORGANIZING "SNOW MANY SMILES," A FREE HOLIDAY EVENT THAT ENCOURAGES COMMUNITY CONNECTION AND SUPPORT. CRMC PROVIDES RESOURCES, VOLUNTEERS, AND LOGISTICAL SUPPORT FOR THESE EVENTS, ENHANCING COMMUNITY RESILIENCE AND REDUCING SOCIAL ISOLATION.3. DEPRESSION SCREENING IN CLINICS:TO ADDRESS MENTAL HEALTH PROACTIVELY, CRMC SCREENS ALL CLINIC PATIENTS FOR DEPRESSION. POSITIVE SCREENINGS ARE MET WITH IMMEDIATE ASSISTANCE AND REFERRALS TO APPROPRIATE MENTAL HEALTH RESOURCES, ENSURING TIMELY INTERVENTION AND CONTINUITY OF CARE.4. PROMOTION OF MENTAL WELLBEING:CRMC PROMOTES MENTAL WELLBEING THROUGH COMMUNITY ENGAGEMENT BY SHARING POSITIVE MESSAGES, ORGANIZING SOCIAL AND CREATIVE ACTIVITIES, AND PROVIDING INTERACTIVE OUTLETS LIKE PAINTING ROCKS WITH AFFIRMATIONS. THESE ACTIVITIES ARE DESIGNED TO FOSTER POSITIVITY AND COMMUNITY SPIRIT.5. WELLNESS PROMOTION PROGRAMS:CRMC ENCOURAGES HOLISTIC WELLNESS WITH INITIATIVES SUCH AS "3 GOOD THINGS" GRATITUDE JOURNALS, RANDOM ACTS OF KINDNESS TREES, AND STRESS RELIEF ACTIVITIES. THESE PROGRAMS EMPHASIZE MENTAL HEALTH AS A CORNERSTONE OF OVERALL WELL-BEING AND HAPPINESS.NEEDS NOT ADDRESSEDWHILE CRMC'S EFFORTS COMPREHENSIVELY TARGET MENTAL HEALTH, CERTAIN NEEDS MAY REMAIN UNMET DUE TO RESOURCE LIMITATIONS OR THE NEED FOR SPECIALIZED SERVICES. FOR EXAMPLE, IF A LACK OF SPECIALIZED INPATIENT PSYCHIATRIC CARE OR CERTAIN DEMOGRAPHIC-SPECIFIC SERVICES EXISTS, THESE GAPS ARE ATTRIBUTED TO WORKFORCE AVAILABILITY. CRMC REMAINS COMMITTED TO EVALUATING THESE GAPS AND EXPLORING POTENTIAL PARTNERSHIPS OR RESOURCES TO EXPAND ITS IMPACT AS OPPORTUNITIES ARISE. THROUGH THESE INITIATIVES, CRMC IS DEDICATED TO FOSTERING A HEALTHIER, MORE SUPPORTIVE COMMUNITY WHILE CONTINUOUSLY EVALUATING AND ENHANCING ITS MENTAL HEALTH SERVICES IN RESPONSE TO EVOLVING NEEDS.SEE PART V, PAGE 8 FOR CONTINUATION.
PART V, LINE 7A, CHNA - HOSPITAL'S WEBSITE	HTTPS://WWW.CUYUNAMED.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, LINE 10, IMPLEMENTATION PLAN WEBSITE:	HTTPS://WWW.CUYUNAMED.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 11, CONTINUED:	PROMOTING HEALTHY EATING AT CUYUNA REGIONAL MEDICAL CENTER (CRMC)CUYUNA REGIONAL MEDICAL CENTER (CRMC) HAS DEVELOPED A COMPREHENSIVE APPROACH TO ADDRESS THE SIGNIFICANT NEED FOR PROMOTING HEALTHY EATING, AS IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). BY COMBINING EDUCATION, DIRECT SUPPORT, AND STRATEGIC COMMUNITY PARTNERSHIPS, CRMC FOSTERS A HEALTHIER COMMUNITY AND SUPPORTS INDIVIDUALS IN MAKING NUTRITIOUS CHOICES.1. DIABETES EDUCATION AND SUPPORT GROUPS:CRMC OFFERS SPECIALIZED EDUCATION AND SUPPORT GROUPS FOR INDIVIDUALS MANAGING DIABETES. THESE PROGRAMS EMPHASIZE THE VITAL ROLE OF HEALTHY EATING IN MANAGING THE CONDITION, PROVIDING PARTICIPANTS WITH KNOWLEDGE AND TOOLS TO MAKE INFORMED DIETARY DECISIONS.2. SPONSORSHIP OF FARMER'S MARKET, POWER OF PRODUCE PROGRAMS AND COMMUNITY FALL HARVEST DINNER:CRMC SPONSORS THE LOCAL FARMER'S MARKET AND ITS POWER OF PRODUCE PROGRAM, WHICH ENCOURAGES YOUTH AND SENIORS TO INCREASE INCREASED THEIR CONSUMPTION OF FRESH FRUITS AND VEGETABLES. ADDITIONALLY, CRMC SUPPORTS THE COMMUNITY FALL HARVEST DINNER TO PROMOTE HEALTHY EATING BY FOSTERING COMMUNITY ENGAGEMENT AND ACCESS TO NUTRITIOUS MEALS. 3. YOUTH NUTRITION PROGRAMS - LUNCH BUNCH:TO COMBAT FOOD INSECURITY AMONG CHILDREN, CRMC ACTIVELY PARTICIPATES IN THE CUYUNA LAKES LUNCH BUNCH PROGRAM, PROVIDING 4,601 FREE LUNCHES TO LOCAL YOUTH. CRMC ALSO CONTRIBUTES FUNDS TO OPERATION SANDWICH, SUPPORTING BRAINERD AREA STUDENTS. THESE INITIATIVES ENSURE THAT CHILDREN HAVE CONSISTENT ACCESS TO NUTRITIOUS MEALS DURING TIMES WHEN SCHOOL-BASED MEAL PROGRAMS ARE UNAVAILABLE.4. SUPPORTED COMMUNITY TABLE:CRMC PROVIDES FINANCIAL SUPPORT AND VOLUNTEERS TO HELP PREPARE AND SERVE MEALS AT ST. JOSEPH'S CHURCH AS PART OF THE COMMUNITY TABLE INITIATIVE. THIS PROGRAM PROMOTES ACCESS TO NUTRITIOUS MEALS, NOURISHES COMMUNITY SPIRT AND STRENGTHENS SOCIAL CONNECTIONS. 5. SENIOR FROZEN MEAL DISTRIBUTION:IN PARTNERSHIP WITH CATHOLIC CHARITIES, CRMC COORDINATES AND DISTRIBUTES FREE FROZEN MEALS TO SENIORS IN DEERWOOD. THIS INITIATIVE IMPROVES ACCESS TO CONVENIENT, NUTRITIOUS MEALS FOR OLDER ADULTS, SUPPORTING THEIR OVERALL HEALTH AND WELL-BEING.6. CARE MANAGEMENT TEAM ADDRESSING FOOD INSECURITY:CRMC'S CARE MANAGEMENT TEAM COLLABORATES WITH HOSPITAL DEPARTMENTS AND STAFF TO STOCK LOCAL FOOD PANTRIES BUILT BY HIGH SCHOOL STUDENTS. THE TEAM ALSO DISTRIBUTES SUPER ONE GIFT CARDS AND FOOD PACKS TO PATIENTS IN NEED, PROVIDING PRACTICAL, IMMEDIATE SUPPORT TO THOSE INDIVIDUALS FACING FOOD INSECURITY. NEEDS NOT ADDRESSEDDESPITE SUBSTANTIAL PROGRESS, CERTAIN NEEDS REMAIN UNADDRESSED DUE TO LIMITED RESOURCES, FUNDING CONSTRAINTS, OR SPECIALIZED SERVICE REQUIREMENTS. EXAMPLES INCLUDE:- SPECIALIZED DIETARY SERVICES: THERE IS LIMITED ACCESS TO PERSONALIZED NUTRITION COUNSELING OR MEAL PLANNING FOR INDIVIDUALS WITH DIETARY NEEDS BEYOND DIABETES MANAGEMENT.- EXPANDED MEAL DELIVERY PROGRAMS: RESOURCE LIMITATIONS RESTRICT THE EXPANSION OF MEAL PROGRAMS TO ADDITIONAL UNDERSERVED AREAS OR POPULATIONS.CRMC REMAINS COMMITTED TO ONGOING EVALUATION AND THE PURSUIT OF ADDITIONAL RESOURCES AND PARTNERSHIPS TO FILL THESE GAPS AS OPPORTUNITIES ARISE.BY PRIORITIZING EDUCATION, DIRECT SUPPORT, AND COMMUNITY ENGAGEMENT, CRMC CONTINUES TO ENHANCE ACCESS TO HEALTHY FOOD AND FOSTER BETTER DIETARY HABITS FOR A HEALTHIER COMMUNITY.PROMOTING ACTIVE LIVING AT CUYUNA REGIONAL MEDICAL CENTER (CRMC)CUYUNA REGIONAL MEDICAL CENTER (CRMC) ACTIVELY ADDRESSES THE SIGNIFICANT NEED FOR PROMOTING ACTIVE LIVING, AS IDENTIFIED IN ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THROUGH DIVERSE INITIATIVES TARGETING STUDENTS, ATHLETES, AND THE BROADER COMMUNITY, CRMC FOSTERS A CULTURE OF PHYSICAL ACTIVITY AND WELL-BEING.1. C-I SCHOOLS MOUNTAIN BIKE TRAIL AND OUTDOOR CLASSROOM:CRMC PROVIDED SUBSTANTIAL FINANCIAL SUPPORT FOR THE CREATION OF A 0.5-MILE MOUNTAIN BIKE TRAIL AND OUTDOOR CLASSROOM AT CROSBY-IRONTON ELEMENTARY SCHOOL (CRES). THIS PROJECT INTRODUCES STUDENTS IN GRADES 3 THROUGH 6 TO MOUNTAIN BIKING SKILLS, OFFERING ACCESS TO A UNIQUE LOCAL RESOURCE. SINCE THE TRAILS WERE BUILT IN 2011 AROUND OLD MINING PITS TURNED LAKES, THE AREA HAS BECOME RENOWNED FOR MOUNTAIN BIKING. THIS INITIATIVE HELPS STUDENTS EXPERIENCE WHAT THEIR COMMUNITY IS KNOWN FOR WHILE PROMOTING OUTDOOR PHYSICAL ACTIVITY.2. ATHLETIC TRAINING SERVICES:CRMC ENHANCES THE HEALTH AND SAFETY OF STUDENT ATHLETES BY PROVIDING ATHLETIC TRAINING SERVICES TO CROSBY-IRONTON SCHOOL, CENTRAL LAKES COLLEGE, AND PEQUOT LAKES HIGH SCHOOL. THIS ENSURES THAT ATHLETES RECEIVE PROPER CARE, INJURY PREVENTION, AND REHABILITATION GUIDANCE, SUPPORTING SAFE SPORTS PARTICIPATION.3. SPONSORSHIP OF THE CUYUNA CRUSHER:CRMC SPONSORS THE CUYUNA CRUSHER, THE AREA'S LARGEST MOUNTAIN BIKE RACE. THIS EVENT ENCOURAGES COMMUNITY PARTICIPATION IN OUTDOOR RECREATION, SUPPORTING BOTH PHYSICAL HEALTH AND SOCIAL ENGAGEMENT.4. COMMUNITY EDUCATION CLASSES AND SEMINARS:CRMC PROVIDES EDUCATION ON ACTIVE LIVING THROUGH CLASSES SUCH AS LIVING WELL, YOUTH SPORTS COACHING, AND COACHES' SEMINARS. ACTIVITIES AT LOCAL FESTIVALS AND NEW PARTNERSHIPS, INCLUDING WITH CROSSLAKE CARES, OFFER SENIORS EDUCATION ON MAINTAINING AN ACTIVE LIFESTYLE. THESE PROGRAMS RAISE AWARENESS ABOUT THE BENEFITS OF PHYSICAL ACTIVITY AND PROVIDE PRACTICAL RESOURCES FOR STAYING ACTIVE.5. SPONSORSHIP OF LOCAL YOUTH RUN AND TRIATHLON:CRMC ACTIVELY PROMOTES PHYSICAL ACTIVITY AMONG YOUTH BY SPONSORING A LOCAL YOUTH RUN AND TRIATHLON. THESE EVENTS FOSTER LIFELONG HEALTHY HABITS BY ENGAGING CHILDREN IN RUNNING, BIKING, AND SWIMMING.NEEDS NOT ADDRESSED WHILE CRMC'S INITIATIVES PROMOTE ACTIVE LIVING BROADLY, CERTAIN GAPS REMAIN DUE TO RESOURCE LIMITATIONS OR SPECIALIZED SERVICE REQUIREMENTS, SUCH AS:- ACCESSIBLE FITNESS PROGRAMS FOR SPECIFIC POPULATIONS: PROGRAMS TAILORED TO INDIVIDUALS WITH DISABILITIES OR CHRONIC CONDITIONS MAY BE LIMITED BY AVAILABLE FUNDING OR PERSONNEL.- YEAR-ROUND INDOOR ACTIVITY SPACES: ACCESS TO INDOOR FACILITIES FOR WINTER ACTIVITY PROMOTION MAY BE RESTRICTED BY BUDGET OR PARTNERSHIPS.CRMC REMAINS COMMITTED TO CONTINUOUSLY ASSESSING AND ADDRESSING THESE NEEDS AS OPPORTUNITIES AND RESOURCES ALLOW.THROUGH A COMBINATION OF DIRECT SERVICES, COMMUNITY SUPPORT, AND EDUCATION, CRMC CONTINUES TO BUILD A HEALTHIER, MORE ACTIVE COMMUNITY THAT VALUES PHYSICAL WELLNESS AND VITALITY.

Schedule H (Form 990) 2023

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?5
Name and address		Type of Facility (describe)
1	1 - BAXTER CLINIC 13205 ISLE DRIVE BAXTER,MN56425	FREE-STANDING CLINIC
2	2 - LONGVILLE CLINIC 180 JORDAN LANE LONGVILLE,MN56655	RURAL HEALTH CLINIC
3	3 - CARE CENTER 320 EAST MAIN CROSBY,MN56441	SKILLED NURSING FACILITY
4	4 - BREEZY POINT CLINIC 30833 NORTH STAR DRIVE SUITE 1 BREEZY POINT,MN56472	FREE-STANDING CLINIC
5	5 - SUPER ONE CLINIC 22418 STATE HWY 6 SUITE 300 CROSBY,MN56441	FREE-STANDING CLINIC
6
7
8
9
10

Schedule H (Form 990) 2023

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 7:	COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED MEDICARE COST REPORT.
PART I, LN 7 COL(F):	IMPLICIT PRICE CONCESSIONS THAT WERE SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $7,604,515.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES AT CUYUNA REGIONAL MEDICAL CENTER (CRMC)CUYUNA REGIONAL MEDICAL CENTER (CRMC) IS DEEPLY COMMITTED TO FOSTERING COMMUNITY WELL-BEING THROUGH A RANGE OF COMMUNITY-BUILDING ACTIVITIES. THESE INITIATIVES ALIGN WITH CRMC'S MISSION TO PROMOTE HEALTH, ENHANCE ECONOMIC STABILITY, AND STRENGTHEN SOCIAL CONNECTIONS, ALL OF WHICH CONTRIBUTE TO IMPROVED HEALTH OUTCOMES IN THE COMMUNITIES IT SERVES.1. FINANCIAL SUPPORT FOR ECONOMIC DEVELOPMENTCRMC PROVIDED FINANCIAL ASSISTANCE TO THE CASS COUNTY ECONOMIC DEVELOPMENT CORPORATION TO SUPPORT THE LONGVILLE LAKES CLINIC. THIS INVESTMENT SUPPORTED JOB CREATION, BUSINESS GROWTH, AND ECONOMIC DIVERSIFICATION IN THE REGION. BY ENHANCING EMPLOYMENT OPPORTUNITIES AND ECONOMIC VITALITY, THIS INITIATIVE ADDRESSED SOCIAL DETERMINANTS OF HEALTH, CONTRIBUTING TO A MORE STABLE AND HEALTHIER COMMUNITY ENVIRONMENT.2. SUPPORT FOR LOCAL CHAMBERS OF COMMERCE AND COMMUNITY EVENTSCRMC ACTIVELY SUPPORTED LOCAL CHAMBERS OF COMMERCE, INCLUDING THE BRAINERD LAKES AND LONGVILLE CHAMBERS. THESE COLLABORATIONS STRENGTHENED THE LOCAL BUSINESS ENVIRONMENT, PROMOTED ECONOMIC RESILIENCE, AND FOSTERED A SENSE OF COMMUNITY CONNECTION. SUPPORTING COMMERCE AND COMMUNITY EVENTS HELPS BUILD A COHESIVE AND THRIVING COMMUNITY, WHICH IS FOUNDATIONAL TO LONG-TERM HEALTH AND WELLNESS.3. COALITION BUILDING THROUGH COMMUNITY EVENTSIN PARTNERSHIP WITH SMILES FOR JAKE, CRMC HOSTED SNOW MANY SMILES/CUYUNA CHRISTMAS, A FREE, FAMILY-ORIENTED EVENT ATTENDED BY OVER 1,100 PEOPLE. THE EVENT TRANSFORMED A COMMUNITY PARK INTO A FESTIVE WINTER CELEBRATION, DIRECTLY ADDRESSING KEY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PRIORITIES, INCLUDING PROMOTING MENTAL HEALTH, ENCOURAGING PHYSICAL ACTIVITY, AND INCREASING ACCESS TO FOOD. - MENTAL HEALTH PROMOTION: THE EVENT CREATED A JOYFUL, INCLUSIVE ENVIRONMENT THAT STRENGTHENED SOCIAL CONNECTIONS, COMBATED ISOLATION, AND FOSTERED A SENSE OF BELONGING - KEY ELEMENTS IN SUPPORTING MENTAL HEALTH. - PHYSICAL ACTIVITY: FUN, ENGAGING ACTIVITIES LIKE REINDEER RACES EMPHASIZED THE IMPORTANCE OF EXERCISE IN A SEASONAL, CREATIVE WAY. - ACCESS TO NUTRITIOUS FOOD: CRMC PROVIDED COMPLIMENTARY CHICKEN NOODLE SOUP, HOT CHOCOLATE, POPCORN, AND COOKIES, ENSURING ATTENDEES HAD ACCESS TO FOOD WHILE ENJOYING THE FESTIVITIES.ATTENDEES EXPERIENCED LIVE MUSIC, FIRE DANCERS, A PETTING ZOO, CAROLERS, AND MORE, CULMINATING IN A FIREWORKS DISPLAY. THE EVENT ENCOURAGED PARTICIPANTS TO DISCONNECT FROM DAILY STRESS AND ENJOY A SUPPORTIVE COMMUNITY ATMOSPHERE, IMPROVING MENTAL WELL-BEING AND BUILDING LASTING COMMUNITY TIES.CRMC'S COMMUNITY-BUILDING INITIATIVES DEMONSTRATE ITS PROACTIVE COMMITMENT TO ADDRESSING SOCIAL DETERMINANTS OF HEALTH BY ENHANCING ECONOMIC DEVELOPMENT, FOSTERING COMMUNITY ENGAGEMENT, AND CREATING SPACES THAT PROMOTE PHYSICAL AND MENTAL WELLNESS. THESE ACTIVITIES REINFORCE CRMC'S DEDICATION TO IMPROVING THE HEALTH AND VITALITY OF THE POPULATIONS IT SERVES.
PART III, LINE 2:	FROM THE DRAFT FINANCIAL STATEMENTS AS OF FEBRUARY 5, 2025:REVENUES GENERALLY RELATE TO CONTRACTS WITH PATIENTS IN WHICH THE PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO THE PATIENTS. REVENUES ARE RECORDED DURING THE PERIOD THE PERFORMANCE OBLIGATIONS TO PROVIDE HEALTH CARE SERVICES ARE SATISFIED. THE CENTER'S PERFORMANCE OBLIGATIONS FOR INPATIENT SERVICES ARE GENERALLY SATISFIED OVER PERIODS THAT AVERAGE APPROXIMATELY THREE DAYS, AND REVENUES ARE RECOGNIZED BASED ON CHARGES INCURRED IN RELATION TO TOTAL EXPECTED CHARGES. PERFORMANCE OBLIGATIONS FOR OUTPATIENT SERVICES ARE GENERALLY SATISFIED OVER A PERIOD OF LESS THAN ONE DAY.REVENUES ARE BASED UPON THE ESTIMATED AMOUNTS THE CENTER EXPECTS TO BE ENTITLED TO RECEIVE FROM PATIENTS, INCLUDING PAYMENTS MADE BY THIRD-PARTY PAYORS ON BEHALF OF PATIENTS. ESTIMATES OF CONTRACTUAL ALLOWANCES UNDER MANAGED CARE AND COMMERCIAL INSURANCE PLANS ARE BASED UPON THE PAYMENT TERMS SPECIFIED IN THE RELATED CONTRACTUAL AGREEMENTS. REVENUES RELATED TO UNINSURED PATIENTS AND UNINSURED COPAYMENTS AND DEDUCTIBLE AMOUNTS FOR PATIENTS WHO HAVE HEALTH CARE COVERAGE MAY HAVE DISCOUNTS APPLIED (UNINSURED DISCOUNTS AND CONTRACTUAL DISCOUNTS). THE CENTER ALSO RECORDS ESTIMATED IMPLICIT PRICE CONCESSIONS (BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE) RELATED TO UNINSURED ACCOUNTS TO RECORD SELF-PAY REVENUES AT THE ESTIMATED AMOUNTS THE CENTER EXPECTS TO COLLECT.UNDER THE PROVISIONS OF FASB ASC 606, WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THE CENTER HAS THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS ARE RECEIVABLES IF THE CENTER'S RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE RATHER THAN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CENTER DETERMINES THIS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH CERTAIN CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN INDIVIDUALLY. THE FINANCIAL STATEMENT EFFECTS OF USING THIS PRACTICAL EXPEDIENT ARE NOT MATERIALLY DIFFERENT FROM AN INDIVIDUAL CONTRACT APPROACH.THE PRIMARY COLLECTIONS RISKS RELATE TO UNINSURED PATIENT ACCOUNTS, INCLUDING PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE CARRIER HAS PAID THE AMOUNTS COVERED BY THE APPLICABLE AGREEMENT, BUT THE PATIENT RESPONSIBILITY AMOUNTS (DEDUCTIBLES AND COPAYMENTS) REMAIN OUTSTANDING. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO AMOUNTS DUE DIRECTLY FROM PATIENTS. ESTIMATED IMPLICIT PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, REGARDLESS OF THE AGING OF THOSE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED.
PART III, LINE 3:	AT CUYUNA REGIONAL MEDICAL CENTER IMPLICIT PRICE CONCESSIONS ARE CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE INABILITY TO PAY.
PART III, LINE 4:	SEE FOOTNOTE 1 ON PAGE 9 OF THE DRAFT FINANCIAL STATEMENTS AS OF FEBRUARY 5, 2025.
PART III, LINE 8:	THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6.
PART III, LINE 9B:	IT IS OUR GOAL TO PROVIDE AFFORDABLE HEALTHCARE SERVICES TO ALL PATIENTS REGARDLESS OF THE ABILITY TO PAY AND ASSIST UNINSURED OR UNDERINSURED PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE.WE ALLOW PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE TO PAY WHAT THEY ARE WILLING AND ABLE TO PAY BUT WE DO NOT REQUEST PAYMENT. PATIENT ASSISTANCE IS NOT CONSIDERED TO BE A SUBSTITUTE FOR PERSONAL RESPONSIBILITY. PATIENTS MUST COOPERATE WITH CRMC PROCEDURES FOR OBTAINING FINANCIAL ASSISTANCE. PATIENTS ARE EXPECTED TO CONTRIBUTE TO THE COST OF THEIR CARE BASED ON THEIR ABILITY TO PAY. INDIVIDUALS WITH THE FINANCIAL MEANS TO PURCHASE HEALTH INSURANCE SHALL BE URGED TO DO SO. THIS ASSURES ACCESS TO HEALTH CARE SERVICES AND PROTECTS THEIR ASSETS.CUYUNA REGIONAL MEDICAL CENTER'S PAYMENT AND COLLECTION POLICY STATES:PURPOSE: CRMC HAS ESTABLISHED A STRONG MISSION OF MEETING THE MEDICAL NEEDS OF THE COMMUNITIES IT SERVES. A SOUND PAYMENT AND COLLECTION POLICY IS A FUNDAMENTAL COMPONENT OF THIS MISSION. CRMC WILL MAINTAIN A POLICY OF COMMUNICATING FINANCIAL RESPONSIBILITY TO OUR PATIENTS WITH THE EXPECTATION OF PAYMENT AT TIME OF SERVICE. CRMC WILL ASSIST PATIENTS IN ALIGNING THEM WITH RESOURCES NEEDED TO FACILITATE THE PROMPT PAYMENT OF ANY PATIENT BALANCE. THE POLICY WILL KEEP IN MIND THE PATIENT'S UNIQUE FINANCIAL SITUATION AND PRESERVE THE DIGNITY OF THOSE INVOLVED.RESPONSIBILITY: CFO, DIRECTOR OF REVENUE CYCLE AND DESIGNATED PERSONNEL ARE RESPONSIBLE FOR THE CREATION, REVISION AND ENFORCEMENT OF THIS POLICY.DEFINITIONS: 1. PATIENT FINANCING OPTIONS: CUYUNA REGIONAL MEDICAL CENTER WILL PROVIDE THE FOLLOWING PAYMENT OPTIONS:A. CASH PAYMENTSI. THE EXPECTATION OF CRMC IS SELF PAY BALANCES WILL BE PAID ON DATE OF SERVICE OR PRIOR TO SERVICE. INQUIRIES INTO PROCEDURE COSTS AND PAYMENT ARRANGEMENTS ARE DIRECTED TO THE DIRECTOR OF REVENUE CYCLE OR REPRESENTATIVE. SELF PAY BALANCES SHOULD BE PAID WITHIN 15 DAYS OF RECEIPT OF FIRST STATEMENT.B. CREDIT CARDSI. CRMC WILL ACCEPT CREDIT CARD PAYMENTS FOR PATIENT'S SELF-PAY PORTION OF BALANCES. MOST MAJOR CREDIT CARDS ARE ACCEPTED.C. MEDICAID ELIGIBILITY & OTHER FUNDING SOURCESI. THE BUSINESS OFFICE OF CRMC WORKS CLOSELY WITH THE STATE MEDICAID ELIGIBILITY PROGRAM TO ENSURE PATIENTS HAVE ACCESS TO AVAILABLE PROGRAMS. NON-INSURED PATIENTS ARE REFERRED TO THE STATE MEDICAID PROGRAM FOR A PROBABILITY OF ELIGIBILITY ASSESSMENT. APPLICATIONS ARE AVAILABLE FROM THE BUSINESS OFFICE. SERVICE ITEMIZATIONS ARE AVAILABLE UPON REQUEST FOR SUBMISSION TO FLEX ACCOUNTS OR HSA'S.D. UNCOMPENSATED CAREI. APPLICATIONS ARE AVAILABLE FROM THE BUSINESS OFFICE. DOCUMENTATION OF INCOME AND MEDICAID ELIGIBILITY MAY BE REQUIRED. FEDERAL POVERTY GUIDELINES MAY BE UTILIZED IN DETERMINING UNCOMPENSATED CARE REDUCTIONS.2. SELF PAY DISCOUNTS: A. CRMC IN COOPERATION WITH THE MN ATTORNEY GENERAL AGREEMENT HAS AGREED TO INITIATE A DISCOUNT EQUAL TO ITS LARGEST COMMERCIAL PAYER TO ANY PATIENT WITHOUT HEALTH INSURANCE. A PAYMENT IN FULL DISCOUNT MAY BE OFFERED TO PATIENTS WITH A SELF-PAY ACCOUNT BALANCE ABOVE $500 WHEN PAID WITHIN THE FIRST BILLING CYCLE. SERVICES EXCLUDED FROM THESE DISCOUNTS MAY INCLUDE: LONG TERM CARE, HOME CARE SPEND DOWNS, ASSISTED LIVING SERVICES, LIFE LINE, AND OTHER CONTRACTED ANCILLARY SERVICES. 3. COLLECTION OF CO-PAYS, DEDUCTIBLES AND CO-INSURANCE:A. COLLECTION OF CO-PAYS, DEDUCTIBLES, AND CO-INSURANCE MAY BE COLLECTED FROM PATIENTS AT THE TIME OF SERVICE OR PRIOR TO SERVICE WHEN THE BENEFIT LEVELS HAVE BEEN VERIFIED. 4. PAYMENT CONTRACTS:A. PATIENTS THAT CANNOT PAY THEIR BALANCE IN FULL MAY ESTABLISH A PAYMENT CONTRACT. CRMC PROMOTES ACHIEVING PATIENT BALANCES AT ZERO WITHIN 6 MONTHS FROM DATE OF SERVICE. IN THE EVENT THAT EXTENDED ARRANGEMENTS NEED TO BE MADE, CONSULTATION WITH THE DIRECTOR OF REVENUE CYCLE OR REPRESENTATIVE WILL BE REQUIRED. CRMC WILL ESTABLISH REASONABLE PAYMENT ARRANGEMENTS BUT NO LESS THAN A MINIMAL PAYMENT OF 4% OF PATIENT'S BALANCE OR $20 PER MONTH WHICHEVER IS GREATER FOR A MAXIMUM PAYMENT CONTRACT OF 24 MONTHS PER ACCOUNT BALANCE. CRMC WILL NOT PROMOTE CONSOLIDATING ACCOUNTS AND WILL WORK WITH PATIENTS TO ENSURE UNDERSTANDING OF ACCOUNTS BALANCES DUE.5. BILLING CONCERNS:A. OUR BUSINESS OFFICE IS OPEN MONDAY THROUGH FRIDAY FROM 7:30 AM UNTIL 4:30 PM TO ANSWER ANY BILLING QUESTIONS. PLEASE HAVE YOUR ACCOUNT NUMBER AVAILABLE WHEN REQUESTING ACCOUNT INFORMATION.6. ESTIMATES:A. PROCEDURE ESTIMATES MAY BE OBTAINED BY CONTACTING THE DIRECTOR OF MANAGED CONTRACTS.POLICY STATEMENT: CUYUNA REGIONAL MEDICAL CENTER'S (CRMC) PAYMENT AND COLLECTION POLICY IS THAT PAYMENT IS DUE WHEN SERVICES ARE RENDERED. HOWEVER, AS A COURTESY, CRMC WILL SUBMIT THIRD PARTY CLAIMS FOR OUR PATIENTS. ANY SELF-PAY PORTION IS DUE AT THE TIME OF SERVICE UNLESS PRIOR ARRANGEMENTS HAVE BEEN MADE WITH THE BUSINESS OFFICE. FOR THE PURPOSES OF THIS POLICY, SELF-PAY PORTION IS DEFINED AS CO-PAYMENTS, DEDUCTIBLES, AND NON COVERED SERVICES (IF KNOWN AT THE TIME OF SERVICE.) SELF-PAY PORTION ALSO REFERS TO AMOUNTS OWED BY INDIVIDUALS WITHOUT INSURANCE.
PART VI, LINE 2:	COMPREHENSIVE HEALTH ASSESSMENT AT CUYUNA REGIONAL MEDICAL CENTER (CRMC)CUYUNA REGIONAL MEDICAL CENTER (CRMC) EMPLOYS A COMPREHENSIVE, MULTIFACETED APPROACH TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. BEYOND THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DESCRIBED IN PART V, SECTION B, CRMC CONTINUOUSLY EVALUATES LOCAL HEALTH CHALLENGES THROUGH DIRECT PATIENT INTERACTION, PROACTIVE COMMUNITY ENGAGEMENT, AND STRUCTURED ADVISORY FEEDBACK.KEY COMPONENTS OF CRMC'S HEALTH ASSESSMENT APPROACH1. PHYSICIAN CLINICS MONITORING:CRMC OPERATES FIVE PHYSICIAN CLINICS LOCATED IN CROSBY, BAXTER, BREEZY POINT, LONGVILLE, AND SUPER ONE CROSBY. THIS NETWORK ENABLES CRMC TO MONITOR THE HEALTH OF ITS PATIENTS ACROSS DIVERSE GEOGRAPHIC AREAS, PROVIDING REAL-TIME INSIGHTS INTO PREVALENT HEALTH CONDITIONS AND SPECIFIC CARE NEEDS WITHIN EACH LOCALITY. THE CLINICS' PROXIMITY TO PATIENTS ALLOWS SERVICES TO BE TAILORED TO THE UNIQUE NEEDS OF THE POPULATIONS THEY SERVE.2. COMMUNITY ENGAGEMENT PROGRAM:CRMC'S ROBUST COMMUNITY ENGAGEMENT PROGRAM ACTIVELY INVOLVES STAFF AND HEALTHCARE PROFESSIONALS IN LOCAL EVENTS AND OUTREACH ACTIVITIES. BY ENGAGING DIRECTLY WITH RESIDENTS, COMMUNITY ORGANIZATIONS, AND LEADERS, CRMC GATHERS QUALITATIVE DATA ON HEALTH CONCERNS, PRIORITIES, AND ACCESS CHALLENGES THAT MIGHT NOT BE EVIDENT THROUGH TRADITIONAL CLINICAL DATA ALONE.3. PATIENT ADVISORY COMMITTEE:CRMC CONVENES A PATIENT ADVISORY COMMITTEE QUARTERLY TO PROVIDE A FORMAL PLATFORM FOR OPEN DIALOGUE BETWEEN HEALTHCARE PROVIDERS AND COMMUNITY MEMBERS. THIS COMMITTEE IDENTIFIES AREAS FOR SERVICE IMPROVEMENT AND EMERGING HEALTH CONCERNS, ENABLING CRMC TO REFINE ITS PROGRAMS AND DELIVERY STRATEGIES BASED ON PATIENT-CENTERED FEEDBACK.BENEFITS OF CRMC'S APPROACH- REAL-TIME DATA COLLECTION: THE PRESENCE OF PHYSICIAN CLINICS ACROSS MULTIPLE LOCATIONS PROVIDES TIMELY, LOCALIZED HEALTH DATA TO IDENTIFY TRENDS AND EMERGING HEALTH NEEDS.- TAILORED HEALTHCARE SERVICES: INSIGHTS FROM DIRECT PATIENT CARE AND COMMUNITY ENGAGEMENT ALLOW CRMC TO CUSTOMIZE ITS SERVICES TO MEET THE SPECIFIC REQUIREMENTS OF EACH COMMUNITY.- PROACTIVE COMMUNITY COLLABORATION: PARTICIPATION IN COMMUNITY ACTIVITIES AND THE PATIENT ADVISORY COMMITTEE DEMONSTRATES CRMC'S PROACTIVE ENGAGEMENT, FOSTERING TRUST AND COLLABORATIVE PROBLEM-SOLVING.- CONTINUOUS IMPROVEMENT: REGULAR ASSESSMENTS AND OPEN DISCUSSIONS SUPPORT ONGOING REFINEMENT OF HEALTHCARE DELIVERY, ENSURING RESPONSIVE, PATIENT-CENTERED CARE.BY INTEGRATING CLINICAL MONITORING, COMMUNITY ENGAGEMENT, AND ADVISORY INPUT, CRMC'S HEALTH ASSESSMENT APPROACH IS DYNAMIC AND ADAPTIVE, ENSURING THAT HEALTHCARE SERVICES ARE BOTH RESPONSIVE TO CURRENT NEEDS AND FORWARD-LOOKING IN ADDRESSING FUTURE HEALTH CHALLENGES.
PART VI, LINE 3:	CUYUNA REGIONAL MEDICAL CENTER'S COMMITMENT TO COMMUNITY HEALTH AND WELLNESSCUYUNA REGIONAL MEDICAL CENTER (CRMC) FURTHERS ITS EXEMPT PURPOSE BY PROMOTING COMMUNITY HEALTH AND WELLNESS THROUGH A COMPREHENSIVE RANGE OF INITIATIVES THAT EXTEND BEYOND CLINICAL CARE. CRMC'S EFFORTS ENCOMPASS WELLNESS PROGRAMS, PHYSICIAN RECRUITMENT, FINANCIAL SUPPORT, VOLUNTEER ENGAGEMENT, STRATEGIC GOVERNANCE, AND CAPITAL INVESTMENTALL AIMED AT IMPROVING ACCESS TO QUALITY HEALTHCARE AND ADDRESSING COMMUNITY-SPECIFIC HEALTH CHALLENGES.1. COMPREHENSIVE COMMUNITY HEALTH PROGRAMSCRMC OFFERS PROGRAMS DESIGNED TO IDENTIFY HEALTH RISKS AND PROVIDE PROACTIVE CARE:- WELLNESS SCREENINGS: BREAST AND CERVICAL HEALTH SCREENINGS ARE CONDUCTED TO PROMOTE EARLY DETECTION AND INTERVENTION. - HEALTH EDUCATION: CLASSES AND COMMUNITY EVENTS PROVIDE EDUCATION ON CRITICAL HEALTH TOPICS, EMPOWERING INDIVIDUALS TO MAKE INFORMED LIFESTYLE AND HEALTHCARE DECISIONS.2. PROACTIVE PHYSICIAN RECRUITMENT AND RETENTIONCRMC CONTINUALLY ASSESSES THE COMMUNITY'S HEALTHCARE NEEDS TO ENSURE THE AVAILABILITY OF ESSENTIAL SERVICES:- NEEDS ASSESSMENT AND RECRUITMENT: IDENTIFIES SPECIALTY GAPS AND ALLOCATES RESOURCES TO RECRUIT PHYSICIANS ACCORDINGLY.- RETENTION STRATEGIES: FOCUSES ON RETAINING SKILLED MEDICAL PROFESSIONALS TO ENSURE CONTINUITY OF CARE AND MAINTAIN LONG-TERM PROVIDER-PATIENT RELATIONSHIPS.3. FINANCIAL ASSISTANCE AND VOLUNTEERISMCRMC DEMONSTRATES A STRONG COMMITMENT TO SUPPORTING PATIENTS AND ENGAGING IN COMMUNITY SERVICE:- FINANCIAL SUPPORT: PROVIDED $58,900 IN FINANCIAL ASSISTANCE TO LOCAL CANCER PATIENTS TO EASE THE BURDEN OF TREATMENT-RELATED EXPENSES.- VOLUNTEERISM: STAFF DEDICATED 3,255 VOLUNTEER HOURS TO COMMUNITY INITIATIVES, REINFORCING CRMC'S ROLE AS A PROACTIVE PARTNER IN PUBLIC HEALTH.4. GOVERNANCE STRUCTURECRMC'S GOVERNANCE MODEL PRIORITIZES COMMUNITY REPRESENTATION AND HIGH-QUALITY CARE:- NON-PROFIT BOARD OF DIRECTORS: A NINE-MEMBER BOARD COMPRISING COMMUNITY LEADERS, DISTRICT BOARD MEMBERS, MEDICAL STAFF, AND THE CEO GOVERNS CRMC. THIS STRUCTURE ENSURES SERVICES MEET LOCAL NEEDS AND ADHERE TO THE HIGHEST STANDARDS OF SAFETY AND QUALITY.5. CAPITAL INVESTMENTS FOR ADVANCED CARECRMC ALLOCATES APPROXIMATELY $2 MILLION ANNUALLY TO CAPITAL IMPROVEMENTS, REINFORCING ITS COMMITMENT TO STATE-OF-THE-ART, PATIENT-CENTERED HEALTHCARE THROUGH THE LATEST TREATMENTS AND TECHNOLOGIES.CRMC'S COMPREHENSIVE AND PROACTIVE INITIATIVES REFLECT ITS DEEP COMMITMENT TO ADVANCING HEALTH AND WELL-BEING ACROSS ITS SERVICE AREA. BY INTEGRATING CLINICAL EXCELLENCE WITH COMMUNITY OUTREACH AND STRATEGIC INVESTMENTS, CRMC CONTINUALLY ENHANCES ACCESS TO CARE AND PROMOTES A HEALTHIER, MORE VIBRANT COMMUNITY.
PART VI, LINE 4:	OVERVIEW OF CUYUNA REGIONAL MEDICAL CENTER (CRMC) AND ITS COMMUNITY:CUYUNA REGIONAL MEDICAL CENTER (CRMC) STANDS AS A COMMUNITY-BUILT FACILITY, SERVING APPROXIMATELY 60,000 RESIDENTS IN THE BRAINERD LAKES AREA, RENOWNED AS MINNESOTA'S VACATION DESTINATION FOR ITS PICTURESQUE LAKES AND WOODLANDS, OFFERING DIVERSE OUTDOOR RECREATION OPPORTUNITIES.HEALTHCARE STATISTICS:- CRMC HANDLES AN AVERAGE DAILY CENSUS OF 16 PATIENTS.- THE MEDICAL CENTER SERVES AROUND 4,700 INPATIENTS AND ACCOMMODATES 195,000 OUTPATIENTS ANNUALLY.- IT MANAGES OVER 10,700 EMERGENCY ROOM VISITS AND FACILITATES APPROXIMATELY 225 BIRTHS EACH YEAR.PATIENT DEMOGRAPHICS:- 70% OF CRMC'S PATIENTS RESIDE IN BRAINERD, BAXTER, LONGVILLE, AITKIN, ONAMIA, AND THEIR SURROUNDING AREAS.- ANOTHER 30% COME FROM VARIOUS HOSPITAL DISTRICTS, INCLUDING BAY LAKE, CROSBY, CUYUNA, DEAN LAKE, DEERFIELD, DEERWOOD, EMILY, FAIRFIELD, FIFTY LAKES, LITTLE PINE, RABBIT LAKE, RIVERTON, TROMMALD, AND WOLFORD.COMMUNITY DEMOGRAPHICS:- THE MAJORITY OF RESIDENTS (95%) IN THE CRMC SERVICE AREA ARE OF WHITE ETHNICITY.- GENDER DISTRIBUTION IS ROUGHLY EQUAL, WITH ABOUT HALF MALE AND HALF FEMALE RESIDENTS.- OVER 77% OF THE POPULATION RESIDES IN RURAL AREAS.AGE DISTRIBUTION:- APPROXIMATELY 20.1% OF RESIDENTS ARE UNDER 18 YEARS OLD.- ANOTHER 25% ARE 65 YEARS AND OLDER.SOCIOECONOMIC SNAPSHOT:- THE MEDIAN HOUSEHOLD INCOME IS $60,810.- ABOUT 94% OF RESIDENTS ARE HIGH SCHOOL GRADUATES, AND 26% HAVE A BACHELOR'S DEGREE OR HIGHER.- 27% OF CHILDREN LIVE IN SINGLE-PARENT HOUSEHOLDS.- CHILDREN LIVING IN POVERTY, UNDER 18 YEARS OLD IS 8.6%- 37% OF CHILDREN ARE ELIGIBLE FOR FREE OR REDUCED-PRICE LUNCH.SUMMARY:CRMC PLAYS A VITAL ROLE IN PROVIDING HEALTHCARE SERVICES TO A DIVERSE COMMUNITY, CATERING TO A MIX OF RURAL AND URBAN RESIDENTS. UNDERSTANDING THE DEMOGRAPHICS AND SOCIOECONOMIC FACTORS OF ITS SERVICE AREA, CRMC IS WELL-POSITIONED TO ADDRESS THE UNIQUE HEALTHCARE NEEDS OF THE POPULATION IT SERVES, CONTRIBUTING TO THE OVERALL WELL-BEING OF THE COMMUNITY.
PART VI, LINE 5:	CUYUNA REGIONAL MEDICAL CENTER'S COMMITMENT TO COMMUNITY HEALTH AND WELLNESS:CUYUNA REGIONAL MEDICAL CENTER (CRMC) IS DEDICATED TO PROMOTING THE HEALTH, HEALING, AND WELLNESS OF ITS COMMUNITY. RECOGNIZING THAT FACTORS INFLUENCING HEALTH EXTEND BEYOND TRADITIONAL HEALTHCARE SETTINGS, CRMC ACTIVELY ENGAGES IN COMMUNITY-FOCUSED INITIATIVES TO ADDRESS SPECIFIC HEALTH NEEDS:1) COMPREHENSIVE COMMUNITY HEALTH PROGRAMS:- WELLNESS SCREENINGS: CRMC CONDUCTS WELLNESS SCREENINGS TO IDENTIFY HEALTH RISKS EARLY ON, ALLOWING FOR PROACTIVE INTERVENTION.- HEALTH EDUCATION CLASSES AND EVENTS: CRMC OFFERS INFORMATIVE CLASSES AND EVENTS TO EDUCATE THE COMMUNITY ON VARIOUS HEALTH TOPICS, EMPOWERING INDIVIDUALS TO MAKE INFORMED DECISIONS ABOUT THEIR WELL-BEING.- HEALTH FAIRS: CRMC ORGANIZES HEALTH FAIRS TO PROVIDE ACCESSIBLE HEALTH INFORMATION, SCREENINGS, AND RESOURCES TO A BROAD AUDIENCE.2) PROACTIVE PHYSICIAN RECRUITMENT AND RETENTION:- NEEDS ASSESSMENT: CRMC PROACTIVELY ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY TO DETERMINE THE REQUIRED PHYSICIAN SPECIALTIES.- RECRUITMENT PLANNING: THE ORGANIZATION PLANS AND ALLOCATES RESOURCES TO RECRUIT PHYSICIANS BASED ON THE IDENTIFIED NEEDS, ENSURING THAT THE COMMUNITY IS SERVED BY A DIVERSE AND SKILLED MEDICAL STAFF.- RETENTION EFFORTS: CRMC WORKS DILIGENTLY TO RETAIN ITS MEDICAL STAFF, RECOGNIZING THE IMPORTANCE OF CONTINUITY OF CARE AND BUILDING LONG-TERM RELATIONSHIPS WITH HEALTHCARE PROFESSIONALS.3) FINANCIAL ASSISTANCE AND VOLUNTEERISM:- FINANCIAL ASSISTANCE: CRMC DEMONSTRATES ITS COMMITMENT TO COMMUNITY WELL-BEING BY PROVIDING $52,000 IN FINANCIAL ASSISTANCE TO AREA CANCER PATIENTS REQUIRING SUPPORT DURING TREATMENT.- VOLUNTEERISM: CRMC STAFF CONTRIBUTE 2,353 HOURS OF THEIR TIME THROUGH VOLUNTEER ACTIVITIES, FURTHERING THE ORGANIZATION'S IMPACT ON COMMUNITY HEALTH BEYOND THE CLINICAL SETTING.4. GOVERNANCE STRUCTURE:- NON-PROFIT BOARD OF DIRECTORS: CRMC IS GOVERNED BY A NINE-MEMBER NON-PROFIT BOARD OF DIRECTORS, CONSISTING OF COMMUNITY LEADERS, DISTRICT BOARD MEMBERS, MEDICAL STAFF, AND THE CEO. THE BOARD ENSURES THAT SERVICES MEET COMMUNITY STANDARDS, PRIORITIZE PATIENT SAFETY, AND UPHOLD THE HIGHEST QUALITY OF HEALTHCARE SERVICES.5. CAPITAL INVESTMENTS FOR ADVANCED CARE:COMMITMENT TO ADVANCED CARE: CRMC INVESTS APPROXIMATELY $2 MILLION ANNUALLY IN CAPITAL IMPROVEMENTS. THIS INVESTMENT ENSURES THAT THE MEDICAL CENTER CAN DELIVER COMPASSIONATE, PATIENT-CENTERED CARE USING THE LATEST TREATMENTS AND TECHNOLOGIES AVAILABLE.CRMC'S MULTIFACETED APPROACH, ENCOMPASSING COMMUNITY HEALTH PROGRAMS, PROACTIVE PHYSICIAN RECRUITMENT, FINANCIAL ASSISTANCE, VOLUNTEERISM, AND STRATEGIC GOVERNANCE, REFLECTS ITS UNWAVERING COMMITMENT TO ENHANCING THE WELL-BEING OF THE COMMUNITIES IT SERVES. THE ORGANIZATION CONTINUES TO EVOLVE AND INVEST IN RESOURCES THAT POSITIVELY IMPACT THE HEALTH AND VITALITY OF ITS COMMUNITY MEMBERS.
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEM:N/A
PART VI, LINE 7, REPORTS FILED WITH STATES	MN

Schedule H (Form 990) 2023

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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

2023

Open to Public
Inspection

Name of the organization
CUYUNA REGIONAL MEDICAL CENTER

Employer identification number
41-1724637

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) CROSBY SENIOR SERVICES 2845 N HAMLINE AVE ROSEVILLE,MN55113	20-4631039	501(C)(3)	75,000	0			TO SUPPORT HEARTWOOD SENIOR LIVING COMMUNITY
(2) CENTRAL LAKES COLLEGE 501 WEST COLLEGE DRIVE BRAINERD,MN56401	41-1687554	GOVERNMENTAL	10,000	0			ANNUAL DONATION TOWARDS BUILDING THE SCOREBOARD AT THE FOOTBALL STADIUM
(3) PGA TOUR ENTERPRISES LLC PO BOX 1065 PONTE VEDRA BEACH,FL32004	37-2113106		250,000	0			2024 CRMC CHAMPIONSHIP SPONSORSHIP
(4) CROSBY-IRONTON SCHOOLS 711 POPLAR STREET CROSBY,MN56441	41-6000760	GOVERNMENTAL	10,000	0			DONATION FOR BUILDING THE MOUNTAIN BIKE TRAILS AT THE ELEMENTARY SCHOOL
(5) CROSBY FIRE DEPARTMENT PO BOX 6 CROSBY,MN56441	41-6005078	GOVERNMENTAL	0	5,521	FMV	GIVEAWAYS AT THE CROSBY 4TH OF JULY CELEBRATION	12,750 GIVEAWAYS HANDED OUT TO THE COMMUNITY ON THE CROSBY 4TH OF JULY CELEBRATION PARADE ROUTE

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2023

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) COURAGE CABINET - HELPING LOCAL CANCER PATIENTS	57	58,900
(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:	CRMC'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INVOLVE A COMBINATION OF REPORTING, FINANCIAL REVIEW, ONGOING COMMUNICATION, PROJECT EVALUATION, AND RECORDKEEPING. THESE MEASURES ARE IMPLEMENTED TO UPHOLD TRANSPARENCY, MEET CONTRACTUAL OBLIGATIONS, AND ENSURE THAT GRANT FUNDS CONTRIBUTE EFFECTIVELY TO THE INTENDED PURPOSES OUTLINED IN THE GRANT AGREEMENTS.

Schedule I (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2023

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1FAWN ATCHISON ANESTHESIOLOGIST	(i) (ii)	632,229 ------------- 0	0 ------------- 0	127 ------------- 0	15,250 ------------- 0	15,533 ------------- 0	663,139 ------------- 0	0 ------------- 0
2LEAH KIPPES ANESTHESIOLOGIST	(i) (ii)	569,822 ------------- 0	0 ------------- 0	83 ------------- 0	15,250 ------------- 0	40,685 ------------- 0	625,840 ------------- 0	0 ------------- 0
3KYLE MOORE PHYSICIAN	(i) (ii)	514,034 ------------- 0	0 ------------- 0	50 ------------- 0	14,954 ------------- 0	30,705 ------------- 0	559,743 ------------- 0	0 ------------- 0
4KYLE DURGIN PHYSICIAN	(i) (ii)	489,291 ------------- 0	0 ------------- 0	44 ------------- 0	15,250 ------------- 0	29,522 ------------- 0	534,107 ------------- 0	0 ------------- 0
5AMY HART CEO	(i) (ii)	481,056 ------------- 0	0 ------------- 0	366 ------------- 0	15,250 ------------- 0	20,295 ------------- 0	516,967 ------------- 0	0 ------------- 0
6CHRISTOPHER KACZMARCZYK PHYSICIAN	(i) (ii)	498,854 ------------- 0	0 ------------- 0	50 ------------- 0	15,250 ------------- 0	2,287 ------------- 0	516,441 ------------- 0	0 ------------- 0
7KATIE BERG CFO	(i) (ii)	315,499 ------------- 0	0 ------------- 0	55 ------------- 0	15,250 ------------- 0	4,602 ------------- 0	335,406 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation

Schedule J (Form 990) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
CUYUNA REGIONAL MEDICAL CENTER

Employer identification number
41-1724637

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	09-30-2013	14,245,000	SERIES 2013A - CONSTRUCTION		X		X		X
B	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	09-30-2013	15,470,000	SERIES 2013B - REFINANCING OF 9/13/05 AND 8/30/05 BOND ISSUES		X		X		X
C	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	11-30-2018	10,000,000	SERIES 2018A - CONSTRUCTION AND REFINANCING OF 4/25/07 BOND ISSUE		X		X		X
D	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	11-30-2018	10,000,000	SERIES 2018B - CONSTRUCTION AND REFINANCING OF 4/25/07 BOND ISSUE		X		X		X
	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	11-30-2018	7,000,000	SERIES 2018C - CONSTRUCTION AND REFINANCING OF 4/25/07 BOND ISSUE		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	8,555,000		9,595,000		6,313,521		4,761,716
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	14,245,000		15,470,000		10,000,000		10,000,000
4 Gross proceeds in reserve funds .............	655,181
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	227,309				40,741		40,741
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	13,390,489				6,042,592		6,042,592
11 Other spent proceeds .............	2,741,666		15,470,000		3,916,667		3,916,667
12 Other unspent proceeds .............
13 Year of substantial completion .............	2015		2013		2020		2020
	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) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		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 .........	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 Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X	X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

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 Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
CUYUNA REGIONAL MEDICAL CENTER

Employer identification number
41-1724637

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	09-30-2013	14,245,000	SERIES 2013A - CONSTRUCTION		X		X		X
B	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	09-30-2013	15,470,000	SERIES 2013B - REFINANCING OF 9/13/05 AND 8/30/05 BOND ISSUES		X		X		X
C	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	11-30-2018	10,000,000	SERIES 2018A - CONSTRUCTION AND REFINANCING OF 4/25/07 BOND ISSUE		X		X		X
D	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	11-30-2018	10,000,000	SERIES 2018B - CONSTRUCTION AND REFINANCING OF 4/25/07 BOND ISSUE		X		X		X
	CUYUNA RANGE HOSPITAL DISTRICT	41-0879376	000000000	11-30-2018	7,000,000	SERIES 2018C - CONSTRUCTION AND REFINANCING OF 4/25/07 BOND ISSUE		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	8,555,000		9,595,000		6,313,521		4,761,716
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	14,245,000		15,470,000		10,000,000		10,000,000
4 Gross proceeds in reserve funds .............	655,181
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	227,309				40,741		40,741
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	13,390,489				6,042,592		6,042,592
11 Other spent proceeds .............	2,741,666		15,470,000		3,916,667		3,916,667
12 Other unspent proceeds .............
13 Year of substantial completion .............	2015		2013		2020		2020
	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) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		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 .........	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 Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X	X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

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 Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

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) 2023

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SHERRY SKJEVELAND	WIFE OF JAMIE SKJEVELAND, DIRECTOR	43,601	EMPLOYMENT		No
(2) BRIAN HOLMGREN	HUSBAND OF PAIGE HOLMGREN, DIRECTOR	254,696	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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE CFO AND CEO WILL REVIEW THE FINAL 990 PRIOR TO ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY ALL EMPLOYEES COMPLETE A CONFLICT OF INTEREST FORM. IT'S REVIEWED BY OUR HUMAN RESOURCES, AND ANY CONCERNS ARE BROUGHT TO THE COMPLIANCE OFFICERS AND THE SENIOR LEADERSHIP TEAM. 1. DUTY TO DISCLOSE: IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS: AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS BY MAJORITY VOTE. 3. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: A. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY UNANIMOUS VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE ORGANIZATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. 4. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: A. IF THE GOVERNING BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. B. IF, AFTER HEARING THE MEMBER'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE GOVERNING BOARD OR COMMITTEE DETERMINES THE MEMBER HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. RECORDS OF PRECEDINGS: THE MINUTES OF THE GOVERNING BOARD AND ALL COMMITTEES WITH BOARD DELEGATED POWERS SHALL CONTAIN: 1. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE GOVERNING BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. 2. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE PROCEEDINGS. COMPENSATION: 1. A VOTING MEMBER OF THE GOVERNING BOARD WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 2. A VOTING MEMBER OF ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION FOR SERVICES IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. 3. NO VOTING MEMBER OF THE GOVERNING BOARD OR ANY COMMITTEE WHOSE JURISDICTION INCLUDES COMPENSATION MATTERS AND WHO RECEIVES COMPENSATION, DIRECTLY OR INDIRECTLY, FROM THE ORGANIZATION, EITHER INDIVIDUALLY OR COLLECTIVELY, IS PROHIBITED FROM PROVIDING INFORMATION TO ANY COMMITTEE REGARDING COMPENSATION. ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON: 1. HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, 2. HAS READ AND UNDERSTANDS THE POLICY, 3. HAS AGREED TO COMPLY WITH THE POLICY. PERIODIC REVIEWS: TO ENSURE THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH PUBLIC HOSPITAL DISTRICT REQUIREMENTS, PERIODIC REVIEWS SHALL BE CONDUCTED. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: 1. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION AND THE RESULT OF ARM'S LENGTH BARGAINING. 2. WHETHER PARTNERSHIPS, JOINT VENTURES AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ORGANIZATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15A	A COMMITTEE MADE UP OF INDEPENDENT BOARD MEMBERS REVIEWED COMPENSATION AND MARKET DATA TO DETERMINE COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND THE FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 22,604,763. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,604,763. OTHER FEES: PROGRAM SERVICE EXPENSES 5,256,794. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,256,794. OTHER FEES FOR SERVICES (NON EMPLOYEES): PROGRAM SERVICE EXPENSES 13,053,093. MANAGEMENT AND GENERAL EXPENSES 984,722. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,037,815.
FORM 990, PART XI, LINE 9:	BOOK/TAX DIFFERENCE -12,835.
FORM 990, PART IV, LINES 11F & 12B AND PART XII, LINE 2B:	AS OF THE DATE OF FILING THIS FORM 990, THE ORGANIZATION IS IN THE PROCESS OF FINALIZING ITS AUDITED FINANCIAL STATEMENTS FOR THE FISCAL YEAR ENDED MARCH 31, 2024. THE AMOUNTS REFLECTED ON FORM 990 ALIGN WITH THE DRAFT AUDIT REPORT.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CUYUNA REGIONAL MEDICAL CENTER

Employer identification number

41-1724637

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) LONGVILLE DEVELOPMENT LLC 320 EAST MAIN STREET CROSBY,MN56441 41-1724637	LEASE REVENUE	MN	0	6,247,031	CUYUNA REGIONAL MEDICAL CENTER
(2) CUYUNA LAKES PHARMACY LLC 320 EAST MAIN STREET CROSBY,MN56441 41-1999938	RETAIL PHARMACY	MN	2,168,652	439,415	CUYUNA REGIONAL MEDICAL CENTER

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) MINNESOTA RADIOLOGY INSTITUTE 320 EAST MAIN STREET CROSBY,MN56441 20-3803271	RADIOLOGY SERVICE CENTER	MN	CUYUNA REGIONAL MEDICAL CENTER	RELATED	1,313,773	688,199		No		Yes		63.250 %
(2) SLEEP CENTER OF CENTRAL MINNESOTA LLC 320 EAST MAIN STREET CROSBY,MN56441 26-0580544	DIAGNOSIS AND TREATMENT OF SLEEP DISORDERS	MN	CUYUNA REGIONAL MEDICAL CENTER	RELATED	179,314	511,005		No			No	75.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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

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

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

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

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

Yes

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

Yes

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

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

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

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

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

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

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) MINNESOTA RADIOLOGY INSTITUTE	J	116,950	FMV
(2) MINNESOTA RADIOLOGY INSTITUTE	L	190,843	FMV
(3) MINNESOTA RADIOLOGY INSTITUTE	M	4,464,769	FMV
(4) MINNESOTA RADIOLOGY INSTITUTE	D	7,167,792	FMV
(5) SLEEP CENTER OF CENTRAL MINNESOTA LLC	L	650,792	FMV
(6) SLEEP CENTER OF CENTRAL MINNESOTA LLC	D	865,889	FMV
(7) MINNESOTA RADIOLOGY INSTITUTE	E	7,879,338	FMV

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: ACCOMMODATING YOU WITH CARE AND COMPASSION BY DEDICATING OURSELVES TO YOU EVERY DAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
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 2023 (Part V, line 2a) ......	5	1,408
6	Total number of volunteers (estimate if necessary) .............	6	15
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	345,419	516,663
9	Program service revenue (Part VIII, line 2g) .........	190,392,674	206,024,185
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	224,642	158,527
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	586,668	726,424
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	191,549,403	207,425,799
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	122,784	473,452
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)	87,551,716	93,792,865
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	104,779,719	115,609,913
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	192,454,219	209,876,230
19	Revenue less expenses. Subtract line 18 from line 12.......	-904,816	-2,450,431
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	129,107,678	120,957,677
21	Total liabilities (Part X, line 26).............	88,329,030	82,689,849
22	Net assets or fund balances. Subtract line 21 from line 20.....	40,778,648	38,267,828

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 197,977,094 including grants of $ 473,452 ) (Revenue $ 205,936,472 )
	CRMC MAKES SIGNIFICANT EFFORTS TO ENSURE CHARITY CARE IS GRANTED TO ALL PATIENTS WHO QUALIFY. IN FY24 A TOTAL OF $563,353 IN SERVICES WERE PROVIDED TO LOW-INCOME PATIENTS AT FREE OR REDUCED PRICES AND WAS PROVIDED TO THOSE WHO HAVE EXHAUSTED THIRD-PARTY RESOURCES, DO NOT QUALIFY FOR MEDICAID, OR HAVE INSUFFICIENT INCOMES. THE CUYUNA LAKES AREA HAS A HIGH NEED FOR SEVERAL HEALTHCARE SERVICES THAT DO NOT GENERATE ENOUGH REVENUE TO COVER THE COST OF PROVIDING THEM. CRMC SUBSIDIZED A TOTAL OF $2,687,115 IN SERVICES IN FY24 TO ENSURE THEIR AVAILABILITY TO OUR COMMUNITY.THROUGH ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, CRMC IDENTIFIED THREE PRIORITIES TO IMPROVE AREA RESIDENTS' HEALTH. THEY ARE TO IMPROVE THEIR HEALTH AND WELL-BEING, NUTRITION, AND ACTIVITY. THE ORGANIZATION'S HEALTH-RELATED EDUCATION FOR THE COMMUNITY THROUGH EVENTS, CLASSES, LECTURES, AND WELLNESS SCREENINGS FOCUSED ON THESE AREAS.IN FY24, CRMC SUPPORTED HEALTH AND WELLNESS THROUGH EVENTS ATTENDED BY 21,885 INDIVIDUALS, INCLUDING COMMUNITY WALKS, TRIATHLONS, BIKE RIDES, RACES, AND SENIOR EXPOS. WEEKLY WALK WITH THE DOC SESSIONS WERE HELD THROUGHOUT THE YEAR. CRMC ALSO PROVIDED ATHLETIC TRAINING SERVICES, SPORTS PHYSICALS FOR LOCAL SCHOOLS AND COLLEGES, AND AN EDUCATIONAL SEMINAR FOR ATHLETIC COACHES. STANDBY AMBULANCES AND FIRST AID BOOTHS WERE AVAILABLE AT COMMUNITY EVENTS.CRMC PARTNERED WITH SMILES FOR JAKE, A SUICIDE PREVENTION COALITION, TO ORGANIZE THE SNOW MANY SMILES EVENT. THIS FREE, FAMILY-FRIENDLY EVENT PROMOTED MENTAL HEALTH, REDUCED SOCIAL ISOLATION, AND STRENGTHENED COMMUNITY CONNECTIONS.TO ADDRESS FOOD INSECURITY, CRMC PROVIDED 4,601 FREE LUNCHES TO YOUTH THROUGH THE CUYUNA LAKES LUNCH BUNCH PROGRAM AND CONTRIBUTED FUNDS TO OPERATION SANDWICH FOR BRAINERD-AREA STUDENTS. DONATIONS OF STAPLES AND FINANCIAL ASSISTANCE WERE MADE TO LOCAL FOOD BANKS, WHILE FRESH PRODUCE TOKENS WERE DISTRIBUTED FOR USE AT THE CROSBY FARMER'S MARKET. OVER 900 FROZEN MEALS WERE DELIVERED TO SENIOR CITIZENS IN COLLABORATION WITH CATHOLIC CHARITIES, AND FOOD PACKS WERE PROVIDED TO PATIENTS IN NEED. CRMC INVESTED OVER $20,000 IN THESE EFFORTS.CRMC OFFERED YEAR-ROUND EDUCATION, INCLUDING COURSES ON FIRST AID, CPR, CHILDBIRTH, WOMEN'S HEALTH, AND WEIGHT MANAGEMENT, AS WELL AS SUPPORT GROUPS FOR MENTAL HEALTH, CANCER, GRIEF, WEIGHT LOSS, AND CAREGIVERS. MONTHLY COMMUNITY AREA CONNECTIONS LUNCH-AND-LEARN PROGRAMS FOR SENIORS WERE ALSO PROVIDED.ADDITIONAL COMMUNITY INITIATIVES INCLUDED FUNDING A MOUNTAIN BIKE TRAIL AT AN ELEMENTARY SCHOOL AND CONTRIBUTING $446,006 IN CASH AND IN-KIND DONATIONS TO LOCAL ORGANIZATIONS ADDRESSING HEALTH, SOCIAL, CULTURAL, AND EDUCATIONAL NEEDS. CRMC STAFF ALSO DONATED TIME AND LEADERSHIP TO MORE THAN 47 COMMUNITY GROUPS, INCLUDING SCHOOLS, CHAMBERS OF COMMERCE, FIRE DEPARTMENTS, AND NONPROFIT ORGANIZATIONS.THE COURAGE CABINET PROVIDED $58,900 IN FINANCIAL ASSISTANCE TO LOCAL CANCER PATIENTS FOR TREATMENT-RELATED TRAVEL AND ESSENTIAL NEEDS, SUCH AS FOOD, HOUSING, AND HEAT.THE TOTAL COMMUNITY BENEFIT IMPACT OF CRMC'S INITIATIVES IN FY24-INCLUDING HEALTH PROGRAMS, FOOD SECURITY EFFORTS, EDUCATIONAL OPPORTUNITIES, AND COMMUNITY PARTNERSHIPS-WAS VALUED AT $666,004.CRMC ALSO INVESTS APPROXIMATELY $2 MILLION PER YEAR IN CAPITAL IMPROVEMENTS SUCH AS NEW EQUIPMENT, FACILITIES, AND TECHNOLOGY INFRASTRUCTURE.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses197,977,094

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	3,501,560	0	250,083

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	373,757

f	All other contributions, gifts, grants, and similar amounts not included above		1f	142,906

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

h Total. Add lines 1a-1f.......		516,663

		Business Code
2a	PATIENT REVENUE	621110	191,376,241	191,376,241
b	PROFESSIONAL SERVICES	621110	8,943,711	8,943,711
c	OTHER OPERATING REVENUE	900099	3,535,581	3,535,581
d	RETAIL PHARMACY	456110	2,168,652	2,144,900	23,752
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		206,024,185

3 Investment income (including dividends, interest, and othersimilar amounts) ......			158,527			158,527
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b
c	Gain or (loss)	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFETERIA		722514	726,424			726,424
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			726,424
12	Total revenue. See instructions.....			207,425,799	206,000,433	0	908,703

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	414,552	414,552
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	58,900	58,900
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	858,266		858,266
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	75,386,870	73,916,322	1,470,548
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,897,252	1,897,252
9	Other employee benefits .......	10,462,447	10,462,447
10	Payroll taxes ...........	5,188,030	5,051,108	136,922
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	220,145	69,305	150,840
c	Accounting ...........	61,509		61,509
d	Lobbying ...........	1,999		1,999
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	41,899,372	40,914,650	984,722
12	Advertising and promotion ....	275,879	275,879
13	Office expenses .......	2,808,374	2,325,596	482,778
14	Information technology ......	269,079	269,079
15	Royalties ..
16	Occupancy ...........	2,400,371	2,261,343	139,028
17	Travel ............	376,547	283,832	92,715
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	1,077,670	1,828	1,075,842
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	9,533,601	6,294,524	3,239,077
23	Insurance ...	524,988	3,072	521,916
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	22,592,316	22,588,960	3,356
b	DRUGS	15,108,085	15,108,085
c	IMPLICIT PRICE CONCESSI	7,604,515	7,604,515
d	REPAIRS & MAINTENANCE	3,328,592	3,307,591	21,001
e	All other expenses	7,526,871	4,868,254	2,658,617
25	Total functional expenses. Add lines 1 through 24e	209,876,230	197,977,094	11,899,136	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			12,625,489	1	2,728,779
2	Savings and temporary cash investments .........			53,134	2	0
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			32,569,355	4	36,901,966
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 ...........				7
8	Inventories for sale or use ............			5,038,208	8	5,478,473
9	Prepaid expenses and deferred charges ......			3,060,065	9	2,823,565
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	159,972,299
b	Less: accumulated depreciation	10b	104,003,909	59,450,600	10c	55,968,390
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			3,740,714	13	4,992,359
14	Intangible assets ...............			364,025	14	303,354
15	Other assets. See Part IV, line 11 ...........			12,206,088	15	11,760,791
16	Total assets. Add lines 1 through 15 (must equal line 33)...			129,107,678	16	120,957,677

17	Accounts payable and accrued expenses .....	17,379,376	17	16,825,967
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	27,308,047	20	22,477,972
21	Escrow or custodial account liability. Complete Part IV of Schedule D	13,102	21	14,076
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 ..		23
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	43,628,505	25	43,371,834
26	Total liabilities. Add lines 17 through 25..	88,329,030	26	82,689,849

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	40,778,648	27	38,267,828
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	40,778,648	32	38,267,828
33	Total liabilities and net assets/fund balances ........	129,107,678	33	120,957,677