TY 2024 Form 990

- TIN:

Form990

Department of the TreasuryInternal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Do not enter social security numbers on this form as it may be made public.

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

OMB No. 1545-0047

2024

Open to Public Inspection

A For the 2024 calendar year, or tax year beginning 07-01-2024 , and ending 06-30-2025

BCheck if applicable: Address change Name change Initial return Final return/terminated Amended return Application pending

CName of organization
ESSENTIA HEALTH

Doing business as

Number and street (or P.O. box if mail is not delivered to street address)
502 E 2ND ST

Room/suite

City or town, state or province, country, and ZIP or foreign postal code
DULUTH, MN55805

D Employer identification number

20-0360007

E Telephone number

G Gross receipts $ 727,956,757

F Name and address of principal officer:
DAVID HERMAN MD
502 E 2ND ST
DULUTH,MN55805

Tax-exempt status: 501(c)(3) 501(c) ( ) (insert no.) 4947(a)(1) or 527

Website:

WWW.ESSENTIAHEALTH.ORG

H(a)

Is this a group return for
subordinates? Yes No

H(b)

Are all subordinates
included?

Yes No

If "No," attach a list. See instructions.

H(c)

Group exemption number

K Form of organization: Corporation Trust Association Other

L Year of formation: 2003

M State of legal domicile: MN

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2024 (Part V, line 2a) ......	5	3,459
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	7,588,694
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	362,837

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	379,975	606,875
9	Program service revenue (Part VIII, line 2g) .........	339,765,124	364,085,651
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	20,626,715	27,336,417
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	9,104,446	8,804,737
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	369,876,260	400,833,680
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,000	622
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)	279,765,776	301,701,059
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)....	70,606,250	81,267,191
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	350,377,026	382,968,872
19	Revenue less expenses. Subtract line 18 from line 12.......	19,499,234	17,864,808
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	869,746,602	996,812,762
21	Total liabilities (Part X, line 26).............	369,547,738	439,277,156
22	Net assets or fund balances. Subtract line 21 from line 20.....	500,198,864	557,535,606

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name

Firm's EIN

Firm's address

Phone no.

May the IRS discuss this return with the preparer shown above? See Instructions. ..........YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y Form 990 (2024)

Form 990 (2024)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response or note to any line in this Part III..............

Briefly describe the organization’s mission: WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ..................... Yes No

If "Yes," describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ........................... Yes No

If "Yes," describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 186,560,759 including grants of $ 622 ) (Revenue $ 364,085,651 )
	ESSENTIA HEALTH IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND RELIGIOUS PURPOSES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF ITS SUPPORTED ORGANIZATIONS AS LISTED ON SCHEDULE A OF FORM 990, ALL OF WHICH ARE ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986.ESSENTIA HEALTH IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH SYSTEM THAT INCLUDES ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). THE SYSTEM SERVES PATIENTS IN MINNESOTA, NORTH DAKOTA, AND WISCONSIN. HEADQUARTERED IN DULUTH, MINNESOTA, THE SYSTEM COMBINES THE STRENGTHS AND TALENTS OF NEARLY 16,000 EMPLOYEES, INCLUDING MORE THAN 2,300 PHYSICIANS AND ADVANCED PRACTITIONERS, WHO SERVE OUR PATIENTS AND COMMUNITIES THROUGH THE MISSION OF BEING CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. THE SYSTEM, WHICH INCLUDES MANY CATHOLIC FACILITIES, IS GUIDED BY THE VALUES OF QUALITY, HOSPITALITY, RESPECT, JOY, JUSTICE, STEWARDSHIP, AND TEAMWORK. THE SYSTEM DELIVERS ON ITS MISSION BY HAVING PATIENT-CENTERED FOCUS AT 14 HOSPITALS, APPROXIMATELY 80 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 29 RETAIL PHARMACIES, HOME HEALTH SERVICES, AND ONE RESEARCH INSTITUTE. THE SYSTEM SERVES A PREDOMINANTLY RURAL POPULATION WHOSE MEDIAN INCOMES GENERALLY FALL BELOW THE AVERAGES OF THE STATES WHERE THEY LIVE. THE PRESENCE OF OUR CLINICS AND HOSPITALS ENSURES THAT PEOPLE WITH FEW ECONOMIC RESOURCES DO NOT HAVE TO DRIVE AN HOUR OR MORE TO RECEIVE BASIC (AND IN SOME CASES LIFESAVING) MEDICAL CARE. THE LEGAL ENTITIES COMPRISING THE SYSTEM FILE SEPARATE FORM 990S.AT FISCAL YEAR ENDED JUNE 30, 2025, THE SYSTEM'S CONSOLIDATED TOTAL OPERATING REVENUE WAS $3,283,926,000 AND CONSOLIDATED INCOME FROM OPERATIONS WAS $71,629,000.THE SYSTEM'S HOSPITALS HAVE A TOTAL OF 1,202 LICENSED BEDS WHICH PROVIDED OVER 215,000 HOSPITAL PATIENT DAYS AND NEARLY 831,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2025. THE CLINICS HAD 2.2 MILLION ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2025, THE SYSTEM PROVIDED TOTAL COMMUNITY BENEFITS OF NEARLY $181 MILLION WHICH INCLUDED COSTS OF PROVIDING CHARITY CARE, COSTS IN EXCESS OF MEDICAID PAYMENTS, MEDICAID SURCHARGE, MINNESOTACARE TAX, COMMUNITY BUILDING ACTIVITIES AND SERVICES, HEALTH PROFESSIONALS EDUCATION, AND RESEARCH.

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 expenses186,560,759

Form 990 (2024)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule A Click to see attachment

List of Attached Documents:

// Content

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

Yes

Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment

List of Attached Documents:

// Content

...

Yes

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I Click to see attachment

List of Attached Documents:

// Content

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

Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II Click to see attachment

List of Attached Documents:

// Content

.........

Yes

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III Click to see attachment

List of Attached Documents:

// Content

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I Click to see attachment

List of Attached Documents:

// Content

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

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II Click to see attachment

List of Attached Documents:

// Content

....

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III Click to see attachment

List of Attached Documents:

// Content

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

Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV Click to see attachment

List of Attached Documents:

// Content

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

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......

If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.

Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment

List of Attached Documents:

// Content

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

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII Click to see attachment

List of Attached Documents:

// Content

.......

11b

Yes

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII Click to see attachment

List of Attached Documents:

// Content

.......

11c

Yes

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX Click to see attachment

List of Attached Documents:

// Content

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

11d

Yes

Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X Click to see attachment

List of Attached Documents:

// Content

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X Click to see attachment

List of Attached Documents:

// Content

11f

12a

Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII Click to see attachment

List of Attached Documents:

// Content

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

12a

Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment

List of Attached Documents:

// Content

12b

Yes

Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E

14a

Did the organization maintain an office, employees, or agents outside of the United States? .....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment

List of Attached Documents:

// Content

14b

Yes

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV..... Click to see attachment

List of Attached Documents:

// Content

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment

List of Attached Documents:

// Content

Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................

20a

Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....

20a

If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?

20b

Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....

Form 990 (2024)

Page 4

Part IV

Checklist of Required Schedules (continued)

Yes

Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........

Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment

List of Attached Documents:

// Content

Yes

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a............... Click to see list of attachments

List of Attached Documents:

// Content

24a

Yes

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Yes

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............

24c

Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment

List of Attached Documents:

// Content

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I....................... Click to see attachment

List of Attached Documents:

// Content

25b

Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II Click to see attachment

List of Attached Documents:

// Content

...........

Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?

If "Yes," complete

Schedule L, Part III Click to see attachment

List of Attached Documents:

// Content

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

Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV...................... Click to see attachment

List of Attached Documents:

// Content

28a

Yes

A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV..... Click to see attachment

List of Attached Documents:

// Content

28b

A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................

28c

Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................

Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............ Click to see attachment

List of Attached Documents:

// Content

Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1......................... Click to see attachment

List of Attached Documents:

// Content

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

Yes

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ... Click to see attachment

List of Attached Documents:

// Content

35b

Yes

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment

List of Attached Documents:

// Content

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI Click to see attachment

List of Attached Documents:

// Content

Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Part V

Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........

Yes

Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..

703

Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Yes

Form 990 (2024)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance (continued)

Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................

3,459

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?...

Yes

If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...

Yes

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..

Yes

If "Yes," enter the name of the foreign country: CJ
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...

If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................

If "Yes," did the organization notify the donor of the value of the goods or services provided? .....

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................

If "Yes," indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................

Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........

Sponsoring organizations maintaining donor advised funds.

Did the sponsoring organization make any taxable distributions under section 4966?........

Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If "Yes," enter the amount of tax-exempt interest received or accrued during the year.

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.

13a

Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....

13b

Enter the amount of reserves on hand ............

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..

14b

Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.

Yes

Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.

Section 501(c)(21) organizations. Did the trust, or any disqualified or other person engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.

Form 990 (2024)

Page 6

Part VI

Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response or note to any line in this Part VI..............

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year

If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .

Yes

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .......................

Yes

Each committee with authority to act on behalf of the governing body? ............

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......

Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?

10b

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................

11a

Yes

Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....

12a

Did the organization have a written conflict of interest policy? If "No," go to line 13.......

12a

Yes

Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Yes

Other officers or key employees of the organization ................

15b

Yes

If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the states with which a copy of this Form 990 is required to be filed

Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request Other (explain in Schedule O)

Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, address, and telephone number of the person who possesses the organization's books and records:
MARK BORTNEM502 E 2ND ST DULUTH,MN55805 (218) 786-8376

Form 990 (2024)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response or note to any line in this Part VII..............

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."

List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, box 6 of Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.

Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)				(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) DAVID HERMAN MD...................................................................... CHIEF EXECUTIVE OFFICER	60.00 ................. 0.00		X			3,582,443	0	410,785
(2) JODI MANSFIELD...................................................................... EXECUTIVE VICE PRESIDENT, COO	60.00 ................. 0.00			X		1,682,569	0	203,612
(3) TRACI MORRIS...................................................................... CHIEF FINANCIAL OFFICER/TREASURER	40.00 ................. 20.00		X			1,054,730	0	144,686
(4) LLOYD KETCHUM MD...................................................................... BD DIRECTOR/REL ORG PHYS & DIV CHAIR	2.00 ................. 58.00	X				20,000	1,098,019	71,589
(5) BRADLEY BEARD...................................................................... CHIEF OPERATING OFFICER - EAST	1.00 ................. 59.00			X		0	1,000,148	179,046
(6) WILLIAM HEEGAARD MD...................................................................... PRES-EAST THRU 4/24/FRMR PRES-WEST	1.00 ................. 22.00			X		0	975,947	122,346
(7) CHARLES WATSON...................................................................... CHIEF INFORMATION OFFICER	60.00 ................. 0.00				X	859,620	0	145,067
(8) DIANE DAVIDSON...................................................................... CHIEF HUMAN RESOURCES OFF THRU 4/24	60.00 ................. 0.00			X		839,519	0	145,461
(9) KRISTA SKORUPA MD...................................................................... PRESIDENT - EAST	1.00 ................. 59.00			X		0	806,396	146,142
(10) KARYN BAUM MD...................................................................... CHIEF TRANSFORMATION OFF THRU 1/24	60.00 ................. 0.00				X	911,354	0	32,365
(11) JASON SCHULTZ MD...................................................................... CHIEF MEDICAL OFFICER - EAST	1.00 ................. 59.00			X		0	771,443	171,138
(12) ROBERT GREEN...................................................................... SNR VICE PRES, FINANCIAL OPERATIONS	59.00 ................. 1.00				X	782,582	0	151,254
(13) RICHARD VETTER MD...................................................................... CMO - WEST THRU 12/24	1.00 ................. 59.00			X		0	775,719	150,321
(14) MICHAEL WATTERS...................................................................... CHIEF LEGAL OFFICER/SECRETARY	40.00 ................. 20.00		X			773,128	0	151,399
(15) GRATIA PITCHER MD...................................................................... CHIEF MEDICAL OFFICER	60.00 ................. 0.00			X		752,537	0	151,803
(16) SARAH MANNEY KURTH MD...................................................................... CHIEF MEDICAL INFORMATION OFFICER	60.00 ................. 0.00				X	712,811	0	153,626
(17) AL HURLEY...................................................................... CHIEF OPERATING OFFICER - WEST	1.00 ................. 59.00			X		0	706,163	129,814

Form 990 (2024)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)					(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) RHONDA KAZIK........................................................................ CHIEF NURSE EXECUTIVE	54.00 .......................6.00			X			0	685,390	133,586
(19) KEVIN CASEY MD........................................................................ FORMER CHIEF MEDICAL OFFICER	0.00 .......................0.00					X	817,015	0	0
(20) MELANIE WILSON........................................................................ SNR VICE PRES, REVENUE SERVICES	60.00 .......................0.00				X		639,866	0	142,138
(21) MARK THOMPSON MD........................................................................ PRESIDENT - WEST THRU 7/24	1.00 .......................59.00			X			0	702,130	40,293
(22) STEFANIE GEFROH ELLISON MD........................................................................ BD DIRECTOR THRU 2/25/PRESIDENT-WEST	2.00 .......................58.00	X					30,000	532,220	66,878
(23) JOSHUA HONEYMAN MD........................................................................ BD DIRECTOR/REL ORG PHYS & DIV CHAIR	2.00 .......................58.00	X					0	530,437	63,080
(24) ANNE STEPHEN MD........................................................................ CMO - EAST THRU 5/24	1.00 .......................59.00			X			0	499,103	70,794
(25) JANE RUDD MD........................................................................ BD DIRECTOR/REL ORG PHYS & DIV CHAIR	2.00 .......................58.00	X					20,000	313,756	64,738
(26) JOHN VON ARB........................................................................ INTERIM CHRO	60.00 .......................0.00			X			329,329	0	51,683
(27) FRANK MODICH........................................................................ FORMER INTERIM CHIEF LEGAL OFFICER	60.00 .......................0.00					X	280,924	0	28,902
(28) PETER HENRY MD........................................................................ FORMER CHIEF MEDICAL OFFICER	0.00 .......................60.00					X	0	111,544	8,922
(29) SHEILA HART........................................................................ FORMER SNR VP-INT CARE DELIVERY	0.00 .......................1.00					X	108,020	0	0
(30) ALAN HODNIK........................................................................ BOARD CHAIR	2.00 .......................0.00	X	X				45,000	0	0
(31) KEVIN MOUG........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					30,000	0	0
(32) LAURIE LEWANDOWSKI........................................................................ BOARD DIRECTOR	2.00 .......................2.00	X					23,375	0	0
(33) GEORGE GOLDFARB........................................................................ BOARD VICE CHAIR THRU 9/24	2.00 .......................0.00	X	X				22,500	0	0
(34) KIMBERLY STOKES........................................................................ BOARD DIRECTOR	2.00 .......................1.00	X					22,500	0	0
(35) MARK RONNEI........................................................................ BOARD VICE CHAIR	2.00 .......................0.00	X	X				20,000	0	0
(36) SANDEEP WADHWA MD........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					1,296	0	0
(37) DAVID MCMILLAN........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0
(38) FRANK FREDERICKSON........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0
(39) LEANN LITTLEWOLF........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0
(40) PATRICK COURNEYA MD........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0
(41) SISTER BEVERLY RAWAY........................................................................ BOARD DIRECTOR	2.00 .......................1.20	X					0	0	0
(42) SISTER CLARE MARIE TRETTEL........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0
(43) SISTER KATHLEEN HOFER........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0
(44) SISTER THERESE CARSON........................................................................ BOARD DIRECTOR	2.00 .......................1.10	X					0	0	0
(45) TIM PAWLENTY........................................................................ BOARD DIRECTOR	2.00 .......................0.00	X					0	0	0

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	14,361,118	9,508,415	3,331,468

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 349

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............

Yes

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................

Yes

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
AMN HEALTHCARE INC PO BOX 745978 LOS ANGELES,CA90074	MEDICAL STAFFING	21,934,296
MCGOUGH CONSTRUCTION 2737 FAIRVIEW AVE N ST PAUL,MN55113	CONSTRUCTION SERVICES	13,508,293
ADOLFSON & PETERSON CONSTRUCTION 8000 NORMAN CTR DR STE 1000 MPLS,MN55437	CONSTRUCTION SERVICES	12,355,107
EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA,WI53593	MEDICAL BILLING SOFTWARE SUPPORT SERVICE	11,320,228
WEATHERBY LOCUMS INC PO BOX 972633 DALLAS,TX75397	MEDICAL STAFFING	10,923,742
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 313

Form 990 (2024)

Page 9

Part VIII

Statement of Revenue

Check if Schedule O contains a response or note to any line in this Part VIII.............

(A)
Total revenue

(B)
Related or
exempt
function
revenue

(D)
Revenue
excluded from
tax under sections
512 - 514

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	6,818
e	Government grants (contributions)		1e	503,873

f	All other contributions, gifts, grants, and similar amounts not included above		1f	96,184

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

h Total. Add lines 1a-1f.......		606,875

		Business Code
2a	SUPPORT REVENUE	541610	364,085,651	364,085,651
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		364,085,651

3 Investment income (including dividends, interest, and othersimilar amounts) ......			16,737,333		-1,157,276	17,894,609
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	4,000
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	4,000
d	Net rental income or (loss).......			4,000			4,000
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	337,722,161
b	Less: cost or other basis and sales expenses	7b	327,115,310	7,767
c	Gain or (loss)	7c	10,606,851	-7,767
d	Net gain or (loss).........			10,599,084			10,599,084
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	SYSTEM ACCESS/USE REVENUE		541519	8,745,970		8,745,970
b	SETTLEMENTS		900099	42,501			42,501
c	MISCELLANEOUS		900099	7,156			7,156
d	All other revenue ....			5,110			5,110
e	Total. Add lines 11a–11d ......			8,800,737
12	Total revenue. See instructions.....			400,833,680	364,085,651	7,588,694	28,552,460

Form 990 (2024)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	622	622
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	11,139,677	45,412	11,094,265
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........	224,924,997	122,244,702	102,680,295
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,418,774	5,637,011	3,781,763
9	Other employee benefits .......	39,944,396	22,045,714	17,898,682
10	Payroll taxes ...........	16,273,215	8,699,291	7,573,924
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	2,855,113		2,855,113
c	Accounting ...........	546,209		546,209
d	Lobbying ...........	732,907		732,907
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,802,108		1,802,108
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	35,347,481	9,790,183	25,557,298
12	Advertising and promotion ....	7,305,854	6,352,747	953,107
13	Office expenses .......	12,794,017	1,019,075	11,774,942
14	Information technology ......	6,418,616	3,488,460	2,930,156
15	Royalties ..
16	Occupancy ...........	838,917	455,944	382,973
17	Travel ............	2,636,770	1,048,154	1,588,616
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	849,240	315,931	533,309
20	Interest ...........	1,795,106	1,795,106
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,343,376	1,817,095	1,526,281
23	Insurance ...
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	UNRELATED BUSINESS TAX	36,661		36,661
b	PUBLICATIONS & SUBSCRIP	939,198	887,723	51,475
c	DUES	923,084	461,303	461,781
d	FEDERAL EXCISE TAX	747,539		747,539
e	All other expenses	1,354,995	456,286	898,709
25	Total functional expenses. Add lines 1 through 24e	382,968,872	186,560,759	196,408,113	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).

Form 990 (2024)

Page 11

Part X

Balance Sheet

Check if Schedule O contains a response or note to any line in this Part IX..............

				(A) Beginning of year		(B) End of year

1	Cash–non-interest-bearing ........			1,339,619	1	35,054,971
2	Savings and temporary cash investments .........			118,276,666	2	130,531,416
3	Pledges and grants receivable, net ......				3	63,991
4	Accounts receivable, net .............			16,095,265	4	17,256,996
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	815,317
8	Inventories for sale or use ............				8	524,758
9	Prepaid expenses and deferred charges ......			7,326,617	9	6,269,556
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	50,632,285
b	Less: accumulated depreciation	10b	15,078,908	35,869,218	10c	35,553,377
11	Investments—publicly traded securities .			2,280	11	10,673
12	Investments—other securities. See Part IV, line 11 .....			486,821,935	12	543,481,547
13	Investments—program-related. See Part IV, line 11 ..			57,570,317	13	57,570,317
14	Intangible assets ...............			6,301,014	14	6,714,744
15	Other assets. See Part IV, line 11 ...........			140,143,671	15	162,965,099
16	Total assets. Add lines 1 through 15 (must equal line 33)...			869,746,602	16	996,812,762

17	Accounts payable and accrued expenses .....	132,186,930	17	137,961,152
18	Grants payable ...		18
19	Deferred revenue .........	261,257	19	1,748,652
20	Tax-exempt bond liabilities .........	47,583,206	20	46,689,320
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	10,237,396	23	9,799,172
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	179,278,949	25	243,078,860
26	Total liabilities. Add lines 17 through 25..	369,547,738	26	439,277,156

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	500,198,864	27	557,473,167
28	Net assets with donor restrictions ...........		28	62,439
	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 ...........	500,198,864	32	557,535,606
33	Total liabilities and net assets/fund balances ........	869,746,602	33	996,812,762

Form 990 (2024)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response or note to any line in this Part XI..............

Total revenue (must equal Part VIII, column (A), line 12) ............

400,833,680

Total expenses (must equal Part IX, column (A), line 25) ............

382,968,872

Revenue less expenses. Subtract line 2 from line 1 ..............

17,864,808

Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..

500,198,864

Net unrealized gains (losses) on investments ...............

39,571,887

Donated services and use of facilities .................

Investment expenses .....................

Prior period adjustments .....................

Other changes in net assets or fund balances (explain in Schedule O) ........

-99,953

Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))

557,535,606

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response or note to any line in this Part XII.............

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

Were the organization’s financial statements audited by an independent accountant?

Yes

If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separate basis

If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?

Yes

If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Uniform Guidance, 2 C.F.R. Part 200, Subpart F?

Yes

If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.

Yes

Form 990 (2024)

Additional Data

Software ID:
Software Version:

Form 990, Special Condition Description:

Special Condition Description

- 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

2024

Open to Public
Inspection

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

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 ...............................21

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

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) BRAINERD MEDICAL CENTER INC	371532148	3	Yes		4,447,117	0
(B) BRIDGES MEDICAL CENTER	200479568	3	Yes		1,314,644	0
(C) DEER RIVER HEALTHCARE CENTER INC	410844574	3	Yes		5,241,010	0
(D) ESSENTIA HEALTH FOUNDATION	271984704	7	Yes		181,460	0
(E) ESSENTIA HEALTH MOOSE LAKE	845099016	3	Yes		5,411,048	0
(F) ESSENTIA HEALTH SURGERY CENTERS	881577422	3	Yes		1,547,452	0
(G) ESSENTIA INSTITUTE OF RURAL HEALTH	271291124	4	Yes		902,713	0
(H) FIRST CARE MEDICAL SERVICES	410706143	3	Yes		3,912,783	0
(I) GRACEVILLE HEALTH CENTER	410726173	3	Yes		1,457,481	0
(J) INNOVIS HEALTH LLC	261175213	3	Yes		75,231,568	0
(K) NORTHERN PINES MEDICAL CENTER	410841441	3	Yes		2,893,031	0
(L) PINE MEDICAL CENTER	411884597	3	Yes		2,809,778	0
(M) POLINSKY MEDICAL REHABILITATION CENTER	410691275	3	Yes		794,992	0
(N) SMDC MEDICAL CENTER	411878730	3	Yes		95,010,607	0
(O) ST JOSEPH'S MEDICAL CENTER	410695602	3	Yes		34,476,671	0
(P) ST MARY'S EMS	411805811	10	Yes		1,511,897	0
(Q) ST MARY'S HOSPITAL OF SUPERIOR	411811073	3	Yes		14,455,298	0
(R) ST MARY'S INNOVIS HEALTH	262861321	3	Yes		1,252,186	0
(S) ST MARY'S MEDICAL CENTER	410695604	3	Yes		66,872,801	0
(T) ST MARY'S REGIONAL HEALTH CENTER	411620386	3	Yes		21,354,161	0
(U) THE DULUTH CLINIC LTD	410883623	3	Yes		41,863,316	0
Total 21					382,942,014	0

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

Cat. No. 11285F

Schedule A (Form 990) 2024

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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 2024 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2023 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2024. 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—2023. 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—2024. 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—2023. 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) 2024

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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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) 2020	(b) 2021	(c) 2022	(d) 2023	(e) 2024	(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 2024 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2023 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2024 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2023 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2024. 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—2023. 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) 2024

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.

Yes

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.

Yes

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) 2024

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?

Yes

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).

Yes

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.

Yes

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.

Yes

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.

Yes

Schedule A (Form 990) 2024

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) 2024

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 2024 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-2024	(iii) Distributable Amount for 2024
1 Distributable amount for 2024 from Section C, line 6
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2024:
a From 2019.......
b From 2020.......
c From 2021.......
d From 2022.......
e From 2023.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2024 distributable amount
i Carryover from 2019 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2024 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2024 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2024, 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 2024. 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 2025. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2020.....
b Excess from 2021.....
c Excess from 2022.....
d Excess from 2023.....
e Excess from 2024.....

Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024

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, PART I, LINE 12G, COLUMN V:	AMOUNT OF SUPPORT: THE AMOUNT OF SUPPORT INCLUDES ESSENTIA HEALTH'S FUNCTIONAL EXPENSES WHICH ARE INCURRED FOR THE BENEFIT OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS.
SCHEDULE A, PART IV, SECTION A, LINE 6:	SUPPORT TO OTHER ORGANIZATIONS: ESSENTIA HEALTH MADE CONTRIBUTIONS TO UNRELATED ORGANIZATIONS THAT ALIGN WITH ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS' MISSIONS.
SCHEDULE A, PART IV, SECTION D, LINE 3:	SUPPORTED ORGANIZATIONS' VOICE AND DIRECTION: THERE ARE MULTIPLE DIRECTORS THAT SERVE ON ESSENTIA HEALTH'S BOARD OF DIRECTORS AS WELL AS ON ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS' BOARD OF DIRECTORS. IN ADDITION, THE OFFICERS AND OTHER KEY EMPLOYEES OF ESSENTIA HEALTH AND ITS SUPPORTED ORGANIZATIONS MAINTAIN CLOSE AND CONTINUOUS WORKING RELATIONSHIPS BY SITTING ON THE SAME LEADERSHIP COMMITTEES AND TEAMS. FIRST AT THE SUPPORTED ORGANIZATION LEVEL AND THEN AT THE SUPPORTING ORGANIZATION LEVEL, ESSENTIA HEALTH'S INVESTMENTS AND USE OF INCOME AND ASSETS ARE DISCUSSED AND APPROVED RESULTING IN ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS HAVING A SIGNIFICANT VOICE IN DIRECTING THE ACTIVITIES OF ESSENTIA HEALTH.
SCHEDULE A, PART IV, SECTION E, LINE 3A:	POWER TO APPOINT OR ELECT DIRECTORS: ESSENTIA HEALTH HAS THE AUTHORITY TO APPOINT AND REMOVE ALL DIRECTORS, WITH OR WITHOUT CAUSE, ON THE BOARDS OF DIRECTORS OF ITS SUPPORTED ORGANIZATIONS.
SCHEDULE A, PART IV, SECTION E, LINE 3B:	DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF THE SUPPORTED ORGANIZATIONS: ESSENTIA HEALTH HAS COMPREHENSIVE AUTHORITY, AS THE PARENT OF THE SYSTEM, TO MANAGE ALL CHARITABLE ORGANIZATIONS WITHIN THE SYSTEM. THE ARTICLES OF INCORPORATION OF EACH SUPPORTED ORGANIZATION DELEGATES RESERVED POWERS TO ESSENTIA HEALTH OVER THE FOLLOWING FUNCTIONS OF THE SUPPORTED ORGANIZATION: (A) STRATEGIC AND BUSINESS PLANS; (B) MISSION; (C) DEBT ISSUANCE; (D) INITIATING AND APPROVING CHANGES TO GOVERNANCE DOCUMENTS; (E) APPOINTMENT AND REMOVAL OF DIRECTORS; (F) MERGERS, AFFILIATIONS AND DISSOLUTION; (G) TRANSFER OF ASSETS WITHIN THE SYSTEM; (H) TRANSFER OF ASSETS OUTSIDE THE SYSTEM; (I) OFFER OR DISCONTINUING ANY SERVICES OR SERVICE LOCATIONS; (J) BUDGETS; (K) SELECTION OF GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS; (L) CORPORATE ACQUISITIONS; (M) MARKETING; (N) COMPLIANCE; (O) QUALITY PLAN; (P) NON-BUDGETED PURCHASES; (Q) HUMAN RESOURCES; AND (R) SYSTEM COMPENSATION.

Schedule A (Form 990) 2024

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)
(Rev. January 2025)

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

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

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 ......... Right Arrow

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025) Page 2

Name of organization ESSENTIA HEALTH

Part I	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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 3

Name of organization ESSENTIA HEALTH		Employer identification number 20-0360007

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) (Rev. 1-2025)

Schedule B (Form 990) (Rev. 1-2025)

Page 4


Name of organization ESSENTIA HEALTH			Employer identification number 20-0360007
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) (Rev. 1-2025)

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

2024

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

ESSENTIA HEALTH

Employer identification number

20-0360007

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) 2024

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) 2021	(b) 2022	(c) 2023	(d) 2024	(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) 2024

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

(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)? ........

Yes

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

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

Yes

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

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

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

Yes

88,548

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

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

Yes

732,907

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

821,455

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1, LOBBYING ACTIVITIES:	DURING FY 2025, ESSENTIA HEALTH EMPLOYED FIVE FULL-TIME IN-HOUSE PUBLIC POLICY INDIVIDUALS AND CONTRACTED WITH VARIOUS CONSULTANT FIRMS TO MONITOR FEDERAL AND STATE LEGISLATIVE ACTIVITIES OF INTEREST RELATED TO HEALTH AND HUMAN SERVICES ISSUES AND RURAL HEALTH CARE. ESSENTIA HEALTH'S PUBLIC POLICY ACTIVITIES OCCUR ON THE LOCAL, STATE, AND FEDERAL LEVEL IN MINNESOTA, NORTH DAKOTA, AND WISCONSIN. ESSENTIA HEALTH PUBLIC POLICY ACTIVITIES INCLUDED IN-PERSON, TELEPHONIC, ELECTRONIC COMMUNICATION AND INFORMATION RELAY WITH LEGISLATORS AND STAFF, ADMINISTRATIVE OFFICIALS, GOVERNMENT AGENCIES AND DEPARTMENTS ON THE LOCAL, STATE, AND FEDERAL LEVELS. THIS ALSO INCLUDED EMPLOYEE-LED ADVOCACY EFFORTS THROUGH OUR ESSENTIA HEALTH ADVOCACY NETWORK. THE PRIMARY ISSUES OF INTEREST AND CONCERN INCLUDE: VALUE-BASED CARE CRITICAL ACCESS HOSPITAL DESIGNATION, STATUS AND REIMBURSEMENT PHYSICIAN AND HOSPITAL SERVICES REIMBURSEMENT MEDICARE AND MEDICAID REIMBURSEMENT POLICIES DISPROPORTIONATE SHARE HOSPITAL FUNDING SOLE COMMUNITY HOSPITAL STATUS AND FUNDING GRADUATE MEDICAL EDUCATION/INDIRECT MEDICAL EDUCATION FUNDING HEALTH INFORMATION TECHNOLOGY FUNDING AND PRIVACY ISSUES CYBERSECURITY STATE AND FEDERAL SHARED SAVINGS DEMONSTRATION PROJECTS MEDICARE REIMBURSEMENT FOR REHAB FACILITIES MEDICARE 340B PRESCRIPTION DRUG DISCOUNT PROGRAM MULTI-STATE NURSE LICENSURE COMPACT MULTI-STATE ADVANCED PRACTICE REGISTERED NURSE LICENSURE COMPACT MULTI-STATE PHYSICIAN LICENSURE COMPACT MULTI-STATE PHYSICAL THERAPY COMPACT MANDATED NURSE STAFFING QUOTAS ELECTRONIC MEDICAL RECORD INTEROPERABILITY/HEALTH INFORMATION TECHNOLOGY MEDICARE RECOVERY AUDIT CONTRACTOR AUDITS (RAC) HEALTH INFORMATION EXCHANGE MEDICAL EDUCATION AND RESEARCH COSTS (MERC) STATE CHILDREN'S HEALTH INSURANCE PROGRAM WORKFORCE DEVELOPMENT ISSUES PUBLIC HEALTH INITIATIVES COMMUNITY BENEFITS WORKERS COMPENSATION SYSTEM TAX EXEMPT STATUS ENVIRONMENTAL PROTECTION & SOLID WASTE ADVANCED CARE PLANNING PANDEMIC PREPAREDNESS AND READINESS EXPANSION OF TELEHEALTH SERVICES MENTAL HEALTH/BEHAVIORAL HEALTH ISSUES PRIOR AUTHORIZATION REFORM ESSENTIA HEALTH ALSO PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT INCLUDED IN THE TOTAL IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING.

Return Reference

Explanation

SCHEDULE C, PART II-B, LINE 1, LOBBYING ACTIVITIES:

DURING FY 2025, ESSENTIA HEALTH EMPLOYED FIVE FULL-TIME IN-HOUSE PUBLIC POLICY INDIVIDUALS AND CONTRACTED WITH VARIOUS CONSULTANT FIRMS TO MONITOR FEDERAL AND STATE LEGISLATIVE ACTIVITIES OF INTEREST RELATED TO HEALTH AND HUMAN SERVICES ISSUES AND RURAL HEALTH CARE. ESSENTIA HEALTH'S PUBLIC POLICY ACTIVITIES OCCUR ON THE LOCAL, STATE, AND FEDERAL LEVEL IN MINNESOTA, NORTH DAKOTA, AND WISCONSIN. ESSENTIA HEALTH PUBLIC POLICY ACTIVITIES INCLUDED IN-PERSON, TELEPHONIC, ELECTRONIC COMMUNICATION AND INFORMATION RELAY WITH LEGISLATORS AND STAFF, ADMINISTRATIVE OFFICIALS, GOVERNMENT AGENCIES AND DEPARTMENTS ON THE LOCAL, STATE, AND FEDERAL LEVELS. THIS ALSO INCLUDED EMPLOYEE-LED ADVOCACY EFFORTS THROUGH OUR ESSENTIA HEALTH ADVOCACY NETWORK. THE PRIMARY ISSUES OF INTEREST AND CONCERN INCLUDE: VALUE-BASED CARE CRITICAL ACCESS HOSPITAL DESIGNATION, STATUS AND REIMBURSEMENT PHYSICIAN AND HOSPITAL SERVICES REIMBURSEMENT MEDICARE AND MEDICAID REIMBURSEMENT POLICIES DISPROPORTIONATE SHARE HOSPITAL FUNDING SOLE COMMUNITY HOSPITAL STATUS AND FUNDING GRADUATE MEDICAL EDUCATION/INDIRECT MEDICAL EDUCATION FUNDING HEALTH INFORMATION TECHNOLOGY FUNDING AND PRIVACY ISSUES CYBERSECURITY STATE AND FEDERAL SHARED SAVINGS DEMONSTRATION PROJECTS MEDICARE REIMBURSEMENT FOR REHAB FACILITIES MEDICARE 340B PRESCRIPTION DRUG DISCOUNT PROGRAM MULTI-STATE NURSE LICENSURE COMPACT MULTI-STATE ADVANCED PRACTICE REGISTERED NURSE LICENSURE COMPACT MULTI-STATE PHYSICIAN LICENSURE COMPACT MULTI-STATE PHYSICAL THERAPY COMPACT MANDATED NURSE STAFFING QUOTAS ELECTRONIC MEDICAL RECORD INTEROPERABILITY/HEALTH INFORMATION TECHNOLOGY MEDICARE RECOVERY AUDIT CONTRACTOR AUDITS (RAC) HEALTH INFORMATION EXCHANGE MEDICAL EDUCATION AND RESEARCH COSTS (MERC) STATE CHILDREN'S HEALTH INSURANCE PROGRAM WORKFORCE DEVELOPMENT ISSUES PUBLIC HEALTH INITIATIVES COMMUNITY BENEFITS WORKERS COMPENSATION SYSTEM TAX EXEMPT STATUS ENVIRONMENTAL PROTECTION & SOLID WASTE ADVANCED CARE PLANNING PANDEMIC PREPAREDNESS AND READINESS EXPANSION OF TELEHEALTH SERVICES MENTAL HEALTH/BEHAVIORAL HEALTH ISSUES PRIOR AUTHORIZATION REFORM ESSENTIA HEALTH ALSO PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT INCLUDED IN THE TOTAL IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING.

Schedule C (Form 990) 2024

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

Open to Public Inspection

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

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) (Rev. 1-2025)

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 .....	1,037,213		1,037,213
b	Buildings ....	21,029,827	745,348	20,284,479
c	Leasehold improvements
d	Equipment ....	27,155,993	14,245,102	12,910,891
e	Other .....	1,409,252	88,458	1,320,794
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				35,553,377

Schedule D (Form 990) (Rev. 1-2025)

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) POOLED INVESTMENT FUNDS	542,328,497	F
(B) BOND CONSTRUCTION FUND	1,153,050	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	543,481,547

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)INVESTMENT IN BENEDICTINE HEALTH SYSTEM	53,227,022	C
(2)INVESTMENT IN ST. FRANCIS REGIONAL MEDICAL CENTER	4,343,295	C
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	57,570,317

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)DEFERRED COMPENSATION FUND				156,492,114
(2)REINSURANCE RECEIVABLE				3,496,464
(3)RECEIVABLES FROM RELATED ORGS				2,879,083
(4)DEFERRED TAX ASSET				762,297
(5)OPERATING LEASE ASSET				60,118
(6)DEFERRED TAX ALLOWANCE				-724,977
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				162,965,099

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
BENEFIT PLAN LIABILITY	156,492,114
PAYABLES TO RELATED ORGS	86,445,103
UNCLAIMED PROPERTY	83,352
OPERATING LEASES	58,291





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	243,078,860
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) (Rev. 1-2025)

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)
(Rev. January 2025)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right arrow

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

OMB No. 1545-0047

Open to Public Inspection

Name of the organization
ESSENTIA HEALTH

Employer identification number

20-0360007

Part I

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

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

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

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

Yes

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

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

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS,	0	0	INVESTMENTS		229,221,083
	CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS,	0	0	PROGRAM SERVICES	SELF INDEMNITY	18,138,785















3a	Sub-total ....	0	0			247,359,868
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			247,359,868

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) (Rev. 1-2025)

Schedule F (Form 990) (Rev. 1-2025)

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) (Rev. 1-2025)

Schedule F (Form 990) (Rev. 1-2025)Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) (Rev. 1-2025)

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) (Rev. 1-2025)

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)
(Rev. January 2025)

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

Open to Public Inspection

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

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 .....

Yes

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? ....

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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) (Rev. 1-2025)

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)
1DAVID HERMAN MD CHIEF EXECUTIVE OFFICER	(i) (ii)	1,892,379 ------------- 0	1,343,320 ------------- 0	346,744 ------------- 0	407,599 ------------- 0	3,186 ------------- 0	3,993,228 ------------- 0	332,467 ------------- 0
2JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO	(i) (ii)	1,064,984 ------------- 0	391,240 ------------- 0	226,345 ------------- 0	202,044 ------------- 0	1,568 ------------- 0	1,886,181 ------------- 0	153,729 ------------- 0
3TRACI MORRIS CHIEF FINANCIAL OFFICER/TREASURER	(i) (ii)	702,675 ------------- 0	269,075 ------------- 0	82,980 ------------- 0	142,406 ------------- 0	2,280 ------------- 0	1,199,416 ------------- 0	71,480 ------------- 0
4LLOYD KETCHUM MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR	(i) (ii)	20,000 ------------- 1,093,117	0 ------------- 0	0 ------------- 4,902	0 ------------- 27,600	0 ------------- 43,989	20,000 ------------- 1,169,608	0 ------------- 0
5BRADLEY BEARD CHIEF OPERATING OFFICER - EAST	(i) (ii)	0 ------------- 644,035	0 ------------- 243,376	0 ------------- 112,737	0 ------------- 134,559	0 ------------- 44,487	0 ------------- 1,179,194	0 ------------- 90,640
6WILLIAM HEEGAARD MD PRES-EAST THRU 4/24/FRMR PRES-WEST	(i) (ii)	0 ------------- 330,418	0 ------------- 136,878	0 ------------- 508,651	0 ------------- 80,633	0 ------------- 41,713	0 ------------- 1,098,293	0 ------------- 0
7CHARLES WATSON CHIEF INFORMATION OFFICER	(i) (ii)	542,704 ------------- 0	219,580 ------------- 0	97,336 ------------- 0	117,386 ------------- 0	27,681 ------------- 0	1,004,687 ------------- 0	64,148 ------------- 0
8DIANE DAVIDSON CHIEF HUMAN RESOURCES OFF THRU 4/24	(i) (ii)	538,135 ------------- 0	203,807 ------------- 0	97,577 ------------- 0	115,436 ------------- 0	30,025 ------------- 0	984,980 ------------- 0	74,636 ------------- 0
9KRISTA SKORUPA MD PRESIDENT - EAST	(i) (ii)	0 ------------- 593,854	0 ------------- 210,216	0 ------------- 2,326	0 ------------- 129,886	0 ------------- 16,256	0 ------------- 952,538	0 ------------- 0
10KARYN BAUM MD CHIEF TRANSFORMATION OFF THRU 1/24	(i) (ii)	64,064 ------------- 0	133,812 ------------- 0	713,478 ------------- 0	5,701 ------------- 0	26,664 ------------- 0	943,719 ------------- 0	27,600 ------------- 0
11JASON SCHULTZ MD CHIEF MEDICAL OFFICER - EAST	(i) (ii)	0 ------------- 769,400	0 ------------- 0	0 ------------- 2,043	0 ------------- 127,523	0 ------------- 43,615	0 ------------- 942,581	0 ------------- 0
12ROBERT GREEN SNR VICE PRES, FINANCIAL OPERATIONS	(i) (ii)	548,932 ------------- 0	222,166 ------------- 0	11,484 ------------- 0	118,444 ------------- 0	32,810 ------------- 0	933,836 ------------- 0	0 ------------- 0
13RICHARD VETTER MD CMO - WEST THRU 12/24	(i) (ii)	0 ------------- 514,300	0 ------------- 195,353	0 ------------- 66,066	0 ------------- 107,093	0 ------------- 43,228	0 ------------- 926,040	0 ------------- 46,808
14MICHAEL WATTERS CHIEF LEGAL OFFICER/SECRETARY	(i) (ii)	506,819 ------------- 0	192,028 ------------- 0	74,281 ------------- 0	109,834 ------------- 0	41,565 ------------- 0	924,527 ------------- 0	62,797 ------------- 0
15GRATIA PITCHER MD CHIEF MEDICAL OFFICER	(i) (ii)	609,084 ------------- 0	141,754 ------------- 0	1,699 ------------- 0	124,680 ------------- 0	27,123 ------------- 0	904,340 ------------- 0	0 ------------- 0
16SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER	(i) (ii)	491,248 ------------- 0	185,092 ------------- 0	36,471 ------------- 0	110,404 ------------- 0	43,222 ------------- 0	866,437 ------------- 0	23,210 ------------- 0
17AL HURLEY CHIEF OPERATING OFFICER - WEST	(i) (ii)	0 ------------- 453,221	0 ------------- 183,113	0 ------------- 69,829	0 ------------- 102,252	0 ------------- 27,562	0 ------------- 835,977	0 ------------- 59,141
18RHONDA KAZIK CHIEF NURSE EXECUTIVE	(i) (ii)	0 ------------- 468,896	0 ------------- 189,548	0 ------------- 26,946	0 ------------- 105,482	0 ------------- 28,104	0 ------------- 818,976	0 ------------- 13,802
19KEVIN CASEY MD FORMER CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	817,015 ------------- 0	0 ------------- 0	0 ------------- 0	817,015 ------------- 0	83,079 ------------- 0
20MELANIE WILSON SNR VICE PRES, REVENUE SERVICES	(i) (ii)	453,005 ------------- 0	184,443 ------------- 0	2,418 ------------- 0	103,019 ------------- 0	39,119 ------------- 0	782,004 ------------- 0	0 ------------- 0
21MARK THOMPSON MD PRESIDENT - WEST THRU 7/24	(i) (ii)	0 ------------- 417,961	0 ------------- 0	0 ------------- 284,169	0 ------------- 0	0 ------------- 40,293	0 ------------- 742,423	0 ------------- 0
22STEFANIE GEFROH ELLISON MD BD DIRECTOR THRU 2/25/PRESIDENT-WEST	(i) (ii)	30,000 ------------- 530,965	0 ------------- 0	0 ------------- 1,255	0 ------------- 27,600	0 ------------- 39,278	30,000 ------------- 599,098	0 ------------- 0
23JOSHUA HONEYMAN MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR	(i) (ii)	0 ------------- 529,909	0 ------------- 0	0 ------------- 528	0 ------------- 25,519	0 ------------- 37,561	0 ------------- 593,517	0 ------------- 0
24ANNE STEPHEN MD CMO - EAST THRU 5/24	(i) (ii)	0 ------------- 222,571	0 ------------- 200,424	0 ------------- 76,108	0 ------------- 55,596	0 ------------- 15,198	0 ------------- 569,897	0 ------------- 65,980
25JANE RUDD MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR	(i) (ii)	20,000 ------------- 311,209	0 ------------- 0	0 ------------- 2,547	0 ------------- 25,051	0 ------------- 39,687	20,000 ------------- 378,494	0 ------------- 0
26JOHN VON ARB INTERIM CHRO	(i) (ii)	291,270 ------------- 0	36,209 ------------- 0	1,850 ------------- 0	15,748 ------------- 0	35,935 ------------- 0	381,012 ------------- 0	0 ------------- 0
27FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER	(i) (ii)	249,235 ------------- 0	31,320 ------------- 0	369 ------------- 0	13,299 ------------- 0	15,603 ------------- 0	309,826 ------------- 0	0 ------------- 0
28PETER HENRY MD FORMER CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 111,529	0 ------------- 0	0 ------------- 15	0 ------------- 8,922	0 ------------- 0	0 ------------- 120,466	0 ------------- 0
29SHEILA HART FORMER SNR VP-INT CARE DELIVERY	(i) (ii)	1,200 ------------- 0	0 ------------- 0	106,820 ------------- 0	0 ------------- 0	0 ------------- 0	108,020 ------------- 0	0 ------------- 0

Schedule J (Form 990) (Rev. 1-2025)

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART I, LINE 1A

BENEFITS PROVIDED: DURING CALENDAR YEAR 2024, CHARTER TRAVEL WAS USED BY THREE DIRECTORS, TWO OFFICERS, AND THREE KEY EMPLOYEES FOR TRAVEL BETWEEN ESSENTIA HEALTH AND OTHER ORGANIZATIONS. THE USE OF CHARTER TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION TO THESE INDIVIDUALS AS ALL TRAVEL WAS BUSINESS RELATED. DURING CALENDAR YEAR 2024, KEY EMPLOYEE JODI MANSFIELD RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION.

PART I, LINES 4A-B

SEVERANCE PAYMENT: KEY EMPLOYEE WILLIAM HEEGAARD, MD RECEIVED PAYMENTS TOTALING $393,086 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, HEEGAARD WILL RECEIVE PAY TOTALING $1,095,026 AND BENEFITS TOTALING $45,337 FROM JUNE 2, 2024 TO DECEMBER 2, 2025. HIGHEST-COMPENSATED EMPLOYEE KARYN BAUM, MD RECEIVED PAYMENTS TOTALING $614,952 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, BAUM WILL RECEIVE PAY TOTALING $1,029,319 AND BENEFITS TOTALING $31,774 FROM JANUARY 23, 2024 TO JULY 23, 2025. FORMER KEY EMPLOYEE KEVIN CASEY, MD RECEIVED PAYMENTS TOTALING $686,213 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, CASEY WILL RECEIVE PAY TOTALING $1,029,319 AND BENEFITS TOTALING $33,928 FROM OCTOBER 9, 2023 TO APRIL 8, 2025. KEY EMPLOYEE MARK THOMPSON, MD RECEIVED PAYMENTS TOTALING $278,656 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, THOMPSON WILL RECEIVE PAY TOTALING $1,086,758 AND BENEFITS TOTALING $39,075 FROM JULY 26, 2024 TO JANUARY 31, 2026. ALL OTHER INDIVIDUALS LISTED AS FORMERS IN FORM 990, PART VII, SECTION A, LINE 1A DID NOT RECEIVE A SEVERANCE PAYMENT DURING CALENDAR YEAR 2024. SOME OF THESE INDIVIDUALS REMAIN EMPLOYED WITHIN ESSENTIA HEALTH AND ITS SUBSIDIARIES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: DAVID HERMAN, MD $332,467 JODI MANSFIELD $153,729 TRACI MORRIS $78,928 BRADLEY BEARD $90,640 WILLIAM HEEGAARD, MD $112,499 CHARLES WATSON $89,854 DIANE DAVIDSON $74,636 KARYN BAUM, MD $97,663 RICHARD VETTER, MD $54,695 MICHAEL WATTERS $62,797 SARAH MANNEY KURTH, MD $26,860 AL HURLEY $59,235 RHONDA KAZIK $15,955 KEVIN CASEY, MD $83,079 ANNE STEPHEN, MD $65,980 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: DAVID HERMAN, MD $379,999 JODI MANSFIELD $174,444 TRACI MORRIS $114,806 BRADLEY BEARD $106,959 WILLIAM HEEGAARD, MD $48,668 CHARLES WATSON $89,786 DIANE DAVIDSON $87,836 KRISTA SKORUPA, MD $91,234 JASON SCHULTZ, MD $85,394 ROBERT GREEN $90,844 RICHARD VETTER, MD $79,493 MICHAEL WATTERS $84,801 GRATIA PITCHER, MD $99,364 SARAH MANNEY KURTH, MD $82,804 AL HURLEY $75,236 RHONDA KAZIK $77,882 MELANIE WILSON $75,419 ANNE STEPHEN, MD $32,992

Schedule J (Form 990) (Rev. 1-2025)

Additional Data

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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

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

Open to Public
Inspection

Name of the organization
ESSENTIA HEALTH

Employer identification number
20-0360007

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	DULUTH ECONOMIC DEVELOPMENT AUTHORITY	90-0848286	26444CHF2	11-01-2018	704,253,406	SERIES 2018A (SEE PART VI)		X		X		X
B	CASS COUNTY ND	45-6002205	000000000	02-18-2020	61,320,000	SERIES 2020A (SEE PART VI)		X		X		X
C	WI HEALTH & EDU FAC AUTH	39-1337855	000000000	02-18-2020	13,095,000	SERIES 2020B (SEE PART VI)		X		X		X
D	DULUTH ECONOMIC DEVELOPMENT AUTHORITY	90-0848286	000000000	02-18-2020	116,955,000	SERIES 2020C (SEE PART VI)		X		X		X
	MN AGRICULTURAL AND ECONOMIC DEVELOPMENT BRD	41-6007162	000000000	06-22-2023	44,585,000	SERIES 2023C (SEE PART VI)		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................							4,501,250
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	3,776,805		3,985,800		851,175		7,602,074
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	32,652		14,300		7,800		46,800
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	35,137,758
11 Other spent proceeds .............	3,744,153		3,971,500		843,375		7,555,274
12 Other unspent proceeds .............	1,153,051
13 Year of substantial completion .............	2023		2020		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) (Rev. 1-2025)

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?								X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
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) (Rev. 1-2025)

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 ..........	SEE PART VI
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X
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
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023
SCHEDULE K:	ADDITIONAL INFORMATION/COMMENTS RELATING TO THE REPORTING OF LIABILITIES BY RELATED ORGANIZATIONS: ESSENTIA HEALTH HAS AN OBLIGATED GROUP CREATED UNDER THE MASTER TRUST INDENTURE WHICH IS COMPOSED OF THE FOLLOWING MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, ST. MARY'S INNOVIS HEALTH, THE DULUTH CLINIC, LTD. AND ESSENTIA HEALTH WEST (THE "OBLIGATED GROUP MEMBERS"). THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY OBLIGATED ON ALL INDEBTEDNESS EVIDENCED OR SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. SERIES 2018A: THE SERIES 2018A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH DULUTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020A: THE SERIES 2020A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020B: THE SERIES 2020B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020B BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020C: THE SERIES 2020C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2023C: THE SERIES 2023C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2023C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH.
SCHEDULE K, PART I, COLUMN (F):	DESCRIPTION OF PURPOSE: SERIES 2018A: ACQUIRE, CONSTRUCT, BUILD, AND EQUIP MEDICAL CAMPUS PROJECT IN DULUTH, MN; REFUND SERIES 2008E BONDS ISSUED MAY 2, 2008 TO REFINANCE SERIES 1997 BONDS ISSUED DECEMBER 18, 1997 TO FINANCE EQUIPMENT PURCHASES IN DULUTH, MN AND FINANCE PROPERTY ACQUISITIONS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN NORTHERN MINNESOTA; AND REFUND SERIES 2014 BONDS ISSUED JULY 29, 2014 TO REFINANCE PRIOR NOTE USED FOR CAPITAL IMPROVEMENTS TO SKILLED NURSING FACILITY LOCATED IN DETROIT LAKES, MN AND VARIOUS CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN BAXTER, FRAZEE, AND PELICAN RAPIDS, MN AND FINANCE CAPITAL EXPENDITURES TO REPLACE THE CHILLER UNIT FOR ESSENTIA HEALTH VIRGINIA, RENOVATE APPROXIMATELY 118,000 SQUARE FEET OF CLINIC SPACE FOR ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, REMODEL AND EQUIP EXISTING CLINIC SPACE IN EMILY, MN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND EXPAND AND REMODEL THE IMAGING AREA IN THE EMERGENCY ROOM OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES' HOSPITAL. SERIES 2020A: REFUND SERIES 2008A BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFINANCE A PORTION OF THE ACQUISITION OF CERTAIN ASSETS OF ESSENTIA HEALTH WEST IN CONNECTION WITH THE AFFILIATION OF ESSENTIA HEALTH WITH ESSENTIA HEALTH WEST. SERIES 2020B: REFUND SERIES 2008B BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 1999B BONDS ISSUED MAY 18, 1999 FOR CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN SUPERIOR, WI AND VARIOUS DULUTH CLINIC LOCATIONS IN NORTHWESTERN WISCONSIN. SERIES 2020C: REFUND SERIES 2008C BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 2004 BONDS ISSUED MARCH 19, 2004 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN DULUTH, BRAINERD, AND DETROIT LAKES, MN AND REFUND SERIES 1999A BONDS ISSUED MAY 18, 1999 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN BRAINERD, DETROIT LAKES AND DULUTH, MN AND VARIOUS DULUTH CLINIC SITES IN NORTHERN MINNESOTA. SERIES 2023C: ACQUIRE, CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH FACILITIES IN ESKO AND STAPLES, MN.
SCHEDULE K, PART II, LINE 3:	ISSUE PRICE: THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. IN ADDITION, THE SERIES 2023C TOTAL PROCEEDS ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINES 3 THROUGH 12:	PROCEEDS: THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH'S ALLOCATED PORTION OF THE PROCEEDS.
SCHEDULE K, PART IV, LINE 5B:	NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK

Schedule K (Form 990) (Rev. 1-2025)

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization
ESSENTIA HEALTH

Employer identification number
20-0360007

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	DULUTH ECONOMIC DEVELOPMENT AUTHORITY	90-0848286	26444CHF2	11-01-2018	704,253,406	SERIES 2018A (SEE PART VI)		X		X		X
B	CASS COUNTY ND	45-6002205	000000000	02-18-2020	61,320,000	SERIES 2020A (SEE PART VI)		X		X		X
C	WI HEALTH & EDU FAC AUTH	39-1337855	000000000	02-18-2020	13,095,000	SERIES 2020B (SEE PART VI)		X		X		X
D	DULUTH ECONOMIC DEVELOPMENT AUTHORITY	90-0848286	000000000	02-18-2020	116,955,000	SERIES 2020C (SEE PART VI)		X		X		X
	MN AGRICULTURAL AND ECONOMIC DEVELOPMENT BRD	41-6007162	000000000	06-22-2023	44,585,000	SERIES 2023C (SEE PART VI)		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................							4,501,250
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	3,776,805		3,985,800		851,175		7,602,074
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	32,652		14,300		7,800		46,800
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	35,137,758
11 Other spent proceeds .............	3,744,153		3,971,500		843,375		7,555,274
12 Other unspent proceeds .............	1,153,051
13 Year of substantial completion .............	2023		2020		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) (Rev. 1-2025)

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?								X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
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) (Rev. 1-2025)

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 ..........	SEE PART VI
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........	X
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
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023
SCHEDULE K:	ADDITIONAL INFORMATION/COMMENTS RELATING TO THE REPORTING OF LIABILITIES BY RELATED ORGANIZATIONS: ESSENTIA HEALTH HAS AN OBLIGATED GROUP CREATED UNDER THE MASTER TRUST INDENTURE WHICH IS COMPOSED OF THE FOLLOWING MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, ST. MARY'S INNOVIS HEALTH, THE DULUTH CLINIC, LTD. AND ESSENTIA HEALTH WEST (THE "OBLIGATED GROUP MEMBERS"). THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY OBLIGATED ON ALL INDEBTEDNESS EVIDENCED OR SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. SERIES 2018A: THE SERIES 2018A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH DULUTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020A: THE SERIES 2020A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020B: THE SERIES 2020B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020B BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020C: THE SERIES 2020C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2023C: THE SERIES 2023C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2023C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH.
SCHEDULE K, PART I, COLUMN (F):	DESCRIPTION OF PURPOSE: SERIES 2018A: ACQUIRE, CONSTRUCT, BUILD, AND EQUIP MEDICAL CAMPUS PROJECT IN DULUTH, MN; REFUND SERIES 2008E BONDS ISSUED MAY 2, 2008 TO REFINANCE SERIES 1997 BONDS ISSUED DECEMBER 18, 1997 TO FINANCE EQUIPMENT PURCHASES IN DULUTH, MN AND FINANCE PROPERTY ACQUISITIONS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN NORTHERN MINNESOTA; AND REFUND SERIES 2014 BONDS ISSUED JULY 29, 2014 TO REFINANCE PRIOR NOTE USED FOR CAPITAL IMPROVEMENTS TO SKILLED NURSING FACILITY LOCATED IN DETROIT LAKES, MN AND VARIOUS CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN BAXTER, FRAZEE, AND PELICAN RAPIDS, MN AND FINANCE CAPITAL EXPENDITURES TO REPLACE THE CHILLER UNIT FOR ESSENTIA HEALTH VIRGINIA, RENOVATE APPROXIMATELY 118,000 SQUARE FEET OF CLINIC SPACE FOR ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, REMODEL AND EQUIP EXISTING CLINIC SPACE IN EMILY, MN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND EXPAND AND REMODEL THE IMAGING AREA IN THE EMERGENCY ROOM OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES' HOSPITAL. SERIES 2020A: REFUND SERIES 2008A BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFINANCE A PORTION OF THE ACQUISITION OF CERTAIN ASSETS OF ESSENTIA HEALTH WEST IN CONNECTION WITH THE AFFILIATION OF ESSENTIA HEALTH WITH ESSENTIA HEALTH WEST. SERIES 2020B: REFUND SERIES 2008B BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 1999B BONDS ISSUED MAY 18, 1999 FOR CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN SUPERIOR, WI AND VARIOUS DULUTH CLINIC LOCATIONS IN NORTHWESTERN WISCONSIN. SERIES 2020C: REFUND SERIES 2008C BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 2004 BONDS ISSUED MARCH 19, 2004 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN DULUTH, BRAINERD, AND DETROIT LAKES, MN AND REFUND SERIES 1999A BONDS ISSUED MAY 18, 1999 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN BRAINERD, DETROIT LAKES AND DULUTH, MN AND VARIOUS DULUTH CLINIC SITES IN NORTHERN MINNESOTA. SERIES 2023C: ACQUIRE, CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH FACILITIES IN ESKO AND STAPLES, MN.
SCHEDULE K, PART II, LINE 3:	ISSUE PRICE: THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. IN ADDITION, THE SERIES 2023C TOTAL PROCEEDS ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS.
SCHEDULE K, PART II, LINES 3 THROUGH 12:	PROCEEDS: THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH'S ALLOCATED PORTION OF THE PROCEEDS.
SCHEDULE K, PART IV, LINE 5B:	NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK

Schedule K (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)
(Rev. January 2025)

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

Open to Public Inspection

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

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) (Rev. 1-2025)

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) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	103,820	INDEPENDENT CONTRACTOR ARRANGEMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)
(Rev. January 2025)
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 instructions and the latest information.

OMB No. 1545-0047

Open to Public
Inspection

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

Return Reference	Explanation
FORM 990, PART V, LINE 1A:	1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH.
FORM 990, PART V, LINE 1C:	NO GAMING (GAMBLING) WINNINGS.
FORM 990, PART VI, SECTION A, LINE 4	SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: DURING THE FISCAL YEAR ENDED JUNE 30, 2025, THE BYLAWS OF ESSENTIA HEALTH WERE AMENDED TO MODIFY THE COMPOSITION OF THE BOARD OF DIRECTORS TO CONSIST OF NO FEWER THAN 11 AND NO MORE THAN 21 VOTING DIRECTORS, INCLUDING THE PRIORESS OF THE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH ("SSMD") OR HER DESIGNEE (WHO SHALL BE A BENEDICTINE SISTER OF SSMD), PLUS ONE OR MORE ADDITIONAL DULUTH BENEDICTINE MINISTRIES NOMINEE(S).
FORM 990, PART VI, SECTION A, LINE 7B	MEMBER WITH RIGHT TO APPROVE GOVERNING BODY DECISIONS: THE DULUTH BENEDICTINE MINISTRIES ("DBM") HOLDS CERTAIN RESERVED POWERS AS IT RELATES TO ESSENTIA HEALTH'S MANAGEMENT AND OVERSIGHT OF ITS CATHOLIC-SPONSORED ENTITIES. DBM HAS THE RESERVED POWER TO APPROVE ANY AMENDMENTS TO ESSENTIA HEALTH'S GOVERNING DOCUMENTS THAT WOULD ALTER THE NUMBER OF DBM NOMINEES SERVING ON THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS: THE CURRENT FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY MANAGEMENT AND THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF FORM 990.
FORM 990, PART VI, SECTION B, LINE 12C	MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS, AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE THEIR MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR THEIR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE, OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND, IF APPROPRIATE, WITHDRAW FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, THEY WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE.
FORM 990, PART VI, SECTION B, LINE 15	PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2025 FOR ESSENTIA HEALTH'S CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT, COO, CHIEF FINANCIAL OFFICER, CHIEF LEGAL OFFICER, CHIEF MEDICAL OFFICER, CHIEF NURSE EXECUTIVE, AND CHIEF HUMAN RESOURCES OFFICER; ESSENTIA HEALTH EAST'S CHIEF OPERATING OFFICER, PRESIDENT, AND CHIEF MEDICAL OFFICER; AND ESSENTIA HEALTH WEST'S CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER, AND PRESIDENT.
FORM 990, PART VI, SECTION C, LINE 19	AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).
FORM 990, PART XI, LINE 9:	NET ASSET TRANSFERS WITH RELATED ORGS -99,953.
FORM 990, PART XII, LINE 3:	CONSOLIDATED UNIFORM GUIDANCE AUDIT: ESSENTIA HEALTH, AS PART OF ESSENTIA HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, WAS REQUIRED AND UNDERWENT A CONSOLIDATED AUDIT SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. THE CONSOLIDATED AUDIT IS REVIEWED BY THE ESSENTIA HEALTH AUDIT COMMITTEE.

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

Cat. No. 51056K

Schedule O (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)
(Rev. January 2025)

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

Open to Public Inspection

Name of the organization

ESSENTIA HEALTH

Employer identification number

20-0360007

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD,MN56401 37-1532148	CLINIC	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(2)BRIDGES MEDICAL CENTER 201 9TH ST W ADA,MN56510 20-0479568	HOSPITAL/CLINIC	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(3)DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER,MN56636 41-0844574	HOSPITAL/CLINIC/SKILLED NURSING FACILITY	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(4)ESSENTIA HEALTH ACO INC 502 E 2ND ST DULUTH,MN55805 99-3256474	SUPPORTING ORG	DE	501(C)(3)	LINE 12A, I	ESSENTIA HEALTH	Yes
(5)ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH,MN55805 27-1984704	FOUNDATION	MN	501(C)(3)	LINE 7	ESSENTIA HEALTH	Yes
(6)ESSENTIA HEALTH MOOSE LAKE 4572 COUNTY ROAD 61 MOOSE LAKE,MN55767 84-5099016	HOSPITAL/CLINIC	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(7)ESSENTIA HEALTH SURGERY CENTERS 502 E 2ND ST DULUTH,MN55805 88-1577422	SURGERY CENTER	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(8)ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2ND ST DULUTH,MN55805 27-1291124	RESEARCH	MN	501(C)(3)	LINE 4	THE DULUTH CLINIC LTD	Yes
(9)FIRST CARE MEDICAL SERVICES 900 HILLIGOSS BLVD SE FOSSTON,MN56542 41-0706143	HOSPITAL/CLINIC/SKILLED NURSING FACILITY	MN	501(C)(3)	LINE 3	INNOVIS HEALTH LLC	Yes
(10)GRACEVILLE HEALTH CENTER 115 WEST 2ND ST GRACEVILLE,MN56240 41-0726173	HOSPITAL/CLINIC/SKILLED NURSING FACILITY	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(11)INNOVIS HEALTH LLC 3000 32ND AVE S FARGO,ND58103 26-1175213	HOSPITAL/CLINIC	DE	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(12)MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC 502 E 2ND ST DULUTH,MN55805 41-1674021	MEDICAL EQUIPMENT	MN	501(C)(3)	LINE 10	ST MARY'S MEDICAL CENTER	Yes
(13)NORTHERN PINES MEDICAL CENTER 5211 HWY 110 AURORA,MN55705 41-0841441	HOSPITAL/CLINIC/SKILLED NURSING FACILITY	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(14)PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE,MN55072 41-1884597	HOSPITAL	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(15)POLINSKY MEDICAL REHABILITATION CENTER 1600 MILLER TRUNK HWY BLDG C DULUTH,MN55811 41-0691275	REHABILITATION SERVICES	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(16)SMDC MEDICAL CENTER 502 E 2ND ST DULUTH,MN55805 41-1878730	HOSPITAL/CLINIC	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(17)ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD,MN56401 41-0695602	HOSPITAL/CLINIC	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(18)ST MARY'S DULUTH CLINIC HEALTH SYSTEM 502 E 2ND ST DULUTH,MN55805 41-1836633	SUPPORTING ORG	MN	501(C)(3)	LINE 12B, II	ESSENTIA HEALTH	Yes
(19)ST MARY'S EMS 1027 WASHINGTON AVE DETROIT LAKES,MN56501 41-1805811	EMERGENCY SERVICES	MN	501(C)(3)	LINE 10	ESSENTIA HEALTH	Yes
(20)ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR,WI54880 41-1811073	HOSPITAL/CLINIC	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(21)ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES,MN56501 26-2861321	PHARMACY	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(22)ST MARY'S MEDICAL CENTER 402 E 2ND ST DULUTH,MN55805 41-0695604	HOSPITAL	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(23)ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES,MN56501 41-1620386	HOSPITAL/CLINIC/SKILLED NURSING FACILITY	MN	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes
(24)THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH,MN55805 41-0883623	CLINIC	DE	501(C)(3)	LINE 3	ESSENTIA HEALTH	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) (Rev. 1-2025)

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) BRIGHTSIDE SURGICAL LLC 401 N 9TH ST BISMARCK,ND58501 83-1888619	AMBULATORY SURGERY CENTER	ND	N/A	N/A				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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
(1) ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN K71-1102 CJ 98-1829514	SELF INSURANCE	CJ	ESSENTIA HEALTH	C	23,235,445	61,335,063	100.000 %	Yes
(2) MID DAKOTA CLINIC INC 502 E 2ND ST DULUTH,MN55805 45-0311334	CLINIC OPERATIONS CEASED 9/30/22	ND	N/A	C				Yes

Schedule R (Form 990) (Rev. 1-2025)

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

Yes

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

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

Yes

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

Yes

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

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

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

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

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

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

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) .................

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

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

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

Yes

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

Yes

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

Yes

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

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) BRAINERD MEDICAL CENTER INC	L	3,516,624	ACTUAL COSTS
(2) BRAINERD MEDICAL CENTER INC	Q	1,010,328	ACTUAL COSTS
(3) BRIDGES MEDICAL CENTER	L	1,278,108	ACTUAL COSTS
(4) BRIDGES MEDICAL CENTER	Q	761,510	ACTUAL COSTS
(5) BRIGHTSIDE SURGICAL LLC	Q	157,192	ACTUAL COSTS
(6) DEER RIVER HEALTHCARE CENTER INC	L	5,146,752	ACTUAL COSTS
(7) DEER RIVER HEALTHCARE CENTER INC	Q	2,099,485	ACTUAL COSTS
(8) ESSENTIA HEALTH FOUNDATION	Q	257,377	ACTUAL COSTS
(9) ESSENTIA HEALTH INSURANCE SERVICES SPC	P	18,138,785	ACTUAL COSTS
(10) ESSENTIA HEALTH INSURANCE SERVICES SPC	Q	13,177,792	ACTUAL COSTS
(11) ESSENTIA HEALTH MOOSE LAKE	L	4,800,792	ACTUAL COSTS
(12) ESSENTIA HEALTH MOOSE LAKE	Q	2,367,186	ACTUAL COSTS
(13) ESSENTIA HEALTH SURGERY CENTERS	Q	518,136	ACTUAL COSTS
(14) ESSENTIA HEALTH SURGERY CENTERS	L	1,787,424	ACTUAL COSTS
(15) ESSENTIA INSTITUTE OF RURAL HEALTH	L	770,964	ACTUAL COSTS
(16) ESSENTIA INSTITUTE OF RURAL HEALTH	Q	899,314	ACTUAL COSTS
(17) FIRST CARE MEDICAL SERVICES	L	3,814,548	ACTUAL COSTS
(18) FIRST CARE MEDICAL SERVICES	Q	1,945,102	ACTUAL COSTS
(19) GRACEVILLE HEALTH CENTER	L	1,375,716	ACTUAL COSTS
(20) GRACEVILLE HEALTH CENTER	Q	974,253	ACTUAL COSTS
(21) INNOVIS HEALTH LLC	L	69,445,824	ACTUAL COSTS
(22) INNOVIS HEALTH LLC	Q	36,654,838	ACTUAL COSTS
(23) MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC	Q	78,455	ACTUAL COSTS
(24) MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC	L	76,491	ACTUAL COSTS
(25) NORTHERN PINES MEDICAL CENTER	L	2,719,524	ACTUAL COSTS
(26) NORTHERN PINES MEDICAL CENTER	Q	1,185,310	ACTUAL COSTS
(27) PINE MEDICAL CENTER	L	2,979,444	ACTUAL COSTS
(28) PINE MEDICAL CENTER	Q	1,043,381	ACTUAL COSTS
(29) POLINSKY MEDICAL REHABILITATION CENTER	L	758,280	ACTUAL COSTS
(30) POLINSKY MEDICAL REHABILITATION CENTER	Q	700,821	ACTUAL COSTS
(31) SMDC MEDICAL CENTER	A	440,425	ACTUAL COSTS
(32) SMDC MEDICAL CENTER	L	83,685,237	ACTUAL COSTS
(33) SMDC MEDICAL CENTER	Q	46,559,917	ACTUAL COSTS
(34) ST JOSEPH'S MEDICAL CENTER	L	31,642,740	ACTUAL COSTS
(35) ST JOSEPH'S MEDICAL CENTER	Q	18,284,254	ACTUAL COSTS
(36) ST JOSEPH'S MEDICAL CENTER	R	4,500,000	ACTUAL COSTS
(37) ST MARY'S EMS	L	1,238,016	ACTUAL COSTS
(38) ST MARY'S EMS	Q	984,157	ACTUAL COSTS
(39) ST MARY'S HOSPITAL OF SUPERIOR	Q	6,027,163	ACTUAL COSTS
(40) ST MARY'S HOSPITAL OF SUPERIOR	L	11,258,580	ACTUAL COSTS
(41) ST MARY'S INNOVIS HEALTH	L	890,628	ACTUAL COSTS
(42) ST MARY'S INNOVIS HEALTH	Q	174,754	ACTUAL COSTS
(43) ST MARY'S MEDICAL CENTER	L	61,995,924	ACTUAL COSTS
(44) ST MARY'S MEDICAL CENTER	Q	34,882,033	ACTUAL COSTS
(45) ST MARY'S MEDICAL CENTER	R	87,250,000	ACTUAL COSTS
(46) ST MARY'S REGIONAL HEALTH CENTER	L	20,157,288	ACTUAL COSTS
(47) ST MARY'S REGIONAL HEALTH CENTER	Q	12,752,610	ACTUAL COSTS
(48) ST MARY'S REGIONAL HEALTH CENTER	R	50,750,000	ACTUAL COSTS
(49) THE DULUTH CLINIC LTD	D	151,363	ACTUAL COSTS
(50) THE DULUTH CLINIC LTD	L	27,627,588	ACTUAL COSTS
(51) THE DULUTH CLINIC LTD	Q	6,685,102	ACTUAL COSTS

Schedule R (Form 990) (Rev. 1-2025)

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) (Rev. 1-2025)

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference

Explanation

SCHEDULE R, PART II, COLUMN (A):

THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH EMS ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES

Schedule R (Form 990) (Rev. 1-2025)

Additional Data

Software ID:
Software Version:

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No