4A (Expenses $ 3396199192 including grants of $ 7517022) (Revenue $ 4681072546)
PROVIDING MEDICAL SERVICESHOSPITAL, MEDICAL AND OTHER HEALTH CARE SERVICESALLINA HEALTH DELIVERS HIGH QUALITY HOSPITAL, MEDICAL AND OTHER HEALTH CARE SERVICES TO PATIENTS IN MINNESOTA AND WESTERN WISCONSIN. AS A MISSION-DRIVEN ORGANIZATION, ALLINA HEALTH IS COMMITTED TO IMPROVING THE LIFELONG HEALTH OF THE COMMUNITIES IT SERVES. ALLINA HEALTH PROVIDES THESE SERVICES TO THE COMMUNITY THROUGH ITS FAMILY OF HOSPITALS TO INCLUDE:ABBOTT NORTHWESTERN HOSPITAL - MINNEAPOLIS, MINNESOTALOCATED IN SOUTH MINNEAPOLIS, ABBOTT NORTHWESTERN HOSPITAL IS THE TWIN CITIES' LARGEST NOT-FOR-PROFIT HOSPITAL. ABBOTT NORTHWESTERN IS KNOWN AROUND THE REGION AND ACROSS THE UNITED STATES FOR ITS CENTERS OF EXCELLENCE: CANCER CARE THROUGH THE VIRGINIA PIPER CANCER INSTITUTE; CARDIOVASCULAR SERVICES IN PARTNERSHIP WITH THE MINNEAPOLIS HEART INSTITUTE; THE SPINE INSTITUTE; NEUROSCIENCE INSTITUTE; ORTHOPAEDIC INSTITUTE; PERINATOLOGY, OBSTETRICS AND GYNECOLOGY THROUGH WOMENCARE AND PHYSICAL REHABILITATION THROUGH COURAGE KENNY REHABILITATION INSTITUTE.BUFFALO HOSPITAL - BUFFALO, MINNESOTALOCATED IN THE WESTERN METROPOLITAN COMMUNITY OF BUFFALO, BUFFALO HOSPITAL IS RECOGNIZED AS ONE OF THE NATION'S 100 TOP HOSPITALS ACCORDING TO THOMSON REUTERS. BUFFALO HOSPITAL PROVIDES HIGH QUALITY, PERSONAL CARE IN PRIVATE ROOMS. THE HOSPITAL PROVIDES MANY SPECIALTY SERVICES INCLUDING THE BIRTH CENTER, CARDIAC CENTER, EMERGENCY SERVICES, SLEEP CENTER, PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING, PHILLIPS EYE INSTITUTE, COURAGE KENNY REHABILITATION INSTITUTE AND VIRGINIA PIPER CANCER INSTITUTE.CAMBRIDGE MEDICAL CENTER - CAMBRIDGE, MINNESOTALOCATED IN THE COMMUNITY OF CAMBRIDGE, CAMBRIDGE MEDICAL CENTER IS A REGIONAL HEALTH CARE FACILITY PROVIDING COMPREHENSIVE HEALTH CARE SERVICES TO RESIDENTS OF ISANTI COUNTY. THE MEDICAL CENTER IS COMPRISED OF A LARGE MULTI-SPECIALTY CLINIC AND A HOSPITAL ON ONE LARGE CAMPUS. A SAME DAY CLINIC, RETAIL PHARMACY, AND EYE CARE CENTER ARE ALSO LOCATED IN THE FACILITY.DISTRICT ONE HOSPITAL - FARIBAULT, MNLOCATED JUST SOUTH OF THE TWIN CITIES IN FARIBAULT, DISTRICT ONE HOSPITAL PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES: BIRTH CENTER, COURAGE KENNY REHABILITATION INSTITUTE, CARDIOPULMONARY REHABILITATION, DIAGNOSTIC IMAGING, EMERGENCY, GENERAL SURGERY, LABORATORY, PHARMACY, SLEEP STUDY AND VIRGINIA PIPER CANCER INSTITUTE. THE DYNAMIC HEALTH CARE CAMPUS ALSO INCLUDES THE ALLINA HEALTH FARIBAULT CLINIC AND MAYO CLINIC HEALTH SYSTEM-FARIBAULT. MERCY HOSPITAL - COON RAPIDS, MINNESOTALOCATED IN COON RAPIDS, MERCY HOSPITAL OFFERS NATIONALLY RECOGNIZED CLINICAL EXCELLENCE AND COMPASSIONATE HEALTH CARE SERVICES TO NORTH METRO COMMUNITIES. AMONG THE SERVICES PROVIDING CUTTING-EDGE CARE ARE THE HEART & VASCULAR CENTER, CANCER CARE, THE MOTHER BABY CENTER, EMERGENCY SERVICES, MENTAL HEALTH SERVICES AND A WIDE RANGE OF HEALTH EDUCATION AND SUPPORT GROUPS. THE UNITY CAMPUS OF MERCY, LOCATED IN FRIDLEY, ALSO PROVIDES A WIDE RANGE OF HEALTH CARE SERVICES TO THE NORTH METRO AREA, INCLUDING A RENOWNED BARIATRIC [SURGICAL WEIGHT LOSS] CENTER. OTHER SERVICES INCLUDE MEDICAL SURGICAL CARE, CANCER CARE, EMERGENCY SERVICES AND MENTAL HEALTH AND ADDICTION SERVICES INCLUDING GERIATRIC MENTAL HEALTH. UNITY ALSO OFFERS A COMPLETE ARRAY OF HEALTH EDUCATION AND SUPPORT GROUPS TO PATIENTS AND THE COMMUNITY. NEW ULM MEDICAL CENTER - NEW ULM, MINNESOTALOCATED IN SOUTH CENTRAL MINNESOTA, NEW ULM MEDICAL CENTER (NUMC) CONSISTS OF A HOSPITAL AND CLINIC THAT SERVES THE REGION IN AND AROUND BROWN COUNTY. NUMC OFFERS AN EXTENSIVE RANGE OF HEALTH CARE OPTIONS, INCLUDING FAMILY PRACTICE, INTERNAL MEDICINE, GENERAL SURGERY, PEDIATRICS, ORTHOPEDICS, OBSTETRICS AND GYNECOLOGY, RADIOLOGY, EMERGENCY MEDICINE, PSYCHIATRY, PODIATRY, MENTAL HEALTH AND SUBSTANCE ABUSE, HOME CARE AND HOSPICE. AS A FULLY INVOLVED MEMBER OF ITS COMMUNITY, NUMC CONTINUALLY FOSTERS AN ATMOSPHERE OF WELL-BEING OUTSIDE ITS FOUR WALLS THROUGH A VARIETY OF COMMUNITY-FOCUSED INITIATIVES.OWATONNA HOSPITAL - OWATONNA, MINNESOTALOCATED SOUTH OF THE TWIN CITIES METROPOLITAN AREA, OWATONNA HOSPITAL PROVIDES COMPREHENSIVE CARE TO PATIENTS IN AND AROUND STEELE COUNTY. OWATONNA HOSPITAL HAS HELPED TO MAKE A POSITIVE DIFFERENCE IN THE LIVES OF ITS PATIENTS AND THE COMMUNITY FOR MORE THAN 110 YEARS. THE 38-BED REPLACEMENT HOSPITAL THAT OPENED IN OCTOBER 2009 FEATURES INTERNATIONAL BEST PRACTICES IN CONTEMPORARY HOSPITAL DESIGN. THE HOSPITAL OFFERS A FULL RANGE OF INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES.PHILLIPS EYE INSTITUTE - MINNEAPOLIS, MINNESOTALOCATED IN MINNEAPOLIS, PHILLIPS EYE INSTITUTE IS THE THIRD LARGEST SPECIALTY EYE HOSPITAL IN THE U.S., SPECIALIZING IN THE DIAGNOSIS, TREATMENT AND CARE OF EYE DISORDERS AND DISEASES. PHILLIPS EYE INSTITUTE DRAWS PATIENTS FROM A FIVE-STATE REGION WITH AN EXTENSIVE ARRAY OF SERVICES, RANGING FROM DIAGNOSTIC TESTS AND VISION REHABILITATION TO LASER EYE TREATMENTS AND SPECIALIZED EYE SURGERY. IN AUGUST, 2019, PHILLIPS EYE INSTITUTE BECAME A CAMPUS AND CLINICAL PROGRAM OF ABBOTT NORTHWESTERN HOSPITAL.REGINA MEDICAL CENTER-HASTINGS, MNLOCATED IN HASTINGS, REGINA HOSPITAL PROVIDES HEALTH CARE SERVICES INCLUDING, PRIMARY CARE, INTERNAL MEDICINE, GENERAL SURGERY, ORTHOPEDICS, OBSTETRICS AND GYNECOLOGY, ONCOLOGY, PEDIATRICS, EMERGENCY MEDICINE, INPATIENT GERIATRIC MENTAL HEALTH, UROLOGY AND OCCUPATIONAL MEDICINE. SINCE ITS FOUNDATION, REGINA HOSPITAL CONTINUES TO MAINTAIN ITS CATHOLIC HERITAGE FOCUSING ON SERVING THE WHOLE PERSON - MIND, BODY AND SPIRIT. THE HASTINGS CAMPUS INCLUDES SENIOR LIVING FACILITIES, TWO ALLINA HEALTH CLINICS AND A SURGERY CENTER.RIVER FALLS AREA HOSPITAL - RIVER FALLS, WISCONSINLOCATED IN WESTERN WISCONSIN, RIVER FALLS AREA HOSPITAL IS PART OF A SHARED MEDICAL CAMPUS THAT PROVIDES EASY ACCESS TO HOSPITAL SERVICES AS WELL AS PRIMARY CARE AND SPECIALTY CLINICS, A LONG-TERM CARE FACILITY AND A WELLNESS AND FITNESS CENTER. RIVER FALLS AREA HOSPITAL PROVIDES HIGH QUALITY PATIENT FOCUSED CARE AT THEIR VIRGINIA PIPER CANCER CENTER BIRTH CENTER AND SLEEP CENTER. RIVER FALLS AREA HOSPITAL PROVIDES PATIENTS A FULL RANGE OF INPATIENT, OUTPATIENT, CANCER AND EMERGENCY SERVICES INCLUDING SURGICAL, CARDIOVASCULAR AND REHABILITATION SERVICES.UNITED HOSPITAL - ST. PAUL, MINNESOTALOCATED IN DOWNTOWN ST. PAUL, UNITED HOSPITAL IS AMONG LARGEST HOSPITALS IN THE TWIN CITIES EAST METRO AREA. UNITED HAS A REPUTATION FOR EXCELLENCE IN PATIENT CARE AND STATE-OF-THE-ART FACILITIES, WITH INNOVATIVE PROGRAMS SUCH AS CARDIOVASCULAR SERVICES (INCLUDING NASSEFF HEART CENTER, WOMEN'S HEART CENTER AND VASCULAR CENTER); NASSEFF NEUROSCIENCE CENTER; AND PSYCHIATRY, WOMEN'S HEALTH, SURGICAL, REHABILITATION AND EMERGENCY SERVICES.ALLINA HEALTH ALSO PROVIDES SERVICES TO THE COMMUNITY THROUGH ITS FAMILY OF CLINICS. WITH MORE THAN 90 CLINICS THROUGHOUT MINNESOTA AND WESTERN WISCONSIN, WE PROVIDE PRIMARY CARE, SPECIALTY CARE AND URGENT CARE SERVICES TO PEOPLE IN MORE THAN 40 COMMUNITIES. ALLINA AND ITS SUBSIDIARIES PROVIDE A FULL RANGE OF PRIMARY AND SPECIALTY HEALTH CARE SERVICES INCLUDING TECHNICALLY ADVANCED INPATIENT AND OUTPATIENT CARE, 24-HOUR EMERGENCY CARE, MEDICAL TRANSPORTATION, PHARMACY, LABORATORY, HOME CARE AND HOSPICE SERVICES. MORE THAN 750 HEALTH CARE PRACTITIONER'S HELP PATIENTS IDENTIFY HEALTH RISKS, MANAGE CHRONIC ILLNESS AND FIND THEIR PATH TO BETTER HEALTH. ALLINA HEALTH ALSO OPERATES ADDITIONAL SERVICES WHICH INCLUDE:HOME CARE, HOSPICE AND PALLIATIVE CAREHOME OXYGEN AND MEDICAL EQUIPMENTMEDICAL LABORATORIESMEDICAL TRANSPORTATION PHARMACYPHYSICAL REHABILITATIONIN 2019, ALLINA HEALTH EXPENDED OVER $3 BILLION TO PROVIDE SERVICES TO PATIENTS THAT INCLUDED 5,000,000 CLINIC VISITS, 111,101 INPATIENT ADMISSIONS AND 1,500,000 HOSPITAL OUTPATIENT VISITS. THERE WERE 344,843 EMERGENCY CARE VISITS, 413,983 HOMECARE AND HOSPICE VISITS, AND 14,637 BIRTHS AT ALLINA HEALTH HOSPITALS. FOR MORE INFORMATION PLEASE VISIT HTTP://WWW.ALLINAHEALTH.ORG.SUBSIDIZED HEALTH SERVICESALLINA HEALTH SUBSIDIZES CERTAIN NECESSARY HEALTH CARE SERVICES, WHICH INCLUDE 24-HOUR EMERGENCY SERVICES TO THE COMMUNITY, ESPECIALLY THOSE LOCATED IN MEDICALLY UNDERSERVED OR HIGH-NEED AREAS, AND MENTAL HEALTH SERVICES. IN 2019, ALLINA HEALTH EXPENDED $11,982,781 TO MAKE AVAILABLE AND PROVIDE THESE SERVICES TO THE COMMUNITIES WE SERVE.

4B (Expenses $ 397121972 including grants of $ 0) (Revenue $ 0)
COST OF PARTICIPATING IN GOVERNMENT PROGRAMSALLINA HEALTH IS COMMITTED TO SERVING ALL PERSONS IN NEED, REGARDLESS OF RACE, CREED, SEX, NATIONALITY, RELIGION, DISABILITY, AGE, OR ABILITY TO PAY. TO PROMOTE ACCESS TO CARE FOR ALL INDIVIDUALS, ALLINA HEALTH PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH CARE PROGRAMS: MEDICARE, MEDICAID, MINNESOTACARE, AND GENERAL ASSISTANCE. PAYMENTS FROM THESE PROGRAMS FREQUENTLY DO NOT COVER THE COSTS ALLINA HEALTH INCURS TO SERVE PROGRAM BENEFICIARIES. IN 2019, ALLINA HEALTH PROVIDED $397,121,972 IN HEALTH CARE SERVICES IN EXCESS OF THE REIMBURSEMENT RECEIVED BY PUBLIC PROGRAMS AND SURCHARGES, TAXES AND FEES RELATED TO THESE PROGRAMS. THE FOLLOWING IS A BREAKDOWN ON COSTS RELATED TO THESE PROGRAMS, SERVICES AND ADDITIONAL TAXES AND FEES.COSTS IN EXCESS OF MEDICARE AND MEDICAID PAYMENTSALLINA HEALTH PROVIDES SERVICES TO PUBLIC PROGRAM ENROLLEES. SUCH PUBLIC PROGRAMS HAVE HISTORICALLY BEEN REIMBURSED AT AMOUNTS LESS THAN COST. IN 2019, ALLINA HEALTH EXPENDED $269,064,924 BEYOND REIMBURSEMENTS TO PROVIDE CARE FOR MEDICARE PATIENTS AND AN ADDITIONAL $41,752,818 BEYOND REIMBURSEMENTS FOR MEDICAID PATIENTS. MEDICAID SURCHARGEALLINA HEALTH IS A PARTICIPANT IN THE MEDICAID SURCHARGE PROGRAM. THE CURRENT PROGRAM INCLUDES A 1.56% SURCHARGE ON A HOSPITAL'S NET PATIENT SERVICE REVENUE (EXCLUDING MEDICARE REVENUE). REPORTED AMOUNTS ARE NET OF ANY DISPROPORTIONATE SHARE ADJUSTMENTS. IN 2019, ALLINA HEALTH PAID $26,557,071 FOR THE MEDICAID SURCHARGE. MINNESOTACARE TAXALLINA HEALTH ALSO PARTICIPATES IN THE FUNDING OF MEDICAL CARE FOR THE UNINSURED THROUGH A MINNESOTACARE TAX OF 2% ON CERTAIN NET REVENUE. PATIENTS WHO ARE UNABLE TO GET INSURANCE THROUGH THEIR EMPLOYER ARE ELIGIBLE TO PARTICIPATE IN MINNESOTACARE IF THEY MEET RESIDENCY AND INCOME GUIDELINES. ALLINA HEALTH PAID $54,943,542 FOR THE MINNESOTACARE TAX IN 2019. TAXES AND FEES ALLINA HEALTH PAYS PROPERTY TAXES TO LOCAL AND STATE GOVERNMENT USED IN FUNDING CIVIL AND EDUCATION SERVICES TO THE COMMUNITY. IN TOTAL, ALLINA HEALTH PAID $4,803,617 IN TAXES AND FEES IN 2019.

4C (Expenses $ 71221913 including grants of $ 0) (Revenue $ -127677457)
UNCOMPENSATED CARE:CHARITY CAREALLINA HEALTH PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COST TO RESIDENTS OF THE COMMUNITIES THAT IT SERVES THROUGH THE PROVISION OF CHARITY CARE. OUR PARTNERS CARE WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE SUCH AS MEDICAID AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275% OF THE FEDERAL POVERTY LEVEL. CHARITY CARE DOES NOT INCLUDE BAD DEBT (CHARGES WRITTEN OFF FOR PROVIDING SERVICES TO PERSONS ABLE, BUT UNWILLING, TO PAY FOR THESE SERVICES). THROUGH THIS PROGRAM, ALLINA HEALTH STRIVES TO ENSURE THAT ALL MEMBERS OF THE COMMUNITY RECEIVE QUALITY MEDICAL CARE; REGARDLESS OF ABILITY TO PAY. IN 2019, ALLINA HEALTH PROVIDED $23,442,084 IN CHARITY CARE.UNINSURED DISCOUNT PROGRAMFOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR MEDICAID OR MEET THE FINANCIAL THRESHOLD FOR CHARITY CARE, BUT REQUIRE SOME FINANCIAL ASSISTANCE, ALLINA HEALTH PROVIDES A SLIDING SCALE DISCOUNT. ALL UNINSURED PATIENTS ARE ELIGIBLE FOR A MINIMUM OF A 25 PERCENT DISCOUNT ON BILLED CHARGES AND MAY QUALIFY FOR DISCOUNTS UP TO 44 PERCENT BASED ON ELIGIBILITY CRITERIA. IN 2019, ALLINA HEALTH PROVIDED $47,779,829 IN SUCH DISCOUNTS TO LOW-INCOME, UNINSURED INDIVIDUALS. BAD DEBT - BAD DEBT WILL BE REPORTED AS A REDUCTION TO REVENUE.ALLINA HEALTH PROVIDES MEDICAL CARE TO ALL IN NEED. THERE ARE TIMES WHEN PATIENT ACCOUNT BALANCES GO UNPAID, KNOWN AS BAD DEBT. THESE BAD DEBT AMOUNTS IN 2019 TOTALED $127,677,457.

4D (Expenses $ 43575365 including grants of $ 0) (Revenue $ 0)
"COMMUNITY SERVICES:IN 2019, ALLINA HEALTH CONTRIBUTED $43,575,365 TO COMMUNITY PROGRAMS AND SERVICES TO ADVANCE THE HEALTH OF THE BROADER COMMUNITY. BELOW ARE EXAMPLES OF PROGRAMS AND SERVICES ALLINA HEALTH PROVIDES WITHIN THE COMMUNITIES WE SERVE THAT OFFER COMMUNITY BENEFIT.COMMUNITY HEALTH IMPROVEMENT SERVICESACCORDING TO IRS REPORTING CATEGORIES AND THE CATHOLIC HEALTH ASSOCIATION (CHA/VHA) GUIDELINES, COMMUNITY HEALTH IMPROVEMENT SERVICES INCLUDE ACTIVITIES TO IMPROVE COMMUNITY HEALTH THAT ARE SUBSIDIZED BY THE HEALTH CARE ORGANIZATION AND DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS. ALLINA HEALTH PROVIDES MANY PROGRAMS AND SERVICES THAT FALL UNDER THIS CATEGORY. A FEW EXAMPLES INCLUDE: HEALTH POWERED KIDS (HPK), LAUNCHED IN 2012, IS A FREE COMMUNITY EDUCATION PROGRAM DESIGNED TO EMPOWER CHILDREN AGES 3 TO 14 YEARS TO MAKE HEALTHIER CHOICES ABOUT EATING, EXERCISE, KEEPING CLEAN AND MANAGING STRESS. IN 2019, MORE THAN 70,000 USERS VISITED THE HPK WEBSITE.CHANGE TO CHILL (CTC) IS A FREE, ONLINE RESOURCE THAT PROVIDES STRESS REDUCTION TIPS, LIFE BALANCE TECHNIQUES AND HEALTH EDUCATION SERVICES FOR TEENS. IN ADDITION TO THE EXISTING RESOURCES, CHANGE TO CHILL ADDED A MENTAL HEALTH AND VAPING SECTION TO THE WEBSITE IN 2019 IN RESPONSE TO THE RISING VAPING EPIDEMIC. FROM MINNESOTA ALONE, MORE THAN 30,000 USERS VISITED THE CHANGE TO CHILL WEBSITE IN 2019. SOME OF THE USERS ARE TEACHERS WHO USE IT IN THEIR CLASSROOMS, TEENS WHO USE IT IN SOCIAL GROUPS AND PARENTS LOOKING FOR WAYS TO HELP THEIR CHILD STRESS LESS. ALSO IN 2019, CTC CONTINUED ITS CHANGE TO CHILL SCHOOL PARTNERSHIP (CTCSP) THAT WAS LAUNCHED IN 2018. THE GOAL OF CTCSP IS TO PROMOTE AND SUPPORT A CULTURE OF MENTAL WELL-BEING IN LOCAL HIGH SCHOOLS. DURING THE 2019-2020 SCHOOL YEAR, ALLINA HEALTH PARTNERED WITH SIXTEEN HIGH SCHOOLS THROUGH CTCSP. COMPONENTS OF CTCSP INCLUDE STAFF TRAINING ON CTC, CTC MESSAGING FOR PARENTS, A PAID STUDENT INTERNSHIP AND FUNDING FOR A ""CHILL ZONE"" - A DESIGNATED SPACE FOR STUDENTS AND STAFF TO PRACTICE SELF-CARE. MORE THAN 1,100 HEALTH AND EDUCATION PROFESSIONALS WERE TRAINED ON HOW TO USE THE CHANGE TO CHILL RESOURCES AND CURRICULUMS AS PART OF CTCSP. THIRTY-FOUR CHILL CHAMPION INTERNS LED STRESS REDUCTION ACTIVITIES WITHIN THEIR SCHOOL PARTNERSHIP SCHOOL. INITIAL EVALUATIONS OF CTCSP HAVE SHOWN INCREASES IN CONFIDENCE IN ABILITY TO COPE WITH STRESS AMONG STUDENTS WHO PARTICIPATE IN PROGRAM COMPONENTS.NEIGHBORHOOD HEALTH CONNECTION (NHC) IS A COMMUNITY GRANTS PROGRAM THAT AIMS TO IMPROVE THE HEALTH OF COMMUNITIES BY BUILDING SOCIAL CONNECTIONS THROUGH HEALTHY EATING AND PHYSICAL ACTIVITY. EACH YEAR, ALLINA HEALTH AWARDS OVER 50 NEIGHBORHOOD HEALTH CONNECTION GRANTS, RANGING IN SIZE FROM $500-$10,000, TO LOCAL NONPROFITS AND GOVERNMENT AGENCIES IN MINNESOTA AND WESTERN WISCONSIN. IN 2019, NEIGHBORHOOD HEALTH CONNECTION GAVE $270,000 TO 68 ORGANIZATIONS. THESE ORGANIZATIONS REACHED MORE THAN 3,600 PEOPLE. EVALUATIONS OF THE NHC PROGRAM FIND THAT THE MAJORITY OF PEOPLE WHO PARTICIPATE IN NHC-FUNDED PROGRAMS INCREASE THEIR SOCIAL CONNECTIONS AND MAKE POSITIVE CHANGES IN THEIR PHYSICAL ACTIVITY AND HEALTHY EATING BEHAVIOR. FURTHER, FOLLOW-UP DATA HAS REVEALED THAT THESE POSITIVE CHANGES ARE MAINTAINED SIX MONTHS LATER AND THE MAJORITY OF PARTICIPANTS CONTINUE TO PARTICIPATE IN THE NHC ACTIVITY AFTER THE GRANT PERIOD ENDS.MEDELIGIBLE - MEDELIGIBLE SERVICES SUPPORTS PATIENTS WHO HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS. THE STAFF HELPS PATIENTS APPLY TO FEDERAL, STATE, AND COUNTY AID PROGRAMS SUCH AS MEDICAID, MEDICARE, SOCIAL SECURITY, FOOD STAMPS, EMERGENCY FOOD AND SHELTER. MEDELIGIBLE SERVICES EDUCATES PATIENTS AND THEIR FAMILIES ABOUT THE ADVANTAGES OF THESE PROGRAMS AND WORKS WITH THEM TO GET THE HELP THEY NEED. CENTER FOR MEDICARE AND MEDICAID SERVICES ACCOUNTABLE HEALTH COMMUNITIES COOPERATIVE AGREEMENT - IN MAY 2017, ALLINA HEALTH WAS AWARDED AN ACCOUNTABLE HEALTH COMMUNITIES (AHC) COOPERATIVE AGREEMENT WITH THE CENTERS FOR MEDICARE & MEDICAID SERVICES. THROUGH THE AHC MODEL, CARE TEAMS IN 79 ALLINA HEALTH SITES SCREENED PATIENTS WITH MEDICARE AND/OR MEDICAID INSURANCE FOR FIVE HEALTH-RELATED SOCIAL NEEDS: HOUSING INSTABILITY, FOOD INSECURITY, ACCESS TO TRANSPORTATION, DIFFICULTY PAYING FOR HEAT, ELECTRICITY OR OTHER UTILITIES, AND CONCERNS ABOUT INTERPERSONAL SAFETY. IF A PATIENT IDENTIFIES A NEED, THE CARE TEAM PROVIDES A LIST OF COMMUNITY RESOURCES TAILORED TO THE PATIENT'S UNIQUE NEEDS. IN ADDITION, SOME HIGH-RISK PATIENTS RECEIVE CARE TEAM ASSISTANCE NAVIGATING TO COMMUNITY RESOURCES.IN 2019, NEARLY 180,000 SCREENINGS FOR SOCIAL NEEDS WERE OFFERED TO PATIENTS; MORE THAN 76,000 ALLINA HEALTH PATIENTS COMPLETED AN AHC SCREENING. TWENTY-FOUR PERCENT OF PATIENTS SCREENED IDENTIFIED AT LEAST ONE NEED, WITH THE MOST FREQUENTLY IDENTIFIED NEED BEING FOOD ACCESS FOLLOWED BY HOUSING INSTABILITY. ADDITIONALLY, MORE THAN 580 PATIENTS IDENTIFYING NEEDS RECEIVED SUPPORT FROM A NAVIGATOR IN CONNECTING TO COMMUNITY RESOURCES. ALLINA HEALTH INVESTED MORE THAN $65,000 IN STAFF TIME IN 2019 TO IMPLEMENT THE AHC MODEL, BEYOND WHAT WAS PROVIDED FOR BY THE COOPERATIVE AGREEMENT. HEALTH PROFESSIONS EDUCATION ALLINA HEALTH ACTIVELY SUPPORTS NUMEROUS MEDICAL EDUCATION ACTIVITIES FOR PROVIDERS, HEALTH CARE STUDENTS AND OTHER HEALTH PROFESSIONALS. IN 2019, ALLINA HEALTH INVESTED OVER $21 MILLION IN INTERNSHIP OPPORTUNITIES, MENTORING PARTNERSHIPS, AND GRADUATE MEDICAL EDUCATION PROGRAMMING. ALLINA HEALTH IS COMMITTED TO THE EDUCATION, TRAINING AND DEVELOPMENT OF FUTURE HEALTH CARE PROFESSIONALS AND ENSURES THE AVAILABILITY OF A HIGHLY TRAINED WORKFORCE TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. RESEARCH ALLINA HEALTH PARTICIPATES IN CLINICAL AND COMMUNITY HEALTH RESEARCH THAT IS FOCUSED ON IMPROVING COMMUNITY HEALTH. ALLINA HEALTH INVESTED $4,163,331 TOWARD THIS RESEARCH IN 2019. FINANCIAL AND IN-KIND CONTRIBUTIONSALLINA HEALTH PROVIDES NUMEROUS IN-KIND AND MONETARY CONTRIBUTIONS TO INDIVIDUALS AND OTHER NOT-FOR-PROFIT ORGANIZATIONS TO SUPPORT COMMUNITY NEEDS. IN 2019, ALLINA HEALTH FUNDED MORE THAN $5.2 MILLION FOR DONATIONS OF EQUIPMENT, SUPPLIES, FREE MEALS, STAFF TIME AND SPONSORSHIP OF VARIOUS CIVIC AWARDS, COMMUNITY PROGRAMS AND EVENTS. COMMUNITY-BUILDING ACTIVITIESALLINA HEALTH AND ITS EMPLOYEES ARE ACTIVE PARTICIPANTS IN VARIOUS COMMUNITY ACTIVITIES THAT TARGET THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL ISSUES. EXAMPLES INCLUDE COMMUNITY HEALTH IMPROVEMENT ADVOCACY, WORKFORCE DEVELOPMENT, PARTICIPATING IN VARIOUS COMMUNITY COALITIONS AND DISASTER PREPAREDNESS PLANNING. AWARDSIN 2019, ALLINA HEALTH AND ITS FACILITIES WERE THE RECIPIENT OF NUMEROUS AWARDS, FOR ATTRIBUTES SUCH AS SAFETY, PATIENT EXPERIENCE AND QUALITY. A LOCAL EXAMPLE THAT PERTAINS TO COMMUNITY BENEFIT WAS THE HEART OF NEW ULM PROJECT (IN WHICH NEW ULM MEDICAL CENTER IS A LEADER) BEING AWARDED THE 2019 BROWN COUNTY PUBLIC HEALTH PARTNERSHIP AWARD RECIPIENT. THE ANNUAL AWARD RECOGNIZES AND HONORS THE CONTRIBUTIONS OF CITIZENS OR ORGANIZATIONS IN BROWN COUNTY WHO DEVOTE THEIR TIME, ENERGY AND TALENTS TO HELP ACCOMPLISH THE PUBLIC HEALTH MISSION OF BRINGING PEOPLE TOGETHER TO CREATE A HEALTHY FUTURE FOR ALL COUNTY CITIZENS.COMMUNITY BENEFIT OPERATIONSALLINA HEALTH USES DEDICATED STAFF FOR THE ASSESSMENT AND MANAGEMENT OF COMMUNITY BENEFIT PROGRAMS AND NEEDS. FOR MORE, PLEASE VISIT: HTTP://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/."

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: ABBOTT NORTHWESTERN HOSPITAL, - FACILITY 2: MERCY HOSPITAL, - FACILITY 3: UNITED HOSPITAL, - FACILITY 4: BUFFALO HOSPITAL, - FACILITY 5: NEW ULM MEDICAL CENTER, - FACILITY 6: CAMBRIDGE MEDICAL CENTER, - FACILITY 7: REGINA HOSPITAL, - FACILITY 8: OWATONNA HOSPITAL, - FACILITY 9: DISTRICT ONE HOSPITAL, - FACILITY 10: RIVER FALLS AREA HOSPITAL, - FACILITY 11: PHILLIPS EYE INSTITUTE

GROUP A-FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS: ABBOTT NORTHWESTERN HOSPITAL (INCLUDES PHILLIPS EYE INSTITUTE): PHILLIPS EYE INSTITUTE LEGALLY MERGED INTO ABBOTT NORTHWESTERN HOSPITAL ON 10/1/2019. ABBOTT NORTHWESTERN HOSPITAL DEVELOPED ITS CHNA WITH THE MINNEAPOLIS, HENNEPIN COUNTY AND BLOOMINGTON PUBLIC HEALTH DEPARTMENTS, WHICH WERE SIMULTANEOUSLY DEVELOPING A COMMUNITY HEALTH IMPROVEMENT PLAN FOR HENNEPIN COUNTY. THESE ENTITIES AND 50 NONPROFIT AND GOVERNMENT REPRESENTATIVES REVIEWED HOSPITAL, STATE AND LOCAL DATA AND CONDUCTED 23 KEY INFORMANT INTERVIEWS WITH INDIVIDUALS REPRESENTING VARIOUS CULTURAL GROUPS, BUSINESS AND ORGANIZATIONS. ABBOTT NORTHWESTERN IDENTIFIED ITS 2020-2022 PRIORITIES BASED ON THIS REVIEW. STAFF THEN CONDUCTED 10 KEY INFORMANT INTERVIEWS WITH STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS SUCH AS AN ADVOCACY ORGANIZATION SERVING LOCAL BUSINESSES, A FEDERALLY-QUALIFIED HEALTH CENTER, A HOUSING PROVIDER FOR PEOPLE LIVING WITH HIV/AIDS AND THE LOCAL PARKS SYSTEM, AMONG OTHERS, TO UPDATE ITS UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON THESE HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM. IN ADDITION, A LOCAL PUBLIC AFFAIRS CONSULTANT INTERVIEWED 25 HEALTH AND CIVIC LEADERS TO EXPLORE THEIR PERCEPTIONS OF HEALTH, HEALTHCARE, PUBLIC HEALTH AND THE HOSPITAL.

GROUP A-FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:ABBOTT NORTHWESTERN HOSPITAL: GOAL 1: REDUCE OVERWEIGHT AND OBESITY BY IMPROVING NUTRITION AND PHYSICAL ACTIVITY LEVELS.IN 2019, ABBOTT NORTHWESTERN HOSPITAL (ANW) WORKED TO IMPROVE THE NUTRITION AND PHYSICAL ACTIVITY OPPORTUNITIES FOR THE RESIDENTS LIVING IN HENNEPIN COUNTY BY FOCUSING EFFORTS ON POPULATIONS THAT ARE FACING DISPARITIES. THE HOSPITAL WORKED WITH A LOCAL NON-PROFIT, THE SHERIDAN STORY, TO ENSURE THAT 175 CHILDREN AT A NEARBY ELEMENTARY SCHOOL HAD ONGOING ACCESS TO HEALTHY FOOD THROUGH THE WEEKEND FOOD BACKPACK PROGRAM. WE ALSO FUNDED AND WORKED CLOSELY WITH THE BACKYARD COMMUNITY HEALTH HUB AS THEY IMPLEMENTED WEEKLY DIABETES EDUCATION, YOGA AND HEALTHY EATING EDUCATION TO RESIDENTS LIVING IN THE PHILLIPS NEIGHBORHOOD. WE ALSO SENT OUR PHYSICIANS AND STAFF OUT INTO COMMUNITY TO PROVIDE HEALTH EDUCATION, INCLUDING AT THE MILL CITY FARMERS MARKET AND AT THE EBENEZER SENIOR LIVING COMPLEX. TO ENCOURAGE PHYSICAL ACTIVITY IN THE COMMUNITY, WE CONTINUED TO FUND AND IMPLEMENT PROGRAMS AIMED AT GETTING KIDS ON BIKES, ONTO CROSS-COUNTRY SKIIS, ACTIVE IN THEIR LOCAL PARK PROGRAMS AND USING ADAPTIVE EQUIPMENT. GOAL 2: PROMOTE MENTAL HEALTH BY INCREASING ACCESS TO MENTAL HEALTH SERVICES AND PROVIDE OPPORTUNITIES FOR INCREASED SOCIAL CONNECTIONS.ANW CONTINUES TO PROMOTE AND IMPROVE ACCESS TO MENTAL HEALTH SERVICES WITH OUR CHANGE TO CHILL PROGRAM BEING IMPLEMENTED IN AT LEAST 8 HIGH SCHOOLS IN HENNEPIN COUNTY. ANW'S SCHOOL DISTRICT PARTNERS ARE USING THE ONLINE CURRICULUM WITH STUDENTS, TEACHERS, COACHES, CLUBS, SCHOOL-BASED MENTAL HEALTH CARE PROVIDERS AND OTHER COMMUNITY GROUPS.ANW STAFF ALSO CONTINUE TO CO-CHAIR THE HENNEPIN COUNTY COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (CHIP). CHIP IS A COLLECTIVE OF COMMUNITY PARTNERS, NON-PROFITS, HEALTHCARE PROVIDERS AND PUBLIC HEALTH WORKING TOGETHER TO ADDRESS WAYS TO IMPROVE THE MENTAL WELLBEING OF COMMUNITY, AND DETERMINE HOW TO RESPOND TO THE GROWING HOUSING CRISIS TAKING PART IN OUR COUNTY. THE FOCUS OF HENNEPIN COUNTY CHIP'S MENTAL WELLBEING WORK HAS MOVED TOWARDS THE PROMOTION OF SOCIAL CONNECTIONS AMONGST HENNEPIN COUNTY RESIDENTS BY FOCUSING ON CREATING AWARENESS ABOUT THE IMPORTANCE OF BEING TRAUMA-INFORMED WHEN INTERACTING WITH THE MOST VULNERABLE MEMBERS OF THE COMMUNITY. GOAL 3: IMPROVE GENERAL POPULATION HEALTH BY INCREASING ACCESS TO HEALTH CARE PROVIDERS AND HEALTH-RELATED RESOURCES.DURING THE CREATION OF THE 2017-2019 CHNA, ONE THING ANW STAFF HEARD LOUD AND CLEAR WAS THAT PEOPLE WERE NOT ACCESSING THE HOSPITAL AS MUCH AS THEY WOULD LIKE BECAUSE THE FACILITY WAS TOO CONFUSING TO NAVIGATE. IN 2019, ANW ADDED AN INTERNAL WAYFINDING APP WHICH PROVIDES VISITORS AND THE PUBLIC WITH STEP-BY-STEP DIRECTIONS TO HELP THEM ACCESS THE SERVICES THEY NEED. ANW STAFF HAS ALSO BEEN WORKING WITH COMMUNITY-BASED HEALTHCARE PARTNERS AND NEARBY FEDERALLY-QUALIFIED HEALTHCARE CENTERS TO IDENTIFY OPPORTUNITIES FOR COLLABORATION TO PROVIDE HEALTH SERVICES IN COMMUNITY. ONGOING PARTNERSHIPS AND COLLABORATIONS WITH OUR NEARBY FEDERALLY-QUALIFIED HEALTHCARE CLINICS HAS BEEN ESSENTIAL TO ENSURING THAT THESE CLINICS HAVE THE ABILITY TO PROVIDE COMMUNITY-BASED SERVICES TO RESIDENTS WHO MIGHT OTHERWISE NOT BE SEEKING NON-EMERGENT HEALTHCARE. ANW STAFF HAVE ALSO CONTINUED TO PARTNER WITH LOCAL GOVERNMENTS TO REDUCE BARRIERS TO TRANSPORTATION BY ACTIVELY ADVOCATING FOR THE METRO BLUE LINE EXTENSION LIGHT RAIL PROJECT IN THE NORTHWEST METRO, PARTNERING WITH METRO TRANSIT TO EXPAND TRANSIT ACCESS IN THE PHILLIPS NEIGHBORHOOD AND IMPROVING THE CHICAGO-LAKE TRANSIT STATION.

GROUP A-FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 2 -- MERCY HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS: MERCY HOSPITAL: MERCY HOSPITAL COLLABORATED WITH ANOKA COUNTY PUBLIC HEALTH TO ENGAGE REPRESENTATIVES FROM 20 AGENCIES IN A COMMITTEE THAT COMPLETED ITS CHNA. THE COMMITTEE REVIEWED HOSPITAL, STATE AND LOCAL DATA AND RESPONSES FROM INTERVIEWS WITH 14 COMMUNITY LEADERS AND DATA FROM 857 RESIDENT-RESPONSES ON A 2018 ANOKA COUNTY COMMUNITY HEALTH SURVEY. MERCY HOSPITAL IDENTIFIED ITS 2020-2022 PRIORITIES BASED ON THIS REVIEW. ADDITIONALLY, TO GAIN RESIDENTS' PERSPECTIVES ON THESE PRIORITIES, MERCY CONDUCTED COMMUNITY DIALOGUES WITH 64 PEOPLE REPRESENTING THE WEST AFRICAN COMMUNITY, THE ANOKA COUNTY HEAD START POLICY COUNCIL, ALEXANDRA HOUSE DOMESTIC AND SEXUAL ASSAULT CENTER AND THE NORTHWEST COMMUNITY HEALTH ADVISORY COUNCIL.

GROUP A-FACILITY 2 -- MERCY HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 2 -- MERCY HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 2 -- MERCY HOSPITAL PART V, SECTION B, LINE 11:
"BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:MERCY HOSPITAL: GOAL 1: PROMOTE MENTAL HEALTH AND WELLNESS SERVICES FOR INDIVIDUALS, YOUTH AND FAMILIES IN OUR COMMUNITIES.TO ADVOCATE AND PARTNER WITH COMMUNITIES TO DEVELOP A COMPREHENSIVE AND RELIABLE CONTINUUM OF MENTAL HEALTH AND ADDICTION CARE, MERCY HOSPITAL PRIORITIZED CHARITABLE GIVING TO ORGANIZATIONS THAT PROMOTE MENTAL HEALTH SERVICES OR AWARENESS. 2019 CONTRIBUTIONS WERE MADE TO THE ANOKA MENTAL HEALTH WELLNESS CAMPAIGN, LEE CARLSON CENTER, TOUCHSTONE MENTAL HEALTH, & MN MILITARY FAMILIES. ALLINA HEALTH'S MENTAL HEALTH CLINICAL SERVICE LINE STAFF PARTNERED WITH ANOKA COUNTY PUBLIC HEALTH AND COMMUNITY MENTAL HEALTH PROVIDERS TO IDENTIFY GAPS IN THE COMMUNITY'S INFRASTRUCTURE. A COMMON PROVIDER NETWORK WAS ESTABLISHED TO TIMELY ACCESS NEEDED CARE APPOINTMENTS. ADDITIONALLY, THE NW MENTAL HEALTH ROUNDTABLE WAS ESTABLISHED AND CO-CHAIRED BY SARA CRIGER (MERCY PRESIDENT), RHONDA SIVARAJAH (ANOKA CO BOARD CHAIR) AND DONNA ZIMMERMAN (HEALTH PARTNERS). WORK GROUPS HAVE BEEN FORMED TO ADDRESS: 1) EFFECTIVE COMMUNICATION AND CONNECTIONS ACROSS SERVICES/STAKEHOLDERS, 2) BETTER PUBLIC INFORMATION AND COMMUNICATION ABOUT RESOURCES, 3) IMPROVED RESOURCING AND FUNDING, AND 4) ASSURING A CONTINUUM OF SERVICES - INCLUDING CRISIS SERVICES - FOR THOSE IN NEED. FINALLY, WORKING GROUP THAT INCLUDES VARIOUS COMMUNITY STAKEHOLDERS AND PARTNERS WAS ESTABLISHED IN 2019 TO ADVANCE COMMUNITY EDUCATION AROUND EDUCATION ON MENTAL HEALTH AND ADDICTION AND STIGMA REDUCTION. THE HOSPITAL ALSO PARTNERED WITH THE ANOKA HENNEPIN SCHOOL DISTRICT TO DEVELOP, PROMOTE AND IMPROVE ACCESS TO COMMUNITY AND SCHOOL-BASED ACTIVITIES THAT ADDRESS ADOLESCENT MENTAL HEALTH AND RESILIENCY. KEY 2019 INITIATIVES INCLUDE BRINGING THE CHANGE TO CHILL INITIATIVES AND TOOLS TO COON RAPIDS, FRIDLEY AND BLAINE HIGH SCHOOLS. ADDITIONALLY, ANOKA COUNTY AND MERCY HOSPITAL CREATED A PARTNERSHIP TO COMPLETE A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT AND EXAMINE TEEN MENTAL HEALTH NEEDS/ISSUES. ALSO, COMMUNITY VERSION OF MAKE IT OK CAMPAIGN WAS SUCCESSFULLY OFFERED TO 10 FAITH COMMUNITY NURSES.GOAL 2: PROMOTE EVIDENCE-BASED STRATEGIES FOR PREVENTION, DETECTION, TREATMENT AND MANAGEMENT OF CHRONIC DISEASE32 COMMUNITY HEALTH SCREENINGS (20 FOR ADULTS, 12 FOR ADOLESCENTS) WERE HELD IN THE COMMUNITY. THESE PROVIDED OPPORTUNITIES TO PRESENT HEALTH EDUCATION TO COMMUNITY MEMBERS THAT ARE MORE DIFFICULT TO REACH, IN ADDITION TO PROVIDING SCREENINGS. IN TOTAL, 1,610 PEOPLE WERE SERVED AT THE HEALTH SCREENINGS. MERCY'S FAITH COMMUNITY NURSE (FCN) PROGRAM PARTNERED WITH 35 FAITH COMMUNITIES TO OFFER ASSISTANCE IN HEALTHY PROGRAMMING THAT INCLUDES DISEASE PREVENTION AND EMPOWERING INDIVIDUALS AND CONGREGATIONS TO TAKE CHARGE OF THEIR OWN HEALTH. FCNS FOLLOW PEOPLE AFTER A HOSPITALIZATION AND ASSIST IN MONITORING THEIR CARE PLAN IN ORDER TO PREVENT READMISSIONS. TO PROVIDE EDUCATIONAL OPPORTUNITIES ON THE HEALTH IMPACTS OF VIOLENCE, MERCY CONTINUED ITS ONGOING PARTNERSHIP WITH THE ALEXANDRA HOUSE TO ASSIST SURVIVORS OF DOMESTIC VIOLENCE. ADDITIONALLY, OVER 1,000 COMMUNITY MEMBERS AND ALLINA HEALTH EMPLOYEES WERE REACHED BY EDUCATIONAL PROGRAMS ON THE IMPACT OF VIOLENCE ON HEALTH AND ITS PREVENTION, INCLUDING PROVIDING A DOMESTIC VIOLENCE ADVOCATE TRAINING TO TWO HOSPITALS, AND PARTNERING WITH ANOKA ELDER ABUSE INITIATIVE TO PROVIDE ELDER ABUSE EDUCATION TO THE PUBLIC AND STAFF. AN ADDITIONAL 300 COMMUNITY MEMBERS AND ALLINA HEALTH EMPLOYEES RECEIVED ADVERSE CHILDHOOD EVENT EDUCATION OFFERED THROUGH THE FAITH COMMUNITY NURSES PROGRAM. MERCY HOSPITAL WORKED WITH THE WEST AFRICAN POPULATION AND THE LIBERIAN HEALTH INITIATIVE TO OFFER HEALTH EDUCATION AND HEALTH SCREENINGS IN THEIR COMMUNITIES. ADDITIONALLY, HEALTH SCREENINGS & EDUCATION FOR THE UNDERSERVED WERE OFFERED THROUGH OUR STEPPING STONE FREE CLINIC (MONTHLY) AND THE COMMUNITY FAMILY TABLE (WEEKLY AND INCLUDES FOOD OFFERINGS).IN 2019, CHARITABLE GIVING RELATED TO THIS GOAL INCLUDED CHARITABLE CONTRIBUTIONS TO STEPPING STONE HOMELESS SHELTER, NORTH METRO PEDIATRICS, THE YMCA AND COMMUNITY EMERGENCY ASSISTANCE PROGRAM. GOAL 3: IMPROVE AND/OR MAINTAIN THE HEALTH OF SENIORS IN OUR COMMUNITIES (IN TERMS OF FUNCTIONAL, PHYSICAL, MENTAL, EMOTIONAL AND SPIRITUAL HEALTH).THROUGH WORK WITH OUR 35 FAITH COMMUNITY PARTNER NURSES, MAAA, THE YMCA AND MERCY TRAUMA DEPARTMENT OFFERED FALLS-PREVENTION EDUCATION AND TRAINING. CLASSES OFFERED INCLUDED ""STEPPING ON"", ""MATTER OF BALANCE AND ""TAI JI QUAN: MOVING FOR BETTER BALANCE AND WERE ATTENDED BY 160 MEMBERS IN THE COMMUNITY. ADDITIONAL WORK IN THIS AREA INCLUDED THE PROVISION OF THE ""GATHERING"", A FAITH-BASED VOLUNTEER RESPITE PROGRAM PROVIDED IN COLLABORATION WITH ANOKA COUNTY FAMILY CAREGIVER CONNECTION, TO 200 PARTICIPANTS. THERE ARE SIX GATHERING SITES WHICH PROVIDE EDUCATION, SUPPORT AND REFERRAL TO 24/7 CAREGIVERS. CARE RECIPIENTS RECEIVE COMPANION CARE AND SOCIALIZATION PROVIDED BY TRAINED VOLUNTEERS FROM FAITH COMMUNITIES. ADDITIONALLY, MERCY HOSPITAL PROMOTED FOOD SECURITY PROGRAMS THROUGH THE ""FAMILY TABLE"" WHICH PROVIDES MEALS THROUGHOUT ANOKA COUNTY. OUR FCNP RN PROVIDES PERSONAL HEALTH COUNSELING & EDUCATION TO 250 MEMBERS OF THE COMMUNITY THAT ARE THE WORKING POOR, OR UNEMPLOYED, MANY HAVE MENTAL HEALTH ISSUES AND DO NOT HAVE MUCH SOCIAL SUPPORT. FREE SCREENINGS ARE PROVIDED THROUGHOUT THE YEAR, APPROPRIATE REFERRALS ARE MADE TO OTHER AGENCIES, ACCESS TO HEALTH CARE IS PROVIDED. ADVANCE CARE PLANNING AND ""HONORING CHOICES"" WAS OFFERED IN 2019 THROUGH SPECIFICALLY TRAINED PARISH NURSES TO 50 COMMUNITY MEMBERS.FINALLY, TO INCREASE AWARENESS OF, AND ACCESS TO, MENTAL HEALTH AND ADDICTION SERVICES FOR SENIORS THE NW MERCY HOSPITAL CONTINUED PARTICIPATING IN MENTAL HEALTH ROUNDTABLE; OBJECTIVES INCLUDE DEVELOPMENT OF STRATEGIES TO ADDRESS SENIOR MENTAL HEALTH."

GROUP A-FACILITY 2 -- MERCY HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 2 -- MERCY HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 3 -- UNITED HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:UNITED HOSPITAL: UNITED HOSPITAL WORKED WITH THE CENTER FOR COMMUNITY HEALTH (CCH) EAST METRO CHNA COLLABORATIVE AND THE ST. PAUL-RAMSEY COUNTY STATEWIDE HEALTH IMPROVEMENT PROGRAM (SHIP) COMMUNITY LEADERSHIP TEAM TO COMPLETE ITS CHNA. MEMBERSHIP IN THESE GROUPS INCLUDED OTHER LOCAL HEALTH CARE SYSTEMS, LOCAL PUBLIC HEALTH, COMMUNITY RESIDENTS AND STAFF FROM LOCAL UNIVERSITIES AND SOCIAL SERVICE AGENCIES. THE CHNA WAS INFLUENCED BY OTHER ORGANIZATIONS' DATA REVIEW AND COMMUNITY ENGAGEMENT ACTIVITIES. AS PART OF THESE GROUPS, UNITED HOSPITAL'S STAFF REVIEWED HOSPITAL, STATE AND LOCAL DATA AND FEEDBACK FROM 2,100 RAMSEY, WASHINGTON OR DAKOTA COUNTY RESIDENTS WHO SHARED THEIR PERSPECTIVES VIA A SURVEY CONDUCTED BY THE CCH EAST METRO CHNA COLLABORATIVE. THE HOSPITAL'S 2020-2022 PRIORITIES WERE BASED ON THIS REVIEW. TO FURTHER REFINE ITS PRIORITIES, UNITED HOSPITAL STAFF ATTENDED COMMUNITY DIALOGUES FACILITATED BY LOCAL PARTNERS AND ATTENDED BY APPROXIMATELY 60 COMMUNITY RESIDENTS INCLUDING PUBLIC HOUSING RESIDENTS, HALF-WAY HOUSE RESIDENTS, INDIVIDUALS EXPERIENCING HOMELESSNESS, SENIORS, PEOPLE WITH CRIMINAL RECORDS AND COMMUNITY ACTIVISTS. STAFF ALSO PARTICIPATED IN RAMSEY COUNTY EAST METRO MENTAL HEALTH CRISIS ALLIANCE MEETINGS AND CONDUCTED INTERVIEWS WITH SIX REPRESENTATIVES FROM HEALTH, PUBLIC HEALTH AND SOCIAL SERVICE AGENCIES.

GROUP A-FACILITY 3 -- UNITED HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 3 -- UNITED HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 3 -- UNITED HOSPITAL PART V, SECTION B, LINE 11:
"BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:UNITED HOSPITAL: GOAL 1: IMPROVE MENTAL HEALTH AND WELL-BEING OF TEENS, ADULTS AND SENIORS IN RAMSEY COUNTY.UNITED CONTINUED SUPPORTING THE EAST METRO MENTAL HEALTH CRISIS ALLIANCE WITH REGULAR PARTICIPATION IN AND CHARITABLE CONTRIBUTIONS IN SUPPORT OF THE EAST METRO MENTAL HEALTH CRISES ALLIANCE AND THE EAST METRO MENTAL HEALTH ROUNDTABLE. CHARITABLE CONTRIBUTIONS WERE MADE TO MINNESOTA COMMUNITY CARE (FOR SCHOOL-BASED, MENTAL-HEALTH PROGRAMS), YMCA (DOWNTOWN ST. PAUL, FOR MENTAL HEALTH SERVICES, YOGA, MINDFULNESS EDUCATION AND OTHER SIMILAR WORK), KIDS N KINSHIP, AND SEVERAL OTHER SIMILAR MENTAL HEALTH SERVICE PROVIDERS.IN 2019, UNITED HOSPITAL DEVELOPED NEW AND/OR DEEPENED PARTNERSHIPS WITH CATHOLIC CHARITIES, YOUTH SERVICES BUREAU, FAMILYMEANS, WOODBURY THRIVES (INCLUDING ANNUAL CHARITABLE SUPPORT OF FAMILY MEALTIME PROGRAM IN WOODBURY SCHOOLS), STILLWATER WASHINGTON COUNTY CONNECT, FOREST LAKE AREA PARTNERSHIP FOR FAMILIES, AND OTHER SIMILAR COMMUNITY-BASED MENTAL-HEALTH SERVICE PROVIDERS.UNITED COLLABORATED WITH THE ST. PAUL PUBLIC HOUSING AGENCY ON MENTAL WELLNESS IN SEVERAL WAYS, INCLUDING TRAINING AND SUPPORT IN PILOTING A SIX-WEEK BOUNCE BACK PROJECT FOR YOUTH. THE HOSPITAL ALSO PROVIDED CHANGE TO CHILL TRAININGS AND TOOLS TO NUMEROUS COMMUNITY PARTNERS, INCLUDING PUBLIC SCHOOL SYSTEMS AND COUNTY PUBLIC HEALTH DEPARTMENTS IN WASHINGTON, RAMSEY AND DAKOTA COUNTIES; PROVIDED CHANGE TO CHILL TRAININGS, MATERIALS AND TOOLS TO NUMEROUS COMMUNITY-BASED HEALTH INITIATIVES, INCLUDING WOODBURY THRIVES, FOREST LAKE HEALTH UP!, AND OTHER SIMILAR COMMUNITY PARTNERS AND COMMUNITY-BASED, MENTAL HEALTH WELL-BEING INITIATIVES.TO INCREASE AWARENESS OF MENTAL HEALTH CONDITIONS AND ELIMINATE STIGMA AROUND MENTAL HEALTH CONDITIONS, UNITED CONTINUED TO PARTICIPATE IN CENTER FOR COMMUNITY HEALTH COLLECTIVE ACTION WORK GROUP AND RELATED METRO-WIDE MENTAL HEALTH STIGMA ELIMINATION INITIATIVES INCLUDING:- WORKING TO DEVELOP NEW ""COLLECTIVE ACTION FOR COMMUNITY IMPACT"" INITIATIVE RELATED TO SOCIAL CONNECTEDNESS.- PROMOTION OF THE MAKE IT OKAY PROGRAM (REDUCING STIGMA RELATED TO MENTAL HEALTH ISSUES);- PROMOTION OF, SUPPORT OF TRAININGS, AND DIRECT PROGRAM OFFERINGS OF MENTAL HEALTH FIRST AID KIT;- PROMOTION OF COMMUNITY TRAININGS FOR PSYCHOLOGICAL FIRST AID AND QPR (QUESTION, PERSUADE, REFER) PROGRAMS. ADDITIONALLY, IN 2019 THE HOSPITAL PROVIDED FINANCIAL AND VOLUNTEER SUPPORT FOR DEPRESSION SCREENING FOR ALL FOREST LAKE AREA SCHOOL'S NINTH AND TENTH GRADERS. GOAL 2. DECREASE THE PERCENTAGE OF THE POPULATION WHO IS OVERWEIGHT OR OBESE.UNITED HOSPITAL PROMOTED EMPLOYEE-LED VOLUNTEER OPPORTUNITIES RELATED TO PROMOTING HEALTHY EATING, INCLUDING OPPORTUNITIES TO DELIVER HEALTH POWERED KIDS MATERIALS IN THE COMMUNITY. ADDITIONALLY, THE HOSPITAL COLLABORATED WITH HIGHLAND PARK CLINIC AND HIGHLAND CATHOLIC SCHOOL TO HOST A WALK TO SCHOOL EVENT ON OCTOBER 2. HEALTH POWERED KIDS MATERIALS WERE DISTRIBUTED AT THE EVENT.GOAL 3. INCREASE PERCENTAGE OF POPULATION WITH ACCESS TO HEALTHY FOOD.IN 2019, UNITED HOSPITAL HOSTED A HEALTHY FOOD DRIVE IN SUPPORT OF THE FOOD GROUP. CHARITABLE CONTRIBUTIONS WERE MADE TO FROGTOWN FARMS, ST. PAUL PUBLIC SCHOOLS FOR SCHOOL GARDENS, HEALTHY EATING EDUCATION, AND HEALTHY MEALS. UNITED HOSPITAL ALSO PARTNERED WITH RAMSEY COUNTY PUBLIC HEALTH TO DEVELOP THEIR NEW ""SCREEN AND REFER"" INITIATIVE HELPING LOW-INCOME FAMILIES ADDRESS FOOD INSECURITY. CHARITABLE CONTRIBUTIONS WERE MADE TO URBAN ROOTS, INTERFAITH ACTION OF GREATER ST. PAUL, OPEN ARMS; ASSISTING RAMSEY COUNTY IN DEVELOPING PROPOSAL FOR CHARITABLE CONTRIBUTION REQUEST IN SUPPORT OF THEIR NEW SCREENING/REFERRAL INITIATIVE. THE HOSPITAL CONTINUED TO SUPPORT TWIN CITIES MOBILE MARKET AND KEYSTONE SERVICES FOOD BANKS WITH ONGOING CHARITABLE CONTRIBUTIONS AND PROMOTING VOLUNTEER OPPORTUNITIES AT THESE PARTNER ORGANIZATIONS."

GROUP A-FACILITY 3 -- UNITED HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 3 -- UNITED HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 4 -- BUFFALO HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:BUFFALO HOSPITAL: BUFFALO HOSPITAL CONDUCTED A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT AS PART OF THE WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE (WCCHC). WCCHC MEMBERS INCLUDE ALL WRIGHT COUNTY ORGANIZATIONS WHO ARE ENCOURAGED OR REQUIRED TO COMPLETE A CHNA: BUFFALO HOSPITAL, PART OF ALLINA HEALTH, CENTRACARE-MONTICELLO, WRIGHT COUNTY PUBLIC HEALTH AND WRIGHT COUNTY COMMUNITY ACTION. WCCHC MEMBERS REVIEWED HOSPITAL, STATE AND LOCAL DATA AND 2018 FINDINGS AND THREE-YEAR TRENDS FROM A COMMUNITY HEALTH SURVEY TO WHICH 2,039 PEOPLE RESPONDED. ADDITIONALLY, MEMBERS TALKED TO COMMUNITY MEMBERS AT WRIGHT COUNTY FAIR IN JULY 2018. FINALLY, WCCHC CONDUCTED KEY INFORMANT INTERVIEWS AND COMMUNITY MEETINGS WITH 150 RESIDENTS AND REPRESENTATIVES FROM 40 COMMUNITY ORGANIZATIONS, INCLUDING SENIORS, LOW-INCOME FAMILIES, REPRESENTATIVES FROM RACIAL/ETHNIC MINORITY POPULATIONS, AND ORGANIZATIONS SERVING PEOPLE LIVING ON LESS TO UNDERSTAND THE COMMUNITY'S PERSPECTIVE ON IDENTIFIED PRIORITIES.

GROUP A-FACILITY 4 -- BUFFALO HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES

GROUP A-FACILITY 4 -- BUFFALO HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 4 -- BUFFALO HOSPITAL PART V, SECTION B, LINE 11:
"BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:BUFFALO HOSPITAL: GOAL 1: SUPPORT MENTAL WELLNESS IN WRIGHT COUNTY BY IDENTIFYING AND EXPANDING THE OFFERING OF COMMUNITY MENTAL AND BEHAVIORAL HEALTH AND WELLNESS RESOURCES AND STRENGTHENING SOCIAL CONNECTIONS AND RELATIONSHIPS.TO ACTIVELY ENGAGE PROVIDERS IN PUBLIC DISCUSSIONS AROUND MENTAL HEALTH TOPICS TO DECREASE STIGMA, BUFFALO HOSPITAL CONTINUED TO HOST MONTHLY MDH MENTAL WELL-BEING AND RESILIENCE LEARNING COMMUNITY WEBINAR SERIES-FACILITATED ON-SITE AND VIA WEBINAR. COMMUNITY MEMBERS AND LEADERS WERE INVITED TO PARTICIPATE AND DISCUSS MENTAL HEALTH AND WELLNESS RESOURCES AND ISSUES IN OUR COMMUNITY. IN 2019, BUFFALO HOSPITAL ALSO BECAME AN ACTIVE MEMBER OF MENTAL HEALTH ADVISORY COUNCIL. BUFFALO HOSPITAL WAS THE HOST SITE FOR MONTHLY MENTAL HEALTH MEETINGS, WHICH INCLUDED REPRESENTATIVES FROM ALLINA MENTAL HEALTH SERVICE LINE, EMERGENCY DEPARTMENT, COMMUNITY ENGAGEMENT, CARE MANAGEMENT, WRIGHT COUNTY HEALTH AND HUMAN SERVICES, LOCAL AND COUNTY LAW ENFORCEMENT, CENTRAL MN MENTAL HEALTH AND OTHERS AS APPROPRIATE.TO STRENGTHEN COLLABORATION AND LINK THE POPULATION TO AVAILABLE RESOURCES IN THE COMMUNITY, BUFFALO PROVIDED CHARITABLE CONTRIBUTION SUPPORT TO LOCAL INITIATIVES ADDRESSING MENTAL HEALTH ISSUES AND PARTNERED WITH LOCAL AND NATIONAL SUICIDE PREVENTION AND MENTAL HEALTH ORGANIZATIONS. THESE INCLUDED ATOZ AND SAVE. BUFFALO ALSO HOSTED THE ""MENTAL WELLNESS AND ADDICTION: BEYOND STIGMA"" EVENT IN PARTNERSHIP WITH SAVE. ADDITIONALLY, BUFFALO HOSPITAL CONTINUED TO WORK CLOSELY WITH COMMUNITY PARTNERS TO EXPAND ITS BOUNCE BACK PROGRAM INITIATIVE THROUGHOUT THE COMMUNITY. BOUNCE BACK IS A COMMUNITY-WIDE PROGRAM IN THE WRIGHT COUNTY AREA THAT PROMOTES HEALTH THROUGH HAPPINESS WITH A VARIETY OF TOOLS AND EVENTS INCLUDING RANDOM ACTS OF KINDNESS, SOCIAL CONNECTIONS, AND GRATITUDE LETTERS. BOUNCE BACK PROGRAM EXPANDED IN 2019 AND WAS PILOTED USING THREE GRASS ROOTS COMMUNITY TEAMS IN BUFFALO, ANNANDALE AND COKATO. IN 2019, 4,713 PARTICIPANTS WERE REACHED LOCALLY THROUGH IN-SCHOOL BOUNCE BACK PROGRAM OFFERINGS, ONE TIME PRESENTATIONS AND TRAIN-THE-TRAINER SESSIONS. THE CHANGE TO CHILL INITIATIVE WAS ROLLED OUT IN BUFFALO AND MONTICELLO HIGH SCHOOLS AND CONTINUED PARTNERSHIP WITH MAPLE LAKE HIGH SCHOOL. THE ROLL-OUT INCLUDED FINANCIAL AND OTHER RESOURCES TO HELP STUDENTS DEAL WITH STRESS AND ANXIETY ISSUES. FINALLY, BUFFALO CONTINUED TO PARTNER WITH AND SUPPORTED THE PENNY GEORGE INSTITUTE FOR HEALTH AND HEALING IN PROVIDING ALTERNATIVE INTEGRATIVE CARE AT BUFFALO HOSPITAL TO PROMOTE A VARIETY OF MENTAL WELLNESS OPTIONS SUCH AS MINDFULNESS CLASSES. PGIHH PROGRAMS HAVE BEEN INCLUDED IN THE COMMUNITY WELLNESS OFFERINGS BROCHURE THAT IS SENT OUT TO HOUSEHOLDS, VARIOUS COMMUNITY GROUPS AND ORGANIZATIONS AS WELL AS PCPS IN AND AROUND THE WRIGHT COUNTY AREA. THEIR OFFERINGS ARE INCLUDED IN LOCAL COMMUNITY EDUCATION PUBLICATIONS. GOAL 2. REDUCE OR MAINTAIN THE LEVEL OF OBESITY AND INCREASE PHYSICAL ACTIVITY AMONG THE POPULATION OF WRIGHT COUNTY THROUGH EDUCATIONAL PROGRAMMING, ACTIVITIES AND POLICIES THAT PROMOTE AND SUPPORT HEALTHY LIFESTYLE.BUFFALO CONTINUED IMPLEMENTATION OF EVIDENCE-BASED AND ALLINA-DEVELOPED WELLNESS PROGRAMMING, AND WELLNESS COACHING ON-SITE, AT THE HOSPITAL AND VIA TELEPHONE. EVIDENCE-BASED CLASSES OFFERED IN 2019 INCLUDE HEALTHY EATING FOR BETTER HEALTH CLASSES FOR THE COMMUNITY (TWO 4 WEEK CLASSES IN 2019), DIABETES PREVENTION PROGRAM (THREE GROUPS OFFERED IN 2019 - ONE YEAR LONG COURSE), LET'S TALK WELLNESS CLASSES, AND GROCERY STORE TOURS. COOKING DEMOS WERE PART OF THE HEALTHY EATING FOR BETTER HEALTH AND LET'S TALK WELLNESS CURRICULUM. THE HOSPITAL REACHED ALMOST 2,000 PEOPLE WITH THESE OFFERINGS IN JUST 2019. ADDITIONALLY, THE HOSPITAL IMPLEMENTED THEIR FIRST PHYSICIAN REFERRAL PILOT FOR TWO OFFERINGS - DIABETES PREVENTION PROGRAM AND LIVING WELL WITH CHRONIC PAIN PROGRAM. A DIRECT MAIL COMMUNICATION PROCESS WAS DEVELOPED WITH THE QUALIFYING PATIENT POPULATION. IN 2019, THE HOSPITAL HAD SUCCESSFUL ENROLLMENT AND ADDED ONE ADDITIONAL CLASS FOR EACH OFFERING.THE HOSPITAL WORKED WITH SCHOOLS AND COMMUNITY ORGANIZATIONS (E.G. ECFE AND TIMBERBAY) TO PROVIDE SUPPORT AND EDUCATION TO MINORS AND PARENTS GROUPS AROUND HEALTHY CHOICES AND PHYSICAL ACTIVITY. IN COLLABORATION WITH TEACHERS AND LOCAL CHEFS, HANDS-ON COOKING CLASSES WERE TAUGHT VIA FAMILY DINNER NIGHTS HELD AT THE PHOENIX LEARNING CENTER. A 16-WEEK YOGA AND MINDFULNESS COURSE WAS ALSO OFFERED AT THE PHOENIX LEARNING CENTER. BUFFALO PARTNERED WITH FARE FOR ALL, LOCAL FARMERS MARKETS, GROCERY STORES, LOCAL FOOD SELVES AND WRIGHT COUNTY CROW RIVER FOOD COUNCIL AROUND ACCESSIBILITY TO HEALTHY FOOD AT AFFORDABLE COST AND ADDRESSING FOOD INSECURITIES. IN 2019, 2,386 FAMILIES WERE SERVED AT THE BUFFALO FARE FOR ALL EVENTS. THE ALLINA HEALTH BUCKS PROGRAM SERVED 232 FAMILIES WITH $2,320 WORTH OF PRODUCE PURCHASED. THE 'BUCKS' ARE USED JUST LIKE CASH, AND ARE GIVEN BY ALLINA HEALTH DOCTORS, CARE MANAGERS AND PUBLIC HEALTH NURSES TO PATIENTS WHO ARE FOOD INSECURE. $8,410 IN CHARITABLE CONTRIBUTIONS WAS PROVIDED TO ALL AREA FOOD SHELVES AND FARMERS MARKET POP PROGRAMS. GOAL 3. SUPPORT COMMUNITY ACCESS TO CLINICAL AND NON-CLINICAL SERVICES IN WRIGHT COUNTY BY ENGAGING PROVIDERS AND COMMUNITY PARTNERS IN COLLABORATIVE NETWORK AND RESOURCE SHARING.TO CREATE OPTIONS FOR PATIENTS UNABLE TO ACCESS SERVICES DUE TO TRANSPORTATION CONCERNS, BUFFALO HAS WORKED CLOSELY WITH COMMUNITY PARTNERS, LOVEINC AND WRIGHT COUNTY COMMUNITY ACTION, WHO PROVIDE VOLUNTEER DRIVERS FOR MEMBER OF THE COMMUNITY WHO ARE UNABLE TO ACCESS CARE DUE TO TRANSPORTATION CONCERNS. THE ALLINA HEALTH CLINIC ON WHEELS BEGAN THIS YEAR TO PROVIDE CLINIC VISITS IN AREAS OF THE COUNTY WHERE COMMUNITY MEMBERS HAVE LIMITED ACCESS TO A CLINIC IN THEIR COMMUNITY. ADDITIONALLY, TO SUPPORT ORGANIZATIONS WHOSE PRIMARY FOCUS IS IMPROVING ACCESS TO HEALTHCARE, BUFFALO MADE CHARITABLE CONTRIBUTIONS TO WCCA FOR EMERGENCY FOOD BOXES AND BEGAN STOCKING THOSE FOOD BOXES IN ALLINA HEALTH CLINICS IN THE WRIGHT COUNTY AREA AND THE BUFFALO HOSPITAL EMERGENCY DEPARTMENT. FINALLY, BUFFALO IS WORKING WITH COMMUNITY PARTNERS TO INCREASE THE AVAILABILITY OF RESOURCES THAT PROMOTE WELLNESS OUTSIDE OF THE HOSPITAL CLINICAL SETTING. EXAMPLE PROJECTS INCLUDE GIRL'S SUPPORT GROUP TO SUPPORT MENTAL WELLNESS AMONG AT RISK TEENS AT PHOENIX LEARNING CENTER AND BUFFALO HIGH SCHOOL PARTNERING WITH VARIOUS LOCAL EXPERTS TO LEAD A TOPIC AND LOCAL CHEFS TO HELP GIRLS PREP A MEAL. THE BOUNCE BACK PROJECT AND CHANGE TO CHILL PROGRAMS HAVE BEEN PROVIDED IN NUMEROUS LOCAL SCHOOLS AND THROUGHOUT THE BUFFALO HOSPITAL SERVICE AREA."

GROUP A-FACILITY 4 -- BUFFALO HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 4 -- BUFFALO HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 5 -- NEW ULM MEDICAL CENTER PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:NEW ULM MEDICAL CENTER: NEW ULM MEDICAL CENTER COLLABORATED WITH BROWN COUNTY PUBLIC HEALTH TO COMPLETE ITS CHNA TO ENGAGE REPRESENTATIVES FROM 15 AGENCIES IN A COMMITTEE THAT COMPLETED ITS CHNA. THE COMMITTEE REVIEWED HOSPITAL, STATE AND LOCAL DATA, SUCH AS THE 2016 BROWN COUNTY COMMUNITY HEALTH SURVEY. NEW ULM MEDICAL CENTER IDENTIFIED ITS 2020-2022 PRIORITIES BASED ON THIS REVIEW. TO GAIN COMMUNITY MEMBERS' PERSPECTIVES ON THESE PRIORITIES, THE MEDICAL CENTER HOSTED TWO COMMUNITY DIALOGUES IN OCTOBER 2018 THAT WERE ATTENDED BY 32 PEOPLE REPRESENTING 18 BROWN COUNTY ORGANIZATIONS SUCH AS EARLY CHILDHOOD FAMILY EDUCATION (ECFE), LOCAL FAITH COMMUNITIES, BROWN COUNTY UNITED WAY, NEW ULM PARK AND REC AND PUBLIC SCHOOLS, AND LOCAL SOCIAL SERVICE AGENCIES, AMONG OTHERS.

GROUP A-FACILITY 5 -- NEW ULM MEDICAL CENTER PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 5 -- NEW ULM MEDICAL CENTER PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 5 -- NEW ULM MEDICAL CENTER PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:NEW ULM MEDICAL CENTER:GOAL 1: SUPPORT EDUCATIONAL PROGRAMS, ACTIVITIES AND POLICIES THAT HELP INDIVIDUALS INCREASE ACCESS TO PHYSICAL ACTIVITY AND HEALTHFUL FOODS, ASWELL AS SUPPORT EATING WELL AND ACTIVE LIVING.IN 2019, NEW ULM MEDICAL CENTER PROVIDED QUARTERLY WORKPLACE WELLNESSTRAININGS, AS FOLLOWS:- JANUARY: SMART GOAL SETTING- APRIL: COURAGEOUS CONVERSATIONS- JULY: WELLNESS CULTURENEW ULM MEDICAL CENTER CONTINUED TO MAINTAIN AND SUPPORT THE COALITION FOR ACTIVE, SAFE AND HEALTHY STREETS AND THE SAFE ROUTES TO SCHOOL ACTION TEAMS TO MAKE IMPROVEMENTS TO THE BUILT ENVIRONMENT IN NEW ULM BY DECEMBER2019. NUMC HELPED TO PROMOTE SAFETY STUDY IN LOCAL NEIGHBORHOODS TO IMPROVE FUNCTIONALITY OF THE ROADS FOR SAFE WALKING AND BIKING PRACTICES(FOR EXAMPLE, NEW ROUNDABOUT WAS INSTALLED BECAUSE OF THE STUDY). HEART OF NEW ULM (HONU) LEADERSHIP TEAM CONTINUED TO EXPAND THE RESTAURANT RECOGNITION PROGRAM AND MAKE IT SUSTAINABLE BY THE ACTION TEAM. IN 2019, THE GROUP ASSESSED 15 RESTAURANTS IN THE NEW RECOGNITION PROGRAM. EIGHT RESTAURANTS PASSED THE ASSESSMENT WITH THE GOLD AND SILVER STATUS.ADDITIONALLY, HONU CONTINUED TO PROMOTE COMMUNITY GARDENING. COMMUNITY GARDEN WAS NEARLY FULL IN 2019 WITH 74 PLOTS RENTED. LARGE COMPOST BIN, A NEW SHED, RAISED BEDS, BIKE FIX-IT STATION WERE ADDED AND ABOUT 450 POUNDS OF FOOD WERE DONATED TO THE FOOD SHELF.ADDITIONALLY, IN PARTNERSHIP WITH THE COMMUNITY CENTER, NEW ULM OFFERED TEN STEPPING ON FALLS-PREVENTION CLASSES TO 124 PARTICIPANTS AND NEW ULM MEDICAL CENTER OFFERED COOKING CLASSES AT BRIDGE ON CENTER, NUMAS HOUSE, SUNSET APARTMENTS AND MRCI. GOAL 2. REDUCE THE BURDEN OF MENTAL HEALTH BY REDUCING STIGMA, IMPROVING EARLY IDENTIFICATION AND OFFERING RESILIENCY PROGRAMMING FOCUSED ON MENTAL HEALTH CONDITIONS.-CONTINUED COLLABORATING WITH LOCAL SHIP AND PUBLIC HEALTH DEPARTMENT ON MAKE IT OK CAMPAIGN. BILLBOARD IN OCTOBER, DOCUMENTARY SHARED INFORMATION WITH PARTNERS, LETTER TO THE EDITOR FROM THE ACTION TEAM.-BROWN COUNTY LOCAL ADVISORY COUNCIL ON MENTAL HEALTH OFFERS MONTHLY BROWN BAG LUNCHEONS ON MENTAL HEALTH TOPICS.-NUMC OFFERS MONTHLY SUPPORT GROUPS (PARKINSON'S SUPPORT, LOSS OF LOVEDONE, CANCER SUPPORT)-NUMC CONTINUED OFFERING AND PROMOTING CHANGE TO CHILL PROGRAM. IN 2019,NEW ULM HIGH SCHOOL, SPRINGFIELD HIGH SCHOOL AND SLEEPY EYE HIGH SCHOOL PARTICIPATED IN THE CHANGE TO CHILL SCHOOL PARTNERSHIP. GOAL 3. SUPPORT EDUCATIONAL PROGRAMS, ACTIVITIES AND POLICIES THAT INCREASES AWARENESS REGARDING ADDICTION AND USE OF LEGAL AND ILLEGAL SUBSTANCE USE.-THE FOLLOWING INDUSTRIES REQUESTED AND RECEIVED THE AMERICAN LUNG TOBACCO FREE WORKSITE TOOLKIT BOOKS FROM SHIP: UVERA, FIRMENICH, WINDINGS, MLC, CHRISTENSEN FARMS, CITY OF NEW ULM, UNITED FARMERS CO-OP.-NEW ULM MEDICAL CENTER CURRENTLY SUPPORTS THE UNDERAGE SUBSTANCE ABUSE COALITION (USAC) TO INCREASE AWARENESS OF ALCOHOL AND TOBACCO USE AMONG YOUTH.-TOBACCO 21 ORDINANCE WAS PASSED IN DECEMBER 2019.

GROUP A-FACILITY 5 -- NEW ULM MEDICAL CENTER PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 5 -- NEW ULM MEDICAL CENTER PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 6 -- CAMBRIDGE MEDICAL CENTER PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:CAMBRIDGE MEDICAL CENTER: CAMBRIDGE MEDICAL CENTER COLLABORATED WITH ISANTI COUNTY PUBLIC HEALTH TO ENGAGE REPRESENTATIVES FROM 20 AGENCIES IN A COMMITTEE THAT COMPLETED ITS CHNA. THE COMMITTEE MEMBERS REVIEWED PATIENT, STATE AND LOCAL DATA AND RESULTS FROM THE EAST CENTRAL REGIONAL SURVEY TO SELECT THEIR 2020-2022 PRIORITIES. ADDITIONALLY, TO UNDERSTAND COMMUNITY MEMBERS' PERSPECTIVES ON THESE HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, THE MAPP COMMITTEE CONDUCTED A ROOT CAUSE ANALYSIS AND DEVELOPED A CONVERSATION IN A BOX GUIDE THAT THE COMMUNITY GROUPS USED TO FACILITATE 13 DIALOGUES WITH A TOTAL OF 150 CLIENTS AND CONSTITUENTS FROM LOCAL SCHOOLS, SENIORS, THE LOCAL CHAMBER OF COMMERCE, EARLY CHILDHOOD PROGRAMS, SUBSTANCE USE PREVENTION AND RECOVERY PROGRAMS AND LOCAL SOCIAL SERVICE AGENCIES, AMONG OTHERS. AN ADDITIONAL 36 PEOPLE PROVIDED INPUT THROUGH AN ONLINE SURVEY.

GROUP A-FACILITY 6 -- CAMBRIDGE MEDICAL CENTER PART V, SECTION B, LINE 6A:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:CAMBRIDGE MEDICAL CENTER: CAMBRIDGE MEDICAL CENTER COLLABORATED WITH ISANTI COUNTY PUBLIC HEALTH TO ENGAGE REPRESENTATIVES FROM 20 AGENCIES IN A COMMITTEE THAT COMPLETED ITS CHNA. THE COMMITTEE MEMBERS REVIEWED PATIENT, STATE AND LOCAL DATA AND RESULTS FROM THE EAST CENTRAL REGIONAL SURVEY TO SELECT THEIR 2020-2022 PRIORITIES. ADDITIONALLY, TO UNDERSTAND COMMUNITY MEMBERS' PERSPECTIVES ON THESE HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, THE MAPP COMMITTEE CONDUCTED A ROOT CAUSE ANALYSIS AND DEVELOPED A CONVERSATION IN A BOX GUIDE THAT THE COMMUNITY GROUPS USED TO FACILITATE 13 DIALOGUES WITH A TOTAL OF 150 CLIENTS AND CONSTITUENTS FROM LOCAL SCHOOLS, SENIORS, THE LOCAL CHAMBER OF COMMERCE, EARLY CHILDHOOD PROGRAMS, SUBSTANCE USE PREVENTION AND RECOVERY PROGRAMS AND LOCAL SOCIAL SERVICE AGENCIES, AMONG OTHERS. AN ADDITIONAL 36 PEOPLE PROVIDED INPUT THROUGH AN ONLINE SURVEY.

GROUP A-FACILITY 6 -- CAMBRIDGE MEDICAL CENTER PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 6 -- CAMBRIDGE MEDICAL CENTER PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:CAMBRIDGE MEDICAL CENTER: GOAL 1: IMPROVE MENTAL HEALTH AND WELLNESS FOR COMMUNITY THROUGH INCREASED ACCESS TO CARE, PROGRAMS AND SERVICESIN ADDITION TO IMPLEMENTING THE CHANGE TO CHILL SCHOOL PARTNERSHIP IN BRAHAM AREA HIGH SCHOOL, CAMBRIDGE MEDICAL CENTER CONTINUED WORKING WITH MIDDLE AND HIGH-SCHOOL STUDENTS IN THE COMMUNITY THROUGH THE IN-PERSON CHANGE TO CHILL LEAD A SERIES-CURRICULUM. ADDITIONALLY, THE MEDICAL CENTER PROMOTED HEALTHY COPING SKILL-BUILDING AMONG ADULTS AND YOUTH BY PROVIDING PRESENTATIONS AND TRAINING TO SCHOOL DISTRICT NURSES, STUDENTS, CAREGIVER GROUPS, LOCAL COMMUNITY GROUPS AND BUSINESSES. 1,160 ADULTS AND YOUTH WERE REACHED THROUGH THESE INITIATIVES. ADDITIONAL WELLNESS CLASSES AND EVENTS OFFERED TO THE COMMUNITY INCLUDE STRESS 101 SERIES AND ANTI-STIGMA EVENTS OFFERED THROUGHOUT THE YEAR. GOAL 2. INCREASE AWARENESS AMONG COMMUNITY MEMBERS OF ALL AGES ABOUT THE NEGATIVE HEALTH IMPACTS OF USE OF TOBACCO/E-CIGARETTES, ALCOHOL AND OTHER DRUGS.THROUGH A PARTNERSHIP BETWEEN CAMBRIDGE INTERMEDIATE SCHOOL AND CAMBRIDGE MEDICAL CENTER, FIFTH-GRADE STUDENTS CONTINUED TO TAKE PART IN AN INTERACTIVE CURRICULUM, TAR WARS, FOCUSED ON THE DANGERS OF SMOKING. THROUGH THE TAR WARS CURRICULUM, STUDENTS ARE TAUGHT ABOUT THE POWER OF ADVERTISING AND THE NEED FOR TOBACCO COMPANIES TO DESIGN ADS THAT ATTRACT A WIDE VARIETY OF PEOPLE. A SIMILAR CURRICULUM, TOBACCO 101, WAS PROVIDED TO LOCAL MIDDLE- AND HIGH-SCHOOL STUDENTS THROUGHOUT THE YEAR. ALLINA PATIENT EDUCATION MATERIALS ON TOBACCO CESSATION/PREVENTION WERE PROVIDED TO LOCAL EMPLOYEE GROUPS. CAMBRIDGE MEDICAL CENTER ALSO SUPPORTED DRUG TAKE BACK DAY IN APRIL THAT COLLECTED OVER 70 POUNDS OF UNUSED PRESCRIPTION DRUGS THROUGHOUT ISANTI COUNTY. CMC PROVIDED CAMBRIDGE-ISANTI AND BRAHAM PUBLIC SCHOOLS, CAMBRIDGE CHRISTIAN SCHOOL AND THE ARTS AND SCIENCE ACADEMY WITH UP TO DATE INFORMATION ABOUT THE DANGERS OF ELECTRONIC CIGARETTES AND VAPING. ADDITIONALLY, INFORMATION ON DANGERS OF VAPING WAS PROVIDED THROUGH COFFEE CHATS AND LUNCH-N-LEARNS.TO DECREASE YOUTH ACCESS TO TOBACCO, IN 2019 CMC SUCCESSFULLY COLLABORATED WITH THE ISANTI COUNTY SUBSTANCE ABUSE PREVENTION AND RECOVER COALITION TO PASS TOBACCO 21 ORDINANCE IN ISANTI COUNTY. GOAL 3. IMPROVE HEALTHY EATING AND ACTIVE LIVING IN COMMUNITIES SERVED BY CAMBRIDGE MEDICAL CENTER.CAMBRIDGE MEDICAL CENTER CONTINUED TO OFFER ITS 16-WEEK PREVENT TYPE 2 (T2) DIABETES PROGRAM. FROM FEBRUARY THROUGH JUNE, SEVEN COMMUNITY MEMBERS PARTICIPATED IN THIS PROGRAM AND LOST A TOTAL OF 51 POUNDS. EXAMPLES OF ADDITIONAL HEALTHY EATING AND ACTIVE LIVING CLASSES OFFERED TO CAMBRIDGE MEDICAL CENTER COMMUNITY MEMBERS IN 2019 INCLUDE:- CHARITABLE CONTRIBUTION AND FINANCIAL SUPPORT TO LOCAL ORGANIZATIONS AND INITIATIVES PROMOTING HEALTHY EATING AND PHYSICAL ACTIVITY (TOTAL OF $13,950)- LET'S TALK WELLNESS HEALTHY EATING SESSION OFFERED TO 100 GRACEPOINT CROSSING EMPLOYEES;- VARIOUS HEALTHY EATING PRESENTATIONS TO LOCAL EMPLOYEE GROUPS;- MEMORY CAF AND NORTH BRANCH COMMUNITY GARDEN PRESENTATIONS ON NUTRITION.

GROUP A-FACILITY 6 -- CAMBRIDGE MEDICAL CENTER PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 6 -- CAMBRIDGE MEDICAL CENTER PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 7 -- REGINA HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:REGINA HOSPITAL: REGINA HOSPITAL DEVELOPED ITS CHNA AS PART OF THE DAKOTA COUNTY PUBLIC HEALTH'S HEALTHY DAKOTA INITIATIVE, THE CENTER FOR COMMUNITY HEALTH (CCH) EAST METRO CHNA COLLABORATIVE AND THE HASTINGS EQUITY AND INCLUSION COMMITTEE. MEMBERS OF THE HEALTHY DAKOTA INITIATIVE REVIEWED STATE AND LOCAL DATA RESOURCES AND SURVEY RESPONSES FROM 1,244 RESIDENTS AND 46 ORGANIZATIONAL ASSESSMENTS. ADDITIONALLY, THEY CONDUCTED LISTENING SESSIONS WITH COMMUNITY REPRESENTATIVES FROM SOCIAL SERVICE AGENCIES, HOUSING ORGANIZATIONS AND LEGAL AND MENTAL HEALTH SERVICES. BASED ON THE DATA REVIEW, THE HEALTHY DAKOTA INITIATIVE STEERING COMMITTEE SELECTED 19 HEALTH PRIORITIES. REGINA STAFF NARROWED THE LIST BY REVIEWING ALLINA HEALTH PATIENT DATA AND HOLDING THREE DIALOGUES WITH MEMBERS OF THE HASTINGS EQUITY AND INCLUSION COMMITTEE. THIS GROUP INCLUDES REGINA HOSPITAL AND 50 OTHER MEMBERS, INCLUDING COMMUNITY RESIDENTS, BUSINESS OWNERS AND REPRESENTATIVES FROM GOVERNMENT AND NONPROFIT ORGANIZATIONS. ADDITIONALLY, TO GAIN RESIDENTS' PERSPECTIVES ON THESE PRIORITIES AND GATHER IDEAS FOR ADDRESSING THEM, REGINA STAFF INTERVIEWED REPRESENTATIVES FROM FIVE COMMUNITY ORGANIZATIONS SUCH AS LOCAL SOCIAL SERVICE AGENCIES AND THE LOCAL HIGH SCHOOL AND SENIOR CENTER.

GROUP A-FACILITY 7 -- REGINA HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES

GROUP A-FACILITY 7 -- REGINA HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 7 -- REGINA HOSPITAL PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:REGINA HOSPITAL: GOAL 1: IMPROVE MENTAL WELL-BEING OF TEENS, ADULTS AND SENIORS IN DAKOTA COUNTY.REGINA CONTINUED SUPPORTING HASTINGS HIGH SCHOOL WITH ANNUAL CHARITABLE CONTRIBUTIONS TO ITS HASTINGS HIGH SCHOOL PEER HELPERS PROGRAM, CHANGE TO CHILL MATERIALS, CHANGE TO CHILL SCHOOL PARTNERSHIP AND SIMILAR OPPORTUNITIES. CHANGE TO CHILL TRAININGS AND TOOLS WERE ALSO OFFERED TO NUMEROUS COMMUNITY PARTNERS, INCLUDING PUBLIC SCHOOL SYSTEMS AND COUNTY PUBLIC HEALTH DEPARTMENTS. REGINA HOSPITAL CONTINUED ITS' PARTNERSHIP WITH DAKOTA COUNTY PUBLIC HEALTH RELATED TO THEIR WORK ON MENTAL HEALTH AND ELIMINATING STIGMA IN THE COMMUNITY. REGINA PROMOTED MENTAL HEALTH FIRST AID OFFERINGS AND MAKE IT OK CAMPAIGN TRAININGS AND WORKSHOPS IN THE COMMUNITY. IN EARLY 2019, IN PARTNERSHIP WITH REGINA'S GRACE UNIT CODE GREEN FACILITATOR AND/OR ALLINA SECURITY TEAM, PROVIDED DE-ESCALATION TRAINING TO HASTINGS FAMILY SERVICES. REGINA HOSPITAL ALSO CONTINUED TO PARTICIPATE IN AND MAKE CHARITABLE CONTRIBUTIONS TO THE EAST METRO MENTAL HEALTH CRISES ALLIANCE AND THE EAST METRO MENTAL HEALTH ROUNDTABLE.GOAL 2. DECREASE THE PERCENTAGE OF THE POPULATION WHO IS OVERWEIGHT OR OBESE.ONE PRIMARY OBJECTIVE UNDER THIS GOAL IS TO IMPROVE ACCESS TO HEALTHY FOOD THROUGH CHARITABLE CONTRIBUTIONS, EMPLOYEE VOLUNTEER OPPORTUNITIES AND INNOVATIVE COMMUNITY PARTNERSHIPS. IN 2019, THIS WORK WAS ADVANCED BY:- PROMOTING AND MANAGING COMMUNITY GARDENS ON REGINA HOSPITAL CAMPUS, INCLUDING DISTRIBUTION OF HEALTHY RECIPES AND OPPORTUNITIES TO EXCHANGE HEALTHY COOKING IDEAS.- CHARITABLE CONTRIBUTIONS TO PRESCOTT FOOD PANTRY.- PROMOTING VOLUNTEER OPPORTUNITIES IN SUPPORT OF LOCAL FOOD SHELVES AND COMMUNITY NUTRITION INITIATIVES, INCLUDING OPPORTUNITIES WITH MARKETCART WHO DISTRIBUTES FOOD TO AREA SENIOR-LIVING APARTMENTS.GOAL 3. BROADEN THE ARRAY OF PROGRAMS AND SERVICES AVAILABLE TO SUPPORT THE AGING CONTINUUM.THE OBJECTIVE FOR THIS GOAL IS TO IMPROVE AVAILABILITY AND COMMUNITY AWARENESS OF PROGRAMS AVAILABLE TO THE AGING POPULATION AND CARE PROVIDERS. ACTIVITIES IN 2019 INCLUDED:- PROVIDED CHARITABLE CONTRIBUTION IN SUPPORT OF ORGANIZATIONS SERVING AGING POPULATION.- CONTINUED PARTICIPATION IN THE HASTINGS TRANSPORTATION OPTION ADVISORY BOARD. - PARTNERED WITH HASTINGS COMMUNITY CENTER IN SUPPORT OF FURTHER DEVELOPING PROGRAMS FOR AGING INDIVIDUALS, NAMELY HONORING CHOICES.

GROUP A-FACILITY 7 -- REGINA HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 7 -- REGINA HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 8 -- OWATONNA HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:OWATONNA HOSPITAL & DISTRICT ONE HOSPITAL (JOINT): OWATONNA HOSPITAL AND DISTRICT ONE HOSPITAL CONDUCTED A JOINT CHNA IN COLLABORATION WITH TWO COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESSES: ONE CONDUCTED BY RICE COUNTY PUBLIC HEALTH AND THE OTHER CONDUCTED JOINTLY BY HEALTH DEPARTMENTS IN STEEL COUNTY AND DODGE COUNTY. BOTH GROUPS REVIEWED HOSPITAL, STATE AND LOCAL DATA. THE RICE COUNTY CHIP COMMITTEE MEMBERS ALSO REVIEWED RESPONSES FROM 639 PEOPLE ON A COMMUNITY HEALTH SURVEY CONDUCTED BY RICE COUNTY PUBLIC HEALTH. THE STEELE-DODGE CHIP COMMITTEE REVIEWED 27 RESPONSES TO AN ONLINE SURVEY OF KEY COMMUNITY PARTNERS' PERSPECTIVES ON PRIORITIES. OWATONNA AND DISTRICT ONE HOSPITALS' PRIORITIES WERE BASED ON THIS REVIEW. ADDITIONALLY, THE COMMITTEES HELD TWO CONVERSATIONS WITH MEMBERS OF FARIBAULT'S SOMALI AND LATINX COMMUNITIES AND CONDUCTED FOCUS GROUPS WITH THE STEELE AND DODGE COUNTIES' SHIP COMMUNITY LEADERSHIP TEAMS, MAYO CLINIC PRIMARY CARE PROVIDERS, OWATONNA HIGH SCHOOL STUDENTS AND RICE COUNTY SOCIAL SERVICE PROVIDERS. IN ADDITION, 80 RESIDENTS PARTICIPATED IN A COMMUNITY DIALOGUE.

GROUP A-FACILITY 8 -- OWATONNA HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 8 -- OWATONNA HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 8 -- OWATONNA HOSPITAL PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL: DUE TO THEIR GEOGRAPHIC PROXIMITY AND TO EFFICIENTLY DISTRIBUTE THEIR SHARED STAFF RESOURCES, DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL COLLABORATED ON THEIR 2019 CHNA ACTIVITIES.MENTAL HEALTH- OWATONNA GOAL 1: INCREASE KNOWLEDGE OF SYMPTOMS, TREATMENTS AND RESOURCES FOR MENTAL HEALTH AND ADDICTION CONDITIONS AND REDUCE SOCIAL STIGMA OF MENTAL HEALTH AND ADDICTION ISSUES.OWATONNA AND DISTRICT ONE HOSPITALS SUPPORTED YOUTH-LED MENTAL HEALTH ACTIVITIES THAT FOCUS ON BUILDING ASSETS, INCLUDING PARTICIPATING IN THE FARIBAULT YOUTH INVESTMENT (FYI) ADVISORY COUNCIL AND PROVIDING CHANGE TO CHILL SCHOOL PARTNERSHIP RESILIENCY PROGRAMMING, STAFF TRAINING AND FUNDING TO NORTHFIELD HIGH SCHOOL IN NORTHFIELD, MN. BOTH HOSPITALS ALSO CONTINUED TO ACTIVELY PARTICIPATE IN LOCAL MENTAL AND CHEMICAL HEALTH COALITIONS INCLUDING THE RICE COUNTY CHEMICAL AND MENTAL HEALTH COALITION ADVISORY COMMITTEE AND THE STEELE COUNTY SAFE AND DRUG FREE COMMUNITY BOARD. ADDITIONALLY, STAFF PARTNERED WITH STEELE COUNTY PUBLIC HEALTH, RICE COUNTY PUBLIC HEALTH AND RICE COUNTY CHEMICAL AND MENTAL HEALTH COALITION TO CREATE THE HEALTH AND HAPPINESS PROJECT. THIS PROJECT IS A FREE MENTAL WELLNESS AND RESILIENCY INITIATIVE THAT WILL PROVIDE A MULTICULTURAL TOOLKIT WITH WELL-BEING ACTIVITIES SUCH AS GRATITUDE, MINDFULNESS AND SELF-CARE. IN PARTNERSHIP WITH HYVEE PHARMACY, THE HOSPITALS SUPPORTED SEVERAL COMMUNITY PRESENTATIONS ON NARCAN USE AND OPIATE OVERDOSE PREVENTION AND PARTNERED WITH SEVERAL AREA NON-PROFITS, LOCAL PUBLIC HEALTH AND LAW ENFORCEMENT, IN THE DEVELOPMENT OF THE RICE COUNTY MOBILE OPIATE SUPPORT TEAM (MOST) PROGRAM.FINALLY, TO INCREASE ACCESS TO HEALTHCARE, HOSPITAL STAFF ADVOCATED FOR POLICIES AIMED AT INCREASING MENTAL HEALTH AND SUBSTANCE USE SERVICES AND ACCESS TO CARE, AND CONTINUED TO PROVIDE SIGNIFICANT CHARITABLE CONTRIBUTIONS, GRANTS AND IN-KIND SUPPORT TO SAFETY NET PROVIDERS (HEALTHFINDERS, CLINIC OF STEELE COUNTY AND CENTER CLINIC).GOAL 2 (SHARED): IMPROVE THE HEALTH, FUNCTION AND QUALITY OF LIFE FOR OLDER ADULTS AGES 50 AND OLDER.DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL CONTINUED THEIR COMPREHENSIVE ADVANCED CARE PLANNING INITIATIVE, HONORING CHOICES OF FARIBAULT AND OWATONNA. THIS INITIATIVE INCLUDES A FULL-TIME COORDINATOR AND ADVISORY COUNCIL OF 12 COMMUNITY LEADERS AND IS FOCUSED ON ENGAGING OLDER ADULTS IN COMPLETING THEIR HEALTH CARE DIRECTIVES. IN 2019, MORE THAN 20 VOLUNTEER FACILITATORS WERE TRAINED IN ADVANCED CARE PLANNING, INCLUDING BILINGUAL/MULTI-CULTURAL STAFF. MORE THAN 50 COMMUNITY OUTREACH EVENTS WERE OFFERED. THROUGH THE HONORING CHOICES INITIATIVE, MORE THAN 100 HEALTH CARE DIRECTIVES ARE COMPLETED ANNUALLY. THE HOSPITALS ALSO PROVIDED FINANCIAL SUPPORT TO HEALTHFINDERS AND GROWING UP HEALTHY WHO REGULARLY HOST COMMUNITY CONNECTIONS/LEARNING GROUPS WITH DIVERSE GROUPS, INCLUDING ELDERLY COMMUNITIES OF COLOR. FINALLY, THE HOSPITALS ARE ACTIVE PARTICIPANTS AND/OR LEADERS IN NORTHFIELD ELDER CARE ADVISORY, THE RECENTLY DEVELOPED COMMUNITY CARE COORDINATION ADVISORY COUNCIL (OWATONNA/STEELE COUNTY) AND THE HEALTH CARE SUMMIT (FARIBAULT/RICE COUNTY), BOTH OF WHICH WORK ON ADDRESSING HEALTHY AGING AND CHRONIC DISEASE MANAGEMENT, INCLUDING SUPPORTING THE GROWING AGING POPULATION AND ASSESSING/SUPPORTING CARE COORDINATION AND SOCIAL DETERMINANTS OF HEALTH TO ADDRESS ACCESS ISSUES, TRANSPORTATION AND LIMITED FINANCIAL RESOURCES.OWATONNA GOAL 3: INCREASE KNOWLEDGE OF AND ADHERENCE TO EVIDENCE-BASED COMMUNITY RESOURCES RELATED TO THE PREVENTION AND SELF-MANAGEMENT OF CHRONIC DISEASES; SUPPORT POLICY, SYSTEM AND ENVIRONMENTAL CHANGES AIMED AT THE PREVENTION OF CHRONIC DISEASES.HOSPITAL STAFF CONTINUE TO WORK TO PREVENT CHRONIC DISEASE BY ACTIVELY CONTRIBUTING TO AND PARTICIPATING IN COMMUNITY COALITIONS AND PARTNERSHIPS RELATED TO HEALTHY EATING AND ACTIVE LIVING SUCH AS THE STEELE COUNTY HEALTHY EATING WORKGROUP AND BOTH THE RICE COUNTY & STEELE COUNTY STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP COMMUNITY LEADERSHIP TEAMS AND WORKSITE WELLNESS COALITIONS. HOSPITAL STAFF WERE ALSO INVOLVED WITH AREA CHAMBERS OF COMMERCE AT VARIOUS LEVELS FROM ATTENDING PUBLIC EVENTS TO BOARD OF DIRECTORS MEMBERSHIP.THE HOSPITALS CONTINUED THEIR WORK AROUND FOOD INSECURITY INCLUDING: PROVIDING SUPPLEMENTAL SNACKS FOR PATIENTS, VISITORS AND COMMUNITY MEMBERS EXPERIENCING HUNGER; OFFERING $10,000 ANNUALLY IN ALLINA HEALTH BUCKS, WHICH MAKE HEALTHY, LOCALLY-GROWN FOODS MORE ACCESSIBLE AND AFFORDABLE; OFFERING DISCOUNT COUPONS FOR FOOD PROGRAMS SUCH AS FARE FOR ALL AND LOCAL CSAS TO COMMUNITY MEMBERS; CONDUCTING A HEALTHY FOODS DRIVE AND CHARITABLE GIVING TO LOCAL FOOD SHELVES. THE HOSPITALS ALSO WORKED TO IMPROVE INFANT HEALTH BY SUPPORTING LOCAL BREASTFEEDING-FRIENDLY POLICIES, NETWORKS AND PROGRAMS SUCH AS THE OWATONNA HOSPITAL BABY CAF, WHICH OPENED IN 2018.TO INCREASE ACCESS TO CARE AND REDUCE COMMUNITY HEALTH-RELATED SOCIAL NEEDS, FARIBAULT AND NORTHFIELD CLINICS PILOTED A TWO-WAY REFERRAL PROCESS IN 2019 WITH HEALTHFINDERS COLLABORATIVE, A LOCAL COMMUNITY-BASED ORGANIZATION. THIS WORK WAS FUNDED BY A 2018 GRANT FROM THE UCARE FOUNDATION OF MINNESOTA. CLINIC STAFF REFERRED HIGH-RISK ACCOUNTABLE HEALTH COMMUNITIES PATIENTS TO HEALTHFINDERS COLLABORATIVE, WHOSE CULTURALLY-CONNECTED COMMUNITY HEALTH WORKERS HELP PATIENTS NAVIGATE COMMUNITY SERVICES. FROM JUNE 1, 2019 THROUGH JANUARY 1, 2020, 58 PATIENTS WERE REFERRED TO HEALTHFINDERS COLLABORATIVE THROUGH THIS PROJECT.

GROUP A-FACILITY 8 -- OWATONNA HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 8 -- OWATONNA HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 9 -- DISTRICT ONE HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:OWATONNA HOSPITAL & DISTRICT ONE HOSPITAL (JOINT): OWATONNA HOSPITAL AND DISTRICT ONE HOSPITAL CONDUCTED A JOINT CHNA IN COLLABORATION WITH TWO COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PROCESSES: ONE CONDUCTED BY RICE COUNTY PUBLIC HEALTH AND THE OTHER CONDUCTED JOINTLY BY HEALTH DEPARTMENTS IN STEEL COUNTY AND DODGE COUNTY. BOTH GROUPS REVIEWED HOSPITAL, STATE AND LOCAL DATA. THE RICE COUNTY CHIP COMMITTEE MEMBERS ALSO REVIEWED RESPONSES FROM 639 PEOPLE ON A COMMUNITY HEALTH SURVEY CONDUCTED BY RICE COUNTY PUBLIC HEALTH. THE STEELE-DODGE CHIP COMMITTEE REVIEWED 27 RESPONSES TO AN ONLINE SURVEY OF KEY COMMUNITY PARTNERS' PERSPECTIVES ON PRIORITIES. OWATONNA AND DISTRICT ONE HOSPITALS' PRIORITIES WERE BASED ON THIS REVIEW. ADDITIONALLY, THE COMMITTEES HELD TWO CONVERSATIONS WITH MEMBERS OF FARIBAULT'S SOMALI AND LATINX COMMUNITIES AND CONDUCTED FOCUS GROUPS WITH THE STEELE AND DODGE COUNTIES' SHIP COMMUNITY LEADERSHIP TEAMS, MAYO CLINIC PRIMARY CARE PROVIDERS, OWATONNA HIGH SCHOOL STUDENTS AND RICE COUNTY SOCIAL SERVICE PROVIDERS. IN ADDITION, 80 RESIDENTS PARTICIPATED IN A COMMUNITY DIALOGUE.

GROUP A-FACILITY 9 -- DISTRICT ONE HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 9 -- DISTRICT ONE HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 9 -- DISTRICT ONE HOSPITAL PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL: DUE TO THEIR GEOGRAPHIC PROXIMITY AND TO EFFICIENTLY DISTRIBUTE THEIR SHARED STAFF RESOURCES, DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL COLLABORATED ON THEIR 2019 CHNA ACTIVITIES.MENTAL HEALTHDISTRICT ONE GOAL 1: IMPROVE ACCESS TO QUALITY, COMPREHENSIVE MENTAL HEALTH AND ADDICTION CARE AND SERVICES; REDUCE SOCIAL STIGMA OF MENTAL HEALTH AND ADDICTION.OWATONNA AND DISTRICT ONE HOSPITALS SUPPORTED YOUTH-LED MENTAL HEALTH ACTIVITIES THAT FOCUS ON BUILDING ASSETS, INCLUDING PARTICIPATING IN THE FARIBAULT YOUTH INVESTMENT (FYI) ADVISORY COUNCIL AND PROVIDING CHANGE TO CHILL SCHOOL PARTNERSHIP RESILIENCY PROGRAMMING, STAFF TRAINING AND FUNDING TO NORTHFIELD HIGH SCHOOL IN NORTHFIELD, MN. BOTH HOSPITALS ALSO CONTINUED TO ACTIVELY PARTICIPATE IN LOCAL MENTAL AND CHEMICAL HEALTH COALITIONS INCLUDING THE RICE COUNTY CHEMICAL AND MENTAL HEALTH COALITION ADVISORY COMMITTEE AND THE STEELE COUNTY SAFE AND DRUG FREE COMMUNITY BOARD. ADDITIONALLY, STAFF PARTNERED WITH STEELE COUNTY PUBLIC HEALTH, RICE COUNTY PUBLIC HEALTH AND RICE COUNTY CHEMICAL AND MENTAL HEALTH COALITION TO CREATE THE HEALTH AND HAPPINESS PROJECT. THIS PROJECT IS A FREE MENTAL WELLNESS AND RESILIENCY INITIATIVE THAT WILL PROVIDE A MULTICULTURAL TOOLKIT WITH WELL-BEING ACTIVITIES SUCH AS GRATITUDE, MINDFULNESS AND SELF-CARE. IN PARTNERSHIP WITH HYVEE PHARMACY, THE HOSPITALS SUPPORTED SEVERAL COMMUNITY PRESENTATIONS ON NARCAN USE AND OPIATE OVERDOSE PREVENTION AND PARTNERED WITH SEVERAL AREA NON-PROFITS, LOCAL PUBLIC HEALTH AND LAW ENFORCEMENT, IN THE DEVELOPMENT OF THE RICE COUNTY MOBILE OPIATE SUPPORT TEAM (MOST) PROGRAM.FINALLY, TO INCREASE ACCESS TO HEALTHCARE, HOSPITAL STAFF ADVOCATED FOR POLICIES AIMED AT INCREASING MENTAL HEALTH AND SUBSTANCE USE SERVICES AND ACCESS TO CARE, AND CONTINUED TO PROVIDE SIGNIFICANT CHARITABLE CONTRIBUTIONS, GRANTS AND IN-KIND SUPPORT TO SAFETY NET PROVIDERS (HEALTHFINDERS, CLINIC OF STEELE COUNTY AND CENTER CLINIC).GOAL 2 (SHARED): IMPROVE THE HEALTH, FUNCTION AND QUALITY OF LIFE FOR OLDER ADULTS AGES 50 AND OLDER.DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL CONTINUED THEIR COMPREHENSIVE ADVANCED CARE PLANNING INITIATIVE, HONORING CHOICES OF FARIBAULT AND OWATONNA. THIS INITIATIVE INCLUDES A FULL-TIME COORDINATOR AND ADVISORY COUNCIL OF 12 COMMUNITY LEADERS AND IS FOCUSED ON ENGAGING OLDER ADULTS IN COMPLETING THEIR HEALTH CARE DIRECTIVES. IN 2019, MORE THAN 20 VOLUNTEER FACILITATORS WERE TRAINED IN ADVANCED CARE PLANNING, INCLUDING BILINGUAL/MULTI-CULTURAL STAFF. MORE THAN 50 COMMUNITY OUTREACH EVENTS WERE OFFERED. THROUGH THE HONORING CHOICES INITIATIVE, MORE THAN 100 HEALTH CARE DIRECTIVES ARE COMPLETED ANNUALLY. THE HOSPITALS ALSO PROVIDED FINANCIAL SUPPORT TO HEALTHFINDERS AND GROWING UP HEALTHY WHO REGULARLY HOST COMMUNITY CONNECTIONS/LEARNING GROUPS WITH DIVERSE GROUPS, INCLUDING ELDERLY COMMUNITIES OF COLOR. FINALLY, THE HOSPITALS ARE ACTIVE PARTICIPANTS AND/OR LEADERS IN NORTHFIELD ELDER CARE ADVISORY, THE RECENTLY DEVELOPED COMMUNITY CARE COORDINATION ADVISORY COUNCIL (OWATONNA/STEELE COUNTY) AND THE HEALTH CARE SUMMIT (FARIBAULT/RICE COUNTY), BOTH OF WHICH WORK ON ADDRESSING HEALTHY AGING AND CHRONIC DISEASE MANAGEMENT, INCLUDING SUPPORTING THE GROWING AGING POPULATION AND ASSESSING/SUPPORTING CARE COORDINATION AND SOCIAL DETERMINANTS OF HEALTH TO ADDRESS ACCESS ISSUES, TRANSPORTATION AND LIMITED FINANCIAL RESOURCES.DISTRICT ONE GOAL 3: IMPROVE HEALTH CARE ACCESS AND POPULATION HEALTH BY LINKING CLINICAL CARE WITH COMMUNITY PREVENTION AND SUPPORTING POLICY, SYSTEM AND ENVIRONMENTAL CHANGES AIMED AT THE PREVENTION OF CHRONIC DISEASE.HOSPITAL STAFF CONTINUE TO WORK TO PREVENT CHRONIC DISEASE BY ACTIVELY CONTRIBUTING TO AND PARTICIPATING IN COMMUNITY COALITIONS AND PARTNERSHIPS RELATED TO HEALTHY EATING AND ACTIVE LIVING SUCH AS THE STEELE COUNTY HEALTHY EATING WORKGROUP AND BOTH THE RICE COUNTY & STEELE COUNTY STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP COMMUNITY LEADERSHIP TEAMS AND WORKSITE WELLNESS COALITIONS. HOSPITAL STAFF WERE ALSO INVOLVED WITH AREA CHAMBERS OF COMMERCE AT VARIOUS LEVELS FROM ATTENDING PUBLIC EVENTS TO BOARD OF DIRECTORS MEMBERSHIP.THE HOSPITALS CONTINUED THEIR WORK AROUND FOOD INSECURITY INCLUDING: PROVIDING SUPPLEMENTAL SNACKS FOR PATIENTS, VISITORS AND COMMUNITY MEMBERS EXPERIENCING HUNGER; OFFERING $10,000 ANNUALLY IN ALLINA HEALTH BUCKS, WHICH MAKE HEALTHY, LOCALLY-GROWN FOODS MORE ACCESSIBLE AND AFFORDABLE; OFFERING DISCOUNT COUPONS FOR FOOD PROGRAMS SUCH AS FARE FOR ALL AND LOCAL CSAS TO COMMUNITY MEMBERS; CONDUCTING A HEALTHY FOODS DRIVE AND CHARITABLE GIVING TO LOCAL FOOD SHELVES. THE HOSPITALS ALSO WORKED TO IMPROVE INFANT HEALTH BY SUPPORTING LOCAL BREASTFEEDING-FRIENDLY POLICIES, NETWORKS AND PROGRAMS SUCH AS THE OWATONNA HOSPITAL BABY CAF, WHICH OPENED IN 2018.TO INCREASE ACCESS TO CARE AND REDUCE COMMUNITY HEALTH-RELATED SOCIAL NEEDS, FARIBAULT AND NORTHFIELD CLINICS PILOTED A TWO-WAY REFERRAL PROCESS IN 2019 WITH HEALTHFINDERS COLLABORATIVE, A LOCAL COMMUNITY-BASED ORGANIZATION. THIS WORK WAS FUNDED BY A 2018 GRANT FROM THE UCARE FOUNDATION OF MINNESOTA. CLINIC STAFF REFERRED HIGH-RISK ACCOUNTABLE HEALTH COMMUNITIES PATIENTS TO HEALTHFINDERS COLLABORATIVE, WHOSE CULTURALLY-CONNECTED COMMUNITY HEALTH WORKERS HELP PATIENTS NAVIGATE COMMUNITY SERVICES. FROM JUNE 1, 2019 THROUGH JANUARY 1, 2020, 58 PATIENTS WERE REFERRED TO HEALTHFINDERS COLLABORATIVE THROUGH THIS PROJECT.

GROUP A-FACILITY 9 -- DISTRICT ONE HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 9 -- DISTRICT ONE HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 10 -- RIVER FALLS AREA HOSPITAL PART V, SECTION B, LINE 5:
IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:RIVER FALLS AREA HOSPITAL: RIVER FALLS AREA HOSPITAL IMPLEMENTED A JOINT CHNA AS PART OF HEALTHIER TOGETHER PIERCE & ST. CROIX COUNTIES (HEALTHIER TOGETHER) A COMMUNITY COALITION THAT INCLUDES STAFF FROM RIVER FALLS AREA HOSPITAL, HUDSON HOSPITAL & CLINIC, WESTERN WISCONSIN HEALTH, WESTFIELDS HOSPITAL & CLINIC, PIERCE COUNTY PUBLIC HEALTH, ST. CROIX COUNTY PUBLIC HEALTH AND THE UNITED WAY OF ST. CROIX VALLEY. HEALTHIER TOGETHER ENGAGED 39 ORGANIZATIONS TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND 1,072 RESIDENT RESPONSES TO A COMPREHENSIVE ONLINE/PAPER SURVEY. BASED ON THIS REVIEW, THE COALITION DEFINED ITS 2020-2022 PRIORITIES. ADDITIONALLY, TO UNDERSTAND RESIDENTS' PERSPECTIVES, HEALTHIER TOGETHER CONDUCTED SEVEN FOCUS GROUPS WITH 61 RESIDENTS INCLUDING FARMERS, SENIORS, YOUTH, PEOPLE IN MENTAL HEALTH OR SUBSTANCE USE RECOVERY, PROVIDERS AND PEOPLE WHO WORK WITH YOUTH.

GROUP A-FACILITY 10 -- RIVER FALLS AREA HOSPITAL PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 10 -- RIVER FALLS AREA HOSPITAL PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 10 -- RIVER FALLS AREA HOSPITAL PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:RIVER FALLS AREA HOSPITAL (HEALTHIER TOGETHER):GOAL 1: REDUCE ALCOHOL ABUSE OF RESIDENTS OF PIERCE AND ST. CROIX COUNTIES.TO DECREASE ADULT ALCOHOL ABUSE THROUGH CHANGES TO POLICY, SYSTEMS, ENVIRONMENT AND COMMUNITY SUPPORT, 2019 WORK FOCUSED ON THE COMMUNITY OF RIVER FALLS. THE POLICE CHIEF IS VERY SUPPORTIVE OF POLICY AND ENVIRONMENTAL STRATEGIES TO HELP REDUCE ALCOHOL USE AND ABUSE. HUDSON, BALDWIN, AND NEW RICHMOND ARE PLANNING TO INITIATE THIS WORK (AND LEARN FROM RIVER FALLS) IN 2020 AND BEYOND.GOAL 2. IMPROVE MENTAL HEALTH STATUS OF RESIDENTS OF PIERCE AND ST. CROIX COUNTIES.THIRTY INDIVIDUALS COMPLETED THE MENTAL HEALTH FIRST AID TRAIN THE TRAINER CERTIFICATION. THE INSTRUCTORS HAVE HAD A HUGE SUCCESS IN ADMINISTERING 73 MENTAL HEALTH FIRST AIDE TRAININGS THROUGHOUT PIERCE AND ST CROIX COUNTY, TRAINING 462 ADULTS. SUBSTANCE IMPAIRMENT TRAINING FOR SCHOOL DISTRICT STAFF AND COMMUNITY OFFERED BY HUDSON POLICE DEPARTMENT. ADDITIONALLY, HUDSON HIGH SCHOOL AND ELLSWORTH WERE CHOSEN AS A CHANGE TO CHILL PARTNERS FOR THE 2019-2020 SCHOOL YEAR. THIS PARTNERSHIP INCLUDES ACTIVITIES FOR STUDENTS AROUND MENTAL HEALTH, HOW TO REDUCE AND COPE WITH STRESS, ACCEPTANCE OF OTHERS. PARENT COMMUNICATIONS, PRESENCE AT SCHOOL EVENTS (COLLEGE NIGHT/OPEN HOUSE) AND STAFF TRAININGS. SCHOOL ADMINISTRATORS, COUNTY LEADERS AND HEALTHIER TOGETHER LEADERSHIP CONDUCTED A MENTAL HEALTH COLLABORATION SESSION TO BETTER UNDERSTAND THE NEEDS OF SCHOOL AND CHALLENGES, NEXT STEPS ARE BEING REVIEWED.GOAL 3. DECREASE THE PERCENTAGE OF THE POPULATION THAT'S OVERWEIGHT OR OBESE IN PIERCE AND ST. CROIX COUNTIESMUCH OF THIS WORK FOCUSED ON INCREASING ACCESS TO HEALTHY FOODS IN THE COMMUNITY. FARE FOR ALL CONTINUED IN RIVER FALLS PROVIDING OVER 105 FAMILIES WITH FRESH FRUITS, VEGETABLES AND MEAT. CSA SHARES DISTRIBUTED 2.5 TONS OF FOOD EVERY OTHER WEEK TO LOCAL FOOD PANTRIES. UTILIZING THE CSA PRODUCE AND FOOD READILY AVAILABLE AT THE PANTRY, IN CONJUNCTION WITH THE UW EXTENSION OFFICE MEAL KITS WITH RECIPES WERE CREATED. UW EXTENSION AND HT ARE WORKING ON EDUCATIONAL TRAINING AND TOOLS FOR STAFF AND VOLUNTEERS AT FOOD PANTRIES. THROUGH AN ALLINA HEALTH GRANT TO ALIGN WITH THE SAFE AND HEALTHY FOOD PANTRIES PROJECT THE SPRING VALLEY FOOD PANTRY WAS AWARDED A GRANT TO REDESIGN THEIR PANTRY. ADDITIONALLY, TO INCREASE PHYSICAL ACTIVITY, CORE 4+ POWER POINT WAS CREATED AND DISTRIBUTED TO SCHOOLS AND ADDED TO HEALTHIER TOGETHER WEBPAGE ALONG WITH OTHER SERVICES AVAILABLE SUCH AS WELLNESS POLICY ASSISTANCE. WALK TO SCHOOL DAY WAS A HUGE SUCCESS WITH OVER 1,700 STUDENTS PARTICIPATING. FINALLY, THE PIERCE AND ST CROIX COUNTY FOOD RESOURCE DIRECTORIES WERE UPDATED TO REFLECT ANY CHANGES IN RESOURCES. HEALTHIER TOGETHER FACEBOOK PAGE TO SHARE INFORMATION ABOUT THE THREE HEALTH PRIORITIES, INCLUDING LOCAL EVENTS AND RESOURCES. 2-1-1 PROVIDES LOCAL RESOURCE INFORMATION.

GROUP A-FACILITY 10 -- RIVER FALLS AREA HOSPITAL PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 10 -- RIVER FALLS AREA HOSPITAL PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

GROUP A-FACILITY 11 -- PHILLIPS EYE INSTITUTE PART V, SECTION B, LINE 5:
PHILLIPS EYE INSTITUTE LEGALLY MERGED INTO ABBOTT NORTHWESTERN HOSPITAL ON 10/1/2019.IN 2019, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. DETAILS ON EACH HOSPITAL'S APPROACH ARE AS FOLLOWS:ABBOTT NORTHWESTERN HOSPITAL (INCLUDES PHILLIPS EYE INSTITUTE): ABBOTT NORTHWESTERN HOSPITAL DEVELOPED ITS CHNA WITH THE MINNEAPOLIS, HENNEPIN COUNTY AND BLOOMINGTON PUBLIC HEALTH DEPARTMENTS, WHICH WERE SIMULTANEOUSLY DEVELOPING A COMMUNITY HEALTH IMPROVEMENT PLAN FOR HENNEPIN COUNTY. THESE ENTITIES AND 50 NONPROFIT AND GOVERNMENT REPRESENTATIVES REVIEWED HOSPITAL, STATE AND LOCAL DATA AND CONDUCTED 23 KEY INFORMANT INTERVIEWS WITH INDIVIDUALS REPRESENTING VARIOUS CULTURAL GROUPS, BUSINESS AND ORGANIZATIONS. ABBOTT NORTHWESTERN IDENTIFIED ITS 2020-2022 PRIORITIES BASED ON THIS REVIEW. STAFF THEN CONDUCTED 10 KEY INFORMANT INTERVIEWS WITH STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS SUCH AS AN ADVOCACY ORGANIZATION SERVING LOCAL BUSINESSES, A FEDERALLY-QUALIFIED HEALTH CENTER, A HOUSING PROVIDER FOR PEOPLE LIVING WITH HIV/AIDS AND THE LOCAL PARKS SYSTEM, AMONG OTHERS, TO UPDATE ITS UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON THESE HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM. IN ADDITION, A LOCAL PUBLIC AFFAIRS CONSULTANT INTERVIEWED 25 HEALTH AND CIVIC LEADERS TO EXPLORE THEIR PERCEPTIONS OF HEALTH, HEALTHCARE, PUBLIC HEALTH AND THE HOSPITAL.

GROUP A-FACILITY 11 -- PHILLIPS EYE INSTITUTE PART V, SECTION B, LINE 6A:
THE 11 ALLINA HEALTH HOSPITALS - ABBOTT NORTHWESTERN HOSPITAL, UNITED HOSPITAL, MERCY HOSPITAL (INCLUDING UNITY CAMPUS), CAMBRIDGE MEDICAL CENTER, BUFFALO HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, REGINA HOSPITAL, DISTRICT ONE HOSPITAL, RIVER FALLS AREA HOSPITAL AND PHILLIPS EYE INSTITUTE USE A COORDINATED APPROACH AND CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT ON A GEOGRAPHIC REGIONAL COMMUNITY BASIS. EACH REGIONAL CHNA CONTAINED ONLY ONE ALLINA HOSPITAL FACILITY WITH THE FOLLOWING EXCEPTIONS:- ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY.- DISTRICT ONE HOSPITAL AND OWATONNA HOSPITAL WERE INCLUDED IN THE SAME REGIONAL CHNA DUE TO THEIR CLOSE GEOGRAPHIC PROXIMITY. - BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A JOINT, COLLABORATIVE EFFORT WITH OTHER ORGANIZATIONS, INCLUDING OTHER HOSPITAL FACILITIES.

GROUP A-FACILITY 11 -- PHILLIPS EYE INSTITUTE PART V, SECTION B, LINE 6B:
IN MOST CASES, THE HOSPITAL CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. CAMBRIDGE MEDICAL CENTER, MERCY HOSPITAL, NEW ULM MEDICAL CENTER, OWATONNA HOSPITAL, AND DISTRICT ONE HOSPITAL CONDUCTED JOINT ASSESSMENTS IN PARTNERSHIP WITH LOCAL PUBLIC HEALTH. ABBOTT NORTHWESTERN HOSPITAL, PHILLIPS EYE INSTITUTE, UNITED HOSPITAL AND REGINA HOSPITAL ALSO DEVELOPED THEIR ASSESSMENT AS PART OF COLLABORATIONS WITH PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES:MINNESOTA:ANOKA, BROWN, CARVER, DAKOTA, HENNEPIN, ISANTI, RAMSEY, STEELE, SCOTT, WASHINGTON, AND WRIGHT COUNTY PUBLIC HEALTH DEPARTMENTS. WISCONSIN:PIERCE COUNTY PUBLIC HEALTH DEPARTMENT.BUFFALO HOSPITAL AND RIVER FALLS AREA HOSPITAL CONDUCTED THEIR CHNA AS A FORMAL COLLABORATIVE EFFORT - WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE AND HEALTHIER TOGETHER PIERCE AND ST. CROIX COUNTIES, RESPECTIVELY.

GROUP A-FACILITY 11 -- PHILLIPS EYE INSTITUTE PART V, SECTION B, LINE 11:
BEYOND SYSTEM-WIDE ACTIVITIES, EACH HOSPITAL IS ADDRESSING THE COLLECTIVE NEEDS IDENTIFIED ACROSS THE SYSTEM AS WELL AS ANY ADDITIONAL NEEDS DOCUMENTED FOR THIS PRIMARY SERVICE AREA, SUCH AS:PHILLIPS EYE INSTITUTE (PEI)GOAL 1: INCREASE CHILDHOOD READINESS FOR SCHOOL.PEI PROVIDES THE EARLY YOUTH EYE CARE (E.Y.E.) VISION SCREENING PROGRAM FOR ALL CHILDREN IN THE MINNEAPOLIS AND ST. PAUL PUBLIC SCHOOLS. THE GOAL IS TO ENSURE THAT ALL CHILDREN IN GRADES K, 2, 4, 6 AND 8TH RECEIVE A SCHOOL-BASED VISION SCREENING. LAST YEAR, 25,375 ELEMENTARY-AGED CHILDREN RECEIVED A VISION SCREENING THROUGH THIS PROGRAM, 779 OF THESE CHILDREN RECEIVED A PAIR OF GLASSES AND 392 WERE REFERRED FOR FURTHER VISION ASSESSMENT AND TREATMENT. THESE CHILDREN ARE TREATED THROUGH THE KIRBY PUCKETT EYE MOBILE, WHERE THEY RECEIVED EYE EXAMS, GLASSES, FOLLOW-UP CARE AND SURGERY (IF NEEDED) AT NO COST TO THE CHILD OR THEIR FAMILY. GOAL 2. INCREASE ACCESS TO HEALTHCARE SERVICES.PEI PROVIDES FREE TRANSPORTATION FOR PHILLIPS EYE INSTITUTE PATIENTS TO ACCESS THEIR VISION CARE SERVICES. ABOUT 2,600 PATIENTS RECEIVED FREE TRANSPORTATION IN 2019. PROVIDING TRANSPORTATION AS A WAY TO INCREASE ACCESS TO HEALTHCARE SERVICES HAS BECOME A CORE COMPONENT OF PEI'S WORK AS 25% OF THEIR PATIENTS REQUIRE THIS SERVICE, MOST OF WHOM ARE ELDERLY AND LOW-INCOME.

GROUP A-FACILITY 11 -- PHILLIPS EYE INSTITUTE PART V, SECTION B, LINE 13B:
SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H, PART VI FOR EXPLANATION OF CRITERIA.

GROUP A-FACILITY 11 -- PHILLIPS EYE INSTITUTE PART V, SECTION B, LINE 24:
NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT.

PART V, SECTION B, LINE 7 A
HOSPITAL FACILITY WEBSITE URL -HTTPS://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/NEED-ASSESSMENTS/2017-2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-PLANS/

PART V, SECTION B, LINE 11
"THE FOLLOWING ARE SYSTEM WIDE INITIATIVES THAT APPLY TO ELEVEN ALLINA HEALTH HOSPITALS. PLEASE REFER TO PART V SECTION B LINE 11 EXPLANATION FOR EACH HOSPITAL FACILITY FOR ADDITIONAL NEEDS ADDRESSED AT THE HOSPITAL LEVEL. ACROSS THE ALLINA HEALTH SYSTEM, TWO PRIMARY NEEDS, IDENTIFIED VIA THE 2016 CHNA, WERE ADDRESSED IN 2017-2019: HEALTHY WEIGHT (NUTRITION AND PHYSICAL ACTIVITY) AND MENTAL HEALTH/WELLNESS. AT THE END OF 2019, ALLINA HEALTH COMPLETED A NEW COMMUNITY HEALTH NEEDS ASSESSMENT. THE 2019 ASSESSMENT IDENTIFIED HEALTHY EATING/ACTIVING LIVING, MENTAL HEALTH AND SUBSTANCE USE AND SOCIAL DETERMINANTS OF HEALTH AS PRIORITY NEEDS FOR 2020-2022 ACROSS ALL ALLINA HEALTH GEOGRAPHIES. EXAMPLES OF SYSTEM-WIDE INITIATIVES IN THESE AREAS INCLUDE: CHANGE TO CHILL (CTC) IS A FREE, ONLINE RESOURCE THAT PROVIDES STRESS REDUCTION TIPS, LIFE BALANCE TECHNIQUES AND HEALTH EDUCATION SERVICES FOR TEENS. IN ADDITION TO THE EXISTING RESOURCES, CHANGE TO CHILL ADDED A MENTAL HEALTH AND VAPING SECTION TO THE WEBSITE IN 2019 IN RESPONSE TO THE RISING VAPING EPIDEMIC. FROM MINNESOTA ALONE, MORE THAN 30,000 USERS VISITED THE CHANGE TO CHILL WEBSITE IN 2019. SOME OF THE USERS ARE TEACHERS WHO USE IT IN THEIR CLASSROOMS, TEENS WHO USE IT IN SOCIAL GROUPS AND PARENTS LOOKING FOR WAYS TO HELP THEIR CHILD STRESS LESS. ALSO IN 2019, CTC CONTINUED ITS CHANGE TO CHILL SCHOOL PARTNERSHIP (CTCSP) THAT WAS LAUNCHED IN 2018. THE GOAL OF CTCSP IS TO PROMOTE AND SUPPORT A CULTURE OF MENTAL WELL-BEING IN LOCAL HIGH SCHOOLS. DURING THE 2019-2020 SCHOOL YEAR, ALLINA HEALTH PARTNERED WITH SIXTEEN HIGH SCHOOLS THROUGH CTCSP. COMPONENTS OF CTCSP INCLUDE STAFF TRAINING ON CTC, CTC MESSAGING FOR PARENTS, A PAID STUDENT INTERNSHIP AND FUNDING FOR A ""CHILL ZONE"" - A DESIGNATED SPACE FOR STUDENTS AND STAFF TO PRACTICE SELF-CARE. MORE THAN 1,100 HEALTH AND EDUCATION PROFESSIONALS WERE TRAINED ON HOW TO USE THE CHANGE TO CHILL RESOURCES AND CURRICULUMS AS PART OF CTCSP. THIRTY-FOUR CHILL CHAMPION INTERNS LED STRESS REDUCTION ACTIVITIES WITHIN THEIR SCHOOL PARTNERSHIP SCHOOL. INITIAL EVALUATIONS OF CTCSP HAVE SHOWN INCREASES IN CONFIDENCE IN ABILITY TO COPE WITH STRESS AMONG STUDENTS WHO PARTICIPATE IN PROGRAM COMPONENTS.BE THE CHANGE - ALLINA HEALTH HAS BEEN A LEADER IN ELIMINATING STIGMA AROUND MENTAL HEALTH AND ADDICTION CONDITIONS WITHIN THE HEALTHCARE INDUSTRY. BE THE CHANGE, IS AN EFFORT TO ELIMINATE STIGMA AROUND MENTAL HEALTH AND ADDICTION CONDITIONS AT ALLINA HEALTH AND ENSURE ALL PATIENTS RECEIVE THE SAME CONSISTENT, EXCEPTIONAL CARE. AT THE CAMPAIGN'S LAUNCH, 500 ALLINA HEALTH EMPLOYEES VOLUNTEERED TO LEAD THE EFFORT AS TRAINED BE THE CHANGE CHAMPIONS AND HELP EDUCATE AND GENERATE AWARENESS AMONG THEIR COLLEAGUES ABOUT MENTAL HEALTH AND ADDICTION CONDITIONS. IN 2019, BE THE CHANGE CONTINUED TO SUPPORTED ANTI-STIGMA WORK IN THE COMMUNITY BY SPONSORING AND PROMOTING THE NAMI WALK AND WALK FOR RECOVERY. ADDITIONALLY, CHAMPIONS RECEIVED ANTI-STIGMA EDUCATION AND MATERIALS TO SHARE WITH THEIR COLLEAGUES THROUGH QUARTERLY COMMUNICATIONS, WITH ADDITIONAL RESOURCES SHARED IN MAY FOR MENTAL HEALTH AWARENESS MONTH AND IN SEPTEMBER FOR RECOVERY MONTH. THROUGH PRESENTATIONS AND EDUCATION EVENTS, BE THE CHANGE CHAMPIONS HAVE REACHED MORE THAN 18,140 EMPLOYEES SINCE THE INITIATIVE'S LAUNCH, OR APPROXIMATELY TWO-THIRDS OF EMPLOYEES. THE EFFORT IS ONGOING AND THE CAMPAIGN'S GOAL IS TO REACH ALL ALLINA HEALTH EMPLOYEES. AN INITIAL AND FOLLOW-UP EMPLOYEE SURVEY IN 2017 REVEALED THAT THE CAMPAIGN IMPROVED EMPLOYEE'S PERCEPTION OF ALLINA HEALTH'S SUPPORT OF PEOPLE WITH MENTAL HEALTH OR ADDICTION CONDITIONS, COMFORT WORKING WITH OR INTERACTING WITH PEOPLE WITH MENTAL HEALTH OR ADDICTION CONDITIONS, AND KNOWLEDGE OF MENTAL HEALTH RESOURCES.NEIGHBORHOOD HEALTH CONNECTION (NHC) IS A COMMUNITY GRANTS PROGRAM THAT AIMS TO IMPROVE THE HEALTH OF COMMUNITIES BY BUILDING SOCIAL CONNECTIONS THROUGH HEALTHY EATING AND PHYSICAL ACTIVITY. EACH YEAR, ALLINA HEALTH AWARDS OVER 50 NEIGHBORHOOD HEALTH CONNECTION GRANTS, RANGING IN SIZE FROM $500-$10,000, TO LOCAL NONPROFITS AND GOVERNMENT AGENCIES IN MINNESOTA AND WESTERN WISCONSIN. IN 2019, NEIGHBORHOOD HEALTH CONNECTION GAVE $270,000 TO 68 ORGANIZATIONS. THESE ORGANIZATIONS REACHED MORE THAN 3,600 PEOPLE. EVALUATIONS OF THE NHC PROGRAM FIND THAT THE MAJORITY OF PEOPLE WHO PARTICIPATE IN NHC-FUNDED PROGRAMS INCREASE THEIR SOCIAL CONNECTIONS AND MAKE POSITIVE CHANGES IN THEIR PHYSICAL ACTIVITY AND HEALTHY EATING BEHAVIOR. FURTHER, FOLLOW-UP DATA HAS REVEALED THAT THESE POSITIVE CHANGES ARE MAINTAINED SIX MONTHS LATER AND THE MAJORITY OF PARTICIPANTS CONTINUE TO PARTICIPATE IN THE NHC ACTIVITY AFTER THE GRANT PERIOD ENDS.HEALTH POWERED KIDS (HPK), LAUNCHED IN 2012, IS A FREE COMMUNITY EDUCATION PROGRAM DESIGNED TO EMPOWER CHILDREN AGES 3 TO 14 YEARS TO MAKE HEALTHIER CHOICES ABOUT EATING, EXERCISE, KEEPING CLEAN AND MANAGING STRESS. IN 2019, MORE THAN 70,000 USERS VISITED THE HPK WEBSITE.CHARITABLE CONTRIBUTIONS- CHARITABLE CONTRIBUTIONS MADE BY ALLINA HEALTH INCLUDE A FOCUS ON HEALTH PRIORITIES IDENTIFIED IN THE NEEDS ASSESSMENT PROCESS AND ON SUPPORTING SAFETY NET PROVIDERS IN THE COMMUNITY TO IMPROVE ACCESS TO CARE. IN 2019 ALLINA HEALTH SYSTEM OFFICE MADE THE FOLLOWING CONTRIBUTIONS BY FOCUS AREA: $86,000 (37%) FOR ACTIVE LIVING, $35,250 (15%) FOR HEALTHY EATING, $51,000 (22%) FOR IMPROVING ACCESS TO HEALTH CARE SERVICES, $18,000 (8%) FOR MENTAL HEALTH AND WELLNESS, $35,100 (15%) FOR OTHER HEALTH-RELATED PURPOSES AND $6,500 (3%) FOR NON-HEALTH RELATED PURPOSES. EXAMPLES OF SPECIFIC CONTRIBUTIONS ARE DESCRIBED BELOW.TO SUPPORT ACTIVE LIVING, ALLINA HEALTH GAVE $75,000 TO FREE BIKES 4 KIDZ. THIS CONTRIBUTION WAS PART OF NINE-YEAR PARTNERSHIP BETWEEN ALLINA HEALTH AND FREE BIKES 4 KIDZ. IN ADDITION TO THE CONTRIBUTION, ALLINA HEALTH PARTNERS WITH FREE BIKES 4 KIDZ EACH YEAR TO COLLECT AND DISTRIBUTE BICYCLES TO CHILDREN WHOSE FAMILIES COULD NOT OTHERWISE AFFORD ONE. FOR THE FOCUS AREA HEALTHY EATING, ALLINA HEALTH GAVE THE FOOD GROUP A CONTRIBUTION OF $10,000. THE FOOD GROUP FIGHTS HUNGER AND INCREASES ACCESS TO HEALTHY FOOD THROUGH A VARIETY OF PROGRAMS. A $10,000 CONTRIBUTION WAS ALSO PROVIDED TO METRO MEALS ON WHEELS TO PROVIDE FOOD AND SOCIAL CONNECTIONS TO OLDER ADULTS AT RISK FOR HUNGER AND ISOLATION. TO IMPROVE MENTAL WELLNESS, ALLINA HEALTH SPONSORED THE CENTER FOR VICTIMS OF TORTURE RESTORING HOPE BREAKFAST AT THE $3,000 LEVEL. THE CENTER FOR VICTIMS OF TORTURE IS AN INTERNATIONAL NONPROFIT DEDICATED TO HEALING SURVIVORS OF TORTURE AND VIOLENT CONFLICT THROUGH DIRECT CARE FOR THOSE WHO HAVE BEEN TORTURED, TRAINING PARTNERS WHO CAN PREVENT AND TREAT TORTURE AND ADVOCATING FOR HUMAN RIGHTS. TO IMPROVE ACCESS TO HEALTH CARE SERVICES, ALLINA HEALTH SPONSORED THE CARONDELET GALA AT THE $30,000 LEVEL, WHICH RAISED FUNDS FOR ST. MARY'S HEALTH CLINICS (SMHC). SMHC SERVES LOW-INCOME, UNINSURED INDIVIDUALS, FAMILIES AND CHILDREN, BY PROVIDING FREE CULTURALLY AND LINGUISTICALLY APPROPRIATE HEALTH CARE SERVICES. FOR OTHER HEALTH-RELATED PURPOSES ALLINA HEALTH SUPPORTED THE METROPOLITAN CONSORTIUM OF COMMUNITY DEVELOPERS (MCCD) WITH A CONTRIBUTION OF $10,000. MCCD IS AN ASSOCIATION OF 47 NONPROFIT COMMUNITY DEVELOPMENT ORGANIZATIONS ENGAGED IN AFFORDABLE HOUSING, COMMERCIAL CORRIDOR REVITALIZATION AND SMALL BUSINESS DEVELOPMENT IN THE TWIN CITIES METRO AREA. ALLINA HEALTH SPONSORED THE GENESYS WORKS TWIN CITIES CIO LUNCHEON AT $5,000 AND THE UNITED NEGRO COLLEGE FUND MARTIN LUTHER KING JR. HOLIDAY BREAKFAST AT $1,000 FOR NON-HEALTH RELATED PURPOSES.THROUGH THE AHC MODEL, CARE TEAMS IN 79 ALLINA HEALTH SITES SCREEN PATIENTS WITH MEDICARE AND/OR MEDICAID INSURANCE FOR FIVE HEALTH-RELATED SOCIAL NEEDS: HOUSING INSTABILITY (E.G. HOMELESSNESS, LOW HOUSING QUALITY), FOOD INSECURITY (E.G. LACK OF ACCESS TO FOOD), ACCESS TO TRANSPORTATION (E.G. LACK OF RELIABLE TRANSPORT OPTIONS), DIFFICULTY PAYING FOR HEAT, ELECTRICITY OR OTHER UTILITIES, AND CONCERNS ABOUT INTERPERSONAL SAFETY (E.G. INTIMATE PARTNER VIOLENCE, CHILD ABUSE, ELDER ABUSE). IF A PATIENT IDENTIFIES A NEED, THE CARE TEAM PROVIDES A LIST OF COMMUNITY RESOURCES TAILORED TO THE PATIENT'S UNIQUE NEEDS. IN ADDITION, SOME HIGH-RISK PATIENTS RECEIVE CARE TEAM ASSISTANCE NAVIGATING TO COMMUNITY RESOURCES.IN 2019, NEARLY 180,000 SCREENINGS FOR SOCIAL NEEDS WERE OFFERED TO PATIENTS; MORE THAN 76,000 ALLINA HEALTH PATIENTS COMPLETED AN AHC SCREENING. TWENTY-FOUR PERCENT OF PATIENTS SCREENED IDENTIFIED AT LEAST ONE NEED, WITH THE MOST FREQUENTLY IDENTIFIED NEED BEING FOOD ACCESS FOLLOWED BY HOUSING INSTABILITY. ADDITIONALLY, MORE THAN 580 PATIENTS IDENTIFYING NEEDS RECEIVED SUPPORT FROM A NAVIGATOR IN CONNECTING TO COMMUNITY RESOURCES."

PART I, LINE 3C:
"CHARITY CARE PROGRAM- ALLINA PARTNERS CARE PROGRAM A KEY COMPONENT OF ALLINA'S MISSION IS TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ADVOCATE FOR THOSE WITH LIMITED FINANCIAL MEANS. ALLINA STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING MEDICAL CARE. THEREFORE, ALLINA HAS SEVERAL FINANCIAL ASSISTANCE PROGRAMS INCLUDING A ROBUST CHARITY CARE PROGRAM KNOWN AS THE ALLINA PARTNERS CARE PROGRAM WHICH PROVIDES FREE CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTRAR.THE CHARITY CARE PROGRAM ALSO PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE ""MEDICALLY INDIGENT"". THE ORGANIZATION EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES THE ORGANIZATION HAS DETERMINED THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM (DESCRIBED BELOW) UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM GUIDELINES. DISCOUNTED CARE PROGRAM - UNINSURED DISCOUNT PROGRAM ALLINA ALSO HAS A FINANCIAL ASSISTANCE PROGRAM KNOWN AS THE UNINSURED DISCOUNT PROGRAM THAT PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED FROM ANY ALLINA HOSPITAL, HOSPITAL BASED CLINIC AND WHOLLY-OWNED AMBULATORY SURGERY CENTERS. THE UNINSURED DISCOUNT PROGRAM DOES NOT USE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. INSTEAD, UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL AND THE LOCATION OF THE SERVICES PROVIDED. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. THERE ARE THREE DISCOUNTS LEVELS ESTABLISHED, ONE FOR METRO HOSPITALS, ONE FOR REGIONAL HOSPITALS, AND ONE FOR HOSPITAL BASED CLINICS WITHIN THE ALLINA SYSTEM.ALLINA HEALTH'S UNINSURED DISCOUNT PROGRAM PROVIDES A SUBSTANTIAL DISCOUNT TO BILLED CHARGES FOR UNINSURED PATIENTS. THE DISCOUNT IS UPDATED ANNUALLY AND IS BASED ON THE REIMBURSEMENT RATE OF THE NON-GOVERNMENTAL THIRD PARTY PAYER WHICH PROVIDED ALLINA HEALTH THE MOST REVENUE DURING THE PREVIOUS YEAR."

PART I, LINE 6A:
ALLINA'S ANNUAL COMMUNITY BENEFIT REPORT URL -HTTP://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/

PART I, LINE 7:
"WHERE APPROPRIATE, THE ORGANIZATION USES A RATIO OF PATIENT CARE COSTS TO CHARGES (""COST TO CHARGE RATIO"") TO CALCULATE THE AMOUNTS REPORTED FOR PART I, LINE 7 (THE TABLE)."

PART I, LINE 7G:
THE AMOUNT REPORTED AS SUBSIDIZED HEALTH SERVICES DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.

PART I, LN 7 COL(F):
BAD DEBT EXPENSE HAS NOT BEEN INCLUDED IN FORM 990, PART IX, LINE 25 AND HAS NOT BEEN USED FOR THE PURPOSE OF CALCULATING THE AMOUNTS REPORTED IN COLUMN 7F. IT HAS BEEN REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON FORM 990, PART VIII, LINE 2B.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY-BUILDING ACTIVITIESUNDERSTANDING THAT GOOD HEALTH IS DEPENDENT ON SOCIETAL, COMMUNITY, AND FAMILY ENVIRONMENTS AS WELL AS INDIVIDUAL CHOICES, AND IS BIGGER THAN THE PROVISION OF HEALTH CARE, ALLINA ENGAGES IN COMMUNITY-BUILDING ACTIVITIES. BELOW ARE EXAMPLES OF WAYS THAT OUR HOSPITALS PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES IN 2019:WORKFORCE DEVELOPMENTMANY OF ALLINA HEALTH HOSPITALS HAVE TRAIN-TO-WORK PROGRAMS AS A MEANS TO BUILD A FUTURE WORKFORCE WITHIN AND OUTSIDE OF OUR ORGANIZATION. BY FOCUSING ON BUILDING THE WORKFORCE, THE GOAL IS THAT THERE WILL BE AN INCREASE IN PERSONAL EMPLOYMENT AND ECONOMIC AND WORKFORCE STABILITY. MULTIPLE ALLINA HEALTH HOSPITALS HAVE DEVELOPED PARTNERSHIPS WITH LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS IN THE PROCESS. SEVERAL HOSPITALS AND THE CORPORATE OFFICE HOST CAREER DAYS FOR HIGH SCHOOL STUDENTS. RIVER FALLS AREA HOSPITAL ALSO HAS SIGNIFICANT INVESTMENTS IN TRAIN TO WORK PROGRAMS, IN PARTICULAR THROUGH AN INTERNATIONAL PROGRAM CALLED PROJECT SEARCH. THIS PROGRAM PROVIDES EMPLOYMENT AND EDUCATION OPPORTUNITIES FOR INDIVIDUALS WITH SIGNIFICANT DISABILITIES. STUDENTS SPEND NINE MONTHS GAINING REAL-LIFE, TRANSFERRABLE SKILLS AT THE HOSPITAL.COMMUNITY COALITIONSALL ALLINA HEALTH HOSPITALS PARTICIPATE ON LOCAL COMMUNITY COALITIONS AND CIVIC GROUPS, SUCH AS COMMUNITY HEALTH ADVISORY COUNCILS AND LOCAL CHAMBERS OF COMMERCE, AS A WAY TO RESPOND TO COMMUNITY NEEDS THROUGH COLLABORATION AND PARTNERSHIP. THESE COALITIONS PROVIDE THE HOSPITALS THE OPPORTUNITIES TO BUILD RELATIONSHIPS AND DETERMINE HOW BEST TO LEVERAGE LOCAL RESOURCES TO ADDRESS COMMUNITY NEEDS THAT EXIST OUTSIDE THE TRADITIONAL REALM OF HEALTH CARE. ALLINA HEALTH HOSPITALS ARE PRESENT AT THOSE DISCUSSIONS TO DETERMINE THE ROLE HEALTH CARE CAN PLAY. ONE EXAMPLE OF THIS IS THE STATEWIDE HEALTH IMPROVEMENT PLAN (SHIP), WHICH HAS LOCAL COALITIONS THROUGHOUT THE STATE VIA LOCAL PUBLIC HEALTH AGENCIES TO WORK ON NUTRITION, PHYSICAL ACTIVITY AND TOBACCO USE. IN ADDITION, MANY OF OUR LEADERS SERVE ON LOCAL COMMUNITY ORGANIZATION LEADERSHIP TEAMS, SUCH AS VOLUNTEER BOARDS, TO ADVANCE COMMUNITY WORK.DISASTER PREPAREDNESSIN ADDITION TO COMMUNITY-BUILDING ACTIVITIES THAT RELATED TO ROOT CAUSES OF HEALTH, ALLINA HEALTH HOSPITALS ENGAGED IN AND LED DISASTER PREPAREDNESS PLANNING TO ENSURE SAFETY, EFFICIENCY AND EXCELLENT HEALTH CARE DURING TIMES OF TRAGEDY AND/OR UPSET. THIS INCLUDED PLANNING MEETINGS AND COMMUNITY MEETINGS/TRAININGS, AMONG OTHER THINGS.THESE PROGRAMS AND SERVICES, AMONG OTHERS, PROVIDE THE HOSPITALS WITHIN OUR SYSTEM THE OPPORTUNITY TO IMPACT COMMUNITY HEALTH BEFORE IT BECOMES PROBLEMATIC AND EXPENSIVE. IN ADDITION, THIS IMPORTANT WORK IS SUPPORTED BY THE MISSION OF OUR ORGANIZATION AND IS OUR RESPONSIBILITY AS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION. WE WILL CONTINUE TO CONTRIBUTE TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH THE PROMOTION OF COMMUNITY HEALTH.

PART III, LINE 4:
FOOTNOTES TO AUDITED FINANCIAL STATEMENT THAT DESCRIBE BAD DEBT EXPENSE:SEE ATTACHED AUDIT, FOOTNOTE 2(T) ON PAGE 12

PART VI, LINE 7, REPORTS FILED WITH STATES
MN,WI

PART III, LINE 2:
"SCH H, PART III, SECTION A, LINES 2 & 3THE ORGANIZATION HAS ADOPTED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION [HFMA] STATEMENT NO. 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE, IMPLICIT PRICE CONCESSIONS AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS (STATEMENT 15). THE BAD DEBT AMOUNT STATED FOR FINANCIAL REPORTING PURPOSES IS REPORTED ""NET"" OF ANY ANTICIPATED PATIENT DISCOUNTS OR IMPLICIT PRICE CONCESSIONS TO WHICH THE PATIENT MAY BE ELIGIBLE INCLUDING, BUT NOT LIMITED TO, THE UNINSURED DISCOUNT PROGRAM (DISCUSSED ABOVE) AND REFLECTS THE ESTIMATED AMOUNT REPORTED AS ""NET PATIENT SERVICE REVENUE"" DURING THE CURRENT PERIOD OR ANY PREVIOUS PERIOD. THIS DOES NOT NECESSARILY EQUAL THE ""COST"" TO PROVIDE THE MEDICAL SERVICES. ALSO, NOTE THAT AMOUNTS RELATED TO PATIENTS WHO HAVE QUALIFIED UNDER THE CHARITY CARE PROGRAM ARE NOT INCLUDED IN EITHER NET PATIENT REVENUE OR IN BAD DEBT EXPENSE. IN OTHER WORDS, THE BAD DEBT EXPENSE REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE IN THE REVENUE SECTION OF THE FINANCIAL STATEMENTS OF THE FORM 990 DOES NOT INCLUDE AMOUNTS RELATED TO QUALIFIED CHARITY CARE PATIENTS AND IS STATED AT THE ""NET"" EXPECTED OR ANTICIPATED COLLECTION AMOUNT WHICH MAY BE SIGNIFICANTLY DIFFERENT THAN PATIENT CHARGES DUE TO THE APPLICATION OF DISCOUNTS SUCH AS THOSE PROVIDED UNDER THE UNINSURED DISCOUNT PROGRAM. THIS AMOUNT ALSO CONSTITUTES A DIFFERENT AMOUNT THAN THE ORGANIZATION'S ACTUAL COST TO PROVIDE THE MEDICAL SERVICES. TO ARRIVE AT THE FORM 990, SCHEDULE H, PART III, LINE 2 BAD DEBT ""AT COST"", THE ORGANIZATION HAS APPLIED A RATIO OF PATIENT CARE COST TO CHARGES (COST TO CHARGE RATIO) TO THE ESTIMATED PATIENT CHARGE AMOUNT INCLUDED IN BAD DEBT AFTER REMOVING THE ANTICIPATED DISCOUNTS. THE COST TO CHARGE RATIO IS CALCULATED INDEPENDENTLY FOR EACH HOSPITAL OR OPERATING UNIT. THE RESULTING BAD DEBT (AT COST) AMOUNT FOR EACH HOSPITAL AND OPERATING UNIT IS THEN AGGREGATED TO ARRIVE AT THE BAD DEBT (AT COST) REPORTED ON LINE 2. THIS PROCESS PROVIDES A VERY CONSERVATIVE ESTIMATE OF THE ORGANIZATION'S BAD DEBT (AT COST). THE ORGANIZATION HAS A ROBUST PROCESS FOR ADMINISTERING THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS INCLUDING THE CHARITY CARE AND UNINSURED DISCOUNT PROGRAM DESCRIBED IN FURTHER DETAIL IN PART VI, LINE 3. EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO APPLY TO THE COMMUNITY CARE PROGRAM AND TO PARTICIPATE, IF QUALIFIED, TO RECEIVE FREE OR DISCOUNTED MEDICAL CARE OR BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM UNDER THE ORGANIZATIONS VARIOUS FINANCIAL ASSISTANCE PROGRAMS. THE ADMINISTRATIVE PROCESS INCLUDES IDENTIFYING ANY PATIENT WITH A FINANCIAL CONCERN, AS WELL AS INFORMING, COUNSELING, QUALIFYING AND ASSISTING PATIENTS TO APPLY FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. ALTHOUGH EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO RECEIVE FINANCIAL ASSISTANCE AND INFORMED MULTIPLE TIMES OF THE CHARITY CARE PROGRAM PRIOR TO OUR CLASSIFYING THE AMOUNTS AS BAD DEBT, IT IS POSSIBLE THAT PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE DO NOT COMPLETE THE APPLICATION. THIS AMOUNT IS NOT REASONABLY ESTIMABLE. AS A TAX-EXEMPT HOSPITAL ORGANIZATION WE ARE REQUIRED TO PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. DUE TO CIRCUMSTANCES BEYOND OUR CONTROL, A PERSON WHO WOULD OTHERWISE QUALIFY UNDER THE CHARITY CARE PROGRAM MAY NOT PROVIDE US THE NECESSARY INFORMATION, QUALIFY FOR THE PROGRAM, AND RECEIVE FREE CARE ALLOWING US TO CLASSIFY AND QUANTIFY IT ACCORDINGLY AND AS SUCH. ULTIMATELY, THOSE AMOUNTS ARE WRITTEN-OFF AND REPORTED AS BAD DEBT EXPENSE. ANY METHODOLOGY WE COULD USE TO QUANTIFY AND PROVIDE AN ESTIMATE OF HOW MUCH BAD DEBT (AT COST AND IF ANY) REPORTED ON LINE 2 REASONABLY COULD BE ATTRIBUTABLE TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY AND FOR US TO PROVIDE AN ESTIMATE OF WHAT PORTION OF BAD DEBT, IF ANY, THE ORGANIZATION BELIEVES SHOULD CONSTITUTE COMMUNITY BENEFIT WOULD BE PURELY SPECULATIVE, IMPRECISE AND SUBJECT TO INHERENT METHODOLOGY FLAWS. WHILE WE FIRMLY BELIEVE, FOR THE REASONS STATED ABOVE, THAT SOME COMPONENT OF OUR REPORTED BAD DEBT EXPENSE (AT COST) ON LINE 2 CONSTITUTES AMOUNTS RELATED TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE PROGRAM, WE CANNOT REASONABLY QUANTIFY THE AMOUNT AND RESPECTFULLY DECLINE THE OPPORTUNITY TO PROVIDE AN AMOUNT. THEREFORE, WE HAVE REPORTED ZERO OR NONE FOR FORM 990, SCHEDULE H, PART III, LINE 3."

PART III, LINE 9B:
THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY AND COLLECTION PRACTICES APPLY UNIFORMLY TO ALL PATIENTS AND INCLUDE PROVISIONS RELATED TO THE ORGANIZATIONS CHARITY CARE PROGRAM AND OTHER FINANCIAL ASSISTANCE PROGRAMS. IF A PATIENT IS KNOWN TO QUALIFY FOR A FINANCIAL ASSISTANCE PROGRAM THEY ARE AUTOMATICALLY AFFORDED THE PROGRAM BENEFITS FOR UP TO ONE YEAR AS THEY WOULD HAVE ALREADY PROVIDED INFORMATION NECESSARY FOR US TO MAKE SUCH A DETERMINATION. FOR EXAMPLE, A PATIENT THAT QUALIFIED FOR THE ORGANIZATION'S CHARITY CARE PROGRAM BEFORE RECEIVING SERVICES WOULD NOT RECEIVE A BILLING STATEMENT FOR THE MEDICAL SERVICES PROVIDED. IN THE CASE OF A PATIENT QUALIFYING FOR THE CHARITY CARE PROGRAM AFTER RECEIVING SERVICES AND THE COMMENCEMENT OF CERTAIN COLLECTION ACTIVITIES, THE AMOUNTS ARE DISCHARGED AS CHARITY CARE AND ALL COLLECTION ACTIVITIES CEASE. AS DISCUSSED IN THE RESPONSE TO PART VI, LINE 3, PATIENTS ARE INFORMED AND EDUCATED ON THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS INCLUDING THE ORGANIZATION'S CHARITY CARE PROGRAM AS PART OF THE ROUTINE REGISTRATION, ADMISSION, INTAKE, BILLING AND COLLECTION PROCESSES. IF A PATIENT DESIRES TO APPLY FOR THE CHARITY CARE PROGRAM, PERSONNEL WILL SEND AN APPLICATION TO THE PATIENT. IF COLLECTION ACTIVITIES HAVE COMMENCED, THOSE ACTIVITIES WILL BE SUSPENDED FOR THIRTY (30) DAYS TO ALLOW TIME FOR THE APPLICATION PROCESS. COLLECTION ACTIVITY MAY RESUME IF, AFTER 30 DAYS, A COMPLETED APPLICATION HAS NOT BEEN RECEIVED. IN THE CASE OF AN INCOMPLETE APPLICATION, THE ORGANIZATION MAY RESUME COLLECTION ACTIVITIES IF REQUESTS FOR ADDITIONAL INFORMATION ARE NOT MET WITH A TIMELY RESPONSE. IF AN APPLICANT DOES NOT MEET THE ELIGIBILITY CRITERIA AND THE APPLICATION IS DENIED, COLLECTION ACTIVITY MAY RESUME UPON DENIAL. HOWEVER, THE PATIENT MAY STILL BE ELIGIBLE FOR OTHER FINANCIAL ASSISTANCE PROGRAMS WHICH ARE APPLIED AS WARRANTED BASED UPON THE INFORMATION PROVIDED. SUCH ACTIVITIES ARE FULLY EXPLAINED TO THE PATIENT DURING THE COLLECTION PROCESS.

PART III, LINE 8:
"THE ORGANIZATION HAS MORE THAN ONE MEDICARE PROVIDER NUMBER AND THEREFORE AGGREGATED THE AMOUNTS REPORTED IN THE MEDICARE COST REPORTS AS THE SOURCE FOR THE AMOUNTS REPORTED ON PART III, LINES 5 & 6 AS OUTLINED IN THE FORM 990, SCHEDULE H INSTRUCTIONS. FOR MEDICARE COST REPORTS, ALLINA USES A RATIO OF PATIENT CARE COSTS TO CHARGES (COST TO CHARGE RATIO) TO DETERMINE MEDICARE ALLOWABLE COSTS. GENERALLY, THE RATIO IS CALCULATED AS THE TOTAL MEDICARE ALLOWABLE PATIENT COSTS OVER THE TOTAL PATIENT CHARGES. MEDICARE CHARGES MULTIPLIED BY THIS RATIO EQUALS THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORTS. THE COST TO CHARGE RATIO IS CALCULATED INDEPENDENTLY FOR EACH MEDICARE COST REPORT/PROVIDER NUMBER. ALLINA BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. ALLINA'S PROVIDING OF THESE SERVICES CLEARLY LESSENS THE BURDENS OF GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINE 7, OUR MEDICARE ""ALLOWABLE COSTS"" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. THE TRUE COMMUNITY BENEFIT FOR OUR PARTICIPATION IN THE CURRENT MEDICARE PROGRAM IS DEPENDENT ON HOW EFFICIENTLY AND COST EFFECTIVELY THE FEDERAL GOVERNMENT COULD OPERATE A DIRECT MEDICAL CARE MEDICARE PROGRAM OR ALTERNATIVELY THE COST TO THE GOVERNMENT TO CONTRACT OUT SUCH SERVICES THROUGH A COMPETITIVE BIDDING PROCESS IN THE OPEN MARKETS FOR THE SAME OR SIMILAR SERVICES FACTORING IN ITEMS SUCH AS QUALITY OF CARE, OUTCOMES AND SIMILAR IMPORTANT FACTORS AS COMPARED TO ALLINA'S ACTUAL COSTS OF PROVIDING THE MEDICAL CARE. THE MEDICARE SHORTFALL CALCULATION ON THE FORM 990, SCHEDULE H, PART III, LINE 7 SIGNIFICANTLY UNDERSTATES ALLINA'S ACTUAL MEDICARE SHORTFALL FOR TWO REASONS. FIRST, ALLINA INCURS SIGNIFICANT COSTS IN EXCESS OF PAYMENTS UNDER THE MEDICARE PROGRAM FOR PROVIDING CERTAIN SERVICES THAT ARE NOT SUBJECT TO MEDICARE COST REPORTING AND THEREFORE NOT REFLECTED IN OUR COST AMOUNTS ON LINE 6. SECOND, THE LINE 6 LIMITS OUR REPORTED COSTS TO ONLY MEDICARE ""ALLOWABLE COSTS"" AS SOLELY DETERMINED BY THE FEDERAL GOVERNMENT MEDICARE PROGRAM. FOR THESE TWO REASONS, THE MEDICARE SHORTFALL REPORTED ON LINE 7 SIGNIFICANTLY UNDERSTATES ALLINA'S ACTUAL MEDICARE SHORTFALL AND THE ACTUAL COST OF PROVIDING MEDICAL CARE TO MEDICARE PROGRAM PARTICIPANTS. WE ESTIMATE THESE TWO ITEMS UNDERSTATE ALLINA'S REPORTED MEDICARE SHORTFALL BY OVER $242 MILLION. WE BELIEVE A DIRECT MEDICAL SERVICE MEDICARE PROGRAM OPERATED BY THE FEDERAL GOVERNMENT AND THE COST TO THE GOVERNMENT TO CONTRACT OUT THE SERVICES UNDER A COMPETITIVE BIDDING PROCESS MAY EVEN PROVE TO BE MORE EXPENSIVE TO THE FEDERAL GOVERNMENT THAN ALLINA'S REPORTED MEDICARE ""ALLOWABLE COSTS"" ON LINE 6 GIVEN OUR QUALITY OF CARE, SUCCESSFUL OUTCOMES AND THE SIGNIFICANT DIFFERENCE BETWEEN ACTUAL COSTS WE INCUR AND MEDICARE ""ALLOWABLE COSTS"" IN PROVIDING CARE UNDER THE MEDICARE PROGRAM. THEREFORE, WE FIRMLY BELIEVE THAT THERE IS A TRUE COMMUNITY BENEFIT COMPONENT TO OUR PARTICIPATION IN THE FEDERAL MEDICARE PROGRAM."

PART VI, LINE 2:
IN 2019, ALLINA HEALTH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH OF THE HOSPITALS IN THE SYSTEM. THE PURPOSE WAS TO IDENTIFY LOCAL PRIORITIES FOR EACH HOSPITAL AS WELL AS OVER-ARCHING THEMES FOR THE HEALTH SYSTEM TO ADDRESS FOR FY 2020-2022. TO RESPOND TO LOCAL NEEDS AND RESOURCES, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. THE HOSPITALS WORKED CLOSELY WITH LOCAL PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PEIRCE COUNTY. SOME ALSO COLLABORATED WITH OTHER HEALTH SYSTEMS AND COMMUNITY ORGANIZATIONS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. THE CHNA PROCESS OCCURRED IN THREE STEPS: DATA REVIEW AND PRIORITIZATION, COMMUNITY INPUT AND THE DEVELOPMENT OF A THREE-YEAR IMPLEMENTATION PLAN. MOST HOSPITALS USED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH. THE OFFICIAL CHNA PROCESS BEGAN IN JUNE 2018 AND WAS COMPLETED IN AUGUST 2019. EACH HOSPITAL'S CHNA TEAM REVIEWED COUNTY-SPECIFIC DATA RELATED TO DEMOGRAPHICS, SOCIAL AND ECONOMIC FACTORS, HEALTH BEHAVIORS, PREVALENCE OF HEALTH CONDITIONS AND HEALTH CARE ACCESS. SOURCES VARIED, BUT INCLUDED THE MINNESOTA STUDENT SURVEY, HEALTH SURVEYS CONDUCTED BY LOCAL PUBLIC HEALTH DEPARTMENTS, LOCAL RESEARCH STUDIES ON TOPICS SUCH AS HOUSING AND SECONDARY PUBLIC HEALTH DATA AVAILABLE THROUGH THE MINNESOTA DEPARTMENT OF HEALTH. ADDITIONALLY, TEAMS REVIEWED SELECT COUNTY-SPECIFIC ALLINA HEALTH PATIENT DATA. MANY HOSPITALS ALSO COLLECTED FEEDBACK ON PERCEIVED COMMUNITY HEALTH NEEDS FROM LOCAL STAKEHOLDERS THROUGH COMMUNITY DIALOGUES, INTERVIEWS AND SURVEYS. BASED ON THE DATA REVIEW AND COMMUNITY FEEDBACK, LOCAL CHNA TEAMS CHOSE CHNA PRIORITIES FOR THE 2020-2022 CYCLE. SPECIFIC PRIORITIZATION CRITERIA WAS DETERMINED LOCALLY, BUT SIZE AND SERIOUSNESS OF THE PROBLEM, IMPORTANCE TO THE COMMUNITY AND ORGANIZATIONAL CAPACITY TO ADDRESS THE NEED WERE ALL CONSIDERED. HOSPITAL PRIORITIES INCLUDE:- MENTAL HEALTH AND WELLNESS, INCLUDING SUBSTANCE USE- OBESITY, PHYSICAL ACTIVITY AND NUTRITION- ACCESS TO CARE- SOCIAL DETERMINANTS OF HEALTH- SOCIAL ISOLATION- VIOLENCE- DENTAL CARE- AGING SERVICES TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. FOCUSED OUTREACH OCCURRED TO HISTORICALLY UNDERSERVED COMMUNITIES WHO EXPERIENCE HEALTH DISPARITIES. IN FEBRUARY AND APRIL 2019, COMMUNITY ENGAGEMENT LEADERS FROM EACH OF ALLINA HEALTH'S HOSPITALS DISCUSSED THE RESULTS OF EACH HOSPITAL'S DATA REVIEW, PRIORITIZATION AND COMMUNITY INPUT PROCESSES. PRIORITIES AND COMMON THEMES FOR ACTION WERE IDENTIFIED ACROSS ALL GEOGRAPHIES. TOGETHER, THEY IDENTIFIED MENTAL HEALTH (INCLUDING SUBSTANCE USE) AND OBESITY CAUSED BY PHYSICAL INACTIVITY AND POOR NUTRITION AS PRIORITY NEEDS IN ALL ALLINA HEALTH GEOGRAPHIES. THEY ALSO IDENTIFIED SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY ACCESS TO HEALTHY FOOD AND STABLE HOUSING, AS KEY FACTORS CONTRIBUTING TO HEALTH. ALL ALLINA HEALTH ASSESSMENTS AND ACTION PLANS WERE APPROVED BY LOCAL FACILITIES AND THE ALLINA HEALTH BOARD OF DIRECTORS BY DECEMBER 2019. COPIES OF EACH FACILITY'S NEEDS ASSESSMENT REPORT AND ACTION PLAN CAN BE FOUND AT: HTTPS://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/NEED-ASSESSMENTS/2020-2022-NEEDS-ASSESSMENTS-AND-IMPLEMENTATION-PLANSONCE IMPLEMENTATION PLANS ARE CREATED, MORE DETAILED PLANNING CONTINUES WITH STAKEHOLDER TO DEVELOP AND DELIVER SPECIFIC PROGRAMS, SERVICES AND ACTIVITIES EITHER LOCALLY OR SYSTEM-WIDE.

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"A KEY COMPONENT OF ALLINA'S MISSION IS TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ADVOCATE FOR THOSE WITH LIMITED FINANCIAL MEANS. ALLINA STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING MEDICAL CARE. PROVIDING CONVENIENT ACCESS TO NECESSARY MEDICAL CARE REGARDLESS OF ONE'S ABILITY TO PAY FOR THOSE SERVICES IS IMPORTANT TO US. ALLINA HAS ESTABLISHED THE FOLLOWING FINANCIAL ASSISTANCE PROGRAMS:- ALLINA PARTNERS CARE PROGRAM (CHARITY CARE)- UNINSURED DISCOUNT PROGRAM- SPECIAL CIRCUMSTANCES- MEDELIGIBLE SERVICES- MEDCREDIT FINANCIAL SERVICES- PAYMENT PLANSOUR CARE GOES BEYOND MEDICAL CARE ASSISTANCE. WE ALSO HELP PEOPLE GET FOOD STAMPS, WIC (WOMEN, INFANTS AND CHILDREN, A FEDERAL PROGRAM THAT SUPPLIES NUTRITIOUS FOODS) OR HEATING ASSISTANCE - ALL OF WHICH ARE VITALLY IMPORTANT TO A PATIENT'S RECOVERY, HEALTH AND WELL-BEING. YOU MAY VISIT WWW.ALLINAHEALTH.ORG AND CLICK ON THE FINANCIAL ASSISTANCE LINK.CHARITY CARE PROGRAM - ALLINA PARTNERS CARE PROGRAM THE ALLINA PARTNERS CARE PROGRAM PROVIDES FREE MEDICALLY NECESSARY CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTRAR. THE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE OR MINNESOTA CARE AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY LEVEL. THE APPLICATION IS BRIEF AND ASKS FOR INFORMATION ON FAMILY SIZE, EMPLOYMENT, INCOME, BANKING AND INSURANCE. IF PATIENTS MEET THE PROGRAM ELIGIBILITY GUIDELINES, THEIR TOTAL ALLINA BALANCE WILL BE ZERO. THEY WILL RECEIVE FREE MEDICAL CARE. AN ELIGIBLE INDIVIDUAL WILL BE COVERED BY THE PROGRAM FOR UP TO ONE YEAR BARRING ANY SIGNIFICANT CHANGE IN INCOME. PATIENTS MAY BE ASKED TO APPLY FOR MEDICAL ASSISTANCE AND MINNESOTA CARE AND BE FOUND INELIGIBLE FOR THOSE PROGRAMS BEFORE THEY QUALIFY FOR THE ALLINA PARTNERS CARE. UNINSURED DISCOUNT PROGRAM - THE UNINSURED DISCOUNT PROGRAM PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED FROM ANY ALLINA HOSPITAL, HOSPITAL BASED CLINIC AND WHOLLY-OWNED AMBULATORY SURGERY CENTER. UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL AND THE LOCATION OF THE SERVICES PROVIDED. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. THERE ARE THREE DISCOUNTS LEVELS ESTABLISHED, ONE FOR METRO HOSPITALS , ONE FOR REGIONAL HOSPITALS, AND ONE FOR HOSPITAL BASED CLINICS WITHIN THE ALLINA SYSTEM. SPECIAL CIRCUMSTANCES ASSISTANCE (ON INDIVIDUAL CASE BY CASE BASIS) - THE ORGANIZATION PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE ""MEDICALLY INDIGENT"". THE ORGANIZATION EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES THE ORGANIZATION HAS DETERMINED THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM GUIDELINES. FINANCIAL ASSISTANCE SERVICES WILL PROVIDE AN EVALUATION OF PATIENTS WITH SPECIAL CIRCUMSTANCES. THERE MAY BE A CIRCUMSTANCE WHERE PATIENTS EXPERIENCE A CATASTROPHIC EVENT THAT PUTS THEM IN A DEVASTATING FINANCIAL POSITION WHEREBY THE PROGRAM REPRESENTATIVES WILL DETERMINE HOW TO BEST SUPPORT THEM FINANCIALLY.MEDELIGIBLE SERVICES - MEDELIGIBLE SERVICES PROVIDES ADVOCACY SUPPORT TO PATIENTS WHO HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS. THEY CAN ASSIST PATIENTS WITH APPLYING FOR FEDERAL, STATE AND COUNTY BENEFIT PROGRAMS. THE MEDELIGIBLE SERVICES PERSONNEL ARE ADVOCATES WHO EDUCATE PATIENTS AND FAMILIES ABOUT THE ADVANTAGE OF PROGRAMS AND ASSIST THEM WITH GETTING HELP. PERSONNEL CAN PROVIDE ASSISTANCE WITH MEDICAID AND MEDICARE, SOCIAL SECURITY, VETERAN'S ADMINISTRATION, FOOD STAMPS, EMERGENCY FOOD, AND SHELTER. MEDCREDIT FINANCIAL SERVICES - MEDCREDIT FINANCIAL SERVICES PROVIDES FINANCIAL LOANS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR MEDICAL BILLS. THE PATIENT CAN CONSOLIDATE ALL MEDICAL EXPENSES FROM PARTICIPATING PROVIDERS SUCH THAT THE PATIENT HAS ONLY ONE MONTHLY PAYMENT. THERE IS NO CREDIT APPLICATION REQUIRED AND NO ANNUAL FEES OR DUES. THE ANNUAL PERCENTAGE INTEREST RATE IS 8 PERCENT. ONCE A PATIENT HAS ESTABLISHED A MEDCREDIT ACCOUNT, AMOUNTS CAN BE ADDED ON ANY ADDITIONAL MEDICAL EXPENSES FOR THEMSELVES AND THEIR FAMILY. PAYMENT PLANS - IF A PATIENT INDICATES THEY ARE UNABLE OR UNWILLING TO PAY THE BALANCE IN FULL, ALLINA OFFERS A PAYMENT PLAN WHICH CANNOT EXCEED TWELVE MONTHS AND CANNOT BE LESS THAN THIRTY DOLLARS PER MONTH. IF THE PATIENT IS UNABLE TO MEET THESE PARAMETERS, MEDCREDIT IS OFFERED TO THEM. THE FINANCIAL ASSISTANCE SERVICES INFORMATION AND EDUCATION METHODS - ALLINA HAS ROBUST METHODS TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAMS INCLUDING ITS CHARITY CARE PROGRAM AND ALSO ABOUT GOVERNMENT PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE TO RECEIVE BENEFITS. EACH PATIENT BILLING STATEMENT CONTAINS INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION. THE ALLINA WEBSITE HOMEPAGE AT WWW.ALLINAHEALTH.ORG PROMINENTLY CONTAINS A LINK TO THE FINANCIAL ASSISTANCE SERVICES PAGE WHICH DESCRIBES THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION.THE ORGANIZATION POSTS SUMMARIES OF ITS FINANCIAL ASSISTANCE PROGRAMS IN BROCHURES IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATIONS FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE BROCHURES CONTAIN SUMMARIES OF THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDE CONTACT INFORMATION FOR THE PROGRAMS. THIS INFORMATION IS ALSO AVAILABLE IN SOMALI AND SPANISH. REGISTRATION, ADMISSIONS AND INTAKE PERSONNEL ARE TRAINED TO PROVIDE FINANCIAL ASSISTANCE PROGRAM INFORMATION TO ANYONE EXPRESSING A CONCERN ABOUT THEIR ABILITY TO PAY FOR SERVICES. ALL ""SELF-PAY"" PATIENTS (THE PATIENT IS NOT COVERED BY INSURANCE OR A GOVERNMENT PROGRAM) THAT COMES TO ONE OF THE ORGANIZATION'S EMERGENCY ROOMS RECEIVES A PACKET OF INFORMATION CONTAINING EVERYTHING NECESSARY TO APPLY FOR THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAMS AND CERTAIN GOVERNMENT PROGRAMS. THERE IS CONTACT INFORMATION AND TELEPHONE NUMBERS THEY CAN CALL WITH ANY QUESTIONS OR TO RECEIVE ASSISTANCE IN COMPLETING APPLICATIONS. FINANCIAL ASSISTANCE PROGRAM PERSONNEL ALSO MEET DIRECTLY WITH ANY SELF-PAY PATIENT ADMITTED TO THE HOSPITAL. PERSONNEL WILL MEET WITH PATIENTS WHEREVER IT IS MOST CONVENIENT FOR THE PATIENT SUCH AS THE HOSPITAL, A CLINIC, THE ORGANIZATION'S OFFICES OR THE PATIENT'S HOME.ALLINA HAS A SYSTEM WIDE INTERPRETER SERVICES TEAM THAT PROVIDES INTERPRETERS TO PATIENTS, COMPANIONS AND FAMILIES WHO HAVE LIMITED ENGLISH PROFICIENCY (LEP) OR ARE DEAF OR HARD OF HEARING (DHH). THIS SERVICE IS PROVIDED AT NO COST TO THE PATIENT. LEP AND DHH PERSONNEL ARE TRAINED TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAMS. ALL PERSONNEL RESPONSIBLE FOR THE ORGANIZATIONS COLLECTION ACTIVITIES ARE EXTENSIVELY TRAINED ON THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS. ANY TIME A PATIENT EXPRESSES A CONCERN REGARDING THEIR ABILITY TO PAY FOR SERVICES, THE PERSONNEL EXPLAIN THE FINANCIAL ASSISTANCE PROGRAMS, ASK CERTAIN QUESTIONS TO OBTAIN INFORMATION AND TO DETERMINE WHICH FINANCIAL ASSISTANCE PROGRAMS THE PATIENT MAY QUALIFY AND BEST FITS THE PATIENTS' NEEDS."

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ALLINA HEALTH SYSTEM (ALLINA HEALTH) IS A NOT-FOR-PROFIT SYSTEM OF CLINICS, HOSPITALS AND OTHER HEALTH CARE SERVICES. ALLINA HEALTH OWNS AND OPERATES 11 HOSPITALS, MORE THAN 90 CLINICS AND HEALTH CARE SERVICES, INCLUDING HOME CARE, HOSPICE CARE, PALLIATIVE CARE, OXYGEN AND MEDICAL EQUIPMENT, PHARMACIES AND EMERGENCY MEDICAL TRANSPORTATION IN OPERATION WITHIN MINNESOTA AND WESTERN WISCONSIN. NEARLY ALL ALLINA HOSPITAL PATIENTS COME FROM MINNESOTA AND WISCONSIN, THE MAJORITY OF WHICH COME FROM THE COUNTIES SURROUNDING ITS HOSPITALS AND CLINICS, INCLUDING THE SEVEN-COUNTY TWIN CITIES METRO AND SUBURBAN AND RURAL COMMUNITIES IN WESTERN WISCONSIN, SOUTHERN MINNESOTA AND CENTRAL MINNESOTA. COMMUNITIES SERVED BY ALLINA HEALTH ARE ASSIGNED INTO ONE OF NINE REGIONS AND EACH REGION INCLUDES AT LEAST ONE HOSPITAL WITHIN OUR SYSTEM. COMMUNITY ENGAGEMENT LEADS ARE ASSIGNED TO EACH REGION TO ENGAGE COMMUNITY IN COMMUNITY BENEFIT ACTIVITIES. WEST METRO THE WEST METRO REGION INCLUDES ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE AND SERVES MOST COMMUNITIES WITHIN HENNEPIN COUNTY, THE LARGEST COUNTY IN MINNESOTA. THE CITY OF MINNEAPOLIS IS ITS LARGEST CITY AND THE COUNTY SEAT. THE WEST METRO REGION SERVES BOTH URBAN AND SUBURBAN COMMUNITIES AND INCLUDES A RANGE OF SOCIOECONOMIC STATUSES AS WELL AS A BROAD REPRESENTATION OF RACES AND ETHNICITIES. EAST METRO THE EAST METRO REGION INCLUDES UNITED HOSPITAL AND SERVES RAMSEY, WASHINGTON AND DAKOTA COUNTIES. THIS REGION SPANS THE EASTERN EDGE OF THE TWIN CITIES METRO, INCLUDING THE CITY OF ST. PAUL AND ITS SURROUNDING COMMUNITIES. ST. PAUL IS THE CAPITAL AND SECOND-MOST POPULOUS CITY IN THE STATE. THE EAST METRO REGION IS HIGHLY DIVERSE; GEOGRAPHICALLY, SOCIOECONOMICALLY AND RACIALLY. NORTHWEST METRO THE NORTHWEST METRO REGION INCLUDES MERCY HOSPITAL AND ITS UNITY CAMPUS AND PRIMARILY SERVES COMMUNITIES WITHIN ANOKA COUNTY, BUT ALSO INCLUDES AREAS WITHIN RAMSEY, SHERBURNE AND HENNEPIN COUNTIES. ANOKA COUNTY IS THE FOURTH-MOST POPULOUS COUNTY IN THE STATE OF MINNESOTA AND INCLUDES THE NORTHWEST METROPOLITAN AREA THAT IS PREDOMINANTLY SUBURBAN IN NATURE. SOUTH METRO THE SOUTH METRO REGION INCLUDES ST. FRANCIS REGIONAL MEDICAL CENTER, A PARTIALLY-OWNED HOSPITAL WITHIN THE ALLINA SYSTEM, AND PRIMARILY SERVES SCOTT AND CARVER COUNTIES. IT ALSO INCLUDES COMMUNITIES IN SIBLEY, LE SUEUR, DAKOTA AND HENNEPIN COUNTIES. THIS REGION INCLUDES BOTH SUBURBAN AND SMALL COMMUNITIES IN THE SOUTHWEST AREA OF THE MINNEAPOLIS-ST. PAUL METROPOLITAN AREA. NORTHWEST REGIONAL THE NORTHWEST REGIONAL AREA INCLUDES BUFFALO HOSPITAL AND IS LOCATED WEST OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. THIS REGION PRIMARILY SERVES WRIGHT COUNTY, BUT ALSO SERVES COMMUNITIES WITHIN STEARNS, MEEKER AND HENNEPIN COUNTIES. THIS REGION IS MADE UP OF BOTH SMALL AND RURAL COMMUNITIES. NORTH REGIONALTHE NORTH REGIONAL AREA INCLUDES CAMBRIDGE MEDICAL CENTER AND SERVES SMALL AND RURAL COMMUNITIES WITHIN ISANTI, CHISAGO, KANABEC AND PINE COUNTIES NORTH OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. SOUTHWEST REGIONALTHE SOUTHWEST REGIONAL AREA IS LOCATED IN SOUTH CENTRAL MINNESOTA AND INCLUDES NEW ULM MEDICAL CENTER. THE REGION SERVES COMMUNITIES AND RURAL AREAS IN AND AROUND BROWN COUNTY AND COMMUNITIES WITHIN SIBLEY AND NICOLLET COUNTIESSOUTH REGIONALLOCATED SOUTH OF THE TWIN CITIES METROPOLITAN AREA, THE SOUTH REGIONAL REGION PRIMARILY SERVES MID-SIZED SUBURBAN CITIES IN RICE, STEELE AND SOUTHERN DAKOTA COUNTIES AS WELL AS COMMUNITIES AND RURAL AREAS ACROSS DODGE, WASECA, AND GOODHUE COUNTIES. OWATONNA HOSPITAL AND DISTRICT ONE HOSPITALS SERVE THESE AREAS.EAST REGIONALTHE EAST REGIONAL REGION IS LOCATED EASTERN MINNESOTA AND WESTERN WISCONSIN. IT INCLUDES REGINA HOSPITAL AND RIVER FALLS AREA HOSPITALS, SERVING COMMUNITIES IN DAKOTA COUNTY IN MINNESOTA, AND PIERCE AND ST. CROIX COUNTIES IN WISCONSIN.

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"GOVERNING BODYTHE ALLINA HEALTH BOARD OF DIRECTORS HAS OVERSIGHT FOR COMMUNITY BENEFIT AND COMMUNITY HEALTH IMPROVEMENT FUNCTIONS. ACCORDING TO ITS CHARTER, THE QUALITY AND POPULATION HEALTH COMMITTEE OF THE BOARD PROVIDES GOVERNANCE OVERSIGHT OF ALLINA'S POPULATION HEALTH AND COMMUNITY BENEFIT AND ENGAGEMENT STRATEGIES; THE QUALITY OF CARE AND SERVICE AT ALLINA HOSPITALS AND CLINICS; AND THE SYNERGIES AND LESSONS AT THE INTERFACE. THE COMMITTEE ASSISTS THE ALLINA BOARD OF DIRECTORS (""BOARD"") TO DELIVER ON ITS PURPOSES OF IMPROVING THE COORDINATION AND INTEGRATION OF CLINICAL CARE; ENHANCING ACCESS TO QUALITY HEALTH CARE FOR THE PEOPLE IT SERVES; IMPROVING THE COST EFFECTIVENESS OF THE HEALTH CARE SERVICES IT DELIVERS; IMPROVING THE PATIENT EXPERIENCE FOR INDIVIDUALS RECEIVING SUCH HEALTH CARE SERVICES, AND IMPROVING HEALTH STATUS INDICATORS BROADLY FOR THE LARGER POPULATION OF RESIDENTS IN OUR COMMUNITIES.TO ENSURE THAT THE BOARD OF DIRECTORS REPRESENTS THE COMMUNITIES SERVED BY ALLINA HEALTH, THE BY-LAWS STATE THAT A MAJORITY OF THE VOTING MEMBERS OF THE BOARD OF DIRECTORS SHALL AT ALL TIMES BE INDEPENDENT CIVIC LEADERS. IN FURTHERANCE OF THIS REQUIREMENT, AND SUBJECT TO VACANCIES THAT MAY OCCUR FROM TIME TO TIME, NO MORE THAN ONE-THIRD (1/3) OF THE DIRECTORS (INCLUDING ANY EX-OFFICIO DIRECTORS WITH VOTE) MAY BE INTERESTED DIRECTORS. INTERESTED DIRECTORS SHALL INCLUDE PERSONS WHO ARE NOT ON THE BOARD OF DIRECTORS BUT SERVE ON COMMITTEES OR OTHERWISE PARTICIPATE IN THE AFFAIRS OF THE CORPORATION AND WOULD BE DEEMED INTERESTED DIRECTORS IF THEY WERE ON THE BOARD OF DIRECTORS. ""INTERESTED DIRECTORS"" ARE: (1) ANY MEMBERS OF THE CORPORATION'S MANAGEMENT WHO SERVE AS DIRECTORS; AND (2) ANY PHYSICIAN DIRECTORS WHO PROVIDE SERVICES IN CONJUNCTION WITH THE ORGANIZATION OR ANY OF ITS HOSPITALS OR CLINICS, INCLUDING WITHOUT LIMITATION SERVICES UNDER A CONTRACT WITH ANY OF THE ORGANIZATION'S HOSPITALS OR CLINICS, AS A PHYSICIAN EMPLOYEE OF ONE OF THE ORGANIZATION'S CLINICS OR AS A MEDICAL STAFF MEMBER OF ONE OF THE ORGANIZATION'S HOSPITALS. IN ADDITION TO THESE BY-LAWS PROVISIONS, THE BOARD'S GOVERNANCE AND NOMINATING COMMITTEE ACTIVELY ENSURES DIVERSITY OF DIRECTORS AND KEY SUBSTANTIVE AND STRATEGIC COMPETENCIES IN RECRUITING BOARD MEMBERS. THE COMMITTEE HAS CHOSEN SEVERAL CURRENT MEMBERS WHO REPRESENT THE PATIENT PERSPECTIVE AND COMMUNITY LEADERS. RECRUITMENT EFFORTS IN THE PAST SEVERAL YEARS HAVE FOCUSED ON ENHANCING THE MEMBERSHIP OF THE BOARD TO INCLUDE DIRECTORS AND COMMITTEE MEMBERS WITH STRATEGIC COMPETENCIES TO SUPPORT ALLINA IN THE NEW PAYMENT AND HEALTH REFORM ENVIRONMENT. OPEN MEDICAL STAFF THE MEDICAL STAFFS WITHIN ALLINA HEALTH ARE OPEN, WITH THE EXCEPTION OF CERTAIN DEPARTMENTS (SUCH AS RADIOLOGY, PATHOLOGY, EMERGENCY, AND CARDIOLOGY) AS TO WHICH SOME HOSPITALS HAVE ENTERED INTO EXCLUSIVE CONTRACTS WITH PARTICULAR MEDICAL GROUPS. THE HOSPITALS ENTER INTO THESE CONTRACTS WHEN THEY DETERMINE SUCH ARRANGEMENTS WILL IMPROVE CARE AND OPERATIONS IN THE HOSPITAL BY, FOR EXAMPLE, IMPROVING THE QUALITY OF PATIENT CARE, ASSURING THE AVAILABILITY OF SPECIFIC SERVICES, REDUCING THE COSTS OF PROVIDING HEALTH CARE, ALLOCATING HOSPITAL RESOURCES MORE EFFICIENTLY, SECURING GREATER PATIENT SATISFACTION, OR FACILITATING THE ORDERLY OPERATIONS OF THE HOSPITAL. IT DOES NOT ENTER INTO THESE ARRANGEMENTS SOLELY TO BENEFIT OR EXCLUDE SPECIFIC PROVIDERS OR TO RESTRAIN COMPETITION."

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"ALLINA HEALTH SYSTEM (""ALLINA HEALTH""), PRIMARILY DOING BUSINESS AS ALLINA HEALTH, IS A MINNESOTA NONPROFIT CORPORATION AND AN INTEGRATED HEALTH CARE DELIVERY NETWORK SERVING THE COMMUNITIES IN THE GREATER MINNEAPOLIS-ST. PAUL (THE ""TWIN CITIES"") METRO AREA, SPANNING THE COUNTIES FROM THE AREA WEST OF MINNEAPOLIS TO THE WESTERN PART OF WISCONSIN. ALLINA HEALTH IS ANCHORED BY THREE TWIN CITIES METRO AREA HOSPITALS AND IS SUPPORTED BY A NETWORK OF COMMUNITY HOSPITALS, INCLUDING TWO CRITICAL ACCESS HOSPITALS. ALLINA HEALTH IS STAFFED BY EMPLOYED PHYSICIANS AND A LARGE ALIGNED PROVIDER NETWORK. WITH MORE THAN 27,500 FULL AND PART-TIME EMPLOYEES, ALLINA HEALTH IS ONE OF THE LARGEST EMPLOYERS IN MINNESOTA. AS AN INTEGRATED HEALTH SYSTEM THAT INCLUDES HOSPITALS, EMERGENCY, AMBULATORY, HOMECARE AND HOSPICE SERVICES, AN AUTOMATED ELECTRONIC MEDICAL RECORD SYSTEM, AND OVER 1,450 EMPLOYED PHYSICIANS, ALLINA HEALTH IS UNIQUELY POSITIONED AS A LEADER IN HEALTHCARE IN THE MINNEAPOLIS/ST. PAUL AREA AND IS WELL POSITIONED FOR HEALTH CARE REFORM.ALLINA HEALTH OWNS AND OPERATES TEN HOSPITALS AND JOINTLY OWNS AND OPERATES ONE OTHER HOSPITAL. THESE INCLUDE URBAN TERTIARY CARE, SUBURBAN COMMUNITY AND RURAL HOSPITALS. ALLINA HEALTH HOSPITALS PROVIDED OVER 105,000 INPATIENT ADMISSIONS AND MORE THAN 1,414,000 OUTPATIENT VISITS DURING THE YEAR ENDED DECEMBER 31, 2019. AS OF YEAR-END, ALLINA HEALTH HOSPITALS HAD LICENSED BED CAPACITY OF 2,451 ACUTE CARE BEDS, 1,783 OF WHICH WERE STAFFED FOR INPATIENT SERVICES. ALLINA HEALTH PROVIDES CLINICAL SERVICES THROUGH ITS ALLINA HEALTH GROUP AND HOSPITAL-BASED PHYSICIANS. ALLINA HEALTH GROUP CONTROLS AND OPERATES 69 ALLINA HEALTH CLINICS, OPERATES THE CLINICAL SERVICES LINES; THREE HOSPITALIST PROGRAMS ON THE ABBOTT NORTHWESTERN, UNITED AND MERCY HOSPITAL CAMPUSES; AND EMPLOYS APPROXIMATELY 780 PHYSICIANS AND 250 HOSPITALISTS. ALLINA SPECIALTY ASSOCIATES, INC. (""ASA""), OPERATING UNDER THE NAME MINNEAPOLIS HEART INSTITUTE, EMPLOYS APPROXIMATELY 80 PHYSICIANS, CONSISTING OF CARDIOLOGISTS, CARDIOTHORACIC AND VASCULAR SURGEONS. IN ADDITION, ALLINA HEALTH HOSPITALS DIRECTLY EMPLOY APPROXIMATELY 340 SPECIALTY PHYSICIANS INCLUDING INTENSIVISTS, PERINATOLOGISTS, AND PSYCHIATRISTS. ALLINA HEALTH PHYSICIANS AND ALLIED PROFESSIONALS GENERATED MORE THAN 8,398,000 WORK RVU'S DURING THE YEAR ENDED DECEMBER 31, 2019. THE ALLINA INTEGRATED MEDICAL (""AIM"") NETWORK ALIGNS ALLINA HEALTH PHYSICIANS, 2,000 INDEPENDENT MEDICAL PHYSICIANS, AND OVER 20 HOSPITALS TO DELIVER MARKET-LEADING QUALITY AND EFFICIENCY IN PATIENT CARE. ALLINA HEALTH IS A COMPREHENSIVE HEALTH CARE SYSTEM AND HAS ONE OF THE LARGEST PHYSICIAN NETWORKS IN MINNESOTA.ALLINA'S HEALTH HOME CARE SERVICES DIVISION PROVIDES HOME HEALTH, HOME OXYGEN AND MEDICAL EQUIPMENT, HOSPICE, PALLIATIVE CARE AND SENIORCARE TRANSITIONS.A LEADER AND INNOVATOR IN PRE-HOSPITAL EMERGENCY MEDICAL DEVICES, ALLINA HEALTH EMERGENCY MEDICAL SERVICES IS DEVOTED TO PROVIDING SKILLED AND COMPASSIONATE ADVANCED LIFE SUPPORT, BASIC LIFE SUPPORT AND SCHEDULED TRANSPORT IN MORE THAN 100 MINNESOTA COMMUNITIES. NEARLY 570 PARAMEDICS, EMERGENCY MEDICAL TECHNICIANS, DISPATCHERS, SPECIAL TRANSPORTATION DRIVERS, MAINTENANCE AND ADMINISTRATIVE AND SUPPORT PERSONNEL WORK TOGETHER TO PROVIDE SERVICE TO AN AREA OF APPROXIMATELY 1,200 SQUARE MILES, REACHING OVER ONE MILLION PEOPLE. IN ADDITION TO THE AMOUNTS DISCLOSED ON THIS SCHEDULE H, ALLINA AND AFFILIATED ION IN GOVERNMENT MEDICAL CARE PROGRAMS IN EXCESS OF GOVERNMENT REIMBURSEMENTS IN THE AMOUNT OF $218,664,999 IN 2019.ALLINA PARTNERS WITH THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL TO PROVIDE PHYSICIAN RESIDENCY PROGRAMS FOR FAMILY PRACTICE AND INTERNAL MEDICINE RESIDENT PHYSICIANS.ALLINA CONTROLS AND OPERATES SEVEN (7) AFFILIATED FOUNDATIONS THAT PROVIDE PHILANTHROPIC FUNDING SUPPORT FOR ALLINA PROGRAMS AND NUMEROUS COMMUNITY PROGRAMS AND INITIATIVES INCLUDING A FEDERALLY QUALIFIED HEALTH CENTER. SEE SCHEDULE R AND SCHEDULE H, PART IV FOR A LIST OF RELATED ORGANIZATIONS AND JOINT VENTURES INCLUDING THE PRIMARY ACTIVITY OF THE AFFILIATED ORGANIZATION. ALLINA AND ITS AFFILIATES ALSO ROUTINELY COOPERATE AND INNOVATE WITH OTHER ORGANIZATIONS INCLUDING HEALTH CARE AND SOCIAL WELFARE ORGANIZATIONS, COMMUNITY GROUPS, GOVERNMENT AGENCIES AND HEALTH CARE PROVIDERS TO PREVENT ILLNESS, PROMOTE AND RESTORE HEALTH TO THE COMMUNITIES WE SERVE AND BEYOND.PHILLIPS EYE INSTITUTE LEGALLY MERGED INTO ABBOTT NORTHWESTERN HOSPITAL ON 10/1/2019."