4A (Expenses $ 110337917 including grants of $ 958493) (Revenue $ 170507492)
CENTRACARE HEALTH SYSTEM (CCHS) IS AN INTEGRATED HEALTH SYSTEM, INCLUDING COMPRISED OF SIX CRITICAL ACCESS HOSPITALS, TWO ACUTE CARE HOSPITALS, A MULTI-SPECIALITY CLINIC, SURGICAL CENTER, RETAIL PHARMACY NETWORK, NURSING HOME AND A FOUNDATION. CCHS SERVES ITS PATIENTS IN SIX MAIN AREAS.CENTRACARE LABORATORY SERVICES ALL HOSPITALS UNDER ITS UMBRELLA AS WELL AS CENTRACARE CLINIC. IT ALSO PERFORMS TESTS FOR VARIOUS FACILITIES IN THE REGION. CENTRACARE LABORATORY PERFORMED 2,238,477 TESTS IN FISCAL YEAR 2022. IN FISCAL YEAR 2022 CENTRACARE LABORATORY GENERATED $115,675,382 OF PROGRAM REVENUE AND INCURRED $94,640,833 OF PROGRAM EXPENSE. CENTRACARE SURGICAL CENTER PROVIDES ELECTIVE SURGERY PROCEDURES TO PATIENTS IN THE CENTRAL MN REGION. IN FY 2022, THE CENTER PERFORMED 6,498 SURGERIES AND GENERATED $14,920,775 OF PROGRAM REVENUE AND $12,707,495 OF PROGRAM EXPENSE.

4B (Expenses $ 147294430 including grants of $ 23598) (Revenue $ 194577941)
CARRIS HEALTH, LLC IS CONSIDERED A DISREGARDED ENTITY OF CCHS FOR PURPOSES OF 990 REPORTING. CARRIS HEALTH, LLC INCLUDES THE SUBSIDIARY CARRIS HEALTH - RICE MEMORIAL HOSPITAL, WHICH HAS 136 LICENSED BEDS. DURING FISCAL YEAR 2022 RICE MEMORIAL HOSPITAL CARED FOR 2,552 INPATIENT ADMISSIONS WITH 9,355 ASSOCIATED PATIENT DAYS. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL CARE, BIRTHING SERVICES, PEDIATRIC SERVICES, BEHAVIORAL HEALTH CARE SERVICES, AND REHABILITATION SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL YEAR 2022 WERE 105,230 AND INCLUDED EMERGENCY ROOM SERVICES, DIALYSIS, IMAGING, RESPIRATORY THERAPY, A REHABILITATION CENTER, SAME DAY SURGERY AND OTHER AMBULATORY CARE SERVICES. CARRIS HEALTH ALSO OFFERS A CERTIFIED SKILLED NURSING FACILITY LOCATED IN WILLMAR, MN WITH 78 LICENSED BEDS. CARRIS HEALTH HAS REALIZED 10,207 RESIDENT DAYS IN THE LONG TERM CARE PORTION OF THE FACILITY AND 3,471 RESIDENT DAYS IN THE SHORT TERM THERAPY SUITES AREA DURING FISCAL YEAR 2022. CARRIS HEALTH ALSO HAS AN ACCREDITED AMBULATORY SURGICAL CENTER LOCATED IN WILLMAR, MN. CARRIS HEALTH SURGICAL CENTER COMPLETED 5,133 OUTPATIENT (SAME DAY) PRODECURES. IN FISCAL YEAR 2022 CARRIS HEALTH GENERATED $146,016,524 OF PROGRAM REVENUE AND $109,512,454 OF PROGRAM EXPENSE.REDWOOD AREA HOSPITAL JOINED CENTRACARE JANUARY OF 2019 AND IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IS INCLUDED WITH THIS 990 FILING. CARRIS HEALTH, LLC INCLUDES THE SUBSIDIARY CARRIS HEALTH - REDWOOD AREA HOSPITAL, WHICH IS A 25 BED CRITICAL ACCESS HOSPITAL. DURING FISCAL YEAR 2022 THEY HAD 480 INPATIENT ADMISSIONS WITH 1,600 ASSOCIATED PATIENT DAYS, 36,786 OUTPATIENT VISITS AND 4,956 EMERGENCY ROOM VISITS. IN FISCAL YEAR 2022, REDWOOD GENERATED $48,561,417 OF PROGRAM REVENUE AND $37,781,976 OF PROGRAM EXPENSE.

4C (Expenses $ 66561451 including grants of $ 4843) (Revenue $ 97099126)
MONTICELLO HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. MONTICELLO HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND ALSO OPERATES A 10 BED ACUTE GERIATRIC PSYCHIATRIC UNIT. IN FISCAL YEAR 2022, THEY HAD 5,168 PATIENT DAYS, 47,376 OUTPATIENT VISITS AND 14,979 EMERGENCY ROOM VISITS' WHICH GENERATED $97,099,126 OF PROGRAM REVENUE AND $66,561,451 OF PROGRAM EXPENSE.

4D (Expenses $ 30241180 including grants of $ 0) (Revenue $ 44328351)
CENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. CENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. IN FISCAL YEAR 2022 THEY HAD 2,520 PATIENT DAYS, 51,559 OUTPATIENT VISITS AND 4,931 EMERGENCY ROOM VISITS. IN FISCAL YEAR 2022, PAYNESVILLE GENERATED $44,329,112 OF PROGRAM REVENUE AND $30,241,180 OF PROGRAM EXPENSE.

CENTRACARE HEALTH - PAYNESVILLE
PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH.AS A FOLLOW UP TO THE PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH, AND STEARNS COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP.

CENTRACARE HEALTH - MONTICELLO
PART V, SECTION B, LINE 5: TO BETTER UNDERSTAND HEALTH ISSUES FACING THE COMMUNITIES OF WRIGHT COUNTY, BUFFALO HOSPITAL, PART OF ALLINA HEALTH, CENTRACARE MONTICELLO, WRIGHT COUNTY PUBLIC HEALTH AND WRIGHT COUNTY COMMUNITY ACTION PARTNERED TO DEVELOP AND CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IN EARLY 2017, THE ORGANIZATIONS FORMED WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE IN AN EFFORT TO COLLECT AND PRIORITIZE DATA FROM VARIOUS SOURCES, AND DEVELOP A JOINT COMMUNITY HEALTH IMPLEMENTATION PLAN. THE PURPOSE OF THE COLLABORATIVE GROUP IS TO SYSTEMATICALLY IDENTIFY AND ANALYZE HEALTH ISSUES IN THE COMMUNITY AND CREATE A PLAN FOR HOW TO ADDRESS THEM. THE GROUP INCLUDES ALL WRIGHT COUNTY ORGANIZATIONS WHO ARE ENCOURAGED OR REQUIRED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE COLLABORATIVE EMPLOYED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) FRAMEWORK WHICH EMPHASIZES COLLABORATION OF HEALTH CARE ENTITIES, PUBLIC HEALTH AND COMMUNITY ORGANIZATIONS AND IS CENTERED UPON COMMUNITY ENGAGEMENT.THE CHNA UTILIZED A VARIETY OF INFORMATION SOURCES AND COMMUNITY INPUT TO ANALYZE AND PRIORITIZE COMMUNITY HEALTH ISSUES. THIS INFORMATION WAS USED TO DEVELOP THE HEALTH IMPROVEMENT ACTION PLAN TO ADDRESS THE IDENTIFIED ISSUES. IMPORTANT ACTIVITIES IN THE CHNA PROCESS ARE OUTLINED IN THE CHNA, AS WELL AS ROLES AND RESPONSIBILITIES AMONG THE PARTNERS IN THE COLLABORATIVE. THE CHNA PROCESS WAS BASED ON THE PARTNERSHIP BETWEEN FOUR ORGANIZATIONS: BUFFALO HOSPITAL, PART OF ALLINA HEALTH, CENTRACARE MONTICELLO, WRIGHT COUNTY PUBLIC HEALTH AND WRIGHT COUNTY COMMUNITY ACTION. MAJOR CHNA DECISIONS WERE BASED ON CONSENSUS AND OPEN DIALOGUE BETWEEN THE PARTNERS, AS WELL AS COMMUNITY INPUT. THE COLLABORATIVE AGREED THAT THE DEFINITION OF HEALTH ENCOMPASSES A BROAD RANGE OF CONDITIONS, NOT JUST HEALTH IN TERMS OF HEALTHCARE. IMPROVING HEALTH IS NO LONGER ABOUT TREATING AND PREVENTING MEDICAL CONDITIONS; IT IS THE IMPROVEMENT OF COMPLETE PHYSICAL, MENTAL, SPIRITUAL AND SOCIAL WELL-BEING. REPRESENTATIVES FROM PARTNERING ORGANIZATIONS MET REGULARLY FROM SEPTEMBER 2017 TO JULY 2019 FOR PROGRESS UPDATES, DISCUSSION ON UPCOMING CHNA ACTIVITIES AND EVENT PLANNING. ALL CORE PARTNERS IN THE COLLABORATIVE CONTRIBUTED TO THE COMPLETION OF THE PROCESS TO THE BEST OF THEIR ABILITY AND UTILIZED THE STRENGTHS AND CAPACIT OF VARIOUS GROUP MEMBERS.THE PARTNERSHIP ADOPTED THE MAPP MODEL FOR ASSESSMENT AND PLANNING. MAPP IS A COMMUNITY DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH. FACILITATED BY PUBLIC HEALTH LEADERS, THIS FRAMEWORK HELPS COMMUNITIES APPLY STRATEGIC THINKING TO PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES TO ADDRESS THEM. MAPP IS NOT AN AGENCY-FOCUSED ASSESSMENT PROCESS; RATHER, IT IS AN INTERACTIVE PROCESS THAT CAN IMPROVE THE EFFICIENCY, EFFECTIVENESS, AND ULTIMATELY THE PERFORMANCE OF LOCAL PUBLIC HEALTH SYSTEMS. COMMUNITY OWNERSHIP IS A KEY COMPONENT OF MAPP. PARTICIPATION FROM THE BROADER COMMUNITY LEADS TO COLLECTIVE THINKING AND SUSTAINABLE SOLUTIONS TO COMPLEX PROBLEMS.THIS EFFORT INCLUDED: (1) COMPLETION OF A CHNA TO SYSTEMATICALLY IDENTIFY AND ANALYZE HEALTH PRIORITIES IN THE COMMUNITY, AND (2) DEVELOPMENT OF A PLAN TO ADDRESS THESE PRIORITIES AS A COLLABORATIVE AND IN PARTNERSHIP WITH OTHERS. THROUGH THIS PROCESS, THE COLLABORATIVE ENGAGED WITH COMMUNITY STAKEHOLDERS TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES, IDENTIFIED INTERNAL AND EXTERNAL RESOURCES FOR HEALTH PROMOTION AND CREATED AN IMPLEMENTATION PLAN THAT LEVERAGES THOSE RESOURCES TO IMPROVE COMMUNITY HEALTH.

CENTRACARE HEALTH - PAYNESVILLE
"PART V, SECTION B, LINE 5: CENTRACARE POPULATION HEALTH CONDUCTED SPECIFIC AND COMPREHENSIVE EVALUATION OF ZIP CODE 56304 THAT HAS THE WORST HEALTH OUTCOMES IN THE THREE COUNTIES INCLUDED IN THE CHNA AND CHIP. THIS EVALUATION INCLUDED DATA EVALUATION, KEY INFORMANT INTERVIEWS, AND HEALTH INDICATORS FOR MINORITY GROUPS. THE CENTRAL MN ALLIANCE ALSO COMPLETED SEVERAL SURVEYS AND ASSESSMENTS TO GET INPUT FROM MULTIPLE SECTORS OF EACH COMMUNITY REPRESENTING DIFFERENT POPULATIONS IN ORDER TO COMPILE A LIST OF TOP PRIORITIES IN THE REGION:THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) WAS DATA COLLECTED FROM THE COMMUNITY HEALTH ASSESSMENT COMPLETED IN 2018, CENTRACARE PATIENT DATA, MINNESOTA STUDENT SURVEY DATA, AND MINNESOTA PUBLIC HEALTH VITAL STATISTICS. THIS DATA WAS COMPARED TO DOCUMENTS AND DATASETS FROM THE MN STATEWIDE HEALTH ASSESSMENT (SHA), CENTRAL MN COMMUNITY HEALTH SURVEY DATA, PREVIOUS PLANNING PROCESS PRIORITY LISTS, HEALTH EQUITY DATA ANALYSES (HEDA) FROM EACH COUNTY, TYPES OF DATA REQUESTS OUR AGENCIES WERE GETTING FROM THE PUBLIC, AND THE MN DEPARTMENT OF HEALTH DATA INDICATOR LIST. A ""COMMUNITY PIRORITY CATEGORY"" WAS ASSIGNED TO EACH DATA POINT TO IDENTIFY A LIST OF COMMUNITY PRIORITIES.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) WAS CONDUCTED IN THE FORM OF KEY STAKEHOLDER INTERVIEWS VIA PHONE WITH A WIDE VARIETY OF COMMUNITY PARTNERS THROUGHOUT THE THREE COUNTIES. A TOTAL OF 54 STAKEHOLDERS WERE INTERVIEWED FROM 10 DIFFERENT SECTORS INCLUDING: HEALTHCARE PROFESSIONALS, STATE, LOCAL OR TRIBAL GOV'T AGENCIES WITH EXPERTISE IN SUBSTANCE ABUSE, BUSINESSES, SCHOOLS, CIVIC GROUPS, LAW ENFORCEMENT, YOUTH, MEDIA, RELIGIOUS/FRATERNAL GROUPS AND YOUTH-SERVING ORGANIZATIONS.FOR THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA) BENTON, SHERBURNE, AND STEARNS COUNTY LPH AGENCIES PARTICIPATED IN A CAPACITY ASSESSMENT TO HELP DETERMINE THE EXTENT TO WHICH REQUIRED LOCAL PUBLIC HEALTH ACTIVITIES ARE IN PLACE STATEWIDE. THE ASSESSMENT QUESTIONS WERE THEN UTILIZED TO FORMULATE A SURVEY FOR THREE SECTORS OF THE LOCAL PUBLIC HEALTH SYSTEM: EMERGENCY PREPAREDNESS, ENVIRONMENTAL HEALTH, AND HEALTHCARE ACCESS/INFECTIOUS DISEASE. COMMUNITY PARTNERS WERE INVITED TO PARTICIPATE IN THE SURVEY VIA EMAIL. AFTER ANALYZING THE RESULTS, THE LPHSA SUBGROUP DEVELOPED A LIST OF THEIR TOP 10 RECOMMENDATIONS FROM ALL 3 SECTORS TO SUPPORT THE DEVELOPMENT OF THE COMMUNITY COMMUNITY HEALTH IMPROVEMENT PLAN.THE FORCES OF CHANGE (FOC) ASSESSMENT WAS COMPLETED IN THE FORM OF A COMUNITY MEETING TO IDENTIFY FORCES THAT MAY AFFECT A COMMUNITY AND OPPORTUNITIES AND THREATS ASSOCIATED WITH THOSE FORCES. THE AGENDA INCLUDED A BRAINSTORMING ACTIVITY AND TIME IN SMALL GROUP AND LARGE GROUP DISCUSSION. A FLIER ADVERTISING THE MEETING WAS DISTRIBUTED TO COMMUNITY MEMBERS VIA EMAIL. THERE WERE 68 PEOPLE THAT ATTENDED REPRESENTING 27 ORGANIZATIONS AND TWO THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. AS A FOLLOW UP TO THE FORCES OF CHANGE COMMUNITY MEETING, A WORLD CAFE WAS HELD IN JANUARY 2019 FOR MEMBERS OF THE COMMUNITY TO COME AND TALK ABOUT THEIR PERCEPTION OF NEEDS IN THE SURROUNDING COMMUNITIES. THERE WERE 94 PEOPLE THAT ATTENDED THE MEETING REPRESENTING 32 ORGANIZATIONS AND THREE THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. ORGANIZATIONS THAT WERE REPRESENTED AT BOTH COMMUNITY MEETINGS INCLUDED LOCAL GOVERNMENT, HEALTHCARE, LOCAL NONPROFITS, EDUCATION, UNDERREPRESENTED COMMUNITIES, FAITH COMMUNITY, AND OTHERS.IN ORDER TO BETTER ENGAGE INDIVIDUALS OR ORGANIZATIONS WITH A PERSPECTIVE OF AT-RISK POPULATIONS, A HEALTH EQUITY ASSESSMENT WAS ALSO COMPLETED. FOCUS GROUP MEETINGS WERE HELD ON THREE SEPARATE OCCASIONS AT THE GREAT RIVER REGIONAL LIBRARY IN ST. CLOUD, AND COMMUNITY INPUT WAS GATHERED AT THE BENTON, SHERBURNE, AND STEARNS COUNTY FAIRS TO REACH OUT TO A VARIETY OF COMMUNITIES. IN TOTAL, THERE WERE 30 SOMALI ADULTS WHO DISCUSSED POSITIVES, NEGATIVES, AND AREAS-TO-IMPROVE-ON WITHIN THE COMMUNITY. AT THE COUNTY FAIRS, INFORMATION WAS GATHERED FROM RESPONDENTS FROM THE 56304-ZIP CODE."

CARRIS HEALTH - RICE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: CONDUCTING A HEALTH NEEDS ASSESSMENT IS A MULTIFACETED PROCESS THAT REQUIRES AMPLE PREPARATION, EFFECTIVE USE OF RESOURCES, SOUND METHODOLOGY, AND COLLABORATION ON BEHALF OF ALL STAKEHOLDERS. WITH THAT IN MIND, THE ASSESSMENT PROCESS WAS ORGANIZED INTO FIVE MAIN PHASES, WHICH WERE FURTHER BROKEN DOWN INTO A SERIES OF INTERCONNECTED COMPONENTS:1. FORMATION OF SYSTEM-WIDE WORKING GROUP AND DEFINITION OF SERVICE AREAS2. DATA COLLECTION AND ANALYSIS (APRIL-JUNE 2018)3. INITIAL PRIORITIZATION (JULY-AUGUST 2018)4. EVALUATION AND ASSESSMENT OF COMMUNITY MEMBERS (SEPTEMBER-OCTOBER 2018)5. FINAL PRIORITIZATION (NOVEMBER-DECEMBER 2018)ALTHOUGH THE PROCESS MOVED IN THIS CHRONOLOGICAL ORDER, THE COMPLEXITY OF THE ASSESSMENT PROCESS NECESSITATED A FLUID MOVEMENT BETWEEN EACH PHASE. INDEED, KEY TO A THOROUGH AND COMPREHENSIVE ASSESSMENT IS THE ABILITY TO EXAMINE AND REEXAMINE EACH COMPONENT OF THE PROCESS IN LIGHT OF WHAT IS LEARNED IN LATER PHASES OF ASSESSMENT.CARRIS HEALTH TAKES PRIDE IN ITS LEVEL OF INVOLVEMENT IN THE COMMUNITY AND ITS RECEPTIVENESS TO THE COMMUNITY'S HEALTH CARE NEEDS. THEREFORE, SYSTEM ADMINISTRATION CONSIDERED IT BOTH REASONABLE AND APPROPRIATE THAT STAFF AND LEADERS WITHIN CARRIS HEALTH BE CHARGED WITH THE TASK OF CONDUCTING THE ASSESSMENT, RATHER THAN CONTRACT WITH A THIRD PARTY REMOVED FROM THE COMMUNITY ITSELF. AN INTERNAL TEAM CALLED THE CHNA WORKING GROUP WAS ASSEMBLED, COMPRISED OF INDIVIDUALS WITH DIVERSE KNOWLEDGE AND EXPERTISE IN HEALTH CARE DELIVERY, ADMINISTRATION, PLANNING AND DEVELOPMENT, MARKETING, COMMUNITY AND GOVERNMENT RELATIONS, AMONG OTHER DEPARTMENTS. THIS GROUP, WHICH CONSISTS OF INDIVIDUALS FROM ACROSS THE CARRIS HEALTH SYSTEM, IS INDICATIVE OF THE COLLABORATIVE NATURE OF THE CHNA PROCESS AND A TESTAMENT, MORE GENERALLY, OF THE MUTUAL SUPPORT THROUGHOUT THE SYSTEM. ADDITIONALLY, HOSPITAL BOARD MEMBERS AND EXECUTIVES WERE ENGAGED IN THE ASSESSMENT PROCESS AT AN EARLY STAGE.IN THE INITIAL STAGES OF DATA ANALYSIS AND PRIORITIZATION, ALL WORKING GROUP MEMBERS WERE PRESENTED WITH DATA BROKEN DOWN BY COUNTY IN ORDER TO INDICATE MOST CLEARLY THOSE ISSUES THAT WERE PREVALENT THROUGHOUT THE CARRIS HEALTH SERVICE AREA AND THOSE ISSUES UNIQUE TO EACH CARRIS LOCATION. FURTHERMORE, EACH MEMBER OF THE WORKING GROUP PARTICIPATED IN THE PRIORITIZATION PROCESS SO THAT THE FINAL SET OF COMMUNITY HEALTH NEEDS MIGHT ACCURATELY REFLECT GENUINE ISSUES THAT ARE PREVALENT WITHIN THE BROADER CARRIS HEALTH SERVICE AREA. AN IMPLEMENTATION STRATEGY, SPECIFIC TO THE NEEDS OF THE CORRESPONDING SERVICE AREA WAS DEVELOPED IN RESPONSE TO THE FINDINGS OF THE COLLABORATIVE.

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 5: CONDUCTING A HEALTH NEEDS ASSESSMENT IS A MULTIFACETED PROCESS THAT REQUIRES AMPLE PREPARATION, EFFECTIVE USE OF RESOURCES, SOUND METHODOLOGY, AND COLLABORATION ON BEHALF OF ALL STAKEHOLDERS. WITH THAT IN MIND, THE ASSESSMENT PROCESS WAS ORGANIZED INTO FIVE MAIN PHASES, WHICH WERE FURTHER BROKEN DOWN INTO A SERIES OF INTERCONNECTED COMPONENTS:1. FORMATION OF SYSTEM-WIDE WORKING GROUP AND DEFINITION OF SERVICE AREAS2. DATA COLLECTION AND ANALYSIS (APRIL-JUNE 2018)3. INITIAL PRIORITIZATION (JULY-AUGUST 2018)4. EVALUATION AND ASSESSMENT OF COMMUNITY MEMBERS (SEPTEMBER-OCTOBER 2018)5. FINAL PRIORITIZATION (NOVEMBER-DECEMBER 2018)ALTHOUGH THE PROCESS MOVED IN THIS CHRONOLOGICAL ORDER, THE COMPLEXITY OF THE ASSESSMENT PROCESS NECESSITATED A FLUID MOVEMENT BETWEEN EACH PHASE. INDEED, KEY TO A THOROUGH AND COMPREHENSIVE ASSESSMENT IS THE ABILITY TO EXAMINE AND REEXAMINE EACH COMPONENT OF THE PROCESS IN LIGHT OF WHAT IS LEARNED IN LATER PHASES OF ASSESSMENT.CARRIS HEALTH TAKES PRIDE IN ITS LEVEL OF INVOLVEMENT IN THE COMMUNITY AND ITS RECEPTIVENESS TO THE COMMUNITY'S HEALTH CARE NEEDS. THEREFORE, SYSTEM ADMINISTRATION CONSIDERED IT BOTH REASONABLE AND APPROPRIATE THAT STAFF AND LEADERS WITHIN CARRIS HEALTH BE CHARGED WITH THE TASK OF CONDUCTING THE ASSESSMENT, RATHER THAN CONTRACT WITH A THIRD PARTY REMOVED FROM THE COMMUNITY ITSELF. AN INTERNAL TEAM CALLED THE CHNA WORKING GROUP WAS ASSEMBLED, COMPRISED OF INDIVIDUALS WITH DIVERSE KNOWLEDGE AND EXPERTISE IN HEALTH CARE DELIVERY, ADMINISTRATION, PLANNING AND DEVELOPMENT, MARKETING, COMMUNITY AND GOVERNMENT RELATIONS, AMONG OTHER DEPARTMENTS. THIS GROUP, WHICH CONSISTS OF INDIVIDUALS FROM ACROSS THE CARRIS HEALTH SYSTEM, IS INDICATIVE OF THE COLLABORATIVE NATURE OF THE CHNA PROCESS AND A TESTAMENT, MORE GENERALLY, OF THE MUTUAL SUPPORT THROUGHOUT THE SYSTEM. ADDITIONALLY, HOSPITAL BOARD MEMBERS AND EXECUTIVES WERE ENGAGED IN THE ASSESSMENT PROCESS AT AN EARLY STAGE.IN THE INITIAL STAGES OF DATA ANALYSIS AND PRIORITIZATION, ALL WORKING GROUP MEMBERS WERE PRESENTED WITH DATA BROKEN DOWN BY COUNTY IN ORDER TO INDICATE MOST CLEARLY THOSE ISSUES THAT WERE PREVALENT THROUGHOUT THE CARRIS HEALTH SERVICE AREA AND THOSE ISSUES UNIQUE TO EACH CARRIS LOCATION. FURTHERMORE, EACH MEMBER OF THE WORKING GROUP PARTICIPATED IN THE PRIORITIZATION PROCESS SO THAT THE FINAL SET OF COMMUNITY HEALTH NEEDS MIGHT ACCURATELY REFLECT GENUINE ISSUES THAT ARE PREVALENT WITHIN THE BROADER CARRIS HEALTH SERVICE AREA. AN IMPLEMENTATION STRATEGY, SPECIFIC TO THE NEEDS OF THE CORRESPONDING SERVICE AREA WAS DEVELOPED IN RESPONSE TO THE FINDINGS OF THE COLLABORATIVE.

CENTRACARE HEALTH - MONTICELLO
PART V, SECTION B, LINE 6A: CENTRACARE HEALTH - MONTICELLO CONDUCTED THE CHNA WITH ALLINA HEALTH BUFFALO HOSPITAL.

CENTRACARE HEALTH - PAYNESVILLE
PART V, SECTION B, LINE 6A: CENTRACARE HEALTH- PAYNESVILLE CONDUCTED THE CHNA WITH CENTRACARE HEALTH SAUK CENTRE, CENTRACARE MELROSE, AND ST. CLOUD HOSPITAL.

CENTRACARE HEALTH - MONTICELLO
PART V, SECTION B, LINE 6B: CENTRACARE HEALTH - MONTICELLO CONDUCTED THE CHNA WITH WRIGHT COUNTY COMMUNITY ACTION AND WRIGHT COUNTY PUBLIC HEALTH.

CENTRACARE HEALTH - PAYNESVILLE
PART V, SECTION B, LINE 6B: CENTRACARE HEALTH-PAYNESVILLE CONDUCTED THE CHNA WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH AND STEARNS COUNTY PUBLIC HEALTH.

CARRIS HEALTH - RICE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: CARRIS HEALTH'S CHNA WAS CONDUCTED WITH THE KANDIYOHI/RENVILLE PUBLIC HEALTH DEPARTMENT.

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 6B: CARRIS HEALTH'S CHNA WAS CONDUCTED WITH THE KANDIYOHI/RENVILLE PUBLIC HEALTH DEPARTMENT.

CARRIS HEALTH - RICE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 7D: IN ADDITION TO MAKING ITS CHNA AVAILABLE TO THE PUBLIC ON ITS WEB SITE AND AT ITS BUSINESS OFFICE, CCH HAS SHARED COPIES OF THE CHNA WITH COUNTY PUBLIC HEALTH OFFICIALS AND, INTERNALLY, WITH INDIVIDUALS WORKING ON QUALITY IMPROVEMENT AND COMMUNITY HEALTH INITIATIVES.CCH HAS ALSO PUBLISHED CONTACT INFORMATION FOR ITS DIRECTOR OF COMMUNITY & GOVERNMENT RELATIONS TO RESPOND TO QUESTIONS OR CONCERNS ABOUT THE CHNA. THE DIRECTOR HAS ALSO PRESENTED RESULTS OF THE CHNA TO COMMUNITY GROUPS AND TO REPRESENTATIVES OF LOCAL FUNDING GROUPS.THE COMMUNITY NEEDS NOT BEING ADDRESSED WERE DUE TO FUNDING AND STAFFING.

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 7D: IN ADDITION TO MAKING ITS CHNA AVAILABLE TO THE PUBLIC ON ITS WEB SITE AND AT ITS BUSINESS OFFICE, CCH HAS SHARED COPIES OF THE CHNA WITH COUNTY PUBLIC HEALTH OFFICIALS AND, INTERNALLY, WITH INDIVIDUALS WORKING ON QUALITY IMPROVEMENT AND COMMUNITY HEALTH INITIATIVES.CCH HAS ALSO PUBLISHED CONTACT INFORMATION FOR ITS DIRECTOR OF COMMUNITY & GOVERNMENT RELATIONS TO RESPOND TO QUESTIONS OR CONCERNS ABOUT THE CHNA. THE DIRECTOR HAS ALSO PRESENTED RESULTS OF THE CHNA TO COMMUNITY GROUPS AND TO REPRESENTATIVES OF LOCAL FUNDING GROUPS.

CENTRACARE HEALTH - MONTICELLO
"PART V, SECTION B, LINE 11: COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, PUBLIC HEALTH AND HOSPITAL/HEALTH SYSTEM STAFF PARTICIPATED IN A PROCESS THAT IDENTIFIED THE FOLLOWING PRIORITY AREAS FOR COMMUNITY HEALTH IN THE COMMUNITIES SERVED BY THE COLLABORATIVE:1) MENTAL HEALTH AND WELLNESS2) DENTAL CARE3) SUBSTANCE USE AND ABUSEIN 2018-19, STAFF SOLICITED COMMUNITY INPUT, ASSESSED EXISTING RESOURCES AND DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN FOR 2020-2022 IN ORDER TO ADDRESS THESE PRIORITIES. THIS IMPLEMENTATION PLAN INCLUDES THE FOLLOWING GOALS, EACH OF WHICH IS SUPPORTED BY MULTIPLE STRATEGIES AND WILL BE IMPLEMENTED THROUGH A VARIETY OF ACTIVITIES MONITORED FOR PROGRESS AND OUTCOMES OVER TIME. MENTAL HEALTH AND WELLNESS GOAL: REDUCE THE RATE OF MENTAL HEALTH CARE DELAY AND THE NUMBER OF NOT GOOD"" MENTAL HEALTH DAYS IN WRIGHT COUNTY.DENTAL CARE GOAL: REDUCE THE RATE OF DENTAL CARE DELAY IN WRIGHT COUNTY. SUBSTANCE USE AND ABUSE GOAL: SUPPORT LOCAL PREVENTION EFFORTS AND ADVOCATE FOR POLICY CHANGES TO ADDRESS SUBSTANCE ABUSE IN WRIGHT COUNTY.DATA REVIEW AND ISSUE PRIORITIZATION APPROXIMATELY 150 STAKEHOLDERS REPRESENTING BROAD INTERESTS OF THE COMMUNITY AND 40 COMMUNITY ORGANIZATIONS PARTICIPATED IN KEY INFORMANT INTERVIEWS AND/OR ATTENDED AT LEAST ONE OF SEVERAL MEETINGS TO REVIEW AND DISCUSS THE CHNA DATA GATHERED AND HELP IDENTIFY THREE PRIORITY HEALTH ISSUES.THE REVIEW PROCESS INCLUDED A FORMAL PRIORITIZATION TOOL KNOWN AS THE HANLON METHOD, WHICH INCLUDES RANKING HEALTH PRIORITIES BASED ON THREE PRIMARY CRITERIA: THE SIZE OF THE PROBLEM, INCLUDING PROJECTION OF FUTURE TRENDS; THE SERIOUSNESS OF THE PROBLEM, INCLUDING DISPARATE HEALTH BURDENS WITHIN THE POPULATION; AND THE EFFECTIVENESS AND FEASIBILITY OF INTERVENTIONS ON THE PART OF HEALTH CARE. AS A RESULT OF THE PRIORITIZATION SESSION, THE COLLABORATIVE ARRIVED AT 10 TOP HEALTH PRIORITIES FACING THE POPULATION OF WRIGHT COUNTY.AFTER COLLECTING EXTENSIVE FEEDBACK AND CONDUCTING COMMUNITY CONVERSATIONS AND DIALOGUES, THE COLLABORATIVE ARRIVED AT TOP 10 PRIORITIES, WHICH WERE THEN REVIEWED BY EACH ORGANIZATIONS' STAKEHOLDER GROUPS. EACH GROUP CONSISTED OF KEY STAKEHOLDERS, INCLUDING SENIOR LEADERS AND MANAGERS. ALL FOUR GROUPS FOCUSED ON DEFINING WHAT HEALTH PRIORITIES ARE THE MOST RELEVANT TO THE POPULATION EACH ORGANIZATION SERVES, AND HOW THE POPULATION IS AFFECTED BY THE GAPS IDENTIFIED IN THE CHNA PROCESS.EACH GROUP ARRIVED AT THEIR OWN PRIORITIZED LIST OF HEALTH ISSUES FACING WRIGHT COUNTY. THE LISTS WERE THEN COMBINED BY THE CORE GROUP AND ISSUES WERE AGAIN PRIORITIZED BASED ON THE RANKINGS FROM INDIVIDUAL ORGANIZATIONS. THE CORE GROUP FOCUSED ON THE ISSUES FACING THE MAJORITY OF THE POPULATION SERVED AND THE SEVERITY AND MAGNITUDE OF THE HEALTH CONCERNS. THE COLLABORATIVE CHOSE THE TOP THREE PRIORITIES BASED ON TRUE COMMUNITY NEED, VERSUS JUST THE ABILITY TO PROVIDE INTERVENTIONS. THE COLLABORATIVE BELIEVES THAT PART OF THE SOLUTION IS STARTING THE CONVERSATION AROUND THE TOPICS THAT HAVE NOT YET BEEN ADDRESSED, AND ENGAGING COMMUNITY PARTNERS AND OTHER ORGANIZATIONS TO ASSIST IN IMPLEMENTATION PLANNING AND DEVELOPMENT OF TACTICS/ACTIVITIES TO ADDRESS THOSE PRIORITIES.NEEDS IDENTIFIED BUT NOT INCLUDED IN THE CHNA:GOING INTO THE HANLON PRIORITIZATION, THE CORE GROUP HAD A LIST OF 20 IDENTIFIED HEALTH ISSUES THAT NEEDED TO BE DISCUSSED AND ARRANGED ACCORDING TO THE WEIGHT OF ITS SIZE, SERIOUSNESS AND EFFECTIVENESS. AFTER ALL THE HEALTH ISSUES WERE RANKED, THE CORE GROUP REALIZED THERE WERE SEVERAL IDENTIFIED ISSUES THAT COULD BE COMBINED WITH TOP PRIORITIES. FOR EXAMPLE, SUICIDE AWARENESS AND PREVENTION CAN BE COMBINED WITH ONE OF THE TOP PRIORITIES OF MENTAL HEALTH AND WELLNESS. OTHER ISSUES THAT WERE IDENTIFIED INCLUDED STRESS, LACK OF PHYSICAL ACTIVITY AND SOCIAL CONNECTEDNESS/ISOLATION. WHILE THE CORE GROUP UNDERSTANDS THAT ALL OF THESE ISSUES ARE IMPORTANT AND NEED CONCENTRATED EFFORTS IN ORDER TO RESOLVE, THEY WILL BE CONSCIOUSLY DISCUSSED AND NATURALLY ADDRESSED IN THE STRATEGIES AND TACTICS EACH ORGANIZATION CREATES. WHILE TOPICS SUCH AS DISTRACTED DRIVING RANKED AS A HIGH NEED IN WRIGHT COUNTY, THERE ARE CURRENTLY MANY GROUPS ALREADY WORKING ON THIS ISSUE AND ACTIVELY PURSUING INTERVENTIONS AROUND THIS CONCERN (SAFE COMMUNITIES OF WRIGHT COUNTY, HIGHWAY 55 COALITION, HIGHWAY 12 COALITION AND I94 WEST CHAMBER OF COMMERCE).SOME OF THE PRIORITIES IDENTIFIED IN 20172019 IMPLEMENTATION PLAN ARE STILL RELEVANT TO THE WORK OF THE COLLABORATIVE (FOOD INSECURITY, OBESITY, PHYSICAL ACTIVITY, ACCESS TO CARE). THE COLLABORATIVE MADE SIGNIFICANT STRIDES IN ADDRESSING THOSE PRIORITIES AND WILL CONTINUE TO SUPPORT THE EFFORTS AROUND THESE INITIATIVES THROUGH CURRENT WORKFLOWS AND SERVICE MODELS.THE NEEDS NOT ADDRESSED WITHIN THE CURRENT YEAR CHNA WERE UNABLE TO BE FULLY ADDRESSED DUE TO FUNDING AND STAFFING."

CENTRACARE HEALTH - PAYNESVILLE
PART V, SECTION B, LINE 11: THE PRIORITIZATION PROCESS TOOK PLACE WHILE UTILIZING THE MAPP PROCESS. THE WORK OF EACH OF THE FOUR MAPP ASSESSMENT SUB-GROUPS RESULTED IN FOUR LISTS OF 10 COMMUNITY PRIORITIES. AS A REMINDER, THE FOUR ASSESSMENTS INCLUDE: COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH STATUS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT. THOSE FOUR LISTS OF 10 ARE INCLUDED IN THE NARRATIVE EARLIER IN THIS DOCUMENT.THE CORE SUPPORT TEAM WAS PROVIDED THOSE FOUR LISTS OF TEN PRIORITIES. THEY TOOK THOSE LISTS AND TALKED WITH THEIR AGENCY STAFF TO IDENTIFY ANY THEMES OR COMMONALITIES AMONGST THE FOUR LISTS. THE CORE SUPPORT TEAM THEN CAME TOGETHER IN A MEETING AND WENT THROUGH A FACILITATED PROCESS USING THE CENTRAL MN ALLIANCE VISION AS A GUIDE TO COME UP WITH A TOP 10 LIST TO SEND ON TO THE DELEGATED AUTHORITIES.THE DELEGATED AUTHORITIES MET AND CONTINUED THE DISCUSSION ABOUT THE PRIORITY LIST. THE PRIORITIES PASSED ON BY THE CORE SUPPORT TEAM WERE RUN THROUGH TWO PRIORITIZATION EXERCISES. THE FIRST WAS A RANKING DISCUSSION WITH POINTS ASSIGNED FOR CERTAIN CRITERIA. RANKS INCLUDED 3 FOR HIGH, 2 FOR MEDIUM, AND 1 FOR LOW. THE CRITERIA INCLUDED: URGENCY: IS THIS A PRIORITY ISSUE THAT NEEDS TO BE ADDRESSED IN THE NEXT 1-3 YEARS?POTENTIAL IMPACT: IS IT LIKELY THAT ADDRESSING THIS CRITICAL ISSUE WILL HAVE A SIGNIFICANT IMPACT ON ONE OR MORE SPECIFIC POPULATIONS? DO YOU HAVE REASON TO BELIEVE YOU CAN BE SUCCESSFUL ON THIS ISSUE?ACTIONABLE/FEASIBLE: ARE THERE OPPORTUNITIES FOR ACTION TO ADDRESS THE CRITICAL ISSUE? IS THERE ROOM TO MAKE MEANINGFUL IMPROVEMENT ON THE ISSUE?RESOURCES: ARE RESOURCES (FUNDS, STAFF, & EXPERTISE) EITHER READILY AVAILABLE OR LIKELY RESOURCES CAN BE OBTAINED TO ADDRESS THE CRITICAL ISSUE? ARE THERE RESOURCES THROUGH THE STATE AND COMMUNITY MEMBERS TO WORK ON THE ISSUE? IF NOT, CAN RESOURCES BE ACQUIRED?COMMUNITY READINESS: IS THIS A CRITICAL ISSUE IDENTIFIED AS IMPORTANT BY THE COMMUNITY? ARE PEOPLE IN THE COMMUNITY INTERESTED IN THE ISSUE? IS THERE COMMUNITY MOMENTUM TO MOVE THIS INITIATIVE FORWARD?INTEGRATION: IS THERE OPPORTUNITY FOR COLLABORATION? IS THERE OPPORTUNITY TO BUILD ON EXISTING INITIATIVES? WILL THIS DUPLICATE EFFORTS? FINALLY, THE PRIORITIES WERE PLACED ON A CONTROL/INFLUENCE GRID.THE PRIORITIES IDETIFIED WERE AS FOLLOWS IN COMMUNITY INFORMED RANKING: 1) BUILDING FAMILIES, 2) MENTAL HEALTH, 3) ENCOURAGING SOCIAL CONNECTION, 4) ADVERSE CHILDHOOD EXPERIENCES (ACES), 5) TOBACCO/NICOTINE USE, 6) HEALTH CARE, 7) RISKY YOUTH BEHAVIOR, 8) FINANCIAL STRESS, 9) TRAUMA, AND 10) EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS. DUE TO THE NEWNESS OF THE COLLABORATION ON THIS WORK, A DECISION WAS MADE TO FOCUS ON THE TOP TWO PRIORITIES (BUILDING FAMILIES AND MENTAL HEALTH) FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIES ENCOURAGING SOCIAL CONNECTION, ADVERSE CHILDHOOD EXPERIENCES (ACES), TOBACCO/NICOTINE USE, HEALTH CARE, RISKY YOUTH BEHAVIOR, FINANCIAL STRESS, TRAUMA, AND EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS WILL NOT SPECIFICALLY BE ADDRESSED THROUGH ACTION PLANNING OR MEASUREMENT DUE TO FUNDING AND STAFFING, HOWEVER, THERE ARE WAYS MANY OF THESE PRIORITIES ARE BEING ADDRESSED EITHER WITHIN THE TOP TWO PRIORITIES OR THE COMMUNITY. IN THE FUTURE, THE GROUP WILL ASSESS THE CAPACITY TO EXPAND THE NUMBER OF PRIORITIES BEING ADDRESSED AND MEASURED. ALTHOUGH NOT DIRECTLY ADDRESSED IN THE PLAN, CENTRACARE DOES ACTIVELY SUPPORT OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO ARE WORKING ON DETERMINANTS OF HEALTH IDENTIFIED DURING THE CHNA PROCESS LIKE ACES, TOBACCO, TRAUMA, EDUCATING POLICYMAKERS, ETC.THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE ACTION PLAN THAT USES GUIDING PRINCIPLES AND STRATEGIES TO ADDRESS THE COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE TOP PRIORITIES ARE BUILDING FAMILIES AND MENTAL HEALTH. WE WILL USE THE GUIDING PRINCIPLES OF COMMUNITY COLLABORATION, AWARENESS, RESILIENCE, EQUITY, EDUCATION, AND HEALTH ORGANIZATIONS TO DRIVE OUR STRATEGIES.THE ST. CLOUD HOSPITAL, CENTRACARE- MELROSE HOSPITAL, CENTRACARE- SAUK CENTRE, AND CENTRACARE- PAYNESVILLE WILL MAINTAIN THEIR ENGAGEMENTS WITH THE CENTRAL MN ALLIANCE AND FOLLOW THE MAPP LEADERSHIP STRUCTURE TO CARRY OUT THE STRATEGIES OUTLINED IN THE CHIP. THERE WILL BE MEETINGS AS OUTLINED IN THE CHIP UNDER LEADERSHIP SYSTEM & PROCESS FOR MONITORING AND REVISION. TO SEE THE FULL CHIP GO TO THE CENTRACARE WEBSITE AT HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/.

CARRIS HEALTH - RICE MEMORIAL HOSPITAL
"PART V, SECTION B, LINE 11: IN ORDER TO PRIORITIZE THE HEALTH INDICATORS THAT WERE IDENTIFIED, THE CHNA WORKING GROUP EVALUATED A SET OF FOUR RANKING CRITERIA TO ALIGN PRIORITIES WITH COMMUNITY HEALTH OBJECTIVES. THE CRITERIA THAT WERE USED, AND THEIR CORRESPONDING DESCRIPTION ARE LISTED BELOW:1. MISSION RELEVANCY: THE HEALTH ISSUE FALLS WITHIN THE HOSPITAL'S OVERALL MISSION AND CORE COMPETENCIES2. COMMUNITY IMPACT: THE PREVALENCE AND SEVERITY OF THE HEALTH ISSUE3. RESOURCE AVAILABILITY: THE AVAILABILITY OF CARRIS HEALTH'S TIME, HUMAN, AND STRATEGIC RESOURCES NECESSARY TO ADDRESS THE ISSUE4. ESTIMATED EXPENSE: THE EXPENSE (BOTH INTERNAL AND EXTERNAL) OF ADDRESSING THE ISSUETHE PRIORITIZATION PROCESS ITSELF WAS DIVIDED INTO THE TWO STAGES. THE FIRST STAGE CONSISTED IN RATING EACH HEALTH INDICATOR ACCORDING TO MISSION RELEVANCY ALONE. EACH CHNA WORKING GROUP MEMBER WAS ASKED TO RESPOND, ""IS EACH RESPECTIVE COURSE OF ACTION RELEVANT TO CARRIS HEALTH'S MISSION AND CORE COMPETENCIES?"" AFTER A REVIEW OF THE RESPONSES TO THE SURVEY, 6 PRIORITY AREAS WERE SELECTED. THE SECOND STAGE OF THE PROCESS CONSISTED IN THE PRIORITIZATION OF THE 6 HIGH PRIORITY AREAS ACCORDING TO COMMUNITY IMPACT, RESOURCE AVAILABILITY, AND ESTIMATED EXPENSES.THESE TOP SIX PRIORITY AREAS WERE REVIEWED IN COMPARISON TO DATA GATHERED BY CARRIS HEALTH'S ONGOING, COLLABORATIVE EFFORT WITH KANDIYOHI PUBLIC HEALTH TO COMPLETE THEIR HEALTH NEEDS ASSESSMENT. NO DATA FROM THE COUNTY HEALTH ASSESSMENT CONTRADICTED THE CHOICE OF THE PRIORITIES FROM THE CARRIS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENTS. THE COLLABORATION BETWEEN CARRIS HEALTH AND KANDIYOHI PUBLIC HEALTH STRENGTHENED THE COLLECTIVE IMPACT THAT THIS GROUP OF HEALTH PROFESSIONALS RECOGNIZE IS NEEDED IN ORDER TO HAVE SUSTAINABLE IMPACT ON POPULATION HEALTH IMPROVEMENT. FINALLY, THE RANKED ISSUES WERE PRESENTED TO CARRIS HEALTH'S OPERATING COMMITTEES, BOARDS, MEDICAL STAFFS AND LEADERSHIP GROUP FOR FEEDBACK AND CLARIFICATION. AN ACTION PLAN WAS DEVELOPED TO ADDRESS THE TOP PRIORITY HEALTH CONCERNS THAT WERE IDENTIFIED BY THE CHNA WORKING COMMITTEE.AN INTERNAL REVIEW OF PERFORMANCE AND OUTCOME DATA USING VARIOUS REPORTING AND DATA COLLECTION TOOLS, IN ADDITION TO THE INCORPORATION OF COMMUNITY CONVERSATIONS LED BY THE LOCAL HEALTH DEPARTMENT SUPPORTED THE IDENTIFICATION OF THE TOP HEALTH PRIORITIES THAT WERE DETERMINED TO HAVE THE LARGEST IMPACT AND POTENTIAL FOR IMPROVEMENT ON POPULATION HEALTH. THESE PRIORITY AREAS ARE AS FOLLOWS: OBESITY, DEPRESSION, TOBACCO, DIABETES, OPIOID USE, AND CANCER."

CARRIS HEALTH - REDWOOD AREA HOSPITAL
"PART V, SECTION B, LINE 11: IN ORDER TO PRIORITIZE THE HEALTH INDICATORS THAT WERE IDENTIFIED, THE CHNA WORKING GROUP EVALUATED A SET OF FOUR RANKING CRITERIA TO ALIGN PRIORITIES WITH COMMUNITY HEALTH OBJECTIVES. THE CRITERIA THAT WERE USED, AND THEIR CORRESPONDING DESCRIPTION ARE LISTED BELOW:1. MISSION RELEVANCY: THE HEALTH ISSUE FALLS WITHIN THE HOSPITAL'S OVERALL MISSION AND CORE COMPETENCIES2. COMMUNITY IMPACT: THE PREVALENCE AND SEVERITY OF THE HEALTH ISSUE3. RESOURCE AVAILABILITY: THE AVAILABILITY OF CARRIS HEALTH'S TIME, HUMAN, AND STRATEGIC RESOURCES NECESSARY TO ADDRESS THE ISSUE4. ESTIMATED EXPENSE: THE EXPENSE (BOTH INTERNAL AND EXTERNAL) OF ADDRESSING THE ISSUETHE PRIORITIZATION PROCESS ITSELF WAS DIVIDED INTO THE TWO STAGES. THE FIRST STAGE CONSISTED IN RATING EACH HEALTH INDICATOR ACCORDING TO MISSION RELEVANCY ALONE. EACH CHNA WORKING GROUP MEMBER WAS ASKED TO RESPOND, ""IS EACH RESPECTIVE COURSE OF ACTION RELEVANT TO CARRIS HEALTH'S MISSION AND CORE COMPETENCIES?"" AFTER A REVIEW OF THE RESPONSES TO THE SURVEY, 6 PRIORITY AREAS WERE SELECTED. THE SECOND STAGE OF THE PROCESS CONSISTED IN THE PRIORITIZATION OF THE 6 HIGH PRIORITY AREAS ACCORDING TO COMMUNITY IMPACT, RESOURCE AVAILABILITY, AND ESTIMATED EXPENSES.THESE TOP SIX PRIORITY AREAS WERE REVIEWED IN COMPARISON TO DATA GATHERED BY CARRIS HEALTH'S ONGOING, COLLABORATIVE EFFORT WITH KANDIYOHI PUBLIC HEALTH TO COMPLETE THEIR HEALTH NEEDS ASSESSMENT. NO DATA FROM THE COUNTY HEALTH ASSESSMENT CONTRADICTED THE CHOICE OF THE PRIORITIES FROM THE CARRIS HEALTH COMMUNITY HEALTH NEEDS ASSESSMENTS. THE COLLABORATION BETWEEN CARRIS HEALTH AND KANDIYOHI PUBLIC HEALTH STRENGTHENED THE COLLECTIVE IMPACT THAT THIS GROUP OF HEALTH PROFESSIONALS RECOGNIZE IS NEEDED IN ORDER TO HAVE SUSTAINABLE IMPACT ON POPULATION HEALTH IMPROVEMENT. FINALLY, THE RANKED ISSUES WERE PRESENTED TO CARRIS HEALTH'S OPERATING COMMITTEES, BOARDS, MEDICAL STAFFS AND LEADERSHIP GROUP FOR FEEDBACK AND CLARIFICATION. AN ACTION PLAN WAS DEVELOPED TO ADDRESS THE TOP PRIORITY HEALTH CONCERNS THAT WERE IDENTIFIED BY THE CHNA WORKING COMMITTEE.AN INTERNAL REVIEW OF PERFORMANCE AND OUTCOME DATA USING VARIOUS REPORTING AND DATA COLLECTION TOOLS, IN ADDITION TO THE INCORPORATION OF COMMUNITY CONVERSATIONS LED BY THE LOCAL HEALTH DEPARTMENT SUPPORTED THE IDENTIFICATION OF THE TOP HEALTH PRIORITIES THAT WERE DETERMINED TO HAVE THE LARGEST IMPACT AND POTENTIAL FOR IMPROVEMENT ON POPULATION HEALTH. THESE PRIORITY AREAS ARE AS FOLLOWS: OBESITY, DEPRESSION, TOBACCO, DIABETES, OPIOID USE, AND CANCER.THE COMMUNITY NEEDS NOT BEING ADDRESSED WERE DUE TO FUNDING AND STAFFING."

CENTRACARE HEALTH - MONTICELLO
PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT

CENTRACARE HEALTH - PAYNESVILLE
PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT

CARRIS HEALTH - RICE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT

CENTRACARE HEALTH - MONTICELLO
PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.

CENTRACARE HEALTH - PAYNESVILLE
PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.

CARRIS HEALTH - RICE MEMORIAL HOSPITAL
PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS.

CENTRACARE HEALTH - MONTICELLO:
PART V, SECTION B, LINE 7A:THE HOSPITAL'S CHNA CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/WRIGHT-COUNTY-COMMUNITY-HEALTH-COLLABORATIVE-CHNA-2019-2022-VERSION-1-UPDATED-10.19.PDF

CENTRACARE HEALTH - MONTICELLO:
PART V, SECTION B, LINE 10A:THE HOSPITAL'S IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/WRIGHT-COUNTY-COMMUNITY-HEALTH-COLLABORATIVE-CHNA-2019-2022-VERSION-1-UPDATED-10.19.PDF

CENTRACARE HEALTH - PAYNESVILLE:
PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF

CENTRACARE HEALTH - PAYNESVILLE:
PART V, SECTION B, LINE 10A: THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF

CARRIS HEALTH - RICE MEMORIAL HOSPITAL:
PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA CAN BE FOUND ON ITS WEBSITE ATHTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CARRIS-COMMUNITYHEALTHNEEDSASSESSMENT.PDF

CARRIS HEALTH - RICE MEMORIAL HOSPITAL:
PART V, SECTION B, LINE 10A: THE HOSPITAL'S IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE ATHTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CARRIS-COMMUNITYHEALTHNEEDSASSESSMENT.PDF

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA CAN BE FOUND ON ITS WEBSITE ATHTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CARRIS-COMMUNITYHEALTHNEEDSASSESSMENT.PDF

CARRIS HEALTH - REDWOOD AREA HOSPITAL
PART V, SECTION B, LINE 10A: THE HOSPITAL'S IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE ATHTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CARRIS-COMMUNITYHEALTHNEEDSASSESSMENT.PDF

SCHEDULE H, PART V, SECTION B, LINE 3
THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REV. PROC 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 3. DURING THE TAX YEAR JUNE 30, 2022, THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CARRIS HEALTH - RICE MEMORIAL HOSPITAL AND CARRIS HEALTH - REDWOOD AREA HOSPITAL DID NOT CONTAIN ALL OF THE REQUIRED ELEMENTS FOR A COMMUNITY HEALTH NEEDS ASSESSMENT UNDER IRC SECTION 501(R)(3). THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT DID NOT INCLUDE A DESCRIPTION OF THE DEMOGRAPHICS OF THE COMMUNITY; THE REPORT DID NOT INCLUDE A DESCRIPTION OF THE PRIMARY AND CHRONIC DISEASE NEEDS AND OTHER HEALTH ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. CENTRACARE IDENTIFIED THIS ERROR IN MARCH 2022 DURING THE PREPARATION OF THE FORM 990 FOR THE TAX PERIOD ENDED JUNE 30, 2021. THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR CARRIS HEALTH - RICE MEMORIAL HOSPITAL AND CARRIS HEALTH - REDWOOD AREA HOSPITAL THAT WAS CONDUCTED DURING THE TAX PERIOD ENDED JUNE 30, 2022 INCLUDED ALL REQUIRED ELEMENTS AND DISCLOSURES UNDER IRC SECTION 501(R)(3). THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN AFTER THE DISCOVERY OF THE ERROR.

SCHEDULE H, PART V, SECTION B, LINE 22
"THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REV. PROC. 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 22B. DURING CENTRACARE HEALTH SYSTEM 41-1813221 THE TAX PERIOD ENDED JUNE 30, 2022, THE FINANCIAL ASSISTANCE POLICY DID NOT INCLUDE THE PERCENTAGE CALCULATED FOR THE ""AMOUNTS GENERALLY BILLED"" USING THE LOOK BACK METHOD. CENTRACARE IDENTIFIED THIS ERROR IN MARCH 2022 DURING THE PREPARATION OF FORM 990 FOR THE TAX PERIOD ENDED JUNE 30, 2021, AND CORRECTED THIS ERROR IN APRIL 2022. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN AFTER THE DISCOVERY OF THE ERROR."

PART I, LINE 6A:
CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS.

PART I, LINE 7:
THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE FINANCIAL ASSISTANCE ON LINE 7A. MEDICAID COMMUNITY BENEFIT EXPENSE AND DIRECT OFFSETTING REVENUES ON LINE 7B ARE REPORTED AT COST. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ON LINE 7E ARE REPORTED AT COST. HEALTH PROFESSIONALS EDUCATION AND DIRECT OFFSETING REVENUES ON LINE 7F ARE REPORTED AT COST. CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT ON LINE 7I ARE REPORTED AT COST.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,574,355.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE HEALTH SYSTEM PROVIDED DRIVE THROUGH TEST SITES, FREE VACCINATION CLINICS, MANDATED EMPLOYEE VACCINATION, TRAINING, SCREENING, PRODUCTS TO ENSURE SAFE ENVIRONMENTS, AND OTHER VARIOUS SERVICES/PRODUCTS.

PART III, LINE 2:
THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS.

PART III, LINE 4:
"THE FOLLOWING IS FROM THE ""ACCOUNTS RECEIVABLE"" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS.""THE SYSTEM REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED."""

PART III, LINE 8:
THE AMOUNT ON LINE 6 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT, PRIMARILY THE D SERIES AND E SERIES.

PART III, LINE 9B:
THE COLLECTION POLICIES AT THE HOSPITALS REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE, IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT RATING AGENCIES.

PART VI, LINE 2:
THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES.

PART VI, LINE 3:
INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE.

PART VI, LINE 4:
CENTRACARE HEALTH - MONTICELLO IS LOCATED IN CENTRAL MINNESOTA IN WRIGHT COUNTY IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 21,223, WITH A PROJECTED 2028 GROWTH PERCENTAGE OF 4.59% TO 22,197 POPULATION LEVEL. THIS AREA OF THE STATE IS SHOWING A SIGNIFICANT INCREASE IN POPULATION AND IS EXPECTED TO CONTINUE INTO THE FUTURE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: -0.90%, 18-44: 1.28%, 45-64: 6.19%, 65+: 20.61%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 84.87%, AFRICAN AMERICAN: 1.84%, ASIAN: 1.43%, HISPANIC: 6.84%, OTHER: 5.02%. THE ESTIMATED 2023 AVERAGE INCOME IS $105,568. THE ESTIMATED MEDICAL UNDERSERVICE SCORE IS 59.80.CENTRACARE HEALTH - PAYNESVILLE IS LOCATED IN CENTRAL MINNESOTA IN STEARNS COUNTY IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 5,766 AND IS PROJECTED TO INCREASE SLIGHTLY TO 5,881 BY 2028 WHICH REPRESENTS A 1.99% INCREASE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: 2.92%, 18-44: 3.95%, 45-64: -7.87%, 65+: 7.87%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 92.18%, AFRICAN AMERICAN: 0.66%, ASIAN: 0.35%, HISPANIC: 2.93%, OTHER: 3.88%. THE ESTIMATED 2023 AVERAGE INCOME IS $97,973. THE ESTIMATED MEDICAL UNDERSERVICE SCORE OF 58.0.CENTRACARE HEALTH - RICE MEMORIAL HOSPITAL IS LOCATED IN CENTRAL MINNESOTA IN KANDIYOHI COUNTY IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 24,752 AND IS PROJECTED TO INCREASE SLIGHTLY TO 25,148 BY 2028 WHICH REPRESENTS A 1.60% INCREASE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: -0.11%, 18-44: 1.57%, 45-64: -4.15%, 65+: 10.32%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 56.88%, AFRICAN AMERICAN: 15.11%, ASIAN: 3.22%, HISPANIC: 21.45%, OTHER: 3.34%. THE ESTIMATED 2023 AVERAGE INCOME IS $85,974. CENTRACARE HEALTH - REDWOOD FALLS HOSPITAL IS LOCATED IN REDWOOD COUNTY, MINNESOTA IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 6,432 AND IS PROJECTED TO DECREASE SLIGHTLY TO 6,407 BY 2028 WHICH REPRESENTS A 0.39% DECREASE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: -1.59%, 18-44: 0.81%, 45 64: -8.17%, 65+: 7.19%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 79.76%, AFRICAN AMERICAN: 1.06%, ASIAN: 0.72%, HISPANIC: 5.32%, OTHER: 13.15%. THE ESTIMATED 2023 AVERAGE INCOME IS $82,159. THE ESTIMATED MEDICAL UNDERSERVICE SCORE OF 61.10.

PART VI, LINE 6:
THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE.

PART VI, LINE 5:
THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IN SEVERAL IMPORTANT WAYS. ONE OF THESE WAYS IS THROUGH THE COMMUNITY COLLABORATION COMMITTEE (CCC), A STANDING COMMITTEE OF THE CENTRACARE HEALTH FOUNDATION. THE CCC HAS A MEMBERSHIP OF OVER 30 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. A MAJORITY OF THE COMMITTEE IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA THAT ARE NOT EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION AND ARE NOT FAMILY MEMBERS THEREOF. THE CCC MEETS MONTHLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND/OR AN INTERVENTION PROJECT. THERE ARE SEVERAL COMMUNITY HEALTH OUTREACH INITIATIVES THAT THE FOUNDATION IS INVOLVED WITH. THESE INITIATIVES INCLUDE: 1) BLEND CHILDHOOD OBESITY COALITION OF CENTRAL MINNESOTA, 2) SMOKE FREE COMMUNITIES (CONTINUED EFFORTS TO CREATE CLEAN INDOOR AND OUTDOOR AIR FOR ALL), 3) TOBACCO CESSATION SERVICES CLINICS (COLLABORATION WITH CLINIC), 4) CENTRACARE CLINIC TEAM BASED CARE PILOT, 5) ST. CLOUD HOSPITAL - TRANSITION OF CARE PILOT (CREATE MORE SEAMLESS INTEGRATION FROM CARE SETTING TO CARE SETTING, AND 6) CLINIC - DIVERSITY AND CULTURAL COMPETENCY TRAINING. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES AND FACILITIES AND EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION AND RESEARCH.

PART VI, LINE 7, REPORTS FILED WITH STATES
MN