SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Sanford Group Return
 
Employer identification number

45-3791176
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    92,732,689 0 92,732,689 2.110 %
b Medicaid (from Worksheet 3, column a) . . . . .     592,684,292 393,314,659 199,369,633 4.540 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     685,416,981 393,314,659 292,102,322 6.650 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     12,078,191 554,595 11,523,596 0.260 %
f Health professions education (from Worksheet 5) . . .     18,783,445 3,498,697 15,284,748 0.350 %
g Subsidized health services (from Worksheet 6) . . . .     561,824,417 455,396,954 106,427,463 2.420 %
h Research (from Worksheet 7) .     55,810,083 47,146,716 8,663,367 0.200 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     40,288,252 0 40,288,252 0.920 %
j Total. Other Benefits . .     688,784,388 506,596,962 182,187,426 4.150 %
k Total. Add lines 7d and 7j .     1,374,201,369 899,911,621 474,289,748 10.800 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     100,000 0 100,000 0 %
2 Economic development     1,536 0 1,536 0 %
3 Community support     430,459 2,970 427,489 0.010 %
4 Environmental improvements     34,000 0 34,000 0 %
5 Leadership development and
training for community members		     1,167 0 1,167 0 %
6 Coalition building     4,227 0 4,227 0 %
7 Community health improvement advocacy     83,285 0 83,285 0 %
8 Workforce development     39,335 0 39,335 0 %
9 Other     0 0    
10 Total     694,009 2,970 691,039 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
55,080,234
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
869,170,146
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
957,173,174
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-88,003,028
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
11 Everist Health
  		Prevention of heart and cardiovascular disease through unique medical tech 22.840 % 15.340 %  
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?24Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Sanford USD Medical Center
1305 W 18th Street
Sioux Falls,SD57117
www.sanfordhealth.org
SD 10564
Sanford Medical Center
460227855 		X X X X     X     A
2 Sanford Medical Center Fargo
5225 23rd Avenue S
Fargo,ND58104
www.sanfordhealth.org
ND 5070
Sanford Medical Center Fargo
450226909 		X X X X     X     A
3 Sanford Broadway Medical Center Fargo
801 Broadway North
Fargo,ND58122
www.sanfordhealth.org
ND 5018A
Sanford Medical Center Fargo
450226909 		X X X X     X     A
4 Sanford Medical Center South University
1720 South University
Fargo,ND58103
www.sanfordhealth.org
ND 5068A
Sanford Medical Center Fargo
450226909 		X X   X           A
5 Sanford Bismarck Medical Center
300 N 7th Street
Bismarck,ND58501
www.sanfordhealth.org
ND 5003A
Sanford Bismarck
450226700 		X X   X     X     A
6 Sanford Bemidji Medical Center
1300 Anne Street NW
Bemidji,MN56601
www.sanfordhealth.org
MN 371073
Sanford Health of Northern Minnesota
411266009 		X X         X     A
7 Sanford Medical Center Thief River Falls
3001 Sanford Parkway
Thief River Falls,MN56701
www.sanfordhealth.org
MN 371500
Sanford Health Network North
450409348 		X X     X   X   Inpatient Mental Health A
8 Sanford Aberdeen Medical Center
2905 3rd Avenue SE
Aberdeen,SD57401
www.sanfordhealth.org
SD 65089
Sanford Health Network
460388596 		X X         X     A
9 Sanford Worthington Medical Center
1018 6th Avenue
Worthington,MN56187
www.sanfordhealth.org
MN 371449
Sanford Health Network
460388596 		X X         X     A
10 Sanford Sheldon Medical Center
118 N 7th Avenue
Sheldon,IA51201
www.sanfordhealth.org
IA 161381
Sanford Health Network
460388596 		X X     X   X   Nursing Facility A
11 Sanford Vermillion Medical Center
20 S Plum Street
Vermillion,SD57069
www.sanfordhealth.org
SD 53082
Sanford Health Network
460388596 		X X     X   X   Nursing Facility A
12 Sanford Chamberlain Medical Center
300 S Byron Blvd
Chamberlain,SD57325
www.sanfordhealth.org
SD 50302
Sanford Health Network
460388596 		X X     X   X   Nursing Facility A
13 Sanford Luverne Medical Center
1600 N Kniss Avenue
Luverne,MN56156
www.sanfordhealth.org
MN 371352
Sanford Health Network
460388596 		X X     X   X     A
14 Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220
www.sanfordhealth.org
MN 371019
Sanford Health Network
460388596 		X X     X   X   Nursing Facility A
15 Sanford Jackson Medical Center
1430 N Highway
Jackson,MN56143
www.sanfordhealth.org
MN 371002
Sanford Health Network
460388596 		X X     X   X     A
16 Sanford Tracy Medical Center
251 5th Street E
Tracy,MN56175
www.sanfordhealth.org
MN 371440
Sanford Health Network
460388596 		X X     X   X     A
17 Sanford Hillsboro Medical Center
12 3rd Street SE
Hillsboro,ND58045
www.sanfordhealth.org
ND 5026A
Sanford Health Network North
450409348 		X X     X   X     A
18 Sanford Medical Center Mayville
42 6th Avenue SE
Mayville,ND58257
www.sanfordhealth.org
ND 5034A
Sanford Health Network North
450409348 		X X     X   X     A
19 Sanford Webster Medical Center
1401 W 1st Street
Webster,SD57274
www.sanfordhealth.org
SD 10573
Sanford Health Network
460388596 		X X     X   X     A
20 Sanford Medical Center Wheaton
401 12th Street N
Wheaton,MN56296
www.sanfordhealth.org
MN 371390
Sanford Health Network North
450409348 		X X     X   X     A
21 Sanford Bagley Medical Center
203 4th Street NW
Bagley,MN56621
www.sanfordhealth.org
MN 371484
Sanford Health of Northern Minnesota
411266009 		X X     X   X     A
22 Sanford Canton-Inwood Medical Center
440 N Hiawatha Drive
Canton,SD57013
www.sanfordhealth.org
SD 51569
Sanford Health Network
460388596 		X X     X   X     A
23 Sanford Clear Lake Medical Center
701 3rd Avenue S
Clear Lake,SD57226
www.sanfordhealth.org
SD 10533
Sanford Health Network
460388596 		X X     X   X     A
24 Sanford Westbrook Medical Center
920 Bell Avenue
Westbrook,MN56183
www.sanfordhealth.org
MN 371439
Sanford Health Network
460388596 		X X     X   X     A
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.sanfordhealth.org/about/community-health-needs-assessment
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
see narrative for full url
b
see narrative for full url
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Part V, Section B Facility Reporting Group A
Facility Reporting Group A consists of: - Facility 1: Sanford USD Medical Center, - Facility 3: Sanford Broadway Medical Center Fargo, - Facility 4: Sanford Medical Center South University, - Facility 5: Sanford Bismarck Medical Center, - Facility 6: Sanford Bemidji Medical Center, - Facility 7: Sanford Medical Center Thief River Falls, - Facility 8: Sanford Aberdeen Medical Center, - Facility 9: Sanford Worthington Medical Center, - Facility 10: Sanford Sheldon Medical Center, - Facility 11: Sanford Vermillion Medical Center, - Facility 12: Sanford Chamberlain Medical Center, - Facility 13: Sanford Luverne Medical Center, - Facility 14: Sanford Canby Medical Center, - Facility 15: Sanford Jackson Medical Center, - Facility 16: Sanford Tracy Medical Center, - Facility 17: Sanford Hillsboro Medical Center, - Facility 18: Sanford Medical Center Mayville, - Facility 19: Sanford Webster Medical Center, - Facility 20: Sanford Medical Center Wheaton, - Facility 21: Sanford Bagley Medical Center, - Facility 22: Sanford Canton-Inwood Medical Center, - Facility 23: Sanford Clear Lake Medical Center, - Facility 24: Sanford Westbrook Medical Center, - Facility 2: Sanford Medical Center Fargo
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 6a: Sanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well-Being - Skilled Labor ForceAccording to the Council on Social Work Education, public policies that promote financial literacy, accessible financial products/economic resources, and opportunities to generate income and build assets help economic wellbeing. Sanford has developed a plan to provide various labor opportunities in the community. Priority 2: Mental/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Depression is one of the most common mental disorders in the U.S. and is caused by many factors. It is also among the most treatable of mental disorders. (National Institute of Mental Health)Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearEconomic Well-Being:In 2020, Sanford USD Medical Center (SUSDMC) continued a comprehensive approach to improve the economic well-being of our community. This included partnerships with higher education organizations for internships, LPN sponsorships, scholarships, residencies, and fellowships, along with supporting our workforce during the COVID pandemic. Educational OpportunitiesIn 2020, we sponsored 55 LPNs and 60 MAs (six through our traditional sponsorship and 54 through MedCerts). Our Certified Medical Assistance Program includes coverage of tuition with a 2-year work commitment. The Sanford Sons and Daughters program includes 273 people in physician education; who are in medical school, a residency, or a fellowship and they receive support including scholarships. The Heart of Tomorrow program provided scholarships of $1,000 to 100 high school or college aged children of Sanford employees. Sanford supports residencies in pediatrics and general surgery, and fellowships in cardiology and interventional cardiology. We partner with other health care facilities for residencies in internal medicine, pathology, transitional year, and family medicine. All programs continue at full capacity.Sanford began a nurse residency program, a 12-month training program to support the transition from student nurse to professional registered nurse. 409 RNs have graduated from the program with 620 in progress. Sanford also supports a student nurse internship, a 10-week summer program offering hands-on experience and professional guidance.Sanford partnered with local organizations to launch Classrooms to Careers for Sioux Falls high school students, to promote post-secondary education. Students earn dual credit from courses taught at Southeast Technical College. A multitude of resources are available for students to develop post-secondary education support/plans. There are now 37 students in this program, and plans for significant growth.Workforce SupportSanford Health is proud to have maintained and supported our workforce through COVID. We created the Sanford Family Stability Plan which offered a stability payment and covered health insurance premiums for those most affected by the pandemic. The Sanford Family also helped our own by making considerable contributions to the PTO donation bank and Employee Crisis Fund.To meet workforce demands, a streamlined just-in-time training program was developed with customized curriculums enabling employees to cross-train and work outside of their current role confidently and safely. During peak COVID additional nursing staff was hired. Finally, Sanford provided childcare to support our workforce and maintain adequate levels of staffing for healthcare workers and first responders during COVID-19 challenges, in partnership with the Sioux Falls School District and Avera.Behavioral Health and Mental Health Access:Sanford Sioux Falls continues to improve access to mental/behavioral health needs. Integrative Health Therapists are in each primary care clinic. PHQ-9 depression remission performance consistently exceeds the national benchmark. Sanford health effectively utilizes the integrated care model at the SUSDMC. In addition, telehealth utilization has increased.The mental/behavioral health team continues to grow. The Psychiatry and Psychology Clinic currently has 25 total providers, 2 adult psychiatrists, 3 child and adolescent psychiatrists, 6 APPs, 6 Psychologists, and 8 Behavioral Health Therapists.There are 24 Integrated Health Therapists in the region including 7 IHTs in Sioux Falls Primary Care Clinics, 2 IHTs covering specialty clinics, 1 IHT covering Oncology, 11 Network IHTs, and 3 Behavioral Health Therapists covering primary care locations in Sioux Falls. Two new IHT's will be starting April 2021 in Sioux Falls. Sanford has collaborated with the City of Sioux Falls, Minnehaha County, and Avera Health to create The Community Triage Center. It will be a voluntary and involuntary commitment mid-level care alternative for those with substance/alcohol abuse, along with potential mental illness co-morbidities who are non-violent. It is scheduled to open June 2021.In addition to In addition to a robust employee assistance program, the Clinician Well-Being Program has been expanded to support clinicians, residents, and fellows as they face unique challenges and stress. The program resources include, a WorkLife Concierge virtual assistant available 24/7, as well as access to peer coaching, mentoring, and free confidential counseling.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.SUSDMC created an incident command center and prepared a comprehensive surge plan. Modeling enabled leadership to make data-driven decisions in real time, supported by state/city models and the analytics team. Sanford addressed needs for PPE, equipment, beds, staffing, and other critical items. Other responses included reduced entrances at the medical center, employee/patient temperature screening, visitor restriction policy, converting to negative airflow rooms, floor graphics to remind patients and staff to social distance, Plexiglas shields for patient registration and scheduling, and limited elective surgeries to preserve PPE were implemented.Virtual visit volume increased significantly. Sanford also supported the Sioux Falls area with timely testing, infusion centers, a patient registry, and clinical trial opportunities. SUSDMC was a tertiary care destination center during the pandemic, fielding and caring for patients from across the region. Community education has been foundational to our COVID response. Dr. Mike Wilde has provided the community with regular COVID updates including City of Sioux Falls Emergency Operations Center press briefings, conversations with state and local leaders regarding vaccination planning, and community presentations at events such as the Chamber of Commerce and Rotary Club meetings. The SMC leadership team held around 30 pre-recorded employee town halls and a live town hall on vaccines, many Facebook Live events, and offered expert information on Sanford Health News site.Identified needs not directly addressed by this facility include: Economic- Need for affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and concern for homelessnessTransportation- Need for door-to-door transportation for community members who do not drive, and the availability of public transportationAging- Cost of long term care and memory careChild and Youth- Substance abuse by youth, childhood obesity, availability of services for at-risk youth, bullying, crime committed by youth, and teen suicideSafety- Abuse of prescription drugsAccess to Health Care- Availability of behavioral health providers, availability of mental health providers, access to affordable prescription drugs, and access to affordable healthcare
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccess to affordable health care is important to overall health. Health insurance, local care options, and a usual source of care can ensure access to health care. Access to care makes it easier to enter the health care system, find local care easily, pay for care, and get health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services so patients can secure timely appointments.Priority 2: Mental/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearHealthcare AccessIn 2020, Sanford was successful in adding access by recruiting additional Behavioral Health providers including; a MD adult psychiatrist, a PhD child psychologist, an APP in adult psychiatry, and Six Integrated Health Therapists.The Tele-behavioral health pilot project in schools launched in spring of 2020. After initial enrollment of two children, the schools in Fargo/Moorhead were shut down and additional enrollment of children was put on hold. The enrolled children were able to complete the program in their homes. The pilot project re-launched in fall of 2020 with 20 kids enrolled. Due to hybrid/virtual learning in schools, the pilot remained on hold until early 2021. Sanford Fargo also began efforts to increase walk in hours and weekend hours but due to COVID those efforts have been put on hold.In 2020, Sanford primary care added access to clinics by recruiting additional Family Medicine and Internal Medicine providers including: 1 APP and 4 MD's in family medicine, and 1 APP and 1 MD in internal medicine.In 2019, the Advanced Practice Fellowship was launched to promote role expansion of Advanced Practice Providers to improve access. The program is a one-year training program for nurse practitioners and physician assistants who have completed their primary training program and are licensed providers. We offer rotations in primary and specialty care for a year. Rural community options are included. Fellows are assigned a preceptor and they see 4-6 patients per day. The fellows practice within primary care clinics to learn the collaborative care practice model with our primary care physicians. However, the fellowship was delayed from August 2020 to January 2021 because of COVID.We opened a Post Hospital transition clinic 6 days a week for medically complex patients that were discharged from the hospital. With care management, social work, integrated health therapists and pharmacists. Now patients could be seen very soon after their discharge.The Pediatric Mental Health Care Access Program is a Sanford project that focuses on collaborative care opportunities for pediatric medical providers to enhance treatment of pediatric mental health difficulties in North Dakota. In this program, primary care providers receive training, mental health education, and expert consultation on treating mental health conditions in children. The program collaborates with the University of North Dakota School of Medicine and Health Sciences and the North Dakota Department of Health. It's funded by the Health Resource Services Administration.Mental Health and Substance Abuse Sanford Health began collaborating with a F5, a Fargo-based peer-to-peer substance abuse support program provider in 2019. The program began in August 2020 and is offered twice per week to inpatients detoxing from alcohol and other substances. Patients are encouraged to meet in a group setting. Outcomes that are measured include re-admission rates, emergency visits, and EMS encounters. At our Suboxone clinic, we are working towards co-prescribing Narcan with any opioid prescription. This is the next step in the effort to decrease deaths by overdose in our community. IHT services have increased in our clinics. Sanford Fargo now has 10 IHTs in primary care clinics, increasing from 9 in 2019. On average IHTs see five patients per day to assess and refer to medical detox or the withdrawal management unit.Sanford Fargo increased the number of medication assisted treatment certified providers in 2019. Five physicians received waivers to prescribe suboxone after completing an 8-hour training course. The program launched in early 2020 and five participants went through the treatment. Outcomes set to be measured include re-admission rates, number of emergency department visits, EMS encounters and rate of peer-to-peer group attendance (goal 50% attendance) for a six-month period beginning July 2020.Patient Health Questionnaires are used to assess patients and refer them to an IHT if needed. This process was disrupted due to COVID. Mental Health First Aid Training was paused in 2020 due to COVID. It will be replaced with BeHeard which has the capacity to be delivered both in-person and virtually.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in their ranking of states with the best vaccination rates.Sanford Fargo offered a home monitoring program for COVID positive patients and monitored patients' oxygen saturation levels, temperature, and symptoms. We also opened a drive through COVID-19 testing center. In 2020, 44,757 COVID-19 tests were conducted in the drive through garage. Early in COVID Sanford Fargo Transitioned to video visits. Over 65 iPads were deployed to all Primary Care and Behavioral Health providers to accommodate the shift. Video or in-person patient visits continue to be offered as a choice to patients.With partnership with local public health, area businesses, and other healthcare organizations two COVID vaccination centers opened in the Fargo/Moorhead community. Sanford Fargo vaccinated 4,539 employees during 2020. Public vaccine centers are opening in early 2021. Developed by the Sanford Center for Biobehavioral Research and the Behavioral Health Department Reach for Resilience is a mental health education, support, and consultation service for healthcare professionals suffering from mental health difficulties during the COVID-19 pandemic. Sanford also worked collaboratively to develop a webpage to provide information about the stresses and risks of the pandemic for mental health, adaptive coping techniques, resources for mental health and more.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, hunger, homelessness, and need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violenceTransportation - Need for door-to-door transportation for community members.Aging - Cost of long-term care and memory care, cost of in-home services, availability of resources for family and friends caring for elders, availability of resources to help the elderly stay safe in their homesChildren and Youth - Availability and cost of services for at-risk youth, cost and availability of quality childcare, substance abuse by youth, teen suicide, childhood obesity, and bullyingSafety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, child abuse and neglect, sex trafficking, and presence of street drugsCost of long term/memory care- Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 3 -- Sanford Broadway Medical Center Fargo Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccess to affordable health care is important to overall health. Health insurance, local care options, and a usual source of care can ensure access to health care. Access to care makes it easier to enter the health care system, find local care easily, pay for care, and get health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services so patients can secure timely appointments.Priority 2: Mental/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearHealthcare AccessIn 2020, Sanford was successful in adding access by recruiting additional Behavioral Health providers including; a MD adult psychiatrist, a PhD child psychologist, an APP in adult psychiatry, and Six Integrated Health Therapists.The Tele-behavioral health pilot project in schools launched in spring of 2020. After initial enrollment of two children, the schools in Fargo/Moorhead were shut down and additional enrollment of children was put on hold. The enrolled children were able to complete the program in their homes. The pilot project re-launched in fall of 2020 with 20 kids enrolled. Due to hybrid/virtual learning in schools, the pilot remained on hold until early 2021. Sanford Fargo also began efforts to increase walk in hours and weekend hours but due to COVID those efforts have been put on hold.In 2020, Sanford primary care added access to clinics by recruiting additional Family Medicine and Internal Medicine providers including: 1 APP and 4 MD's in family medicine, and 1 APP and 1 MD in internal medicine.In 2019, the Advanced Practice Fellowship was launched to promote role expansion of Advanced Practice Providers to improve access. The program is a one-year training program for nurse practitioners and physician assistants who have completed their primary training program and are licensed providers. We offer rotations in primary and specialty care for a year. Rural community options are included. Fellows are assigned a preceptor and they see 4-6 patients per day. The fellows practice within primary care clinics to learn the collaborative care practice model with our primary care physicians. However, the fellowship was delayed from August 2020 to January 2021 because of COVID.We opened a Post Hospital transition clinic 6 days a week for medically complex patients that were discharged from the hospital. With care management, social work, integrated health therapists and pharmacists. Now patients could be seen very soon after their discharge.The Pediatric Mental Health Care Access Program is a Sanford project that focuses on collaborative care opportunities for pediatric medical providers to enhance treatment of pediatric mental health difficulties in North Dakota. In this program, primary care providers receive training, mental health education, and expert consultation on treating mental health conditions in children. The program collaborates with the University of North Dakota School of Medicine and Health Sciences and the North Dakota Department of Health. It's funded by the Health Resource Services Administration.Mental Health and Substance Abuse Sanford Health began collaborating with a F5, a Fargo-based peer-to-peer substance abuse support program provider in 2019. The program began in August 2020 and is offered twice per week to inpatients detoxing from alcohol and other substances. Patients are encouraged to meet in a group setting. Outcomes that are measured include re-admission rates, emergency visits, and EMS encounters. At our Suboxone clinic, we are working towards co-prescribing Narcan with any opioid prescription. This is the next step in the effort to decrease deaths by overdose in our community. IHT services have increased in our clinics. Sanford Fargo now has 10 IHTs in primary care clinics, increasing from 9 in 2019. On average IHTs see five patients per day to assess and refer to medical detox or the withdrawal management unit.Sanford Fargo increased the number of medication assisted treatment certified providers in 2019. Five physicians received waivers to prescribe suboxone after completing an 8-hour training course. The program launched in early 2020 and five participants went through the treatment. Outcomes set to be measured include re-admission rates, number of emergency department visits, EMS encounters and rate of peer-to-peer group attendance (goal 50% attendance) for a six-month period beginning July 2020.Patient Health Questionnaires are used to assess patients and refer them to an IHT if needed. This process was disrupted due to COVID. Mental Health First Aid Training was paused in 2020 due to COVID. It will be replaced with BeHeard which has the capacity to be delivered both in-person and virtually.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in their ranking of states with the best vaccination rates.Sanford Fargo offered a home monitoring program for COVID positive patients and monitored patients' oxygen saturation levels, temperature, and symptoms. We also opened a drive through COVID-19 testing center. In 2020, 44,757 COVID-19 tests were conducted in the drive through garage. Early in COVID Sanford Fargo Transitioned to video visits. Over 65 iPads were deployed to all Primary Care and Behavioral Health providers to accommodate the shift. Video or in-person patient visits continue to be offered as a choice to patients.With partnership with local public health, area businesses, and other healthcare organizations two COVID vaccination centers opened in the Fargo/Moorhead community. Sanford Fargo vaccinated 4,539 employees during 2020. Public vaccine centers are opening in early 2021. Developed by the Sanford Center for Biobehavioral Research and the Behavioral Health Department Reach for Resilience is a mental health education, support, and consultation service for healthcare professionals suffering from mental health difficulties during the COVID-19 pandemic. Sanford also worked collaboratively to develop a webpage to provide information about the stresses and risks of the pandemic for mental health, adaptive coping techniques, resources for mental health and more.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, hunger, homelessness, and need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violenceTransportation - Need for door-to-door transportation for community members.Aging - Cost of long-term care and memory care, cost of in-home services, availability of resources for family and friends caring for elders, availability of resources to help the elderly stay safe in their homesChildren and Youth - Availability and cost of services for at-risk youth, cost and availability of quality childcare, substance abuse by youth, teen suicide, childhood obesity, and bullyingSafety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, child abuse and neglect, sex trafficking, and presence of street drugsCost of long term/memory care- Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 4 -- Sanford Medical Center South University Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccording to County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services. It is Sanford's goal that barriers to accessing health insurance coverage are reduced.Priority 2: Behavioral Health and Substance AbuseThe Substance Abuse and Mental Health Services Administration reports that "Mental and substance use disorders can have a powerful effect on the health of individuals, their families, and their communities. In 2014, an estimated 22.5 million Americans age 12 and older self-reported needing treatment for alcohol or illicit drug use, and 11.8 million adults self-reported needing mental health treatment or counseling in the past year."Sanford has made behavioral health and substance abuse a priority and developed strategies to reduce negative outcomes from mental/substance abuse disorders.Addressing of Significant Needs during Current YearAccess to Affordable CareSanford Health has integrated onsite financial advocates who specialize in healthcare coverage enrollment to help community members secure access to healthcare services. They help Sanford patients as well as community referrals. Individuals unable to secure healthcare coverage and facing medical bills they cannot afford are referred to Sanford's financial assistance program. FAP worked with patients and their families to reduce medical bills, eliminating a portion of or all of their charges. In total, Sanford Bismarck offered over $18.1 million to patients and families unable to pay their medical bills.To help homeless people access healthcare services and prescription medications, Sanford works with shelter residents to apply for and secure healthcare coverage through the state's Medicaid program. Through partnerships with Mandan Public Health, Bismarck/Burleigh Public Health, United Way and the local homeless shelter coalition, we have helped at-risk community members secure healthcare coverage, healthcare services and prescription medications.Often, patients who do not qualify for public assistance do not make enough money to afford the prescriptions they need to get well and stay well. We have helped these patients enroll in Marketplace health plans and provide financial assistance to help cover income gaps. In total, Sanford Bismarck assisted 895 individuals to secure healthcare coverage. When a patient temporarily is unable to afford the medications they need due to extenuating circumstances, e.g., sudden loss of employment, Sanford's Foundation assists them through a fund established to help community members. Sanford helped 800 patients to get the prescription medicine they needed but could not afford. Additionally, Sanford helped these individuals connect to vital community services necessary to regain their health, wellbeing, and financial independence. Meal vouchers, lodging, gas cards, and transportation were also provided to 355 patients. Three hundred new and expecting moms identified at risk for not having enough food received free meals and were connected to community food pantry resources.Behavioral Health and Substance Use Disorder Continuum of CareSanford Bismarck continued its partnership with Heartview, an addiction services provider, to help 11 expecting moms suffering from substance use disorder participate in medication-assisted treatment programming. Sanford and the Bismarck Public Schools expanded our partnership to provide behavioral health services onsite at Simle Middle School. In 2020, Sanford provided nearly 500 onsite visits for at-risk middle school students. During the summer, Sanford continued to see the students, providing video appointments to allow for continued care despite COVID-19. In the fall of 2020, Sanford expanded to a second school and will add a third school in the fall of 2021. Sanford's opioid stewardship program continues to reduce the volume of opioids prescribed to patients. In 2020 Sanford Bismarck further reduced both the number of opioid prescriptions and volume of tablets prescribed. The number of prescriptions dropped six percent (from 9,139 to 8,610 scripts) and the total number of tablets prescribed dropped nine percent (from 498,617 to 454,617 tablets). In total, Sanford Bismarck has decreased the number of prescriptions by nearly 40 percent and the number of tablets prescribed in half. Sanford Bismarck continued the partnership with Bismarck/Burleigh County behavioral health task force, a stakeholder group established to identify and address gaps in the community's substance abuse and behavioral health continuum of care. Additionally, Sanford joined the Bismarck/Burleigh Drug-Free Communities Task Force, representing community healthcare providers.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December, 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources across our footprint. Sanford evaluated more than 100 clinical trials for patient's treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Bismarck provided training to area community access hospitals (CAHs), teaching rural healthcare providers how to care for lower acuity COVID-positive patients. The training was beneficial in many ways. By helping rural providers to be better able to care for patients with COVID, smaller hospitals were able to provide care close to home for more community members and the CAHs helped offload patients when Sanford Bismarck was at 100 percent capacity. Sanford Bismarck offered a COVID-19 Hotline when it created a 24/7 call-in number for rural healthcare providers to call when they needed guidance on how to care for COVID-19 patients and know when the patient's acuity warranted a transfer to a Bismarck hospital. Supply chain offered support by providing personal protective equipment to smaller facilities having difficulty securing PPE at the height of North Dakota's patient surge. Sanford staff worked with community organizations to provide input on how to safely host events and provided updates on COVID precautions and vaccinations throughout the PHE. Telemedicine and phone visits were offered as much as possible to increase access to care. Sanford Bismarck also supported COVID-19 efforts through donations. Backpacks were provided to all second graders attending Bismarck's neediest elementary schools. Each backpack contained a hat, gloves, scarf, lunch bag, water bottle and a grocery store gift card. In partnership with Great Plains Food Bank, the Sanford administration team staffed a food bank drive-thru event for community members in need. The event provided boxes of groceries that included milk and fresh fruit and vegetables to more than 200 vehicles and impacting more than 800 people in need. Identified needs not directly addressed by this facility include:Economic - Homelessness, need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, affordable housing and hunger Aging Population - Cost of long term care, cost of memory care, and the cost of in-home servicesChildren and Youth - Cost and availability of quality childcare, substance abuse by youth, childhood obesity, teen suicide, availability and cost of services for at-risk youth, bullying, and teen tobacco use Crime/Safety - Abuse of prescription drugs, culture of excessive and binge drinking, domestic violence, presence of street drugs, child abuse and neglect, sex trafficking, and criminal activity
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 5 -- Sanford Bismarck Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well-BeingEconomic well-being factors can largely affect someone's physical and mental health, positively or negatively. Sanford Health has developed a strategic plan to address economic well-being of the Bemidji area alongside community leaders.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Depression is one of the most common mental disorders in the U.S. and is caused by many factors. It is also among the most treatable of mental disorders. (National Institute of Mental Health)Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Addressing of Significant Needs during Current YearEconomic Well-BeingEvery year Sanford provides donations and sponsorships to numerous organizations in the area. Sanford Bemidji continued to develop the Sanford Health Kids Initiative addressing opportunities and partnerships for at-risk youth.In Bemidji one in five local children do not get enough to eat. Sanford Health, with Bemidji School District, and United Way of Bemidji took steps in 2019 to change that fact. The three organizations created a program called No Hungry Kids. Sanford Health made a 5 year $405,000 commitment to the program. It grew United Way's Backpack Buddies program and funded the school's Angel fund which covers student lunch debt. Sanford Employees packaged food for this program. The partnership enabled United Way to expand the program to all elementary schools in the district, coordinate a summer program, and initiate a "pantry" program at schools and universities in the area. As part of our COVID-19 Community response, we expanded No Hungry Kids to Blackduck, Kelliher & Red Lake with the United Way. Sanford Bemidji also funded the Backpack Buddies that provided backpacks including necessary school supplies to over 200 kids in need. This was accomplished through Sanford funding and staff donations, and staff prepared backpacks.Sanford also launched a program in the Children's Clinic called Reach Out and Read to address literacy, where children are given age appropriate books to take home and read at checkups. Doctors and nurses will also speak with parents about the importance of reading to their child. Sanford Bemidji coordinated the program with a local elementary school so staff could come to the classroom to read to children and talk about the importance of reading. This program has been paused due to COVID-19 and visitor restrictions, but should restart fall, 21. Sanford helped expand Social Emotional Learning skills by partnering with Peacemaker Resources, Bemidji Area Service Collaborative and Bemidji Area Schools. The expansion gave kindergarten through 3rd grade teachers and students, Social Emotional Learning training, where they learn about, feelings, empathy, and more.Sanford Bemidji has played an active role in positioning the Bemidji community for enhanced economic growth and development. We helped align Greater Bemidji, the Bemidji Chamber of Commerce, Downtown Business Alliance, and Visit Bemidji and sponsored the Bemidji 2030 visioning process. We also meet with entrepreneurs and business people who have an interest in Bemidji.Early 2021, Sanford took an active role in engagement with the Ridgeway Neighborhood Initiative, in partnership with the local Rotary club. This group works to reduce crime and violence at the various apartment buildings in the neighborhood. The RNI Committee leases an apartment (funded by Sanford Health) as a Rotary Resource Room where resources, classes, and training will be offered to the Ridgeway tenants. Mental Health and Substance AbusePrimeWest Residental Treatment Center was completed. This center includes five crisis residential stabilization beds for short-term individualized mental health services, and five beds for intensive residential treatment services assisting patients in need of more focused structure and care. Because of COVID the detox portion of the program was paused.Sanford's First Steps to Healthy Families program offers intensive case management to families with children under the age of 5 who are impacted by substance abuse. Services are provided in partnership with Beltrami County. Sanford Bemidji is exploring the possibility of partnership to open a day center for the local homeless community. In this Sanford would donate the former Upper Mississippi Mental Health Clinic to a community partner so they could convert the building to a day center for the homeless. Sanford received a $3.9 million, 2-year grant from SAMHSA to expand behavioral health services. The grant will allow Behavioral Health to be fully integrated into Sanford Bemidji Medical Center using the Certified Community Behavioral Health Clinic (CCBHC) model. Improving access to all CCBHC required services would greatly benefit the community. Behavioral Health has all the components of what is required though there will be improvements. This grant funding will currently offset some of our existing overhead and services as well as fund coverage for the Medicaid, under insured and uninsured populations. Sanford was recently awarded a grant in the amount of $400,000 from the state of Minnesota. This grant will help provide homelessness prevention and rapid re-housing. Behavioral health services expansion in secondary markets is currently in the exploratory phases.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December, 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources across our footprint. Sanford evaluated more than 100 clinical trials for patient's treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Sanford Bemidji advanced telemedicine capacities and expanded telemedicine usage. We have seen the best telehealth results in behavioral health. We also started to offer "Drive Up Visits". The concept included having designated parking spaces in our lot where patients could drive up and a member of our staff would bring them a tablet and help them connect to their provider. If the patient needed to be seen in-person, the patient was able to come in and be directly placed into a patient room to see the provider. We will continue collaboration with Fargo and our other regions to provide extended telemedicine services to keep patient care close to home.Sanford Health and Public Health leadership came together to share updates on COVID-19 in our community through roundtable discussions. Leaders from Sanford Health also participated in several speaking panels in Bemidji, and nearby counties. Staff implemented weekly meetings with regional public school leaders as they navigated COVIDWe partnered with Bemidji Area Schools and Blackduck School District to offer flu shots for students at their schools after COVID impacted our flu shot distribution. Over 600 students were vaccinated, which we considered a huge success. We hope to continue this program in the future. Sanford Health donated $3 Million across our footprint to Feeding America and local food banks. The impact for our region was nearly $700,000. In addition, staff from SHNM volunteered their time to distribute food to nearly 1,200 families in Bemidji and Park Rapids at the mobile food drive events.Identified needs not directly addressed by this facility include: Economic- Need for affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and concern for homelessnessTransportation- Need for door-to-door transportation for community members who do not drive, and the availability of public transportationAging- Cost of long term care and memory careChild and Youth- Substance abuse by youth, childhood obesity, availability of services for at-risk youth, bullying, crime committed by youth, and teen suicideSafety- Abuse of prescription drugsAccess to Health Care- Availability of behavioral health providers, availability of mental health providers, access to affordable prescription drugs and to affordable healthcare
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 6 -- Sanford Bemidji Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is crucial and affects all aspects of life. Depression is one of the most common mental disorders in the U.S. and is caused by many factors. It is also among the most treatable of mental disorders. (National Institute of Mental Health)Sanford has developed strategies to combat negative outcomes of mental/behavioral health issues, and substance abuse. Priority 2: Children and YouthMinnesota has one of the highest rates of parents in the workforce. Quality childcare should be culturally and linguistically responsive and should be provided by engaged and caring child care providers. Quality childcare incorporates physical activity time and developmental screening practices, and follows food safety guidelines. In addition, quality child care should be easily accessible for all families, regardless of location or socioeconomic status. Inadequate child care can lead to a host of health problems in the child's life.Sanford has developed strategies to combat the negative effects of inadequate childcare in the community.Addressing of Significant Needs during Current YearMental Health and Substance AbuseIn 2019, Sanford Thief River Falls received approval for the development and implementation of a substance use disorder (SUD) service line, but implementation of the program is on hold due to COVID-19. Sanford Thief River Falls completed the renovation of the facility that will house the SUD program in late fall of 2020. Application for licensure through the Minnesota Department of Human Services (DHS) was submitted in November 2020. However, the licensing division of DHS has been operating at greatly reduced staffing levels due to the impact of the COVID-19 pandemic. The reduced capacity has delayed review of the license application and is currently under DHS review as of February 2021. No indication on the timing of a decision has been provided. The program will open and begin providing services as soon as the license is received.The BHS-6 behavioral health screening tool is one of several depression screening tools available to providers to assess a patient's mental health relative to depression. Currently only Sanford One Care Clinics are using the BHS-6 screening tool and all other Sanford clinics are using the PHQ-9 patient health screening tool. TRF is using the PHQ-9 which has been incorporated into the EMR medical record as a screening prompt for providers on an annual basis for all primary care patients.In CY19 TRF's primary care provider teams achieved an overall administration percentage rate in excess of 90% for the PHQ-9; well above the target of 80%. Upon completion of the PHQ-9 screening and based on the individuals score, the provider may recommend additional screenings and further clinical follow-up with a mental health professional. Sanford has an algorithm that outlines each step in the process.Children and YouthThe children and youth priority has been significantly impacted by the COVID-19 pandemic. Employers have not been willing nor engaged in the development of childcare options and strategies, primarily due to the masking, social distancing, and business closure mandates from the state of Minnesota.Children's Therapeutic Support Services (CTSS) is a flexible package of mental health services for children who require varying therapeutic and rehabilitative levels of intervention. The program is provided in all Thief River Falls schools to address the dangers of drugs in addition to other mental health issues. The CTSS program has also been impacted by the COVID-19 pandemic as most schools discontinued in-school learning and implemented distance learning structures; effectively removing children from the CTSS model of behavioral health services. Referrals and engagement decreased during the school shut down/distance learning. Sanford Thief River Falls implemented telehealth services and did more in-home work with families that were willing. Referrals have seen a marked increase since schools returned to in-person learning and we would expect a return to normal caseloads by the end of March 2021.Additionally, TRF behavioral health staff make themselves available and participate with law enforcement educating school age children regarding the Drug Abuse Resistance Education (DARE) program every year. COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December, 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources across our footprint. Sanford evaluated more than 100 clinical trials for patient's treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Thief River Falls implemented all recommended guidelines issued by the CDC and/or Sanford, including masking, social distancing, visitation restrictions, temping employees, patients, visitors, etc. All staff were also re-educated on proper donning and doffing of PPE.To minimize patient and staff exposure, Sanford Thief River Falls developed and implemented curbside Covid-19 testing protocols to provide testing of all Persons under Suspicion (PUI's) without having them enter any of our buildings.An entire 14-bed wing of the medical center was converted to negative pressure rooms utilizing grant dollars from the federal government - these were in advance of the Cares Act Funds.Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, household budgeting and money management, need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic abuse, and a skilled labor workforce Aging - Cost of long-term care and the cost and availability of memory care, cost of in-home care, and the availability of resources for grandparents caring for their grandchildrenChildren and Youth - Childhood obesity, substance abuse by youth, availability and cost of services for at-risk youth, teen tobacco use, bullying, crime committed by youth, and opportunities for youth-adult mentoring Safety - Abuse of prescription drugs, presence of drug dealers, presence of street drugs, child abuse and neglect, criminal activity, and domestic violenceHealth care - access to affordable health insurance coverage, access to affordable healthcare, access to affordable prescription drugs, use of emergency room services for primary health care, availability of specialist physicians, availability of non-traditional hours, availability of behavioral health (substance abuse) providers, access to affordable dental coverage, and availability of mental health providersSanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the findings of the CHNA and the needs with community leaders and public health agencies in the area.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 7 -- Sanford Medical Center Thief River Falls Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointmentsPriority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearHealth Care AccessSanford Aberdeen Medical Center (SAMC) is committed to helping community members understand their health care insurance options. Our goal is that no one in our service area is denied necessary health care services due to lack of coverage and/or insufficient coverage. In 2020, SAMC staff continued to utilize Sanford Health Plan's website and related information and resources to provide relevant insurance information for individuals and companies as needed. This information on coverage options allows consumers to compare Sanford Health Plan's options to see what is right for them. SAMC staff continue to work closely with both Sanford Health Plan representatives as well as various local insurance agents regarding access to a range of insurance products and services for anyone in need. Additionally, SAMC has a representative onsite who assists patients with reviewing health insurance options which includes our Community Care Program. Sanford Health has a webpage to help answer questions for patients and/or directs patients to a representative for assistance. https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/insurance-information Mental Health and Substance AbuseSAMC seeks to ensure that mental health services are available in Aberdeen and the surrounding area. We aim to achieve a reduction in opioid prescriptions. To this end, Sanford Aberdeen Clinic is offering telemedicine options for psychiatry services to increase overall access to mental health care. To identify need and ensure access to appropriate care, PCP visits include a questionnaire assessment tool that is aligned with Sanford Health enterprise protocols for screening. This approach is a more holistic manner by embedding an Integrated Health Therapist (IHT) in our primary care clinics. The IHT also offers ongoing education on services offered through primary care. In 2020, the IHT saw a total of 166 patients (Jan. - June). Volumes were less than expected due to COVID-19 and the IHT resigning end of June 2020. A replacement IHT joined the team at the end of December 2020 and patient volumes are anticipated to increase in 2021 due to enhanced access. Finally, staff and providers are routinely given updates to Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates. Locally, SAMC leadership provided education and updates through communication at city council meetings, Brown County Emergency Management - Incident Command meetings and through social media. Community groups and businesses, including schools, daycares, restaurants, and entertainment venues, were provided COVID safety education that allowed them to remain open throughout the pandemic and provide a safe environment for their students, children, and customers. Sanford Health also provided frequent Q&A sessions with communities to keep them updated and answer questions. Identified needs not directly addressed by this facility include:Economics - Need for a skilled labor forceChildren and Youth - Childhood obesity, and substance abuse by youthAging - Cost of long term care, cost of memory careSafety - abuse of prescription drugsSanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the results of the CHNA and the unmet needs with community leaders.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 8 -- Sanford Aberdeen Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical Center
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Healthcare AccessAccording to County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a priority and developed strategies to promote and improve access to services. It is Sanford's goal that barriers to accessing health insurance coverage are reduced.Priority 2: WellnessThe Centers for Disease Control and Prevention reports that Americans seriously underuse preventive services. Chronic diseases account for 70% deaths among Americans and 75% of U.S. health spending. However these diseases are largely preventable/treatable. Eating healthy, exercising regularly, avoiding tobacco, and receiving preventive services such as cancer screenings, preventive visits and vaccinations help people stay healthy. Sanford has made wellness and chronic disease prevention a priority and developed strategies to promote and improve cancer and chronic disease screening in the community. Addressing of Significant Needs during Current YearHealthcare AccessThe Nobles County Oral Health Taskforce was formed in late 2019 to identify potential solutions to local dental challenges. The group completed a prioritization process called the "Results-Based Accountability Strategy" In which strategies and solutions were offered to stakeholders to rank based on 4 criteria: Leverage, Feasibility, Specificity, and Values.From this process, local dental solutions were identified that were realistic and attainable. The following strategies were selected: Create an oral hygiene education kit for childrenProvide oral health education Create a group to support oral health needs in a multitude of ways including resourcing, programs, and fundingDevelop health system intervention to address and coordinate the oral health needs of youth in the communityAn action plan was created and a follow-up meeting was scheduled for March, but focus quickly shifted to COVID-19, and the meeting was canceled. The dental taskforce has not yet reconvened, but remains a top priority for our community. In May 2020, Sanford Worthington initiated a Community Advisory Council. The council had a COVID focus to start, but has expanded beyond that to aid in improving healthcare access. Efforts were made by the local CAP agency to secure funding that would allow the Children's Dental Service (CDS) of Minnesota to continue to come to Worthington monthly in 2021. They are able to schedule appointments for many dental services, regardless of income or insurance status and most pay little to nothing for the service. Grants awarded by SWIF and the local healthcare foundation will fund CDS for the next year.WellnessTo advance Lung Cancer screening service and promotion, the Sanford Worthington team met early in 2020 to plan for launching a screening program. A contract with American College of Radiology was drafted, but COVID intervened before there was a chance to finalize. The team will re-initiate this by 3rd quarter of 2021. Sanford Worthington offers Radiation Oncology services with a multi-million dollar reinvestment to replace the linear accelerator completed in October 2020. The outcome is increased local access to curative radiation therapy due to upgraded equipment. Sanford Worthington has maintained solid heart and vascular screening numbers thought COVID. Colonoscopies have dropped in that same time and Sanford Worthington is making a push to increase them.At the end of 2019, seven local bilingual leaders were trained to teach the Living Well with Diabetes and Chronic Conditions classes, but no leaders were able to teach a class in 2020 due to COVID. Two classes were scheduled for early 2021. Meetings with Worthington primary care physicians took place to educate them about the program and teach them how to make an EPIC referral. So far, the Worthington physicians have submitted the most referrals of any other Sanford facility in the network, except for Sioux Falls.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, COVID-19 response began middle of March 2020. In April, in only 72 hours' time, Sanford worked with state and local partners to mobilize a mass drive-through COVID-19 testing opportunity for JBS employees. It was the first of its kind in Minnesota, and many others that followed were modeled off our set up. It was set up in the local Worthington hockey arena - 1,087 tests were completed over 4 days. Sanford Worthington clinic then set up a permanent drive-through testing location adjacent to the clinic. Testing continues to occur seven days a week. By end of 2020, approximately 9,900 tests have been completed.Sanford Worthington opened and operated a "COVID Respiratory Clinic" in response to the overwhelming need for follow-up and care to the most ill COVID-19 patients.In May, Sanford Worthington initiated another community collaboration: the Sanford Community Advisory Council. The council is comprised of community representatives of 20 organizations. The collective mission of the council is working collaboratively to provide meaningful patient and family experiences and supportive resources for Nobles County residents to live healthily through partnerships between health care and community stakeholders. A top focus at the start of this meeting was COVID response: being transparent about what was happening inside of healthcare, keeping each other informed on the status of the community, identifying resources, gaps, and opportunities to respond together to needs.Community mask use and mask education was identified as an early priority. Over 30 individuals were recruited to sew masks, coordinated by the hospital auxiliary volunteers. Over 5,500 masks were made, and another 2,000 Hanes masks secured by PH and Sanford. The Hanes masks were distributed in a large community drive-through mask event that included education in multiple languages. The handmade masks were given to local businesses to protect workers and those most vulnerable, as well as during community food distribution events that took place for Nobles County. Masking education was shared in many languages and through many channels to reach the culturally diverse community, including verbally from trusted community partners (many council members themselves), social media outlets, at the JBS plant, through written material, and in the local newspaper and local radio. Identified needs not directly addressed by this facility include:Economics - Availability of affordable housingTransportation - Availability of public transportationAging - Cost of long term care, availability of memory care, and the cost of in-home servicesChildren and Youth - Availability and cost of quality childcare, availability of services for at-risk youth, teen pregnancy, childhood obesity, bullying, substance abuse by youth and the availability of activities for children and youthMental Health - drug use and abuse, depression, stress, and alcohol use and abuseSanford will not develop strategy to address the availability of affordable housing, the availability of public transportation, the cost and availability of long-term care, memory care. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the assessed needs with community leaders that have expertise in the various needs of the community.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 9 -- Sanford Worthington Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Substance abuse is another high raking concern for community members. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Protective factors include: Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford has made children and youth a significant priority and has developed strategies to offer support programs that provide children and youth with safe and healthy environments.Priority 2: Mental Health and Substance Abuse Mental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearChildren and YouthSanford Sheldon takes great pride in supporting the youth of the community in various events. 2020 saw the continued support of the Shop with a Cop program, which provides children in the community the opportunity to go back to school for new school supplies. Sanford Sheldon purchased backpacks for the program. This year there was a need for 90 backpacks. The summer lunch program was held differently due to the pandemic; however Sanford Sheldon was still able to support the program, which delivered meals directly to the students. Need for the program increased as students were not in the school building from mid-March through August. To ensure employees and their children had proper meals Sanford Sheldon was offered the opportunity for freezer meals. This provided staff and their families four free freezer meals for a family of four. The opportunity was provided three times. As many as 130 employees participated in the meal preparation.Local daycares closed due to COVID-19 but due to the necessity of maintaining staffing levels there was a need to develop options for staff to utilize so they could still deliver healthcare to the community. In response, a facility-based daycare program was established for children of Sanford employees.Mental Health and Substance AbuseSanford Sheldon Medical Center is continuing its commitment to meeting the mental health and substance abuse needs of our patients and all community residents. Sanford now employs Psychiatric Mental Health Nurse Practitioner Stacey Jumbeck in addition to the mental health counseling available from Dr. Matthew Eggers and IHT Mark Daniels via telemedince. Sanford Sheldon is able to diagnose and treat the mental health needs of many patients with therapy and prescribing medications for patients who have mental health disorders or substance abuse problems. Sanford Sheldon has seen an increase in both the mental health and substance abuse of our patients due to COVID-19. The increased demands are being met with therapists providing services at Sanford Sheldon.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Sheldon offered telemedicine clinic visit options to patients who wanted to maintain a physical distance due to COVID-19 concerns, but still needed medical care. The telemedicine clinic visit would occur via video with the patient's healthcare provider, allowing patients to remain in their home but still receive basic medical care. The local chamber provided Sanford Sheldon an opportunity to record healthcare educational videos by our medical providers. The videos were posted on the chamber's Facebook page and provided the opportunity to communicate the latest concerns in the community that needed to be addressed.The radio station also provided Sanford Sheldon the opportunity to do weekly interviews and stories on the current COVID-19 issues we were seeing in the community.Identified needs not directly addressed by this facility include:Economic - Need for skilled labor force, affordable housing, housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic violence, and household budgeting and money managementAging - Cost of long term care, cost of memory care, and the cost of in-home services Safety - Abuse of prescription drugsHealth Care - Availability of mental health providers, availability of behavioral health providers, access to affordable health insurance coverage, access to affordable health care, access to affordable prescription drugs, and access to affordable vision insurance
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 10 -- Sanford Sheldon Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well Being Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Sanford Vermillion has made affordable housing and economic well-being a significant priority and has developed strategies to work with community partners and community leaders to improve the availability of affordable housing in the community.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common, and most treatable, mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health, behavioral health, and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearEconomic Well-Being - Availability of Affordable Housing and FoodSanford Vermillion continues to collaborate with the City of Vermillion, the Vermillion Chamber & Development Company, and local community programs to increase awareness and support the community efforts to provide affordable housing and food assistance opportunities for those in need.In 2020, the City of Vermillion issued permits for four apartment complexes with ten units each, one apartment complex with four units, and 13 new single-family homes Sanford Vermillion has also continued to collaborate with the Vermillion Chamber & Development Company (VCDC) on the second phase of housing development at the Bliss Pointe Planned Development District now that the first phase is complete. The second phase focuses on smaller, more affordable housing developments in the center of the 30 acres of land purchased by the VCDC. COVID-19 did not impact the construction of housing units as much as it did many of the other types of businesses in Vermillion. Sanford Vermillion also continues to support the local food assistance programs in Vermillion by being one of the top donors in the community to the local United Way, which funds the Community Connection Center (CCC) that opened in 2019. The CCC houses the United Way, Welcome Table, Vermillion Food Pantry, Weekend Backpack Program and Salvation Army services under one roof in downtown Vermillion for a one-stop shop for their clients. Unfortunately, COVID-19 did affect our ability to participate in the weekly Welcome Table weekly free meal in 2020. However, the hope is to be able to soon provide the meal at least twice a year, similar to the past. Sanford Vermillion staff also participated in providing Meals on Wheels to the community two weeks per year and were able to continue this in 2020 as well.Mental Health - Substance Abuse and Binge Drinking Sanford Vermillion saw an 8% decline in Mental Health visits from a total of 1,349 completed visits in 2019 to a total of 1,236 completed visits in 2020. This is likely due to COVID-19 in 2020. However, a number of visits were shifted to telehealth and video visits rather than in-person visits and actually saw an increase in these type of visits over 2019. Telehealth and video visits also had the benefit of decreasing the number of typical no-show appointments from patients, as it was more convenient and private for them. Sanford Vermillion continues to employ the same providers, which includes a full-time Integrated Behavioral Therapist (IHT)/Psychologist who works 5 days per week and an IHT/Clinical Social Worker who provides counseling two days per week. Additionally, Sanford Vermillion continues to offer a monthly Psychiatric specialty outreach clinic. The provider utilized the telehealth/video visits during 2020 as an option for clients and had an increase in these types of visits as well. Two Integrated Health Therapists provided Sanford Vermillion staff with two in-services during 2020 on coping with stress during COVID-19, which were well-attended and appreciated by the staff. A private counselor is still available in the community for patients as well as Lewis & Clark Behavioral Health, which employs counselors in the Vermillion community including a licensed alcohol and addiction counselor that has privileges at Sanford Vermillion.COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Vermillion offered several services and resources to the community in response to the pandemic. Sanford Vermillion Clinic shifted from in-person visits to video visits for patients with COVID-19 symptoms to reduce the risk of exposure for staff and other patients. Similarly, drive through COVID-19 testing was implemented early, and although operational plans changed a few times, staff was able to test over 100 patients per hour. For patients that contracted the virus, Sanford Vermillion was one of the first facilities to offer Bam Bam Infusion Therapy to reduce the severity of illness and likelihood of hospitalization for highest risk patients. The therapy began in late 2020 and we completed 20 doses for patients by the end of the year.Sanford Vermillion also implemented mitigation strategies for long-term care facilities to keep staff and residents safe during COVID-19. These strategies included PPE education, weekly COVID-19 testing, hand hygiene, staff screenings, resident assessments, isolating sick residents, and visitor limitations. Staff were successful in keeping residents in the nursing home COVID-free until mid-December and then were able to limit it to a small number of residents without significant spread.Sanford Vermillion used several platforms to keep the Vermillion community educated on COVID-19. Long-term care residents were updated as changes occurred in the facilities including if there was a new positive staff member or positive resident or change in the visitation policy. Sanford Vermillion participated in the Vermillion Area & Chamber Development Company's UpNEXT videoconferences with community leaders/businesses to provide the community with Sanford Vermillion's COVID-19 update. Sanford Vermillion partnered with the University of South Dakota (USD) to make plans for an alternate care site for up to 40 patients if needed during COVID-19 should hospital capacity become overwhelmed. Arrangements were made for staff accommodations on the USD campus for COVID-19 positive and suspected positive staff that would need to quarantine and may not be able to do so at home. USD also provided excess PPE supplies to the hospital during times of shortage when vendors were unable to fill orders. Although the alternative plans were never acted upon, it was comforting for all involved to know we had backup plans for our patients and staff.Identified needs not directly addressed by this facility include:Aging - Cost of long term care, cost of memory care, and cost of in-home servicesChildren and Youth - Substance abuse by youth, and childhood obesitySafety - Culture of excessive drinkingHealth Care - Access to affordable health insurance, access to affordable health care, and cost of affordable prescription drugs
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 11 -- Sanford Vermillion Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Substance abuse is another high raking concern for community members. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Protective factors include: Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford has made children and youth a significant priority and has developed strategies to offer support programs that provide children and youth resources for healthy living.Addressing of Significant Needs during Current YearMental Health/Behavioral Health and Substance AbuseSanford Chamberlain Medical Center provides education on substance abuse prevention and behavioral health for students and parents of local schools. Sanford Chamberlain engaged in work with the Chamberlain school district, embedding a licensed mental health counselor in the high school/middle school and elementary school one day per week. Chamberlain schools were virtual from March to May 2020, impacting reach. Sanford Chamberlain works with the Chamberlain Middle School in supporting a curriculum around social/emotional well-being. The social/emotional curriculum is live in classrooms, circulating through 6th to 8th grade students. To increase community safety and decrease substance abuse, Sanford Chamberlain Medical Center has previously trained community members on Mental Health First Aid and intended to continue this services in 2020. Unfortunately, although Sanford Chamberlain has a certified trainer, the Mental Health First Aid training sessions were put on hold due to COVID-19.To advance opioid prescribing best practices, staff and providers are routinely given updates on Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically. Children and YouthSanford Chamberlain intends to make the Sanford fit wellness program available to local schools as well as parents of students. SCMC hosted Sanford fit night in conjunction with parent teacher conferences at the Chamberlain elementary school on February 13, 2020. Approximately 200 people attended the event. Camp FUEL is a summer camp for area youth where healthy eating, exercise, and health outcomes are explored. The camp took place in summer 2019 and plans are underway to hold a Camp FUEL again in 2020. The 2020 camp strategy was paused due to COVID-19.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Chamberlain Medical Center supported the community through a variety of initiatives. SCMC was the primary COVID testing site for the tri-county area of Brule, Buffalo, and Lyman Counties. Community Education was also a key component of their COVID response with educational resources shared locally through social media, schools, and the Chamber of Commerce along with virtual offerings of the Better Choices Better Health program. Other community involvement and support included innovative offerings such as drive-thru Thanksgiving meals, drive-thru flu shots, a drive-thru ice cream treat day, and outdoor walk-in Wednesday interviews.Sanford Chamberlain supported our clinical and non-clinical staff throughout the pandemic in numerous ways including meal certificates, individual treats throughout the year, to-go monthly meals prepared by Dietary, and catered meals. Administration also created an "Island Retreat Break Room" with decorations, a picture station, themed mocktails and treats, and staff massages to create some relaxation, levity, and comradery for the staff.Identified needs not directly addressed by this facility include:Economic - Need for a skilled labor forceAging - Cost of long-term care, and the cost of memory care Safety - presence of drug dealers, presence of street drugs, and abuse of prescription drugs Health Care - Access to affordable health care, and access to affordable health insurance coverageSanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford shared the findings of the CHNA research and these unmet needs with community leaders and community stakeholders.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 12 -- Sanford Chamberlain Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1 Healthcare AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made healthcare access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to healthcare are successful in securing timely appointments.Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearImproving Health Care Access2020 was a year of change. Patient access improved with patients having same day access to providers as all providers have same day appointments held on their schedules to ensure timely access to care. Additionally, Sanford Luverne moved to a rapid deployment of more telehealth and video visit access due to COVID-19. This was instrumental in allowing patients to stay connected to their providers for care during the pandemic. Many patients prefer the face-to-face visits with their providers, but the expectation is that telehealth visit offerings will continue beyond this year. A new family medicine physician is scheduled to join Sanford Luverne in December of 2022 to further expand access.To improve price transparency in 2020, Sanford focused on meeting the new state of Minnesota and CMS mandates by focusing on a goal of displaying shoppable services in a consumer-friendly format and comprehensive listing of pricing for services. Price transparency continues to be a focus for the finance team and will continue to see ongoing efforts to improve this for our patients.Sanford Luverne continues to support dental health access in the community efforts with the mobile dental clinic for lower income residents through promotion and financial support. The mobile dental services were suspended with COVID-19 so access has been more of a challenge for residents needing the service. The community is losing its local dentist due to their relocating. However, a new dentist was successfully recruited to the community to continue the current level of local access. Improving the Mental Health of the CommunitySanford Luverne's Integrated Health Therapist (IHT) had local mental health providers begin a monthly education event through community education to align IHT and crisis resource team with area mental health services for timely access. Approximately 30-40 people attend each event. Meetings were paused in March after the pandemic began but is intended to resume as soon as they are able. The group has focused on encouraged positive messages within the community this past year, has developed a resource listing of options for care, and has done a lot of work as part of our community "Brain Health" initiative. Sanford Luverne's integrated health therapist had 388 individual patient sessions in 2020.The clinic continues to work on management of depression and anxiety to decrease their severity. Sanford's RN care manager resigned at the end of 2020 and a new staff member has been oriented in that role. As of September 2020, 23.3% had optimal depression metrics at six months and 23.5% at 12 months. The six-month quality metric was slightly less than at the end of 2019 but much better at the 12-month mark. Due to quality metric changes in 2019, a comparable for December is not available.The arrival of COVID-19 resulted in increased substance use within the community. Two years of recruitment efforts for a substance use counselor were successful in 2020. The new team member has improved access to care and allowed Sanford Luverne to continue to hold group therapy sessions, although social distancing requirements required larger rooms and smaller groups.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Luverne eliminated all non-essential surgeries, transitioned to mostly online video visits and delayed outpatient care beginning in March. During this time, the focus was ensuring safety measures were implemented to protect our staff and ensure they had the necessary supplies to care for and treat covid patients. Sanford Luverne has taken a lead role in education, COVID-19 testing, and COVID-19 vaccinations during 2020. Sanford Luverne's ambulance team worked with all county first responders to ensure they had the right PPE, knew how to use it, had the right supplies to care for patients, and conducted training sessions with the county first responder teamsIn response to hearing of increased demand on the local food shelf, staff members contributed food and volunteered to package food for distribution to those who needed assistance. In addition, Sanford Health invested in all the area food banks through support of Second Harvest. Sanford Luverne is seeing increased mental health concerns and substance use with due to COVID-19. Sanford's behavioral health therapist is working internally with the wellness committee focusing on staff mental health and resiliency. In addition, she is working with the community "Brain Health" task force on ways to improve brain health in community initiatives. Substance use staff continue to work with county drug courts and providing outpatient assessments and treatment in an individual and group setting to ensure that care is received in a timely manner.Identified needs not directly addressed by this facility include:Economic - Need for a skilled labor force, affordable housing, and employment optionsAging - Cost of long term care, availability of memory care, and cost of in-home servicesChildren and Youth - availability and cost of quality childcare, availability and cost of services for at-risk youth, substance abuse by youth, bullying, and teen suicide.Sanford will not develop strategy to address the cost of long term care, the availability of memory care, the availability and cost of quality child care. However, Sanford shared the results of the CHNA research with community leaders and agencies with expertise to the identified needs. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 13 -- Sanford Luverne Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health According the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Canby has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Mental Health Mental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearPhysical HealthSanford Canby Medical Center (SCMC) remains committed to improving the physical health of the greater Canby, MN community. Once again, SCMC provided sponsorship support to various activities and events in the community. Donation requests are reviewed at administrative council meetings; events/activities aligning with the promotion of healthy living are given strong consideration. Due to the Covid-19 pandemic, many organizations faced challenges holding traditional group events, and many were canceled. However, in 2020, approximately $3,200 was donated to events/organizations of the Canby community including the Canby Golf Course, City of Canby tennis court fundraiser, and Canby 4 Kids.The COVID-19 pandemic forced the Canby, MN schools to move to remote learning in the Spring of 2020. However, SCMC provided the schools with nearly 400 sets of fitKids workout cards that were sent home in virtual learning packets. The cards contained a set of instructions and students could easily follow the steps in order to get a short, 5-minute workout by selecting a warm-up activity card, move activity card, and cool-down activity card. While COVID-19 greatly impacted the ability to meet face-to-face in 2020, Sanford Canby offered pre-diabetes classes in the months of July, August, and November. The diabetes support group was able to meet in the months of February, September, November, and December. In addition, Sanford Canby provided meeting space for bariatric weight loss support group members and provided meeting space for a public educational session - Understanding Alzheimer's and Dementia. Sanford Canby Medical Center successfully conducted the Sanford Power program with 15 area Canby student athletes. The program is designed to prepare young athletes for safe competition by focusing on speed training, agility training, plyometric training, and strength training. COVID-19 prohibited the program from taking place in person, and therefore was held virtually. Mental HealthThe Sanford Canby Pathways Support Group offers support, resources, and routes to thrive and better manage life with chronic conditions. This group provides strategies, solutions, and resources to aid members along an empowered pathway in living life after diagnosis of a chronic disease. The group is open to anyone with, or caregiving for, a person with, a chronic medical condition including Parkinson's, memory loss, vision loss, cancer, heart disease, mental health, grief/loss, or pain. However, the COVID-19 pandemic prohibited the support group from meeting in 2020. Sanford Canby Medical Center utilizes the PHQ-9 screening tool within the electronic medical record to help in the identification of mental health needs. Through the medical home program, RN care manager, and PHQ-9 screening, we can offer and refer mental health services to those with scores indicative of depression. Through quality measures, we are able to track and measure depression remission. In January 2020, 11% of patients recorded remission in 12 months; In January 2021, 8.3% of patients recorded remission. The remission goal is 48.4% of patients. Screening for depression was added to the quality measures in 2021 and includes screening all patients ages 12 and over for depression symptoms and follow-up. This screening is done at least every twelve months. Sanford Canby also expanded mental health services to include a psychiatrist who provides telemedicine visits.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Canby was quick to take action with screening procedures and visitor restrictions put into effect. Leadership teams met frequently to assess the state of the pandemic and lead the local pandemic response. COVID-19 laboratory testing evolved throughout the year with SCMC eventually able to conduct a PCR, in-house, 30-minute Covid-19 test for emergency room patients and hospital inpatients. In-house antigen test for symptomatic patients was added in November. SCMC also retrofitted two hospital rooms for negative air flow in response to the need to treat COVID-19 patients locally. Outpatient monoclonal antibody therapies were added, which has seen great success in reducing hospitalizations resulting from Covid-19 infections. The long-term care administrator conducted a weekly call for resident families to feel connected and informed to their loved ones' care as staffing challenges arose due to employee infections and residents became infected with the virus.Beyond the clinic, hospital staff members posted workout videos online for wellness center members to safely exercise in their own homes when the facility was forced to close. N95 mask fit testing was offered to outside organizations including fire department staff and police. On March 16, 2020 Sanford Canby hosted a parent support group session "Covid-19 Prepare Your Home." Identified needs not directly addressed by this facility include:Economic - Employment options, and skilled labor forceAging - Cost of long term care and memory care, and cost of in-home servicesChildren and Youth - Bullying, and availability of quality childcareHealth Care - Access to affordable health insurance, cost of affordable vision insurance, access to affordable prescription drugs, cost of affordable dental insurance coverage, and access to affordable healthcare
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 14 -- Sanford Canby Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and Youth According to the Centers for Disease Control, obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion. Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer. Sanford Jackson has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity. Priority 2: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearChildren and YouthSanford Jackson Medical Center is working to create awareness of health behaviors for children and parents in our community through several initiatives. Marketing Specialists continue to strengthen relationships with community members specifically for Jackson's annual Kids Tri for Health. The 2020 Tri for Health was scheduled for June but was cancelled due to COVID-19. Planning is underway for the 2021 Tri for Health that is slated for June 11 and 12, 2021. The Sanford Fit Kids curriculum is utilized at various community events, speaking engagements, and in the resource bags for participants in Tri for Health. This year its utilization in schools and other activities were curtailed as COVID-19 resulted in schools and activities moving into the virtual space or were cancelled.Sanford Jackson Medical Center supported Families in the Community throughout 2020 through sponsorship of organizations such as Jackson County Libraries Summer Program and the new Jackson City Splash Pad. Department managers and providers visited with 10th grade high school students interested in healthcare career paths in December.Mental Health and Substance AbuseMental health and behavioral health care continues to be a pressing need for the community. Sanford Jackson Medical Center's goal is to decrease patients presenting to the emergency room with mental and behavioral health issues as well as to decrease substance abuse within the community. Sanford Jackson Medical Center is working internally and with community partners to decrease substance abuse in the area via several projects.SJMC's RN Health Coach specializes in customized care plans for patients needing support in weight loss initiatives, diabetes management, smoking cessation, or assistance in navigating primary care. A key voice in the community, the RN Health Coach has provided education resources at the 2020 Jackson Farm and Home Show. The Weight Loss Support group has transitioned to Facebook Live format for our patients. Providers discuss tobacco use rates and the impact on care for people with diabetes and vascular disease, specifically. The Performance Improvement team monitors these measurements quarterly and updates action plans for all members involved in patient care. To advance opioid prescribing best practices, staff and providers are routinely given updates on Sanford enterprise best practices regarding opioid prescribing. Many of these updates appear as prompts in a patient's Electronic Medical Record (EMR). The EMR prompts providers to do the following: check PDMP (Prescription Drug Monitoring Program) before prescribing opioids, perform routine yearly Urine Drug Screen tests, provide educational resources in dealing with prescribing opioids, and give Controlled Substance Agreements for patients using opioids chronically. SJMC's Integrated Health Therapist leads a community task force comprised of representatives from Des Moines Valley Health and Human Services (Public Health), law enforcement officials, EMS, industry leaders, Southwest Mental Health, and Family Services Network. This task force meets quarterly to discuss behavioral health issues of all ages, available resources, and the impact on our community. The "Ask the Expert" column in the local newspaper educated the community on the National Prescription Drug Take Back Days held in April and October 2020. The public was informed of the ability to take outdated medication for disposal to the law enforcement center in Jackson year round.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, SJMC collaborated with Des Moines Valley Health and Human Services-the local public health department-to provide education to the community via newspaper and radio. Newspaper topics included How to Stop the Spread, covid testing, antibody testing, rapid covid testing, Don't Put Your Health on Hold, and vaccine updates.Handmade mask donations were accepted and made available to patients as needed. As a result, over 1,000 masks were made and distributed.Several programmatic changes were implemented to support the health and wellness of the community during the pandemic. Patient visits were offered through several mediums for those that did not need to present in person for appointments, including MyChart, Facetime, Zoom, and verbal visits. Jackson and Lakefield clinics conducted nearly 600 virtual and verbal visits from March through December 2020. To further lessen exposure, drive up COVID-19 testing was available through the ambulance garage and the clinic time for symptomatic (ie "sick") patients to be seen was condensed to the end of each day allowing the continuation of healthy patient care throughout the day. In addition, to ensure the health and safety of our staff and patients, a screener was placed at the entrance of the facility. The screener continues today taking temperatures and asking screening questions related to COVID-19 symptoms and exposure.Identified needs not directly addressed by this facility include:Children and Youth - Availability and cost of quality childcare, bullying, availability and cost of services for at-risk youth, substance abuse by youth, teen tobacco use, and opportunities for mentoringAging - Cost of long term care, availability and cost of memory careHealth Care - Availability of non-traditional hours, access to affordable health insurance, access to affordable health care, access to affordable prescription drugs, cost of affordable dental insurance coverage
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 15 -- Sanford Jackson Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: WellnessAccording the Center for Disease Control, obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Tracy has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Health Care AccessAccording to the County Health Rankings for Clinical Care, access to affordable health care is important to physical, social, and mental health. Health insurance, local care options, and a usual source of care help to ensure access to health care. Having access to care allows individuals to enter the health care system, find care easily and locally, pay for care, and get their health needs met.Sanford has made health care access a significant priority and has developed strategies to promote and improve access to services. It is Sanford's goal that all patients requiring access to health care are successful in securing timely appointments.Addressing of Significant Needs during Current YearWellnessDietician and RN Health Coach services continued to be offered and referred to in 2020. Sanford Tracy's dietician had 10 visits in 2020, from 11 in 2019. The RN Health Coach had 227 visits in 2020, which was an increase from 182 visits in 2019. The medical supplies that were purchased for low-income/in-need patients were all distributed in 2019. Discussions were progressing on how to find funding to continue this initiative/project but were halted in early 2020 due to COVID-19. The intention is to begin brainstorming once again on how to revive this project. 2020 saw staff continue with the Sanford fit program with the Tracy Area Elementary 4th grade class., which focuses on health lifestyle choices to decrease childhood obesity. Unfortunately, the 2020 session was cut short due to COVID-19 and the schools transitioning to distance learning. Resources for at-home learning and exercise were provided to local teachers. The 4th graders took a pre-test, but were unable to take the post-test, so we were unable to measure their learning from the program.Health Care AccessTo support mental health awareness Sanford Tracy continued awareness campaigns for telemedicine services. Local behavioral health services began in 2020 but were quickly halted in March due to COVID-19. Yet, provider referrals were a major factor in the continued use of Sanford Tracy's in-house behavioral health services. Behavioral Health providers in Tracy saw 77 new referrals in 2020 and a grand total of 1,016 visits for the year. The slight decline in visits may be attributed to COVID-19 and the hesitancy for patients to seek care.Orthopedic and dermatology outreach were scheduled to begin in early 2020 to expand specialty services. However, due to unforeseen circumstances not related to COVID-19, the services did not come to fruition. Sanford continues to look at options for both orthopedic and dermatology outreach services, however, COVID-19 slowed that process down in 2020.The medical supplies that were purchased for low-income/in-need patients were all distributed in 2019. Discussions were progressing on how to find funding to continue this initiative/project but were halted in early 2020 due to COVID-19. The intention is to begin brainstorming once again on how to revive this project. COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Tracy's COVID-19 Response included several measures and greatly reduced the possibility of exposures and infection of the virus for our communities. Measures included the implementation of telehealth visits, phone visits, and drive through COVID-19 testing to limit patients coming into our facility, masking, screening, and visitor guidelines, and COVID-19 pre-op testing before all surgical procedures.Identified needs not directly addressed by this facility include:Economic - Need for employment options, and availability of a skilled labor forceChildren and Youth - Availability of quality childcareAging - Cost of long term care, availability and cost of memory careMental Health and Substance Abuse - Depression, stress, dementia and Alzheimer's
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 16 -- Sanford Tracy Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Hillsboro has made transportation a significant priority and has developed a strategy to work in collaboration with city and county leadership and the department of human services to explore options for the local community and county members.Addressing of Significant Needs during Current YearMental Health Services Sanford Mayville continues to use the PHQ-9 patient health questionnaire on initial and certain follow-up appointments and appropriate patients to ensure those in need of mental health services are identified and offered treatment. The panel management team is completing follow-up for new depression diagnosis.Both Sanford Mayville and Sanford Hillsboro have implemented IHTs (integrated health therapist) into the Clinics, mostly by tele-health due to the COVID-19 pandemic. 1-3 patients per day are being seen by telehealth from each Clinic. Patients and Providers feel it is going well and it is used quite frequently.Hillsboro's Go Live for Senior Life Solutions outpatient group therapy program was scheduled to start Summer of 2020 with an estimated 4-10 patients per day by the end of 2020. Due to the COVID-19 pandemic the program start date was delayed until December 2020. The delay resulted in patients not being seen virtually until January 2021.TransportationSanford Hillsboro and Sanford Mayville coordinated with Traill County to provide a public directory of transportation options, which is available throughout the county. Traill County has a bus/van available for use and seemed to be working very well in the community. Unfortunately, COVID-19 stopped all transportation in 2020. Sanford Hillsboro worked with the City of Hillsboro as they submitted a grant to secure and autonomous bus to transport residents throughout the city. The City did not receive the grant that was submitted and has moved away from any other such types of public transportation for the city.From a healthcare perspective, Sanford offers and promotes several virtual healthcare options in response to COVID-19 and the subsequent impact on travel. Offerings include video visits, telehealth, and e-visits.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Mayville, Sanford Hillsboro, and Traill County Public Health are partnering on a COVID-19 vaccination effort starting the week of January 25, 2021. The effort includes weekly vaccination events.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, and employment optionsAging - Cost of long term care and memory care, availability of resources for family and friends caring for elders the cost of in-home services, cost of in-home services, and help making out a will or healthcare directiveChildren and Youth - Availability of quality childcare, childhood obesity, cost of quality childcare, the availability of services for at-risk youth, bullying, substance abuse by youth, cost of activities, cost of services for at-risk youth, opportunities for youth-adult mentoring, and teen tobaccos useSafety - Culture of excessive drinking, and abuse of prescription drugsHealth Care - Access to affordable health insurance, access to affordable healthcare, access to affordable prescription drugs, access to affordable dental insurance, and access to affordable vision insurance Sanford will not develop strategy to address the cost of long term care and memory care because the state of North Dakota through the Department of Human Services controls the cost. Memory care cannot be added to the LTC facility. Safety issues such as the culture of excessive drinking, and abuse of prescription drugs are issues that the city council and the sheriff's office are issues that the community stakeholders are addressing. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: TransportationThe University of Minnesota's Rural Health Research Center reports that transportation is a concern for rural residents. A social determinant of health, affordable transportation is fundamental to mental, physical, and emotional well-being. Individuals with disabilities, those with low incomes, seniors, and others who may not have reliable access to transportation depend on public and private transportation to access health services, obtain food and other basic needs, and to engage with their communities.Sanford Health Mayville has made transportation a significant priority and has developed a strategy to work in collaboration with city and county leadership and the department of human services to explore options for the local community and county members. Addressing of Significant Needs during Current YearMental Health Services Sanford Mayville continues to use the PHQ-9 patient health questionnaire on initial and certain follow-up appointments and appropriate patients to ensure those in need of mental health services are identified and offered treatment. The panel management team is completing follow-up for new depression diagnosis.Both Sanford Mayville and Sanford Hillsboro have implemented integrated health therapists (IHTs) into the Clinics, primarily via telehealth due to the COVID-19 pandemic. 1-3 patients per day are being seen by telehealth from each Clinic. Patients and Providers feel it is going well and it is used quite frequently.Hillsboro's Go Live for Senior Life Solutions outpatient group therapy program was scheduled to start Summer of 2020 with an estimated 4-10 patients per day by end of 2020 year. Due to the COVID-19 pandemic program start date was delayed until December 2020. The delay resulted in patients not being seen virtually until January 2021.TransportationSanford Hillsboro and Sanford Mayville coordinated with Traill County to provide a public directory of transportation options, which is available throughout the county. Traill County has a bus/van available for use and seemed to be working very well in the community. Unfortunately, COVID-19 stopped all transportation in 2020. From a healthcare perspective, Sanford offers and promotes several virtual healthcare options in response to COVID-19 and the subsequent impact on travel. Offerings include video visits, telehealth, and e-visits.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Mayville, Sanford Hillsboro, and Traill County Public Health are partnering on a COVID-19 vaccination effort starting the week of January 25, 2021. The effort includes weekly vaccination events.Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, and employment optionsAging - Cost of long term care and memory care, availability of resources for family and friends caring for elders, cost of in-home services, and help making out a will or healthcare directiveChildren and Youth - Bullying, availability and cost of quality childcare, childhood obesity, cost of activities for children and youth, availability and cost of services for at-risk youth, substance abuse by youth, opportunities for youth-adult mentoring, and teen tobacco useSafety - Concerned about the culture of excessive drinking, and abuse of prescription drugsHealth Care - Access to affordable health insurance, cost of affordable vision insurance, access to affordable prescription drugs, cost of affordable dental insurance coverage, and access to affordable healthcareSanford will not directly develop strategy to address the cost of long term care and memory care because the state of North Dakota through the Department of Human Services controls the cost. Sanford has deferred to the local nursing home which does have an Alzheimer's unit. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Aging ServicesAccording to the Administration for Community Living, families are the major provider of long-term care for older adults and people with disabilities in the U.S. Research indicates that caregiving also exacts a significant emotional, physical, and financial toll. With nearly half of all caregivers older than age 50, many are vulnerable to a decline in their own health. Studies have shown that coordinated support services can reduce caregiver depression, anxiety, and stress, and enable them to provide care longer, which avoids or delays the need for costly institutional care.Sanford has made the aging population a significant priority and has developed strategies to support caregivers through community services. The creation of collaborative partners will provide the necessary support to make a positive impact on caregivers and to provide the tools to support their work.Addressing of Significant Needs during Current YearMental HealthAs need continues to increase, Sanford Webster aims to ensure that access to mental health services are available for the community. Access is achieved through improved access for mental health specialty care, psychiatry outreach services, and the Bridging Health and Home program. Bridging Health and Home is offered to support older adults in our rural areas. Bridging Health and Home services are free for adults age 55 and older and offers compassion and care to those wishing to remain at home as long as possible.Sanford Webster continues to actively offer access to mental health services through telemedicine. Dr. Mark Daniels is a psychologist and integrated health therapist based in Vermillion, SD offering care to Webster residents. Drs. Nuss and Eggers also support the local community and offer psychiatry services via telehealth. Volume has continued to increase with an average of over 20 patients per month coming for services. Aging PopulationSanford Webster continues to stay active in support of the community's aging population. Unfortunately, the caregiver support group-which offered supportive services to 59 local caregivers in 2019-has not met due to COVID-19 and the better balance class has not been as active with limiting the number of people in a space due to the pandemic. As such, participant numbers trail the 300 total residents that participated in 2019. Lori Reetz at the clinic has started offering Chronic Care Management to the community. We work with individuals with two or more chronic conditions to help them work toward their individual goals of managing their conditions. Currently, 26 individuals are registered with the program and the team has worked with over 30 people since inception of the program. COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Webster has offered care to patients with every level of care, including clinic visits, inpatient hospital, outpatient therapy, swing bed and terminal Covid care. Sanford completed over 1,600 Covid vaccines affecting over 800 individual patients and administered 48 Bamlanivimab infusions to patients in the community. This monoclonal antibody therapy has been very effective in the treatment of patients with COVID-19. Sanford Webster has provided community education through the paper with over five stories related to COVID-19 education. Identified needs not directly addressed by this facility include:Economic - Need for affordable housing, need to maintain energy efficient homes, household budgeting and money management skills, and skilled labor forceChildren and Youth - Bullying, availability of activities for children and youth, childhood obesity, substance abuse by youth, availability and cost of services for at-risk youth, opportunities for adult-youth mentoring, teen tobacco use, and education about birth controlSafety - Presence of street drugs, culture of excessive drinking, presence of drug dealers, abuse of prescription drugs, domestic violence, crime, and child abuse and neglectHealth Care - Access to affordable health insurance, access to affordable vision insurance, access to affordable health care, and access to affordable prescription drugs
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Worthington Medical Center
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health Mental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and depression. All patients in the primary care setting will have a Patient Health Questionnaire (PHQ-9) completed at each visit. The PHQ-9 is an assessment tool used for screening, diagnosing, measuring, and monitoring the severity of depression. Patients are evaluated to determine if there is a need to provide additional services. Sanford is providing on-site mental health services and has implemented telehealth services to improve access to psychiatry services. Priority 2: Economic Well BeingFood security means access by all people at all times to enough food for an active, healthy life. Food insecurity describes a household's inability to provide enough food for every person to live an active, healthy life. According to United States Department of Agriculture, an estimated 12.3 percent of American households were food insecure at least some time during the year in 2016, meaning they lacked access to enough food for an active, healthy life for all household members. That is essentially unchanged from 12.7 percent in 2015. The prevalence of very low food security also essentially unchanged, at 4.9 percent in 2016 and 5.0 percent in 2015. Sanford has made economic well-being specific to food security a significant priority and has developed a strategic plan to sustain the backpack program and food distribution for students in the community.Addressing of Significant Needs during the Current YearMental HealthSanford Wheaton experienced a significant change in depression scores during 2020 due to COVID-19. The pandemic made significant changes to everyone's life and the clinic setting was no different. All patients that are currently under the care of the telehealth psychiatrist receive a PHQ 9 on each visit. The remainder of patients are screened when deemed necessary by the provider, after med changes and to fall into the measured goal need to be done at 4-6 month and 11-13 months. However, the number of patients that came to our facility decreased dramatically in 2020 due to the pandemic, which in turn resulted in fewer patients that allowed for depression screenings through the clinic channel. Sanford Wheaton's depression score decreased every month from March to October but did start increasing again as patients returned to the clinic.Psychiatry and psychology appointments did continue in the midst of COVID-19, but most of these visits have been done through the patient's home via telehealth. Very few patients came to our facility for those visits, which continued through the end of the year. Sanford Wheaton was fortunate to receive a grant from the MN Department of Health for a project of depression and adolescents. This has also been difficult due to the pandemic as many of the strategies were getting groups of students together. We will continue this project into 2021 although the funding cycle ends. Below is the calendar year with the measurement on depression trending regression.Depression Management 19.2%, 16.7%, 17.6%, 12.0%, 12.0%, 11.5%, 10.3%, 8.6%8.3%, 7.7%, 8.3%, 10.8% Economic Well-BeingThe Backpack Program started in 2016 and continued throughout 2020. The program delivers between 80-120 bags monthly to kids age 4 - 18 years twice a month. During COVID-19 additional food was given in each bag. Funding is received through private donations and has sustained throughout this time. Bethlehem Covenant, which served approximately 60 people with a free meal every Wednesday night in 2019, was not able to provide the meals throughout the pandemic due to social distancing issues.Sanford Wheaton continues to collect food for the local food bank and assist with the local food drive each year.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Wheaton implemented all recommended guidelines issued by the CDC and/or Sanford, including masking, social distancing, visitation restrictions, temping employees, patients, visitors, etc. Staff were re-educated on the proper donning and doffing of PPE with continual changes as new information and guidelines became available. To minimize patient and staff exposure, Sanford Wheaton developed and implemented curbside COVID-19 testing protocols in order to provide testing of all Persons Under Suspicion (PUI's) without having them enter any of our buildings.We also secured additional patient care equipment with CARES Act dollars due to increased census.Identified needs not directly addressed by this facility include:Children and Youth - opportunities for youth-adult mentoring, bullying, availability of activities for children and youth, childhood obesity, and teen tobacco use Aging - Cost of long term care, availability of memory care, cost of in-home services, and the availability of activities for seniors.Safety - Abuse of prescription drugs, presence of drug dealers and street drugs, child abuse and neglect, crime, culture of excessive and binge drinking, and domestic violenceHealth Care - Access to affordable health insurance coverage, availability of mental health and substance abuse providers, access to affordable health care, availability of specialist physicians, access to affordable prescription drugs, use of emergency room services for primary health care, access to affordable vision insurance coverage, availability of doctors, physician assistants or nurse practitioners, and availability of non-traditional hours.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Priority 2: Children and YouthAccording the U.S. Department of Drug Enforcement Administration (DEA), nationally almost 20 percent of students surveyed admit to using marijuana at least once during the last 30 days, and 13 percent of students surveyed admitted driving when they used marijuana within the last 30 days.Researchers have identified risk factors that can increase a person's chances for misuse, and protective factors that can reduce the risk. However, many people with risk factors do not abuse substances. The risk factors for substance abuse among youth include boredom, stress, curiosity, the desire to feel grown up, or to lessen peer pressure. Youth may also be more likely to try drugs because of circumstances or events called risk factors. Examples of risk factors include: Poor grades in school Engaging in alcohol or drug use at a young age Friends and peers who engage in alcohol or drug use Persistent, progressive, and generalized substance use, misuse, and use disorders by family members Conflict between parents or between parents and children, including abuse or neglect BullyingProtective factors include:Having high self-esteem Attending a school with policies against using alcohol and drugs Having an adult role model who doesn't use tobacco or drugs or misuse alcohol Participating in athletic, community, or faith-based groups Living in a community with youth activities that prohibit drugs and alcohol Sanford Health Bagley has made children and youth a significant priority and has developed strategies to expand education for healthy lifestyle choices, provide opportunities for local employment and careers, and provide outreach for teen and adolescent behavioral health services.Addressing of Significant Needs during Current YearMental Health and Substance AbuseIn 2019, Sanford Bagley selected a current Family Medicine Nurse Practitioner and supported their return to school to receive a Psychiatric Nurse Practitioner Certification. The intent was to have a local expert in Psychiatric Medication Management for the community. The Psychiatric Nurse Practitioner completed their clinical rotations and began seeing patients at the Bagley and Clearbrook clinics in 2019. At the time, they were able to see patients with both medical and mental health concerns due to the double certification. Unfortunately, the provider had personal commitments that led them to leave their role at Sanford in 2020. Mental health support for the local community continues through psychiatric telehealth, and outreach from Sanford Bemidji Medical Center.Pharma providers use Sanford Prescribing algorithms for opioid prescribing. This allows for a standard approach to opioid prescribing to patients - eliminating the patient trying different doctors to get different answers. Contracts are being used with patients as part of the opioid prescription process, having the patient and provider sign an agreement on how to safely utilize the prescribed medication. In the event we feel a provider is prescribing opioids outside of the guidelines we can audit each provider's prescriptions.Crisis services report in person for crisis visits. The crisis services team is a group out of Sanford Bemidji that can assist our providers in the event they have a patient in the middle of a mental health crisis. The crisis team can help determine the most appropriate next service. For example: a patient comes into the Emergency Department saying they are suicidal. Our provider can have the crisis team help determine next steps - inpatient vs. outpatient vs. other treatment. Children and YouthSanford Bagley intends to make the Sanford fit wellness program available to local schools as well as parents of students. SBMC hosted Sanford fit night in conjunction with parent teacher conferences at the Bagley elementary school on February 13, 2020. Approximately 200 people attended the event. Further expansion into additional districts at an appropriate time due to COVID-19 is under consideration.Sanford Bagley continued to partner with local school districts to support community youth. Unfortunately, most events were cancelled due to the COVID-19 pandemic. We have had the opportunity for our RN Health Coach to meet with patients for education on healthy lifestyle choices. In addition, online education opportunities were available to our patients.Sanford Health Northern Minnesota hired and onboarded a teen/adolescence psychiatric nurse practitioner and a full-time licensed psychologist in September 2019. Approximately 600 patients were seen in 2020.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates. Locally, Sanford Bagley partnered with local public health, emergency management, school districts, local businesses, and long-term care to provide a community centric response to COVID-19. Weekly meetings continued through 2020 into 2021. For COVID-19 testing, Sanford Bagley created a drive through COVID-19 specimen site to allow for ease of collection. We partnered with long term care, school districts, and local public health to complete necessary mass testing events. Sanford Bagley continued the partnerships with local public health and long-term care to provide COVID-19 vaccination opportunities to our patients. Identified needs not directly addressed by this facility include:Economics - Availability of affordable housing, concern for homelessness, food insecurity, and a need for housing that accepts people with chemical dependency, mental health problems, criminal history or victims of domestic abuseAging - Cost of long term care, and availability of memory careSafety - Child abuse and neglect, crime, presence of street drugs, abuse of prescription drugs, presence of drug dealers, and domestic violenceHealth Care - Use of emergency services for primary care, and access to mental health/behavioral health providers
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Economic Well-Being - Affordable HousingResources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Priority 2: Behavioral Health and Mental Health Access - Substance Abuse by YouthMental health is important at every stage of life and affects how people think, feel and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness.Addressing of Significant Needs during Current YearEconomic Well-Being - Availability of Affordable HousingThe Canton area is in need of more affordable housing units to increase the well-being of community members. SCIMC is collaborating with the Canton Economic Development Committee to expand options for local residents. A Sanford Senior Director is the president of the Canton Economic Development Corporation (CEDC) and has been working with CEDC board for the past two years on this project. We have secured the option to purchase land with the goal of starting development of two 16-plex apartment buildings and approximately 10 villa-type homes in 2021, with additional custom homes to begin in late 2022. Three potential developers for the land were interviewed and the ultimate developer has been selected with a final agreement in the works.Behavioral Health and Mental Health Access - Youth Substance Abuse SCIMC has not been able to get into the local school districts since March of 2020 due to COVID-19. The lack of access has resulted in SCIMC's inability to provide and/or sponsor any educational material to the local school. SCIMC intends to re-start the efforts once things open again and provide additional information to the local high school and middle school kids and their families. SCIMC has a number of valuable resources deployed in previous years to support the CHNA, including vaping education seminars and screening services. COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, SCIMC provided additional resources for patients to see providers through video visits and verbal visits. COVID-19 and vaccine information were provided to the public to educate and promote understanding of the topics. Local vaccine clinics for businesses essential works and to patients in the 65 + age group have given out over 1,800 doses of the vaccine. The hospital and the SCIMC Foundation provided staff with Canton Cash, Inwood Bucks, and gift certificates to support local businesses.Identified needs not directly addressed by this facility include:Economic - Employment options, a skilled labor force, household budgeting and money management, and maintaining livable and energy efficient homesTransportation - Availability of good walking or biking options, and driving habits related to speed and road rageAging - Cost of long term care and memory care, cost of in-home services, availability of memory care, availability of resources to help the elderly stay safe in their homes, and availability of resources for caregiversSafety - Abuse of prescription drugs in the community, presence of drug dealers in the communityHealth Care - Access to affordable health insurance, access to affordable vision insurance, availability of health care services for Native American people, access to affordable dental insurance, availability of non-traditional hours, availability of prevention programs, and availability of specialist physicians Children and Youth - Cost and availability of activities for children, cost and availability of quality childcare, cost and availability of services for at-risk youth, bullying, childhood obesity, teen tobacco use, teen suicide, and opportunities for youth mentoringMental Health and Substance Abuse - Depression, stress, dementia and Alzheimer's disease, drug use and abuse, smoking and tobacco use, alcohol use and abuse, and exposure to second hand smoke
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: TransportationAdequate transportation is an essential quality of life issue. People who live in rural areas, people with low incomes or disabilities, seniors, etc. have a harder time receiving healthcare, accessing basic needs, and interacting with the community because of transportation. They often must rely on public or private transportation services to receive needed health care.Sanford Health Clear Lake has made transportation a priority and developed a strategy to work in collaboration with community organizations to explore options for the local community and county members. Priority 2: Physical HealthObesity is a serious and complex health issue. It can be caused by behavior or genetics or a combination of both. Behaviors can include dietary choices, physical activity, medication use, and others. Environmental factors such as education or culture can also contribute to obesity. Obesity is a serious concern because it's highly related to poor health, reduced quality of life, and to morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Clear Lake has made physical health specific to obesity a priority and developed a strategy to improve physical health and reduce the negative health effects of obesity.Addressing of Significant Needs during Current YearTransportationThrough the efforts of motivated individuals in the Clear Lake Community, including Sanford Clear Lake staff, the transit project sustained traction throughout the COVID-19 pandemic. Virtual meetings were utilized to discuss and improve public transit.Community Transit of Watertown/Sisseton received approval by the SDDOT to expand its operations to include Deuel County. Beginning on August 4, 2020, Deuel County Community Transit kicked off service by providing scheduled weekly trips to Watertown, Brookings, and Sioux Falls. Handicapped accessible public transportation was made available to all ages. Service is limited to medical, educational, and employment purposes. The Healthy Hometown project experienced delays and cancelations due to COVID-19. The walking audit to determine the walkability of the City of Clear Lake had to be rescheduled due to travel bans for Wellmark staff leading the project. The Healthy Hometown group still meets virtually to address other projects and hopes to schedule a walking audit Spring 2021. Physical Health Sanford Clear Lake Medical Center is committed to improving the physical health of the Clear Lake community with a particular focus on reducing negative health effects from obesity. 2020 was a challenging year for Sanford Clear Lake Wellness Center. Due to COVID-19, the wellness center closed its doors from March 13 - May 11, 2020. However, Sanford Clear Lake Wellness Center sponsored three separate fitness/wellness challenges in 2020. "March Madness" encouraged daily routine exercise with 23 participants before it was discontinued with the pandemic-related closure of the wellness center. A "Lazy Triathlon" in July and August allowed participants to complete a triathlon at their own pace. Participants who completed the challenge were to return completed log sheet to be entered for a prize. Unfortunately, log sheets were not returned. A "Holiday Hustle" in December encouraged healthy lifestyles by having participants complete a healthy task each day in the month of December. One participant returned a completed log sheet.The Healthy Hometown committee continued work through the pandemic. Virtual meetings allowed committee members to continue to work on projects set forth in the overall master plan designed for Clear Lake in 2019. Staff took on the task of implementing healthy options at concessions and improving access to drinking water in the community. School administration supported this project and provided resources and contact information that enabled the project's success. The impact of making healthier options available at concessions was measured by the frequency of re-ordering and re-supplying the healthier items, i.e. Veggie Straws, fresh fruit, trail mix, and string cheese. A promotional poster at concession informed patrons of the availability of the healthier options. The poster was also shared through social media. Implementation plans for healthier concession options at youth summer recreation concessions were also made, but, due to the COVID-19 pandemic, youth summer recreation activities were altered and concessions were not available. Increasing access to water proved to be a more difficult tactic. Plans were made with city officials to meet and discuss the goals of the project. Unfortunately, the meeting was canceled, and organizers were encouraged to submit a proposal to the city council for approval. Developing a proposal without key information hindered the success of the project. However, due to the COVID-19 pandemic, Deuel School installed five additional water bottle filling stations for students to access while at school.In the spring of 2020, the city council made a proposal for a walking trail at the city park. Sanford Clear wrote a letter to the city in support of the project due to its promotion of physical activity.The CHNA planning team meets monthly and reviews sponsorship requests for community events. In 2020, approximately $1600 was donated to events and organizations including the Clear Lake Baseball Association, Deuel Area Development, Inc., and New Hope Walk for Cancer to name a few. COVID-19 and Community HealthSanford Health started monitoring COVID-19 in December 2019. We activated an Incident Command in March 2020 that included leaders from the entire organization to create and execute a coordinated response to the pandemic. Our integrated system allowed greater access to supplies, and better ability to distribute resources. Sanford evaluated more than 100 clinical trials for treatment and therapies. We also maintain a registry including data and specimens from 90,000 COVID-19 cases so researchers can thoroughly study the disease. Vaccine distribution began December 2020, and the Dakotas ranked as state leaders for CDC vaccination rates.Locally, Sanford Clear Lake Medical Center (SCLMC) was quick to take action with screening procedures and visitor restrictions. Leadership teams met frequently to assess the state of the pandemic and lead the local response. COVID-19 laboratory testing evolved throughout the year with SCLMC eventually able to conduct a PCR, in-house, 30-minute Covid-19 test for emergency room patients and hospital inpatients. In-house antigen test for symptomatic patients was added in November.SCLMC initially transferred COVID-19 patients to the Sanford USD Medical Center in Sioux Falls. However, increasing case counts and hospitalizations necessitated the treatment of COVID-19 patients locally at a designated area within the med/surge unit. Sanford Clear Lake was also able to provide outpatient monoclonal antibody therapies, which has seen great success in reducing hospitalizations resulting from COVID-19 infections.Once vaccines received emergency use authorization from the FDA, Sanford Clear Lake was eager to play a role in the vaccination effort. By December, the first vaccinations had been given to frontline staff. Staff continue to work closely with state officials and county officials in the vaccination effort and continue to work through population lists and priority lists to provide vaccinations to the public. Identified needs not directly addressed by this facility include:Economic Well-Being - Employment options, skilled labor force, availability of affordable housing and the need for budgeting and money management.Children and Youth - Childhood obesity and bullying Aging - Cost of long term care, availability of resources and cost of services to help the elderly stay in the homes, availability of activities for seniors, and availability and cost of memory careSafety - Abuse of prescription drugsHealth Care - Access to affordable health insurance, access to affordable health care, and availability of behavioral and mental health providersMental Health and Substance Abuse - Depression, stress and tobacco use
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 11: The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: WellnessAccording the Center for Disease Control, Obesity is a complex health issue to address. Obesity can be caused from a combination of contributing factors such as behavior and genetics. Behaviors can include dietary patterns, physical activity, inactivity, medication use, and other exposures. Additional contributing factors in our society include the food and physical activity environment, education and skills, and food marketing and promotion.Obesity is a serious concern because it is associated with poorer mental health outcomes, reduced quality of life, and is associated with morbidity and illnesses including diabetes, heart disease, stroke, and some types of cancer.Sanford Health Westbrook has made physical health specific to obesity a significant priority and has developed strategy to improve physical health and reduce the negative health effects of obesity.Priority 2: Mental Health and Substance AbuseMental health is important at every stage of life and affects how people think, feel, and act. According to the National Institute of Mental Health, depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression is among the most treatable of mental disorders. Sanford has made mental health a significant priority and has developed strategies to reduce mortality and morbidity from mental health and behavioral health and substance abuse. It is Sanford's goal to reduce the number of individuals whose overall well-being is negatively impacted by addiction and mental illness. Addressing of Significant Needs during Current YearWellnessDietician and RN Health Coach Services continued to be offered in 2020 as needed. There were five in-person dietician visits in 2020 and zero dietician telemed visits. The RN Health Coach had 152 visits in 2020, an increase over 2019 levels.As part of the community education effort, staff attended local high school basketball games in February 2020 (for the 2nd year in a row) to share heart health information with the community. Staff also worked with A.C.E. to provide a Bone Builders class two times a week and a Matter of Balance class periodically for area seniors at Peterson Estates, a senior living facility attached to Sanford Westbrook. In March, all community education programs were put on pause due to COVID-19. 2020 saw staff continue the Sanford fit program, which focuses on healthy lifestyle choices to prevent childhood obesity, with the Westbrook Walnut Grove Elementary 4th grade class. Unfortunately, the 2020 session was cut short due to COVID-19 and the schools going to distance learning. Resources for at home learning and exercise were provided to the teachers. The 4th graders took a pre-test, but were unable to take the post-test, hindering ability to measure participant learning from the program.Mental Health and Substance AbuseThe initiative focuses on enhanced access and awareness of community resources for mental health and substance abuse. This includes working with community partners to create new and promote current recovery program options, promoting telemedicine options for behavioral health, and providing community education. The awareness campaigns for telemedicine services and local behavioral health services continued into 2020 but were quickly halted in March due to COVID-19. However, provider referrals were a major factor in the continued use of Sanford Westbrook's in-house behavioral health services. Behavioral Health providers in Westbrook saw 27 new referrals in 2020 and a grand total of 752 visits for the year.COVID-19 and Community HealthAs a system, Sanford Health started monitoring COVID-19 in December of 2019 and activated an Incident Command in March 2020. Our Incident Commands included leaders from all areas of the organization to create and carry out a coordinated response to the pandemic. Our integrated system allowed greater access to supplies and the ability to distribute resources like PPE across both urban and rural areas in our footprint. In response to the need for treatments and therapies, Sanford evaluated more than 100 clinical trials for patients and maintains a registry that now includes data and specimens from 90,000 COVID-19 positive cases so researchers can continue to study immunity, reinfection, health complications and more. This approach carried through to vaccine distribution beginning in December 2020, with North and South Dakota among the leaders in the CDC's ranking of states with the best vaccination rates.Locally, Sanford Westbrook's COVID Response included several measures that greatly reduced the possibility of exposures and infection of COVID19 for our communities. Measures included the implementation of telehealth visits, phone visits, and drive through COVID-19 testing to limit patients coming into our facility, masking, screening, and visitor guidelines, and COVID-19 pre-op testing before all surgical procedures.Identified needs not directly addressed by this facility include:Economic Well-Being - Need for employment options, household budgeting, money management and the availability of a skilled labor force Transportation - Availability of public transportationChildren and Youth - Availability and cost of quality childcare, childhood obesity, and teen tobacco useAging - Cost of long term care, and cost of memory careSafety - Abuse of prescription drugs Health Care - Access to affordable health insurance and access to affordable health care
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 5: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 6a: Sanford USD Medical Center Sioux FallsSanford Medical Center FargoSanford Broadway Medical Center FargoSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 7d: Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were inculded.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 11: The following is a list of the community's priority needs and what is being done to address them. Priority needs not directly addressed are either, not within Sanford's expertise, or being addressed collaboratively with community partners. For information concerning those additional needs visit:http://www.sanfordhealth.org/about/community-health-needs-assessment
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 13h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 16j: Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policy
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?198
Name and address Type of Facility (describe)
1 1 - Sanford Clinic Aberdeen
3015 3rd Avenue SE
Aberdeen,SD57401 		Medical Clinic
2 2 - Sanford Clinic Aberdeen Surgical Center
3015 3rd Avenue SE
Aberdeen,SD57401 		Ambulatory Surgery Center
3 3 - Sanford Health Adrian Clinic
201 Maine Ave
Adrian,SD56110 		Rural Health Clinic
4 4 - Sanford Health Broadway Clinic
1527 Broadway Street
Alexandria,MN56308 		Medical Clinic
5 5 - Sanford Health Easton Place Clinic
510 - 22nd Avenue E Suite 602
Alexandria,MN56308 		Medical Clinic
6 6 - Sanford Bagley Clinic
1656 Central St W
Bagley,MN56621 		Rural Health Clinic
7 7 - Sanford Bagley Eye Center & Optical
14 2nd St NE
Bagley,MN56621 		Eye Care Center
8 8 - Sanford Tracy Balaton Clinic
551 Highway 14 E
Balaton,MN56115 		Medicare Certified Rural Health Clinic
9 9 - Sanford Health Bassett Family Clinic
103 Clark St
Bassett,NE68714 		Medical Clinic
10 10 - Sanford Health Baudette Eye Center
103 Main St
Baudette,MN56623 		Eye Care Center
11 11 - Baker Park Inc
803 Dewey Avenue
Bemidji,MN56601 		Assisted Living Center
12 12 - Edith Sanford Breast Center Bemidji
1233 34th St NW
Bemidji,MN56601 		Women's Health
13 13 - Sanford Bemidji 1611 Anne St Clinic
1611 Anne St NW
Bemidji,MN56601 		Medical Clinic
14 14 - Sanford Bemidji 1705 Ann St Clinic
1705 Anne St NW
Bemidji,MN56601 		Medical Clinic
15 15 - Sanford Bemidji Downtown Eye Center & Op
506 Beltrami Ave NW
Bemidji,MN56601 		Eye Care Center
16 16 - Sanford Bemidji Home Care & Hospice
3201 Pine Ridge Ave NW
Bemidji,MN56601 		Home Care and Hospice
17 17 - Sanford Bemidji Main Clinic
1233 34th St NW
Bemidji,MN56601 		Medical Clinic
18 18 - Sanford Dialysis Bemidji
1300 Anne Street NW
Bemidji,MN56601 		Dialysis
19 19 - Sanford Health Neilson Place
1000 Anne St NW
Bemidji,MN56601 		Skilled Nursing Facility
20 20 - Sanford Health Trillium
930 Anne Street NW
Bemidji,MN56601 		Assisted Living Center
21 21 - Sanford Health Windsong
1010 Anne Street N
Bemidji,MN56601 		Assisted Living Center
22 22 - Sanford Joe Lueken Cancer Center
1233 34th St NW
Bemidji,MN56601 		Cancer Center
23 23 - Sanford Behavioral Health Headwaters ACT
116 3rd St NW
Bemidji,MN56601 		Behavioral Health Treatment Center
24 24 - Sanford Health PrimeWest Residential
3124 Hannah Ave NW
Bemidji,MN56601 		Behavioral Health & Addiction Center
25 25 - Sanford Clinic Beresford
600 W Cedar Street
Beresford,SD57004 		Rural Health Clinic
26 26 - Bismarck Cancer Center
500 N 8th Street
Bismarck,ND58501 		Cancer Center
27 27 - Sanford Birth Center
300 N 7th Street
Bismarck,ND58501 		Birth Center
28 28 - Sanford Cancer Center Bismarck
300 N 7th Street
Bismarck,ND58501 		Cancer Center
29 29 - Sanford Tom & Frances Leach Bismarck Dia
209 N 7th Street
Bismarck,ND58501 		Dialysis Center
30 30 - Sanford Clinic
222 N 7th Street
Bismarck,ND58501 		Medical Clinic
31 31 - Sanford Children's North Clinic
765 W Interstate Ave
Bismarck,ND58503 		Children's Clinic
32 32 - Sanford Bemidji Blackduck Clinic
81 1st St NW
Blackduck,MN56630 		Medical Clinic
33 33 - Sanford Boyden Clinic
3971 320th St
Boyden,IA51234 		Medical Clinic
34 34 - Sanford Brandon Family Medicine Clinic
1105 E Holly Blvd
Brandon,SD57005 		Medical Clinic
35 35 - Sanford Health Brookings Clinic
922 - 22nd Avenue S
Brookings,SD57006 		Medical Clinic
36 36 - Sanford Canby Clinic
112 St Olaf Avenue
Canby,MN56220 		Medicare Certified Rural Health Clinic
37 37 - Sanford Canby Dental Clinic
11 St Olaf Ave S
Canby,MN56220 		Dental Clinic
38 38 - Sanford Canby Dialysis Unit
112 St Olaf Avenue S
Canby,MN56220 		Medicare Certified End Stage Renal Dialysis
39 39 - Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220 		Medicare Certified Home Health Agency
40 40 - Sanford Canby Medical Center
112 St Olaf Avenue S
Canby,MN56220 		Class F Home Care Provider
41 41 - Sanford Health Canby Sylvan Place
212 St Olaf Avenue S
Canby,MN56220 		Housing with Services
42 42 - Sanford Health CanistotaUSD Clinic
320 W Main St
Canistota,SD57012 		Rural Health Clinic
43 43 - Sanford Canton Clinic
400 N Hiawatha Drive
Canton,SD57013 		Rural Health Clinic
44 44 - Sanford Health Canton Hiawatha Heights
398 N Hiawatha Drive
Canton,SD57013 		Assisted Living Center
45 45 - Sanford Bemidji Cass Lake Clinic
219 Grant Utley Ave NW
Cass Lake,MN56633 		Medical Clinic
46 46 - Sanford Chamberlain Clinic
300 S Byron Blvd
Chamberlain,SD57325 		Rural Health Clinic
47 47 - Sanford Health Chamberlain Care Center
300 S Byron Blvd
Chamberlain,SD57325 		Nursing Facility
48 48 - Sanford Home Health & Hospice Chamberlai
110 W Beebe Ave
Chamberlain,SD57325 		Home Health Care & Hospice
49 49 - Sanford Health Clark Clinic
211 N Commercial Street
Clark,SD57225 		Rural Health Clinic
50 50 - Sanford Clear Lake Clinic
701 3rd Avenue S
Clear Lake,SD57226 		Rural Health Clinic
51 51 - Sanford Clear Lake Medical Center
701 3rd Avenue S
Clear Lake,SD57226 		Home Health Care
52 52 - Sanford Bagley Clearbrook Clinic
22 Elm Street
Clearbrook,MN56634 		Rural Health Clinic
53 53 - Sanford Health Dakota Dunes Clinic
350 Oak Tree Ln
Dakota Dunes,SD57049 		Medical Clinic
54 54 - Sanford Health Dell Rapids Orchard Hills
200 W 10th Street
Dell Rapids,SD57022 		Assisted Living Center
55 55 - Sanford Dialysis
1234 Washington Ave Suite B
Detroit Lakes,MN56501 		Dialysis Center
56 56 - Sanford Health Detroit Lakes Clinc & Sam
1245 Washington Avenue
Detroit Lakes,MN56501 		Ambulatory Surgery Center/Clinic
57 57 - Sanford Health Detroit Lakes Eye Center
1245 Washington Avenue
Detroit Lakes,MN56501 		Eye Care Center
58 58 - Sanford Health West Dickinson Clinic
2615 Fairway Street
Dickinson,ND58601 		Medical Clinic
59 59 - Sanford Health East Dickinson Clinic
33 9th St W
Dickinson,ND58601 		Medical Clinic
60 60 - Sanford Health Hearing Center Dickinson
1531 W Villard St
Dickinson,ND58601 		Hearing Center
61 61 - Sanford Health 621 DeMers Ave Clinic
621 DeMers Ave NW
East Grand Forks,MN56721 		Medical Clinic
62 62 - Sanford Health 929 Central Ave Clinic
929 Central Ave
East Grand Forks,MN56721 		Medical Clinic
63 63 - Sanford Health EGF Dermatology Clinic
625 DeMers Ave NW
East Grand Forks,MN56721 		Medical Clinic
64 64 - Sanford Home Care East Grand Forks
404 DeMers Ave
East Grand Forks,MN56721 		Home Health Care
65 65 - Sanford Health Edgeley Clinic
506 2nd St
Edgeley,ND58433 		Medical Clinic
66 66 - Sanford Luverne Edgerton Clinic
733 Main Ave
Edgerton,MN56128 		Rural Health Clinic
67 67 - Sanford Health Ellendale Clinic
141 Main St
Ellendale,ND58436 		Rural Health Clinic
68 68 - Sanford Health Enderlin Clinic
201 4th Avenue
Enderlin,ND58027 		Rural Health Clinic
69 69 - Sanford Clinic Estelline
305 Hospital Drive
Estelline,SD57234 		Rural Health Clinic
70 70 - Edith Sanford Breast Center Fargo
737 Broadway N
Fargo,ND58102 		Women's Health
71 71 - Sanford 1711 Medical Building
1711 University Drive S
Fargo,ND58103 		Medical Clinic
72 72 - Sanford 1717 Medical Building
1717 Medical Building
Fargo,ND58103 		Medical Clinic
73 73 - Sanford Broadway Clinic
801 Broadway N
Fargo,ND58102 		Medical Clinic
74 74 - Sanford Children's Broadway Clinic
737 Broadway
Fargo,ND58102 		Medical Clinic
75 75 - Sanford Dialysis Fargo
2801 S University Drive
Fargo,ND58122 		Dialysis
76 76 - Sanford I-94 Clinic
5225 23rd Avenue South
Fargo,ND58104 		Medical Clinic
77 77 - Sanford Home Care Fargo
100 4th Street S
Fargo,ND58103 		Home Health Agency
78 78 - Sanford Roger Maris Cancer Center
840 4th Street N
Fargo,ND58102 		Cancer Center
79 79 - Sanford South University Eye Center & Op
1717 S University Dr
Fargo,ND58103 		Eye Care Center
80 80 - Sanford Children's Southwest Clinic
2701 13th Ave S
Fargo,ND58103 		Children's Clinic
81 81 - Sanford Southpointe Eye Center & Optical
2400 32nd Ave S
Fargo,ND58103 		Eye Care Center
82 82 - Sanford Health Finley Clinic
407 Washington Ave
Finley,ND58230 		Rural Health Clinic
83 83 - Sanford Health Forman Clinic
336 Main St SW
Forman,ND58032 		Rural Health Clinic
84 84 - Sanford Dialysis Fort Yates
100 N River Road
Fort Yates,ND58538 		Dialysis Center
85 85 - Sanford Health Fosston Eye Center & Opti
111 2nd St NE
Fosston,MN56542 		Eye Care Center
86 86 - Sanford Rock Rapids George Clinic
101 N Main
George,IA51237 		Rural Health Clinic
87 87 - Sanford Health Gwinner Clinic
69 ND 13
Gwinner,ND58040 		Medical Clinic
88 88 - Sanford Health Halstad Clinic
445 1st Street E
Halstad,MN56548 		Rural Health Clinic
89 89 - Sanford Health Hartford Clinic
905 N Oaks Ave
Hartford,SD57033 		Medical Clinic
90 90 - Sanford Sheldon Hartley Clinic
512 3rd St NE
Hartley,IA51346 		Medical Clinic
91 91 - Sanford Hawley Clinic
1412 Main St
Hawley,MN56549 		Medical Clinic
92 92 - Sanford Health Comstock Corner
12 3rd Street SE
Hillsboro,ND58045 		Assisted Living Center
93 93 - Sanford Hillsboro Care Center
12 3rd Street SE
Hillsboro,ND58045 		Hospital Based-Nursing Facilities LTC
94 94 - Sanford Health Hillsboro Clinic
315 East Caledonia
Hillsboro,ND58045 		Rural Health Clinic
95 95 - Sanford Health Dialysis Hospers
112 Sunrise Drive
Hospers,IA51238 		End Stage Renal Dialysis
96 96 - Sanford Health International Falls Eye C
1400 Highway 71
International Falls,MN56649 		Eye Care Center
97 97 - Sanford Health Inwood Clinic
303 E Jefferson St
Inwood,IA51240 		Medical Clinic
98 98 - Sanford Clinic Ipswich
110 5th Avenue
Ipswich,SD57451 		Rural Health Clinic
99 99 - Sanford Jackson Clinic
1430 North Highway
Jackson,MN56143 		Medicare Certified Rural Health Clinic
100 100 - Sanford Dialysis Jamestown
300 2nd Avenue NE
Jamestown,ND58401 		Dialysis Center
101 101 - Sanford Health Hearing Center Jamestown
904 5th Ave NE
Jamestown,ND58401 		Hearing Center
102 102 - Sanford Health Jamestown 2nd Ave Clinic
300 2nd Avenue NE
Jamestown,ND58401 		Medical Clinic
103 103 - Sanford Health Jamestown 5th Ave Clinic
904 5th Ave NE
Jamestown,ND58401 		Medical Clinic
104 104 - Sanford Health Kelliher Clinic
243 Clark Ave N
Kelliher,MN56650 		Medical Clinic
105 105 - Sanford Chamberlain Kimball Clinic
101 S Main St
Kimball,SD57355 		Rural Health Clinic
106 106 - Sanford Children's Clinic
3001 Daggett St
Klamath Falls,OR97601 		Medical Clinic
107 107 - Sanford Health Lake Norden Clinic
512 Main Ave
Lake Norden,SD57248 		Rural Health Clinic
108 108 - Sanford Jackson Lakefield Clinic
209 Main Street
Lakefield,MN56150 		Medicare Certified Rural Health Clinic
109 109 - Sanford Health Lake Park Clinic
215 N Market St
Lake Park,IA51347 		Medical Clinic
110 110 - Sanford Health LaMoure Clinic
101 1st Ave SW
LaMoure,ND58458 		Rural Health Clinic
111 111 - Sanford Health Lennox Clinic
108 S Main
Lennox,SD57039 		Rural Health Clinic
112 112 - Sanford Health Lidgerwood Clinic
21 Wiley Ave S
Lidgerwood,ND58053 		Medical Clinic
113 113 - Sanford Health Lisbon Clinic
102 10th Ave W
Lisbon,ND58054 		Medical Clinic
114 114 - Sanford Home Care Lisbon
404 Forest St
Lisbon,ND58054 		Home Health Care
115 115 - Sanford Home Health Luverne
304 N McKenzie St
Luverne,MN56156 		Home Health Care
116 116 - Sanford Luverne Clinic
1601 Sioux Valley Dr
Luverne,MN56156 		Medical Clinic
117 117 - Sanford Luverne Hospice
217 N Oakley St
Luverne,MN56156 		Medicare Certified Hospice
118 118 - Sanford Dialysis
323 SW 10th Street
Madison,SD57042 		End Stage Renal Dialysis
119 119 - Sanford Hospice Madison
900 2nd Avenue
Madison,MN56256 		Hospice (licensed in SD)
120 120 - Sanford Health Mahnomen Clinic
410 W 4th St
Mahnomen,MN56557 		Rural Health Clinic
121 121 - Sanford Home Care Mahnomen
414 W Jefferson Ave
Mahnomen,MN56557 		Home Health Care
122 122 - Sanford Home Care Bismarck
910 18th Street NW
Mandan,ND58554 		Home Health Agency
123 123 - Sanford East Mandan Clinic
102 Mandan Ave
Mandan,ND58554 		Medical Clinic
124 124 - Sanford Home Care Mayville
49 7th Ave SE
Mayville,ND58257 		Home Health Care
125 125 - Sanford Mayville Clinic
600 1st St SE
Mayville,ND58257 		Medical Clinic
126 126 - Sanford Health Highway 2 Clinic
801 21st Ave SE
Minot,ND58701 		Medical Clinic
127 127 - Sanford Health Northwest Clinic
1500 21st Ave NW
Minot,ND58701 		Medica
128 128 - Sanford Health Minneota Clinic
700 N Monroe St
Minneota,MN56264 		Rural Health Clinic
129 129 - Sanford Health Mitchell Clinic
2100 Highland Way
Mitchell,SD57301 		Medical Clinic
130 130 - Sanford Dialysis Morris
400 1st Street East
Morris,MN56267 		Dialysis
131 131 - Sanford Health Mountain Lake Clinic
308 N 8th Street
Mountain Lake,MN56159 		Medicare Certified Rural Health Clinic
132 132 - Sanford Health Oakes Clinic
420 7th St S
Oakes,ND58474 		Medical Clinic
133 133 - Sanford Children's Clinic
3605 Vista Way
Oceanway,CA92056 		Children's Clinic
134 134 - Sanford Health Park Rapids Clinic
110 7th St W
Park Rapids,MN56470 		Medical Clinic
135 135 - Sanford Health Parkers Prairie Clinic
115 E Soo Street
Parkers Prairie,MN56361 		Medical Clinic
136 136 - Sanford Health Pelican Rapids Clinic
211 East Mill Street
Pelican Rapids,MN56572 		Rural Health Clinic
137 137 - Sanford Home Care Pelican Rapids
211 East Mill Street
Pelican Rapids,MN56572 		Home Health Care
138 138 - Sanford Health Pierre Clinic
521 E Sioux Ave
Pierre,SD57501 		Medical Clinic
139 139 - Sanford Dialysis Red Lake
24760 Hospital Drive
Red Lake,MN56671 		Dialysis
140 140 - Sanford Rock Rapids Clinic
803 South Green Street
Rock Rapids,IA51246 		Rural Health Clinic
141 141 - Sanford Sheldon Sanborn Clinic
321 Main Street
Sanborn,IA51248 		Medical Clinic
142 142 - Sanford Health Sheldon Care Center
118 North Seventh Avenue PO Box 250
Sheldon,IA51201 		Home Health Agency and Hospice
143 143 - Sanford Senior Care Sheldon
118 North Seventh Avenue PO Box 250
Sheldon,IA51201 		Hospital Based-Nursing Facilities
144 144 - Sanford Sheldon Clinic
800 Oak Street
Sheldon,IA51201 		Rural Health Clinic
145 145 - Ava's House
1320 W 17th Street
Sioux Falls,SD57104 		Nursing Facility
146 146 - Sanford 10th & Phillips Acute Care & Ort
136 S Phillips Ave
Sioux Falls,SD57104 		Medical Clinic
147 147 - Sanford 27th & Sycamore Family Medicine
4405 E 26th St
Sioux Falls,SD57103 		Medical Clinic
148 148 - Sanford 32nd & Ellis Clinic
2601 S Ellis Road
Sioux Falls,SD57106 		Medical Clinic
149 149 - Sanford Family Medicine 34th & Kiwanis
2701 S Kiwanis Ave
Sioux Falls,SD57105 		Medical Clinic
150 150 - Sanford 49th & Oxbow Family Medicine
3401 W 49th Street
Sioux Falls,SD57106 		Medical Clinic
151 151 - Sanford 4th & Sycamore Family Medicine
600 N Sycamore Ave
Sioux Falls,SD57110 		Medical Clinic
152 152 - Sanford Cancer Center
1309 W 17th St
Sioux Falls,SD57104 		Cancer Center
153 153 - Sanford Children's MB2 Clinic
1205 S Grange Ave
Sioux Falls,SD57105 		Children's Clinic
154 154 - Sanford Children's Residency Clinic
6101 S Louise Ave
Sioux Falls,SD57108 		Children's Clinic
155 155 - Sanford Children's Specialty Clinic
1605 W 22nd St
Sioux Falls,SD57117 		Children's Clinic
156 156 - Sanford Dialysis Sioux Falls
1321 W 22nd Street
Sioux Falls,SD57117 		Dialysis Center
157 157 - Sanford Eye Center & Optical
1621 S Minnesota Ave
Sioux Falls,SD57105 		Eye Care Center
158 158 - Sanford Fetal Care Center
1500 W 22nd Street
Sioux Falls,SD57105 		Birth Center
159 159 - Sanford Health Midtown Family Planning C
1205 S Grange Ave
Sioux Falls,SD57105 		Medical Clinic
160 160 - Sanford Hospice
2710 West 12th Street
Sioux Falls,SD57104 		Hospice (licensed in MN and SD)
161 161 - Sanford Imagenetics
1321 W 22nd Street
Sioux Falls,SD57117 		Genetics
162 162 - Sanford Home Health Sioux Falls
2710 West 12th Street
Sioux Falls,SD57104 		Home Health Care
163 163 - The Birth Place
1305 W 18th Street
Sioux Falls,SD57105 		Birth Center
164 164 - Sanford Health Eye Clinic
2310 S Marion Rd 140
Sioux Falls,SD57106 		Eye Care Center
165 165 - Northern Lights Community Residence
921 Atlantic Ave N
Thief River Falls,MN56701 		Community Residence
166 166 - Sanford Behavioral Health Outpatient Cli
120 Labree Avenue S
Thief River Falls,MN56701 		Behavioral Health Treatment Center
167 167 - Sanford Dialysis Thief River Falls
120 Labree Avenue S
Thief River Falls,MN56701 		Dialysis
168 168 - Sanford Health Thief River Falls Eye Cen
1720 Highway 59 S
Thief River Falls,MN56701 		Eye Care Center
169 169 - Sanford Medical Center Thief River Falls
1720 Highway 59 S
Thief River Falls,MN56701 		Medical Clinic
170 170 - Sanford Health Tracy O'Brien Court
410 State Street
Tracy,MN56175 		Housing with Services
171 171 - Sanford Tracy Clinic
249 Fifth Street E
Tracy,MN56175 		Medicare Certified Rural Health Clinic
172 172 - Shetek Medical Services
251 5th St E
Tracy,MN56175 		Medical Clinic
173 173 - Sanford Health Twin Valley Clinic
501 2nd St NW
Twin Valley,MN56584 		Rural Health Clinic
174 174 - Sanford Health Ulen Clinic
108 Viking Avenue W
Ulen,MN56585 		Rural Health Clinic
175 175 - Sanford Health Valley City Clinic
520 Chautauqua Blvd
Valley City,ND58072 		Medical Clinic
176 176 - Sanford Health Vermillion Clinic
20 S Plum Street
Vermillion,SD56069 		Medical Clinic
177 177 - Sanford Health Vermillion Dakota Gerdens
126 S Plum Street
Vermillion,SD57069 		Residential Living Center
178 178 - Sanford Hospice
848 East Cherry Street
Vermillion,SD57069 		Hospice
179 179 - Sanford Vermillion Care Center
20 S Plum Street
Vermillion,SD57069 		Nursing Facility
180 180 - Sanford Dialysis
111 Washington Ave NW
Wagner,SD57380 		Dialysis Center
181 181 - Sanford Clinic Wahpeton
332 2nd Ave N
Wahpeton,ND58075 		Medical Clinic
182 182 - Sanford Health Wahpeton Eye Center & Opt
332 2nd Ave N
Wahpeton,ND58075 		Eye Care Center
183 183 - Sanford Health Walker Clinic
614 Michigan Avenue
Walker,MN56484 		Rural Health Clinic
184 184 - Sanford Health Walker Rehab
106 5th St S
Walker,MN56484 		Rehabilitative Services
185 185 - Sanford Tracy Walnut Grove Clinic
810 8th St
Walnut Grove,MN56180 		Medicare Certified Rural Health Clinic
186 186 - Sanford Health Watertown Clinic
901 4th Street NW
Watertown,SD57201 		Medical Clinic
187 187 - Sanford Webster Clinic
101 Peabody Drive
Webster,SD57274 		Rural Health Clinic
188 188 - Sanford Health Westrook Peterson Estates
1012 9th Street
Westbrook,MN56183 		Housing with Services
189 189 - Sanford Westbrook Clinic
920 Bell Avenue
Westbrook,MN56183 		Medicare Certified Rural Health Clinic
190 190 - Sanford Home Care Wheaton
405 12th St N
Wheaton,MN56926 		Home Health Care
191 191 - Sanford Wheaton Clinic
401 12th St N
Wheaton,MN56926 		Rural Health Clinic
192 192 - Sanford Clinic Windom
591 2nd Avenue N
Windom,MN56101 		Medicare Certified Rural Health Clinic
193 193 - Sanford Hospice Winner
745 E 8th Street
Winner,SD57580 		Hospice
194 194 - Sanford Dialysis
1018 Sixth Avenue
Worthington,MN56187 		Dialysis Center
195 195 - Sanford Health Cancer Center
1018 Sixth Avenue
Worthington,MN56187 		Cancer Center
196 196 - Sanford Hospice
1151 Ryans Road Suite 100
Worthington,MN56187 		Hospice (licensed in SD)
197 197 - Sanford Worthington Clinic
1680 Diagonal Road
Worthington,MN56187 		Medical Clinic
198 198 - Sanford Worthington Medical Center
1018 Sixth Avenue
Worthington,MN56187 		Medicare Certified End Stage Renal Dialysis
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 3c: Sanford Health does not deny care to anyone based on the ability to pay. Sanford's Financial Assistance (charity care) policy provides discounted and free services to patients who lack the resources to be fully responsible for the healthcare they receive. The Financial Assistance Policy is designed to ensure the entire community served by Sanford has access to needed healthcare services. Eligibility for discounted or free services under the Financial Assistance Policy is based on income levels and family size. Generally, individuals earning income of up to 375% of the Federal Poverty Income Guidelines are eligible for varying levels of discounts, including full discounts for certain income levels. Applications for coverage under the program may be obtained at any Sanford patient registration area.The primary scope of Sanford's financial assistance matrix considers family income and family size to objectively determine financial need. The family income range varies from 0-225% up to 375% of the Federal Poverty Level (FPL). An applicant over 375% may be eligible for some level of financial assistance based on a review of additional factors such as: the size of the account balance, debt-to-income ratio, current assets, current liabilities, IRS food expense allowances, monthly cash flow, etc.Additionally, it is possible for a family to qualify in one segment (based on income and family size alone) but be moved to a more generous (for the patient) segment based on the other financial variables mentioned above. An applicant may be denied if they have substantial assets and applicants are considered on a case by case basis.The Amount Generally Billed (AGB) discount percentage is the least amount Sanford can discount for any patient qualifying under the Sanford Financial Assistance Policy. It is the percentage used for the lowest level of assistance granted for those qualifying under the Sanford Financial Assistance Policy as listed on Appendix 1 - Sliding Discount Schedule for Assistance. Anyone else qualifying for assistance at greater levels will receive discount amounts greater than the Sanford AGB discount amount. Part I, Line 5b: Sanford as a whole did not exceed its financial assistance budget for CY 2020, however, if they would have exceeded their budget it would not impact their ability to serve any patients and no patients would be disallowed services. The organization provided free or discounted services to patients who were eligible for free or discounted care.Part I, Line 6: Sanford Health's Community Benefit Annual Report is posted annually on the Sanford website at:http://www.sanfordhealth.org/about/community-benefit
Part I, Line 7: Cost to Charge Ratios are used to calculate the amounts on Line 7a - 7c (Financial Assistance, Medicaid Shortfall, and Other Means-Tested Government Programs) and also Line 7g (Subsidized Health Services) for each of the subsidiaries included in the return. All other amounts for Lines 7e, 7f, 7h and 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio, or similar cost accounting methodology. These costs still represent the costs to provide benefits.
Part I, Line 7g: Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. Each loss has been calculated after removing losses associated with bad debts, financial assistance and Medicaid. Although these services generate overall losses to Sanford, they continue to meet the needs of the communities served. Various services that generate losses are provided by Sanford through physician practices. For CY 2020, subsidized health services provided through clinic physician practices generated losses of $98,339,610.
Part II, Community Building Activities: Sanford Health is a not-for-profit organization dedicated to the work of health and healing for the public good. Sanford is committed to giving back to the communities in which its employees and patients live and work. Sanford invests resources in order to produce the best outcomes for patient care, education, research, and community enrichment, and partners with others to ensure that the community is a welcoming, healthy environment and one that attracts and sustains a diverse Sanford workforce to deliver the best patient care and much needed medical research. Sanford considers requests for funding and in kind support for new and ongoing programs with all areas supporting the above goals, such as basic human services, education and workforce development by recruiting physicians and other health professionals to medical shortage or underserved areas and collaborating with educational institutions to train and recruit health professionals, advocating community health improvement through efforts to support policies and programs that safeguard or improve public health and help to ensure access to health care services.
Part III, Line 2: Bad debt expense at cost is determined using the same cost to charge ratios that are used to calculate Financial Assistance and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad Debt Expense.
Part III, Line 3: It is Sanford's policy to make financial assistance available to patients who fit the financial assistance criteria. It is the organization's goal to make certain that Sanford is proactive in identification of the patients who need help with financial concerns. Financial counselors make every effort to ensure that financial assistance eligible patients do not progress to bad debt. For this reason, a dollar amount for bad debt is not included.
Part III, Line 4: The audited financial statements of Sanford do not include a bad debt footnote. Sanford reports bad debt in accordance with generally accepted accounting principles (GAAP).
Part III, Line 8: Per IRS instructions, Sanford has identified the cost associated with providing Medicare services from the Medicare cost report. The Medicare cost report calculations are total expense less expenses deemed "unallowable" per Medicare regulations. The net expense is then used to calculate the cost per day and cost to charge ratios which are multiplied by the Medicare days and ancillary charges to determine the cost of providing Medicare services. If all expenses that Sanford incurred were included on the Medicare cost report; this would show a shortfall of approximately $303,103,745. Sanford believes this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if it was not provided by Sanford.
Part III, Line 9b: Sanford will provide services at no cost or reduced cost to patients who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guideline will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commercial insurance, or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges. Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle.Sanford has zero tolerance for abusive, harassing, oppressive, false, deceptive, or misleading language of collections conduct. This zero tolerance applies to internal Sanford staff and third party collection vendors and attorneys.Neither Sanford nor any of its third party collection vendors will take any extraordinary collection efforts until Sanford and the third party collection vendor have made reasonable efforts to determine if a patient is eligible for financial assistance under the Financial Assistance Policy.
Part VI, Line 2: Sanford conducted a community health needs assessment (CHNA) during 2018 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2018 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County in North Dakota and Clay County in Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding economic well-being, transportation, children and youth, the aging population, safety, healthcare and wellness, mental health and substance abuse. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during 2019-2021. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and responses to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Part VI, Line 3: Sanford employs a variety of strategies to make certain that the organization is transparent in the communication of financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities display signage in registration areas advising patients of their ability to request financial assistance. The signage was made available in English and Spanish. Alternate languages were included on the signage that basically stated, if you need interpreter services, please inquire at the registration desk. Financial Assistance applications were available in English, Spanish, Chinese, German, Hindi, Korean, Laotian and Vietnamese upon request or on the Sanford website. All healthcare workers who identify patients with financial need are encouraged to provide patients or their designees a financial application. This may include, but not be limited to the following areas: Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial Counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services.Sanford's Financial Assistance Program is available to anyone who qualifies for assistance. This program ensures that all people receive the care they need, regardless of their financial situation. Sanford makes Financial Assistance information available to community agencies and referral organizations. Financial Assistance information is also available on the Sanford website at:https://www.sanfordhealth.org/patients-and-visitors/billing-and-insurance/financial-assistance-policyfinancial-assistance-policy
Part VI, Line 4: Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 24 hospitals and nearly 448 clinics in 158 locations in nine states and three countries. Sanford Health's approximately 36,000 employees, including 1,500 physicians, make it the largest employer in the Dakotas. Sanford USD Medical Center - Sioux Falls, South DakotaSioux Falls is the largest city in the state of South Dakota and is the County seat of Minnehaha County. Sioux Falls also extends into Lincoln County. The 2020 U.S. Census Bureau estimates a total population of 187,809 for Sioux Falls. According to the 2020 County Health Rankings, the population of Minnehaha County is 82.0% white, 6.0% African American, 2.8% American Indian, 2.1% Asian and 5.1% Hispanic. Sioux Falls is a significant regional health care center. Only 2% of the population is reported to be not proficient in English. The median household income in Sioux Falls is $63,200.Sanford Medical Center Fargo - Fargo, North DakotaFargo is the largest city in North Dakota, accounting for 24% of the state's population. Fargo is also the county seat of Cass County. The 2020 United States Census estimates the population of Fargo was 125,209. According to the 2020 County Health Rankings, the population of Cass County is 84.4% white, 6.2% African American, 1.5% American Indian, 3.4% Asian and 2.8% Hispanic. Only 1% of the population is reported to be not proficient in English. The median household income is $64,000. Sanford Bemidji Medical Center - Bemidji, MinnesotaBemidji is located in Beltrami County, Minnesota. Bemidji houses many Native American Services, including the Indian Health Service. The city is the central hub of the Red Lake Indian Reservation, White Earth Indian Reservation, and the Leech Lake Indian Reservation. According to the 2020 United States Census estimates, the population of Bemidji is 15,452. According to the 2020 County Health Rankings, the population of Beltrami County is 71.7% white, 0.8% African American, 22% American Indian, 0.8% Asian and 2.6% Hispanic. 0% of the population is reported to be not proficient in English. The median household Income is $54,600.Sanford Bismarck Medical Center - Bismarck, North DakotaBismarck is a city located in Burleigh County in central North Dakota. Bismarck is experiencing fast-paced growth as a direct result of oil development throughout the western part of the state. Bismarck is the state capital and is the second largest city in the state of North Dakota with an estimated population of 74,018. According to the 2020 County Health Rankings, the population of Burleigh County is 88.2% white, 2.3 African American, 4.3% American Indian, 0.9% Asian and 2.8% Hispanic. 0% of the population is reported to be not proficient in English. The median household income is $70,100.Sanford Network HospitalsSanford Health Network Hospitals is a network of rural hospitals located throughout South Dakota, North Dakota, Minnesota, and Iowa.Sanford ClinicsSanford Clinic is a multi-specialty clinic comprised of 1,400 physicians providing services in the US as well as internationally.
Part VI, Line 5: Sanford maintains an open medical staff. Community Boards - The Sanford Board of Trustees was comprised of 12 members at the end of the calendar year, including 8 community members, 3 physicians and the CEO. Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve patients and communities.
Part VI, Line 6: Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 24 hospitals and nearly 450 clinics in nine states and three countries. Sanford Health's 36,000 employees, including 1,500 physicians, make it the largest employer in the Dakotas.Sanford Health provides services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area and a network of children's primary care clinic locations across the country and world. Sanford Health operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford Health financially supports health and wellness, education and community development activities to improve the quality of life and strenghten communities throughout the region. Each facility promotes health and healing that responds to the unique needs of the patients in the community, ensuring access to comprehensive and specialized services. Part VI, Line 7: Community benefit reporting is not required and therefore not filed in North Dakota, South Dakota, Nebraska or Iowa. Filing in Minnesota is voluntary.
Schedule H (Form 990) 2020
Additional Data


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