Form 990 for tax year 2023

Revenue

Part VIII, the statement of revenue.

• 2a · Program service revenue: OUTPATIENT REVENUES

  total $10,353,207 · related or exempt $10,353,207

• 7b · Less cost or other basis and sales expenses

  other assets $555

• 7c · Gain or loss

  other assets -$555

• 7d · Net gain or loss

  total -$555 · excluded -$555

Functional expenses

Part IX, the statement of functional expenses.

• 7 · Other salaries and wages

  total $2,409,704 · program services $2,384,816 · management and general $24,888

• 8 · Pension plan contributions

  total $96,004 · program services $95,548 · management and general $456

• 9 · Other employee benefits

  total $435,757 · program services $340,922 · management and general $94,835

• 10 · Payroll taxes

  total $184,734 · program services $176,783 · management and general $7,951

• 11g · Fees: other

  total $352,546 · program services $228,218 · management and general $124,328

• 13 · Office expenses

  total $294,035 · program services $293,652 · management and general $383

• 14 · Information technology

  total $11,819 · program services $11,697 · management and general $122

• 16 · Occupancy

  total $2,191,067 · program services $2,168,437 · management and general $22,630

• 17 · Travel

  total $121 · program services $121

• 19 · Conferences, conventions and meetings

  total $17,436 · program services $16,098 · management and general $1,338

• 20 · Interest

  total $505,107 · program services $505,107

• 22 · Depreciation, depletion and amortization

  total $1,396,493 · program services $1,382,070 · management and general $14,423

• 23 · Insurance

  total $72,132 · program services $71,692 · management and general $440

• 24a · Other expenses: MEDICAL SUPPLIES

  total $4,005,997 · program services $4,005,997

• 24b · Other expenses: AFFILIATE SUPPORT FEE

  total $1,726,100 · program services $858,217 · management and general $867,883

• 24c · Other expenses: AFFILIATE EXPENSE AND R

  total $604,875 · management and general $604,875

• 24d · Other expenses: BAD DEBT EXPENSE

  total $234,814 · program services $234,814

• 24e · All other expenses

  total $181,672 · program services $170,314 · management and general $11,358

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  end of year $236,306

• 2 · Savings and temporary cash investments

  beginning of year $840,022

• 4 · Accounts receivable

  beginning of year $842,632 · end of year $1,744,727

• 8 · Inventories for sale or use

  beginning of year $1,356,208 · end of year $1,784,202

• 10a · Land, buildings and equipment: cost or other basis

  $34,286,676

• 10b · Land, buildings and equipment: accumulated depreciation

  $4,631,899

• 10c · Land, buildings and equipment, net

  beginning of year $429,651 · end of year $29,654,777

• 15 · Other assets

  beginning of year $5,096 · end of year $20,155

• 17 · Accounts payable and accrued expenses

  beginning of year $242,236 · end of year $901,187

• 20 · Tax-exempt bond liabilities

  end of year $28,660,309

• 25 · Other liabilities

  beginning of year $9,005,096 · end of year $14,020,155

• 29 · Capital stock, trust principal or current funds

  beginning of year $0 · end of year $0

• 30 · Paid-in or capital surplus, or land, building or equipment fund

  beginning of year $0 · end of year $0

• 31 · Retained earnings, endowment or other funds

  beginning of year -$5,773,723 · end of year -$10,141,484

The filer's explanations (Part III)

PART I, LINE 3

ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH SURGERY CENTERS' PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.

PART I, LINE 4B

SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: BRADLEY BEARD $297,439 TRACI MORRIS $79,902 AL HURLEY $195,546 MICHAEL WATTERS $33,314 KEVIN BOREN $25,627 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: BRADLEY BEARD $90,640 TRACI MORRIS $97,190 AL HURLEY $59,141 MICHAEL WATTERS $68,732 KEVIN BOREN $38,253

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

• ESSENTIA HEALTH SURGERY CENTERS-DULUTH LLC

  SURGERY CENTER · MN · income $10,352,652 · assets $33,440,167

  Directly controlled by ESSENTIA HEALTH SURGERY CENTERS

• ESSENTIA HEALTH SURGERY CENTERS-MINNESOTA LLC

  SURGERY CENTER · MN · income $0 · assets $0

  Directly controlled by ESSENTIA HEALTH SURGERY CENTERS

• ESSENTIA HEALTH SURGERY CENTERS-NORTH DAKOTA LLC

  SURGERY CENTER · ND · income $0 · assets $0

  Directly controlled by ESSENTIA HEALTH SURGERY CENTERS

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• ESSENTIA HEALTH INSURANCE SERVICES SPC LTD

  C · SELF INSURANCE · CJ · controlled entity

• MID DAKOTA CLINIC INC

  C · CLINIC OPERATIONS CEASED 9/30/22 · ND · controlled entity