Fairview Health Services

Fairview Health Services is an integrated academic health system located in Minneapolis, Minnesota, and, along with its affiliates and subsidiaries, is one of the leading health care providers in Minnesota with $7.3 billion in operating revenue for 2023. Fairview offers a broad continuum of health care services through its hospitals, clinics, and other health care related operations and is a Minnesota nonprofit corporation that is exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code. The most recent community health needs assessment (CHNA) identified 3 key areas as the greatest needs in our community - navigating and accessing care and resources; healing, connectedness, and mental health; structural racism and barriers to equity. Fairview Health Services is meeting the needs of the community by focusing on racial and ethnic populations experiencing health disparities and people experiencing poverty through partnering with the community to build solutions, removing barriers to create and expand relevant programs and focused services. Please see Schedule H for a description of additional services, community benefit activities, and the full spectrum of charity care that Fairview Health Services provides to the community. Fairview serves the entire twelve-county Minneapolis/St. Paul Metro Area, as well as communities throughout greater Minnesota and portions of Northern Iowa and Western Wisconsin and is one of the most comprehensive and geographically accessible systems in Minnesota. The Fairview System consists of ten hospitals, including M Health Fairview University of Minnesota Medical Center and M Health Fairview Masonic Children's Hospital (collectively, "UMMC"), which is the adult and pediatric teaching hospital of the University of Minnesota. UMMC and seven of Fairview's other hospitals are in the Metro Area. Fairview's other two hospitals are located in northern Minnesota. Fairview operates over 80 primary and specialty care clinics, seven ambulatory care centers, 37 retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, physician network, senior care housing and long- term care facilities and medical transportation. Fairview, through its integrated care model, aims to deliver the benefits of academic medicine to more patients and families by expanding care, research, and education by offering access to a greater pool of physicians and patients, while seeking to reduce the total cost of care for patients. Fairview, the University of Minnesota and the University of Minnesota Physicians approved an agreement which became effective in late 2018 (the "M Health Fairview Agreement"). While the parties maintain their separate governance, the M Health Fairview Agreement further integrated operations across the clinical delivery system and enhances research and education by creating a joint clinical enterprise among the parties. The M Health Fairview Agreement brings together UMMC and its related service lines, Fairview's community hospitals and primary care clinics, and other services. All are part of a shared care delivery system that is led by a single structure that includes academic physician leadership. The goal of the joint clinical enterprise is to create a nationally-renowned academic health system. This care system was united in 2020 under a single brand, M Health Fairview, which is inclusive of Fairview's ten hospitals and its clinics. Fairview owns and operates the following hospitals: UMMC, M Health Fairview Southdale Hospital, M Health Fairview Ridges Hospital, M Health Fairview Lakes Medical Center, M Health Fairview Northland Medical Center, Fairview University Medical Center - Mesabi ("Range"), Grand Itasca Clinic and Hospital, M Health Fairview St. John's Hospital, M Health Fairview Woodwinds Hospital and M Health Fairview Bethesda Long Term Acute Hospital. As of December 31, 2023, the Fairview System Hospitals had a total of 3,529 licensed beds and 1,824 staffed beds. Fairview operates their more than 80 primary and specialty care clinics throughout the Metro Area, greater Minnesota and western Wisconsin. These clinics offer services in over 70 medical specialties, including family medicine, pediatrics, obstetrics, gynecology, heart care, cancer care, otolaryngology, transplant care, and orthopedics. As of December 31, 2023, Fairview owned all or a portion of six ambulatory surgery centers located in the Metro Area. Fairview and Fairview Pharmacy Services LLC own and operate pharmacies at 37 locations, including a network of retail pharmacies, oncology pharmacies, two home infusion pharmacies (Minneapolis and Duluth, Minnesota), and a specialty pharmacy. M Health Fairview Rehabilitation Services ("MHFRS") provides a full continuum of inpatient and outpatient rehabilitation services for pediatric and adult patients as well as an inpatient rehabilitation facility, a hospital based skilled nursing facility and an adult day program. In addition to providing inpatient services in nine hospitals, MHFRS has 58 outpatient hospital based and free-standing clinics that serve pediatric and adult patients. Specialty services include rehabilitation in the following areas: Cardiac and Pulmonary rehabilitation, Audiology, Orthopedic, Sports related injuries, Neurological, Vestibular, and Cancer Rehab. Hand therapy services are also provided in seven locations. MHFRS serves about 750,000 patient visits/year. M Health Fairview Emergency Medical Services offers emergency medical services and scheduled transportation across the Metro Area and supports the community by responding to more than 60,000 calls annually. Ebenezer, a non-profit subsidiary of Fairview, provides long-term senior care facilities, senior housing, adult care services. Ebenezer's goal is to provide a supportive environment where older adults can pursue longer, healthier, and more meaningful lives. Fairview, an anchor institution rooted in our communities, continues to invest heavily in the health and wellness of its communities in which it operates. This commitment includes education, training, community programs and research, as well as significant investments in care delivery. The COVID pandemic exposed persistent health inequities for communities of color and has exacerbated racial disparities. Communities of color experienced statistically higher rates of COVID, including higher rates of hospitalization and death. To reduce the impact on Black, Indigenous, or people of color ("BIPOC"), vaccinations must be accessible, free and provided within a trusted space with appropriate language and cultural considerations. Fairview has led a multi-cultural mobile vaccination program for the past 17 years, which excels at reaching BIPOC communities facing barriers to immunization. Further, Fairview's longstanding relationship with local public health agencies and community partners has allowed Fairview to provide staffing, coordination, and outreach for mobile vaccination clinics at schools, public high rises, community centers, churches, and other locations, increasing vaccine access to those in the area. From January 2021 (when Fairview initiated its free community COVID vaccination clinics) through December 31, 2023, Fairview has worked with over 150 partners to provide 1,424 vaccination clinics in community settings, administering 62,416 free COVID-19 vaccine doses and 21,004 free flu shots. In 2020, Fairview established the Healing, Opportunity, People, and Equity ("HOPE") Commission to help create a health system where all members of its community are treated with dignity and respect and all patients receive the highest levels and quality of care. To drive more equitable healthcare outcomes and inclusive environments, as part of its HOPE Commission work, Fairview implemented a multi-year journey to become an anti-racist organization. In addition, the Fairview Community Health and Wellness Hub ("Hub") opened in July 2022 and recently celebrated its one-year anniversary. The Hub represents Fairview's intentional, holistic approach to health and wellbeing and commitment to serving all in its communities, especially those who have been traditionally underserved. Services in the Hub include no- to low-cost primary care provided by Minnesota Community Care, a federally qualified health center, expanded outpatient mental health and addiction services, an enhanced adult day program operated by Ebenezer, a food distribution partnership with Second Harvest Heartland and The Sanneh Foundation, and long-term acute care services. The Hub also includes the M Health Fairview Center for Community Health Equity, which serves as an incubator for the next generation of community-based health and wellness programs focused on prevention and addressing the social determinants of health.

Cost of participating in government programs: Fairview is committed to serving the health care needs of members of its community. To support full access to services, Fairview participates in the following public health care programs: Medicare, Medicaid, and MinnesotaCare. Reimbursement from these programs for services rendered, generally falls below the cost of providing the care. To compensate for the under funding by government programs, Fairview makes a significant financial investment to offset these losses. While Fairview is a tax-exempt entity, it does support its local communities through various taxes it pays. In 2023, Fairview Health Services paid approximately $100 million in real estate, sales, unrelated business income and Minnesota Care taxes. In 2023, Fairview incurred $59,961,570 of medical taxes and surcharge costs in health care services that exceeded the reimbursement received by public programs, surcharge, medical taxes and fees related to these programs and not including Medicare. The following is a breakdown on costs related to the cost of participating in government programs: Costs exceed Medicaid Reimbursement: Fairview is serving thousands of low- income individuals covered by Medical Assistance and MinnesotaCare. Reimbursement from these programs is less than Fairview's cost of providing care to these patients. Total Medicaid surcharge tax costs related to hospitals, pharmacies, and surgical centers was $28,314,080. MinnesotaCare tax: The state of Minnesota levies a 2 percent tax on certain healthcare provider revenues. Money generated from this tax helps to defray the costs incurred from MinnesotaCare and other programs/services for uninsured individuals. In 2023, Fairview paid $31,647,490 in MinnesotaCare taxes. Taxes and fees: Fairview does pay some property tax to local and state government. This helps to fund civil and educational services in the community. The real estate costs for 2023 totaled $1,241,829 and the sales and income taxes totaled $4,752,257. Costs exceeding Medicare Reimbursement: Fairview cares for thousands of individuals ages 65 and older who are covered by Medicare. Fairview incurred $196,728,062 of Medicare reimbursement shortfalls. Reimbursement from Medicare is less than Fairview's cost of providing care to the patient. The total cost of providing these benefits was $1,429,254,779.