ROOTED HERE. GROWING HERE.

ROOTED HERE. GROWING HERE. 2014 Annual Report Rooted Here. Growing Here. 1

ROOTED HERE. GROWING HERE. OUR VISION: Grand Itasca will be a leader in transforming rural health care by achieving the highest levels of quality, access and value. Rooted Here. Growing Here. 2

We spent this last year advancing our mission: Patient Centered Excellence. All of our planning and decision making is guided by this mission. We strive each and every day to better serve our community and patients, and make Grand Itasca an even better place to receive care. In 2014, we added two new full-time OB/Gyns who were instrumental in Grand Itasca s recognition for reducing early elective deliveries. We also had two Radiologists join our medical staff. Both are employed by Radiological Associates of Duluth but live in Grand Rapids and primarily work at our facility. We welcomed a new Family Medicine doctor, a Grand Itasca employed Orthopedic Surgeon and two advanced practice clinicians to our Emergency Department. Another major project for us in 2014 was the opening of the retail pharmacy, which occurred in December. Grand Itasca Pharmacy offers convenient prescription and refill services as well as over-the-counter medicine. We also sent a group of staff representing all areas of the hospital to an intensive emergency preparedness training operated by the Federal Emergency Management Agency (FEMA). The skills they learned at that training were shared across the organization and also with city and county officials. Grand Itasca was also designated as a stroke-ready hospital meaning that we operate best practices for stabilizing stroke patients and administering lifesaving medications. Finally, Grand Itasca was recognized by the Minnesota Hospital Association for our work in a patient safety initiative to address and reduce the top 10 hospital acquired conditions. These are just a few ways Grand Itasca advanced our mission in 2014. In the coming year, we are looking forward to expanding our clinical capabilities and scope of service, including adding another Orthopedic Surgeon and restructuring that department to better accommodate the needs of our patients. We also plan to open a four patient room clinic at the Itasca County Family YMCA to meet people where they already go to stay healthy. Thank you for your support this past year. We are looking forward to caring for you in the upcoming year. Grand Itasca Board of Directors: Elizabeth Miskovich...Board Chair Colleen Nardone... Vice Chair Ron Ianelli...Secretary Josh Skelton... Treasurer Dale Adams...Grand Itasca Foundation Jamie Harker, MD Marva Jean Hutchens Mike Ives Charles Kampen, MD WHAT WE VALUE: Integrity Collaboration Excellence Innovation Service Mark Kosak Kent Koerbitz Jan Rourk, MD Shelly Steere Michael J. Youso President and CEO Elizabeth Miskovich Board Chair Rooted Here. Growing Here. 3

In 2014, the Lead by Example wellness initiative shifted it s focus from Grand Itasca employees to the community at large. Over the course of the year, Grand Itasca completed over 1,000 health screenings at almost 50 community and employer wellness events. At the screening events, community members were provided biometric screenings that included blood pressure, blood glucose, body mass index, and a full lipid panel, including triglycerides. After receiving their screening results, participants had the opportunity to meet with a health coach to discuss ways to improve their numbers. They were also offered access to an online lifestyle health assessment. The screenings and online assessment were provided free of charge to participants, thanks to a Healthy Communities Partnership grant. The Healthy Communities Partnership is a regional health improvement initiative developed by Allina Health and the George Family Foundation. The program was created in 2012 to promote health through prevention and wellness programs in primary care settings, and is in response to recognition that at least 40 percent of deaths in the United States are attributed to four behaviors: poor nutrition, inadequate exercise, smoking, and hazardous drinking. Rooted Here. Growing Here. 4

2014 Grand Itasca Volunteer Services 103 volunteers 10,372 hours $236,482 in wages and benefits Income Generated: Gift Shop...$ 22,961 Coffee Bar...$ 6,126 Tips/Donations/Misc. Income...$ 1,474 Holiday Goodie Sale... $ 852 Books Are Fun Event...$ 249 Total... $ 31,662 Grants & Giving: Mobile Blanket Warmer...$ 9,004 Landscaping...$ 5,000 Reach Out & Read Books...$ 4,000 Fetal Monitors...$ 3,629 Memorials... $ 140 Scholarships...$ 8,350 Total... $ 30,123 Serving Dedicated volunteers provided service in the following areas: Coffee Bar Gift Shop Information Desk Day Surgery Desk Intensive Care/Emergency Dept. Landscaping Sleep Lab Administrative Assistance Education Department Women s Health & Birth Center Scholarship Award Receptions Memorial Blood Centers Blood Drives Community Health Screenings Retired Senior Volunteer Program (RSVP) Rooted Here. Growing Here. 5

GRAND ITASCA PHARMACY Now offering convenient prescription and over-the-counter medication service We are thrilled to announce we ve made patient access to prescriptions and over-the-counter medicine much more convenient with the addition of a retail pharmacy this past year. The pharmacy is located immediately inside the main clinic entrance. Prescriptions can be filled at Grand Itasca Pharmacy before patients leave the clinic or hospital. This saves them an extra stop on their way home, meaning more time at home, getting well. With online, smartphone app and phone refill options, patients have easy access to refills as well. Rooted Here. Growing Here. 6

WELCOME TO OUR NEW PROVIDERS Derek Beyer, MD OB/Gyn Medical Degree: University of MN Duluth & Twin Cities Residency: Mayo Graduate School of Medicine Kevin Gildner, MD OB/Gyn Medical Degree: University of Minnesota Residency: University of Tennessee Christopher Reilly, MD Radiology Medical Degree: University of Chicago Pritzker School of Medicine Residency: Northwestern Memorial Hospital Fellowship: Northwestern Memorial Hospital Kristina Conner, FNP Emergency Department Master s Degree: College of St. Scholastica Rebecca Kuntz, MD Radiology Medical Degree: Loma Linda University Residency: St. Luke s Medical Center Fellowship: Medical College of Wisconsin Shelly Soltis, DO Family Medicine Medical Degree: Des Moines University College of Osteopathic Medicine Residency: Mercy Medical Center Troy Erickson, DO Orthopedics Medical Degree: Kirksville College of Osteopathic Medicine Residency: St. John Oakland Hospital Mark Rasmusson, PA-C Emergency Department Master s Degree: University of Nebraska Medical Center Rooted Here. Growing Here. 7

FISCAL YEAR 2014 Statement of operation This past year was a challenging one for Grand Itasca financially. We managed our expenses very closely and our patient volumes grew, but still we experienced a decline in our income. This was due mostly to the increase of patients we re seeing that have governmental insurance which reimburses well below our cost to provide medical services. While we are happy to be caring for all people in need of health care, this will continue to be a challenge for us in the coming years. The financial strength of Grand Itasca as measured by our balance sheet, however, remains strong. BALANCE SHEET Assets $ FY 2014 $ FY 2013 Total Current Assets 26,387,263 32,659,298 Noncurrent Cash and Investments 16,142,639 13,403,904 Capital Assets, net 41,427,871 42,601,734 Total Assets 83,957,773 88,664,936 Liabilities and Net Assets Total Current Liabilities 9,442,414 8,399,099 Long-Term Debt, net 40,208,775 40,245,619 Total Net Assets 34,306,584 40,020,218 Total Liabilities and Net Assets 83,957,773 88,664,936 CONSOLIDATES STATEMENT OF ACTIVITIES Total Operating Revenue 74,897,087 78,490,097 Total Operating Expense 78,472,585 77,033,513 Operating Income [ 3,575,498 ] 1,456,584 Non-Operating Revenue and Expenses 276,726 444,543 Other Changes in Net Assets - - Revenue & Expense (Non-Controlling Interest) [ 753,646 ] [ 794,161 ] Change in Net Assets [ 4,052,418 ] 1,106,966 Rooted Here. Growing Here. 8

2014 2013 Uncompensated Care $ FY 2014 $ FY 2013 Inpatient 13,432,987 15,700,416 Clinic 68,968,964 62,705,975 Operating Room 25,719,002 32,220,728 Emergency Department 18,336,390 16,144,986 Diagnostic Services 27,565,165 24,970,759 Pharmacy 11,936,854 11,174,557 Total Patient Revenue 165,959,362 162,917,421 Contractual Adjustments & Discounts [ 95,107,642 ] [ 85,806,664 ] Provision for Bad Debt [ 2,975,915 ] [ 3,145,717 ] Charity Care [ 404,953 ] [ 481,674 ] Net Patient Revenue 67,470,852 73,483,366 Operating Expenditure Wages and Benefits 48,447,173 48,785,278 Fees and Purchased Services 4,291,938 3,415,648 Supplies and Other Expenses 14,252,003 14,052,256 Utilities and Maintenance 3,350,084 3,381,199 Depreciation and Amortization 4,684,246 3,956,566 Interest 1,821,827 1,893,001 Health-Related Activities (CDI) 1,625,314 1,549,565 Total 78,472,585 77,033,513 Uninsured Discount $292,500 $298,365 Charity Care $404,953 $481,674 Unsubsidized Care $ 10,764,777 $ 6,496,675 MNCare & Medicaid Surcharge $1,552,391 $1,097,263 Patient Visits Clinic 91,764 89,845 Emergency Department 15,591 14,227 Surgeries 2,852 3,545 Discharges 2,000 1,679 2,000 Births 328 313 Rooted Here. Growing Here. 9

MISSION: To build philanthropic partnerships to support the mission of Grand Itasca Clinic & Hospital. FOUNDATION Guiding Principles: Grand Itasca Foundation will help support the internal needs of Grand Itasca Clinic & Hospital. Grand Itasca Foundation will promote a healthy community by supporting wellness initiatives. Grand Itasca Foundation will raise community awareness about the impact and value of Grand Itasca Clinic & Hospital. Every Gift Matters. Gifts to Grand Itasca Foundation directly support essential programs and services that improve the quality of health care for patients at Grand Itasca. Every gift enables our staff to utilize the best equipment, facilities and medical resources when providing quality health care to our community. 2014 Grants Patient Care Boards...$ 12,000 Health & Wellness Grants...$ 21,801 Patient Room Televisions & Programming...$ 30,000 Caring Fore Kids Pediatric Equipment... $ 15,000 Patient Treadmill in Cardiac Rehab...$ 5,510 Health Care Scholarships...$ 12,500 Total... $96,811 Scholarships: Grand Itasca Foundation High School Health Care Scholarship ($2,000/scholarship): Jenna Namyst Tabitha Hanson Annie Crotteau Solveig Viren Elizabeth Ophoven Dr. & Mrs. Robert Kelly Scholarship ($1,000/scholarship): Ann Hauser Arie DeGrio Deb Shrout Memorial Award ($500/scholarship): Kaylee Guisti Rooted Here. Growing Here. 10

Grand Itasca Foundation Board of Directors: Dale Adams...Board Chair Cricket Guyer... Vice Chair Steve Wright...Secretary Diane Weber... Treasurer Joe Cargill Patty Carlin-Janssen, MD Mandy Dick Cory Jackson Ron Johnson, MD Hans Kaldahl, DVM Donna Kelly Tara Makinen Sue Mattson Andy Shermoen Nathan Tiwari, MD Rooted Here. Growing Here. 11

ROOTED HERE. GROWING HERE. Rooted Here. Growing Here. 12 12 2014 Grand Itasca Clinic & Hospital 1601 Golf Course Road Grand Rapids, Minnesota 55744 Main Line: 218-326-3401 Appointment Line: 218-326-7344