Civic Intelligence

St Lukes Hospital of Duluth

EIN 41-0714079 • 501(c)3 • Duluth, MN

Profile

The patient above all else.

915 East First StreetDuluth, MN 55805

www.slhduluth.com

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

75th percentile

0.63x

Higher debt load relative to assets than 75% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Liabilities / Revenue

79th percentile

1.24x

Higher debt load relative to revenue than 79% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Net Margin

13th percentile

-10.0%

Higher net margin than 13% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Top Officer Pay

3rd percentile

$0

Higher top officer pay than 3% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

501(c)3 • $250M-$1B nonprofits • Source year 2024

Asset Growth

62nd percentile

8.5%

Faster asset growth than 62% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Annualized from 2023 to 2024

Revenue Growth

2nd percentile

-51%

Faster revenue growth than 2% of similar nonprofits.

501(c)3 • $250M-$1B nonprofits • Annualized from 2023 to 2024

Assets

Up

$536,071,505

Up $42,081,846 (+8.5%) from 2023

Liabilities

Down

$335,212,178

Down $27,591,863 (-7.6%) from 2023

Net Assets

Up

$200,859,327

Up $69,673,709 (+53%) from 2023

Revenue

Down

$270,390,037

Down $286,361,113 (-51%) from 2023

Expenses

Down

$297,421,834

Down $272,515,730 (-48%) from 2023

Net Income

Down

-$27,031,797

Down $13,845,383 (-105%) from 2023

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$600M$400M$200M$0Assets 2010: $144,997,293Liabilities 2010: $116,888,629Net Assets 2010: $28,108,6642010Assets 2011: $157,002,357Liabilities 2011: $149,991,647Net Assets 2011: $7,010,7102011Assets 2012: $191,730,114Liabilities 2012: $187,687,919Net Assets 2012: $4,042,1952012Assets 2013: $193,445,478Liabilities 2013: $162,460,176Net Assets 2013: $30,985,3022013Assets 2014: $207,845,921Liabilities 2014: $193,926,118Net Assets 2014: $13,919,8032014Assets 2015: $221,183,753Liabilities 2015: $198,943,870Net Assets 2015: $22,239,8832015Assets 2016: $238,825,446Liabilities 2016: $198,367,590Net Assets 2016: $40,457,8562016Assets 2017: $267,512,352Liabilities 2017: $209,685,113Net Assets 2017: $57,827,2392017Assets 2018: $354,194,269Liabilities 2018: $276,564,960Net Assets 2018: $77,629,3092018Assets 2019: $365,911,818Liabilities 2019: $275,884,072Net Assets 2019: $90,027,7462019Assets 2020: $431,806,158Liabilities 2020: $330,849,907Net Assets 2020: $100,956,2512020Assets 2021: $424,508,169Liabilities 2021: $286,494,053Net Assets 2021: $138,014,1162021Assets 2022: $506,268,982Liabilities 2022: $362,216,996Net Assets 2022: $144,051,9862022Assets 2023: $493,989,659Liabilities 2023: $362,804,041Net Assets 2023: $131,185,6182023Assets 2024: $536,071,505Liabilities 2024: $335,212,178Net Assets 2024: $200,859,3272024

Highlighted filing

2024

Assets$536,071,505
Liabilities$335,212,178
Net Assets$200,859,327

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$600M$400M$200M$0-$200MExpenses 2010: $313,596,4682010Expenses 2011: $328,959,7912011Revenue 2012: $349,914,005Expenses 2012: $345,647,393Net Income 2012: $4,266,6122012Revenue 2013: $377,893,080Expenses 2013: $374,934,872Net Income 2013: $2,958,2082013Revenue 2014: $379,823,114Expenses 2014: $371,973,025Net Income 2014: $7,850,0892014Revenue 2015: $409,113,657Expenses 2015: $394,828,557Net Income 2015: $14,285,1002015Revenue 2016: $431,938,320Expenses 2016: $424,788,304Net Income 2016: $7,150,0162016Revenue 2017: $470,805,978Expenses 2017: $451,977,369Net Income 2017: $18,828,6092017Revenue 2018: $523,728,949Expenses 2018: $490,168,390Net Income 2018: $33,560,5592018Revenue 2019: $521,629,304Expenses 2019: $515,940,197Net Income 2019: $5,689,1072019Revenue 2020: $506,433,764Expenses 2020: $494,917,089Net Income 2020: $11,516,6752020Revenue 2021: $537,764,798Expenses 2021: $523,146,570Net Income 2021: $14,618,2282021Revenue 2022: $548,761,355Expenses 2022: $542,922,416Net Income 2022: $5,838,9392022Revenue 2023: $556,751,150Expenses 2023: $569,937,564Net Income 2023: -$13,186,4142023Revenue 2024: $270,390,037Expenses 2024: $297,421,834Net Income 2024: -$27,031,7972024

Highlighted filing

2024

Revenue$270,390,037
Expenses$297,421,834
Net Income-$27,031,797

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Facts available. Structured filing facts are available, but richer extracted sections are limited.$536$335$201$270$297$27.0
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$494$363$131$557$570$13.2
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$506$362$144$549$543$5.84
2021Facts available. Structured filing facts are available, but richer extracted sections are limited.$425$286$138$538$523$14.6
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$432$331$101$506$495$11.5
2019XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$366$276$90.0$522$516$5.69
2018Facts available. Structured filing facts are available, but richer extracted sections are limited.$354$277$77.6$524$490$33.6
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$268$210$57.8$471$452$18.8
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$239$198$40.5$432$425$7.15
2015Facts available. Structured filing facts are available, but richer extracted sections are limited.$221$199$22.2$409$395$14.3
2014XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$208$194$13.9$380$372$7.85
2013Import issue. A filing source exists for this year, but detailed import did not complete cleanly.$193$162$31.0$378$375$2.96
2012Summary only. Only limited summary data is available for this year.$192$188$4.04$350$346$4.27
2011Facts available. Structured filing facts are available, but richer extracted sections are limited.$157$150$7.01$329
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$145$117$28.1$314
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2024 to Jun 30, 2024
Signed
May 12, 2025
Return Version
2024v5.1
Gross Receipts
$272,080,626
Mission and Program Overview

Mission

The patient above all else.

To serve as a leading healthcare provider of quality healthcare services in our surrounding region.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$163,260,801$254,243,193▲ $90,982,392
Accounts Receivable$110,944,572$86,619,140▼ $24,325,432
Investments in Publicly Traded Securities$51,169,777$43,772,866▼ $7,396,911
Investments Other Securities$58,427,489$30,135,120▼ $28,292,369
Investments Program Related$17,099,516$17,595,249▲ $495,733
Inventories for Sale or Use$13,967,329$12,793,418▼ $1,173,911
Cash and Non-Interest-Bearing Accounts$3,356,088$9,460,054▲ $6,103,966
Prepaid Expenses and Deferred Charges$4,035,740$6,463,913▲ $2,428,173
Intangible Assets$2,827,768$4,000,000▲ $1,172,232
Savings and Temporary Cash Investments$0$343,638▲ $343,638
Total Assets$493,989,659$536,071,505▲ $42,081,846
Other Assets Total$68,900,579$70,644,914▲ $1,744,335
Liabilities
Tax Exempt Bond Liabilities$182,019,306$180,294,466▼ $1,724,840
Other Liabilities$84,436,125$94,898,931▲ $10,462,806
Accounts Payable and Accrued Expenses$75,896,528$58,799,622▼ $17,096,906
Mortgage Notes Payable Secured by Investment Property$20,307,132$0▼ $20,307,132
Deferred Revenue$0$1,219,159▲ $1,219,159
Unsecured Notes Loans Payable$144,950$0▼ $144,950
Total Liabilities$362,804,041$335,212,178▼ $27,591,863
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$131,185,618$200,859,327▲ $69,673,709
Total Net Assets Fund Balance$131,185,618$200,859,327▲ $69,673,709
Total Liabilities and Net Assets / Fund Balance$493,989,659$536,071,505▲ $42,081,846

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$140,919,616$92,534,876$233,454,492
Equipment$38,151,475$153,968,801$192,120,276
Other Land Buildings$58,185,098$2,142,460$60,327,558
Land$16,987,004-$16,987,004
Other Assets Org$4,679,877--
Other Securities$30,135,120--
Compensation and Service Providers

Board Members and Trustees

NameTitle
Yvonne Prettner SolonBoard Chair
Eric LohnCo-president/CEO & CFO
Nicholas Van Deelen MdCo-president/CEO & CMO
Matthew HeywoodPresident & CEO Aspirus
Rene SettergrenBoard Vice Chair
Anna Sackette-urnessBoard Member
Brian MurphyBoard Member
Helena JacksonBoard Member
Jack SeilerBoard Member
Kiera WilsonBoard Member
Scott LyonsBoard Member
Pakou LyBoard Member (thru June 2024)
Patrick HeffernanBoard Member (thru June 2024)
Rick RevoirBoard Member (thru June 2024)
Andrea Benson MdBoard Member/chief of Staff
Mitchell Cardwell DoBoard Member/physician
Sidney SczygelskiBoard Member/SVP Finance/CFO
James MathesonBoard Member/SVP-chief Strat. Off.
Aimee Vanstraaten MdBoard Secretary/physician
Kevin BeardsleyBoard Treasurer
Jerry M YangSVP - Chief Financial Officer
Jeffrey JonesSVP-CFO (thru 04/23)
Revenue and Support

Revenue Composition

Contributions and Grants
$643,573
Program Service Revenue
$266,569,175
Investment Income
$954,654
Other Revenue
$2,222,635
All Other Contributions
$155,731
Change in Net Assets
$-27,031,797
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$163,413,609
Other Expenses$133,776,750
Grants and Similar Amounts Paid$231,475
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$116,155,487$16,177,470-$132,332,957
Fees for Services Other$14,076,900$14,447,029-$28,523,929
Other Employee Benefits$13,155,856$1,933,197-$15,089,053
Occupancy$10,723,967$2,535,360-$13,259,327
All Other Expenses$6,349,900$4,014,115-$10,364,015
Payroll Taxes$7,757,208$2,130,627-$9,887,835
Depreciation Depletion$4,897,764$2,978,041-$7,875,805
Pension Plan Contributions$4,734,390$695,758-$5,430,148
Information Technology$3,191,770$835,160-$4,026,930
Interest$389,537$2,069,750-$2,459,287
Other Expenses$2,291,071--$2,291,071
Office Expenses$548,307$1,659,273-$2,207,580
Insurance$1,194,141--$1,194,141
Conferences and Meetings$715,633$83,865-$799,498
Current Officers, Directors, Trustees, and Key Employees$673,616--$673,616
Advertising$400,222--$400,222
Fees for Services Legal-$398,659-$398,659
Grants to Domestic Orgs$231,475--$231,475
Fees for Service Investment Mgmnt Fees-$84,044-$84,044
Fees for Services Accounting-$63,361-$63,361
Fees for Services Lobbying-$39,573-$39,573
Travel$17,518--$17,518
Total Functional Expenses$247,276,552$50,145,282$0$297,421,834
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Program for Aid to Victims of Sexual AssaultDuluth, MN501(c)(3)Sane Adult/adolescent Program$80,000
Duluth Football ClubDuluth, MNN/aSponsorship$30,000
Duluth Huskies Baseball ClubDuluth, MNN/aSponsorship$25,000
Hermantown Area Futbol ClubDuluth, MN501(c)(3)Sponsorship$25,000
Duluth Area Family YmcaDuluth, MN501(c)(3)Kids Club and Various Events$20,000
American Heart AssociationDallas, TX501(c)(3)Sponsorship$10,000
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
Cassandra BeardsleySpouse of Board MemberEmployee CompensationNo$95,948
Brian CappsSpouse of Board MemberEmployee CompensationNo$88,287
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Right of Use Liabilites - Operating Leases$36,682,290
Deferred Compensation$30,499,718
Capital Leases$12,654,502
Minimum Pension Liability$9,923,728
Due to Related Parties$2,872,097
Asset Retirement Obligation$2,038,913
Malpractice Liability Reserve$225,000
Other Liablities$2,683

Bond Issues

BondIssuerIssuedIssue PricePurpose
CDuluth Economic Development Authority2022-05-12$79,996,284Phase ii building expansion and hospital remodel
DDuluth Economic Development Authority2022-03-17$58,093,185Refinance series 2012 bonds
ADuluth Economic Development Authority2018-12-31$39,500,000Fund operating system upgrade
BDuluth Economic Development Authority2021-09-09$14,236,667Refinance series 2003 and 2012 bonds

Bond Proceeds

BondTotal ProceedsSpentRetiredIssuance Costs
C$79,996,284$548,092-$665,800
D$58,093,185$354,101--
A$39,500,000$39,245,626$3,588,202$284,028
B$14,236,667$13,952,639$3,110,000$851,750

Bond Financing Compliance

No rebate due
No
Rebate not yet due
Yes
Form 8038-T filed
No
Gross proceeds invested
No
Gross proceeds invested in GIC
No
Exception to rebate
No
Corrective action procedures
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
Yes
Business relationship with organization members
No
Material changes to governing documents
Yes
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 1A

The executive committee shall be composed of the chairperson of the board as the presiding officer, all other officers of the hospital who are directors, and such additional directors as the chairperson may appoint. When the board of directors is not in session, the executive committee shall have the power and authority of the board to transact all regular business of the hospital. Including the authority to review the compensation paid to the hospital's employed physicians, subject to any prior limitations imposed by the board or by statute, and shall meet as necessary. In addition, the executive committee shall oversee the hospital's public relations activities and keep the corporation's health care efforts continually before the communities served through the use of st. Luke's hospital of duluth 41-0714079 publications and other communications describing the hospital's services, programs, and needs.

Form 990, Part VI, Section A, Line 4

As of march 1, 2024 the parent organization of st. Luke's hospital of duluth is now aspirus, inc.

Form 990, Part VI, Section A, Line 6

Prior to aspirus, inc. Becoming the sole corporate member on march 1, 2024: st. Luke's hospital shall have three classes of memberships: a) tenured members of st. Luke's hospital of duluth - the individuals and organizations listed on the hospital's official roster of members as of may 20, 2004 shall be members and have the number of votes as identified on that list. B) non-tenured members of st. Luke's hospital of duluth - any individual or organization that, subsequent to may 20, 2004, contributes $100 or more to the hospital shall, upon request from such individual or organization and approval by the board of directors, be a member of the organization with one vote. C) ex officio members - each director and the president/ceo of the hospital shall be a voting member of the hospital during his or her term in such office and shall have one vote. On march 1, 2024, the parent organization, aspirus, inc. Became the sole corporate member of the organization.

Form 990, Part VI, Section A, Line 7A

There shall be a minimum of ten voting directors allocated as follows. There shall be two classes of voting directors: the community class and the member class. No less than eight independent community class directors and two member class directors.

Form 990, Part VI, Section A, Line 7B

Prior to aspirus, inc. Becoming the sole corporate member on march 1, 2024: the voting rights of the members of the corporation shall be limited to the following matters: a) approval of any transaction that would culminate in the transfer of control of hospital operations to a sectarian or religious organization. B) approval of any transactions which would culminate in the transfer of control of the hospital's operations to a for-profit entity. C) approval of the dissolution of the hospital or the cessation of the st. Luke's hospital of duluth 41-0714079 hospital operations. The foregoing actions shall be approved and adopted only after authorization by the board of directors and approval by the members. Subsequent to aspirus, inc. Becoming the sole corporate member after march 1, 2024: the following actions must be approved by the sole member of the organization, aspirus, inc.: 1) change or amend the articles of incorporation or bylaws; 2) change the mission, purpose, or scope of the corporation; 3) ratification or removal of directors or officers; 4) change the formula or methodology for determining physician compensation; 5) approval of annual operating and capital expenditure budgets, strategic and long-range plans.

Form 990, Part VI, Section B, Line 11B

The accounting department accumulates all 990 information, including the ubi calculations. These documents are reviewed by the cfo. The 990 is reviewed by other senior management prior to submission to the internal revenue service and is made available to the board of directors through director's desk or other means of electronic retrieval.

Form 990, Part VI, Section B, Line 12C

Board members and key employees are required to sign annual conflict of interest statements and all managers are required to sign biannual conflict of interest statements. The organization's ceo and board chair review the statements and highlight potential conflicts. The board determines on a case by case basis any actions required. Individuals are not permitted to vote on any transaction where a conflict has been determined to exist. All conflicts and proceedings are noted in the meeting minutes.

Form 990, Part VI, Section B, Line 15

For the purposes of determining compensation, aspirus st. Luke's hospital relied on related organizations to establish the compensation of the ceo, other officers, and key employees. The related organizations used the following practices for establishing compensation for such individuals: compensation committee, independent compensation consultant, written employment contract, compensation survey or study, and approval by the board or compensation committee.

Form 990, Part VI, Section C, Line 19

The organization does not make its governing documents, conflict of interest policy, nor its financial statements available to the public.

Filing and Contact Details

Filer

Filer Name
ST LUKE'S HOSPITAL OF DULUTH
EIN
41-0714079
Phone
2182495555
Address
915 EAST FIRST STREET, DULUTH, MN 55805
Doing Business As
ASPIRUS ST LUKE'S HOSPITAL

Signing Officer

Name
Jerry M Yang
Title
SVP - Chief Financial Officer
Phone
2182495555
Signed
2025-05-12
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Jerry M Yang
Formed
1881
Legal Domicile
Mn
Voting Board Members
17
Independent Board Members
12
Employees
0
Volunteers
74

Preparer

Firm
Wipfli Llp
Address
1502 LONDON ROAD SUITE 200, DULUTH, MN 55812
Preparer
Michael J Peterson CPA
Phone
2187224705
Supplemental Narrative

Additional Explanations

FORM 990, PART XI, LINE 9:

Intercompany transfers 12,001,055. Other changes in net assets 123,364,946. Change in minimum pension liability -38,631,600.

FORM 990, CHANGE IN ACCOUNTING PERIOD:

The filing organization previously filed for the calendar year ending 12/31. After being acquired by aspirus, inc., its new parent organization, the filing organization has changed its year end to 06/30. The current form 990 is for the 6-month period from 01/01/2024 - 06/30/2024. Going forward, the organization will file for the year from 07/01 - 06/30.

FORM 990, PART XII, LINE 2:

The filing organization's financial statements were audited by an independent accountant for the full calendar year 2023. They were acuired march 1 of 2024 and included in the consolidated audit of their parent for fiscal year 07/01/2023-06/30/2024. Technically the activity from january and february were not included in the 06/30/2024 audited financial statements, however procedures were performed to account for those two months. The organization is filing the form 990 for the short year from 01/01/2024-06/30/2024.

FORM 990, PART XII, LINE 2C:

The filing organization relied on their new parent organization, aspirus inc., in the selection of the independent auditors. They were included in the consolidated audit of aspirus, inc.

Financial Statement Notes

PART X, LINE 2:

Aspirus has reviewed its tax positions for all open years and concluded that no material liabilities exist for uncertain tax positions at june 30, 2024.

Raw XML AppendixShowing 400 of 1,751 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Desc0OUR MISSION IS TO SERVE AS A LEADING PROVIDER OF QUALITY HEALTHCARE SERVICES IN OUR LOCAL COMMUNITY AND THE SURROUNDING REGION OF NORTHEASTERN MINNESOTA, NORTHWESTERN WISCONSIN, AND THE UPPER PENINSULA OF MICHIGAN. AS THE FEDERALLY DESIGNATED REGIONAL TRAUMA CENTER FOR THIS REGION, ST. LUKE'S PROVIDES CRITICAL ACCESS TO HIGH QUALITY ACUTE HEALTHCARE SERVICES. ST. LUKE'S RECOGNIZES ITS RESPONSIBILITY TO THE COMMUNITY BY PROVIDING FINANCIAL SUPPORT TO COMMUNITY ORGANIZATIONS; OFFERING EDUCATIONAL PROGRAMS, OUTREACH PROGRAMS, AND SUPPORTING THE COMMUNITY THROUGH EMPLOYEE VOLUNTEER EFFORTS AND DONATIONS. WE SUPPORT THE LAKE SUPERIOR COMMUNITY HEALTH CENTER AND THE HEALTH CARE ACCESS OFFICE. IN 2024, ST. LUKE'S DONATED MORE THAN 34,500 HOURS TO ENRICH THE HEALTHCARE OF THE COMMUNITY, INCLUDING SERVING ON BOARDS OF THE MINNESOTA HOMECARE ASSOCIATION, UNITED WAY, AND OTHER NON-PROFIT ORGANIZATIONS IN OUR COMMUNITY. ST. LUKE'S SERVES A DISPROPORTIONATE SHARE OF MEDICARE AND MEDICAID PATIENTS. THROUGH OUR PATIENT ASSISTANCE PROGRAM, WE PROVIDE FULL OR PARTIALLY SUBSIDIZED SERVICES TO INDIVIDUALS AND FAMILIES WHO ARE UNABLE TO PAY. AT ADMISSION AND THROUGH PATIENT HANDBOOKS, PATIENTS ARE GIVEN INFORMATION TO CONTACT ST. LUKE'S FINANCIAL COUNSELORS FOR INFORMATION ON OUR FINANCIAL ASSISTANCE PROGRAMS. INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. ALSO, ST. LUKE'S PROVIDES MEDICAL TRANSPORT SERVICES AT LESS THAN COST TO OUR PATIENTS IN THE REGION. DURING 2024, THERE WERE 5,385 ADMISSIONS, 27,957 PATIENT DAYS, 14,246 EMERGENCY/URGENT CARE VISITS, 110,059 OUTPATIENT REGISTRATIONS AND 333,930 CLINIC VISITS.
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