2023-05-15T14:31:49-05:00 2022-06-30 420714325 RSM US LLP 4650 EAST 53RD STREET DAVENPORT IA 528073479 990 2021-07-01 420698295 MERCY MEDICAL CENTER MERC 3193986105 701 10TH ST SE CEDAR RAPIDS IA 52403 NATHAN VAN GENDEREN EXECUTIVE VP/CFO 3193986105 2023-05-12 1 NATHAN VAN GENDEREN 999009999 JENIFER L CHASE P01306883 5638884000 2023-05-12 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z NATHAN VAN GENDEREN 701 10TH ST SE CEDAR RAPIDS IA 52403 566477030 0 0928 X WWW.MERCYCARE.ORG X 1900 IA TO CARE FOR THE SICK AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, GUIDED BY THE SPIRIT OF THE SISTERS OF MERCY. 25 20 2962 509 2036565 463680 7084887 11561637 368435862 390702891 20585601 16653110 -4284101 -538223 391822249 418379415 11035907 10528954 0 0 177929914 205610908 0 0 0 185222586 196616824 374188407 412756686 17633842 5622729 779545378 716000674 268558834 209763154 510986544 506237520 X TO CARE FOR THE SICK AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, GUIDED BY THE SPIRIT OF THE SISTERS OF MERCY. 0 0 329343073 10528954 388563580 THE HOSPITAL PROVIDES MEDICAL HEALTH CARE, INCLUDING 24 HOURS A DAY, SEVEN DAYS A WEEK TRAUMA CENTER SERVICE, TO ALL PATIENTS ACCESSING THE SYSTEM, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABILISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO OR NOMINAL PAYMENT IS ANTICIPATED. ADDITIONALLY, EACH HOSPITAL DEPARTMENT ACCEPTS ALL PATIENTS WHO ARE COVERED BY GOVERNMENTAL INDIGENT PROGRAMS. SUCH INDIGENT PROGRAMS TYPICALLY REMIT AMOUNTS SUBSTANTIALLY LESS THAN CHARGES. THE FOLLOWING SUMMARIZES THE HOSPITAL'S CARE OF THE UNINSURED AND UNDERINSURED. COSTS IN EXCESS OF MEDICARE REIMBURSEMENT (COSTS OF PROVIDING THE SERVICES LESS THE AMOUNTS RECEIVED FROM MEDICARE) - $28,080,000; OTHER COMMUNITY BENEFITS (INCLUDES SUBSIDIZED HEALTH SERVICES, FINANCIAL CONTRIBUTIONS) - $2,298,000; FREE SERVICE (TO PATIENTS WHO MEET MERCY'S FREE-SERVICE GUIDELINES) - $4,990,000; COSTS IN EXCESS OF MEDICAID REIMBURSEMENT (COSTS OF PROVIDING THE SERVICES LESS THE AMOUNTS RECEIVED FROM MEDICAID) - $12,580,000, PHYSICIAN EDUCATION - $(1,119,000). IN ADDITION, CHARITY CARE AND COMMUNITY SERVICE ARE PROVIDED THROUGH MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR. THESE PROGRAMS PROVIDE A BONA FIDE COMMUNITY HEALTH NEED, INCLUDING: A. PUBLIC AND PROFESSIONAL EDUCATIONAL SEMINAR ARE OFFERED ON A VARIETY OF TOPICS INCLUDING JOINT REPLACEMENT SURGERY, PRENATAL EDUCATION, DIABETES, MENTAL HEALTH DISORDERS, AND NUMEROUS OTHER MEDICAL CONDITIONS OF MEDICAL AND PSYCHOSOCIAL NATURE. SPECIALIZED CANCER SEMINARS ARE ALSO OFFERED. B. HOSPITAL MEETING FACILITIES WHICH ARE FREQUENTLY USED WITHOUT CHARGE BY SUCH GROUPS AS THE AMERICAN HEART ASSOCIATION, IOWA BREAST CANCER FOUNDATION, HEALTHY LINN NETWORK ADVISORY COMMITTEE, OVEREATERS ANONYMOUS, CATHOLIC LAYMEN, UNITED WAY, CATHERINE MCAULEY CENTER FOR WOMEN, THE AMERICAN CANCER SOCIETY. M.S. SUPPORT GROUP, EASTERN IOWA ONCOLOGY NURSES SOCIETY, THE IOWA CANCER CONSORTIUM, THE PARENT EDUCATION CONSORTIUM, ARC OF EAST CENTRAL IOWA, AND SEVERAL OTHER GROUPS. C. CONTRIBUTIONS OF APPROXIMATELY 76,185 HOURS TOWARD THE COMMON PURPOSE OF SERVING THE HEALTH CARE OF THE COMMUNITY. THE VALUE OF THESE CONTRIBUTIONS WAS APPROXIMATELY $1,106,244 AND WAS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS. 329343073 1 1 0 1 0 0 0 1 0 1 1 0 1 0 1 1 1 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 95 0 1 2962 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 25 20 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X KIM GRADY 3193986105 701 10TH ST SE CEDAR RAPIDS IA 52403 TIMOTHY L CHARLES PRESIDENT & CHIEF EXECUTIVE OFFICER 40.00 X X 1289481 0 78673 JOHN-PAUL BESONG MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 LYDIA BROWN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MICHELE BUSSE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BOB CATALDO MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHRIS DEWOLF MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BARRIE ERNST MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 TONY GOLOBIC MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER LUANN HANNASCH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 NANCY KASPAREK MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER SHARON KERRIGAN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BARB KNAPP MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER TERRY MALTBY MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHERYLE MITVALSKY CHAIRMAN 1.00 X X 0 0 0 DARREL MORF VICE CHAIRMAN/TREASURER 1.00 X X 0 0 0 RUE PATEL MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 FRED PILCHER MD MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MARY QUASS MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JOHN RIFE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHARLES ROHDE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 AL RUFFALO MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 KYLE SKOGMAN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JOHN SMITH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MATT SMITH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER MAURITA SOUKUP SECRETARY 1.00 X X 0 0 0 SISTER MARGARET WEIGEL FORMER MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 TIMOTHY QUINN MD CHIEF OF CLINICAL OPERATIONS 40.00 X 831381 0 73273 NATHAN VAN GENDEREN EXECUTIVE VICE PRESIDENT/CHIEF FINANCIAL OFFICER 40.00 X 640562 0 64928 NANCY HILL-DAVIS CHIEF TALENT OFFICER 40.00 X 436574 0 34477 JEFFREY CASH CHIEF INFORMATION OFFICER 40.00 X 438259 0 52257 MARY BROBST CHIEF NURSING OFFICER 40.00 X 448816 0 50013 SHINY MATTHEWKUTTY MD PHYSICIAN 40.00 X 1033499 0 22872 BHAVYA AKHAURI MD PHYSICIAN 40.00 X 1126703 0 27193 CHONG C LEE MD PHYSICIAN 40.00 X 1503514 0 37568 RYAN D HOLLENBECK MD PHYSICIAN 40.00 X 1138213 0 39427 SHANE A GAILUSHAS MD PHYSICIAN 40.00 X 1417952 0 36568 10304954 0 517249 195 0 1 0 UNIVERSITY OF IOWA HEALTH CARE 200 HAWKINS DRIVE IOWA CITY IA 52242 HEALTHCARE PROFESSIONAL SERVICES 4973836 SOUND PHYSICIANS PO BOX 942936 LOS ANGELES CA 90074 HEALTHCARE PROFESSIONAL SERVICES 4691077 ONCOLOGY ASSOCIATES OF CEDAR RAPIDS 701 10TH STREET CEDAR RAPIDS IA 52403 HEALTHCARE PROFESSIONAL SERVICES 4604157 TRIMEDX 5451 LAKEVIEW PKWY S DRIVE INDIANAPOLIS IN 46268 MAINTAIN AND REPAIR MEDICAL EQUPMENT 4308077 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 HEALTHCARE PROFESSIONAL SERVICES 3316289 53 6624071 4100673 836893 11561637 PATIENT REVENUES 621110 266548530 266548530 LABORATORY REVENUE 621500 129973438 128739484 1233954 FAMILY COUNSELING REVENUE 624100 217887 217887 LESS: PROVISION FOR BAD DEBT 621110 -6036964 -6036964 390702891 8728793 8728793 1762302 1828356 -66054 -66054 -66054 151342451 7820 143425954 0 7916497 7820 7924317 7924317 2473882 2843305 -369423 -369423 INVESTMENT PARTNERSHIP INCOME(LOS 561000 3492038 2689427 802611 MALPRACTICE TRUST FEES 621110 416003 416003 MISCELLANEOUS REVENUE 621110 1225 1225 -4012012 -4012012 -102746 418379415 388563580 2036565 16217633 10528954 10528954 3142880 2490955 651925 168981425 133929729 35051696 3541077 2806554 734523 19489146 15446526 4042620 10456380 8287421 2168959 198592 157398 41194 32511 25767 6744 130 103 27 33619897 26646146 6973751 1615361 1280288 335073 101984949 80830284 21154665 752969 596781 156188 5689907 4509654 1180253 119927 95051 24876 120312 95356 24956 4301678 3409384 892294 22568567 17887185 4681382 1321861 1047668 274193 UNRELATED BUSINESS INCO 97373 97373 CONTRACTED SERVICES 14554204 11535236 3018968 MISCELLANEOUS EXPENSES 2513497 1992124 521373 TAXES & LICENSES 1956111 1550356 405755 5168978 4096780 1072198 412756686 329343073 83413613 0 13060569 17782892 45865439 185218 44639480 50303565 319996 767990 8261581 9318928 9708794 10040012 534880302 364443331 184160952 170436971 324362762 305967083 149165805 151198015 779545378 716000674 90152700 70418461 3728505 2551082 125952887 108015768 48724742 28777843 268558834 209763154 X 437376763 433319726 73609781 72917794 510986544 506237520 779545378 716000674 X 5622729 -24292234 13920481 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 32511 32511 0 PART II-B, LINE 1: THE FOLLOWING PERCENTAGES OF DUES PAID ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES: 18.2% TO THE IOWA HOSPITAL ASSOCIATION, 3.83% TO THE CATHOLIC HEALTH ASSOCIATION, 4.45% TO THE CEDAR RAPIDS METRO ECONOMIC ALLIANCE, 16.05% TO THE AMERICAN ACADEMY OF FAMILY PHYSICIANS, 6% TO THE IOWA STATE BAR ASSOCIATION, 6.57% TO THE SOCIETY FOR HUMAN RESOURCE MANAGEMENT, AND 10% TO AMERICAN ORGANIZATION FOR NURSING LEADERSHIP. X 0 82365623 5693080 -2715364 716834 3046863 81579642 65433553 6112026 10511350 -812952 504258 82365623 34140867 30594750 1101466 232175 171355 65433553 33874605 146716 389112 140348 129218 34140867 33330786 129753 412711 -77440 76085 33874605 0.61190 0.38810 0.00000 0 1 1 20854231 20854231 313647380 213500229 100147151 197517793 148423542 49094251 2860898 2519560 341338 170436971 INVESTMENT IN MERCY MEDICAL CENTER FOUNDATION 136074218 C INVESTMENT IN CEDAR RAPIDS PHO 1670000 C SLEEP LAB JOINT VENTURE 1207000 C INVESTMENT IN MR ASSOCIATES 281000 C INVESTMENT IN MEDICAL MALL 343008 C INVESTMENT IN UMCSC 300000 C INVESTMENT IN MERCY SENIOR HOUSING 3420230 C INVESTMENT IN US RENAL CARE 4137000 C INVESTMENT IN MERCY SURGERY CENTER 3765559 C 151198015 INTEREST RATE SWAP AGREEMENTS 3847800 PENSION LIABILITY 14939989 SELF INSURANCE RESERVES 7567704 THIRD PARTY SETTLEMENTS 2422350 28777843 X 400502026 -24292234 9535123 -14757111 415259137 3120278 3120278 418379415 405251050 2699671 2699671 402551379 10205307 10205307 412756686 PART III, LINE 1A: THE ORGANIZATION HAS A SMALL COLLECTION OF ARTWORK. THE COLLECTION IS ON DISPLAY FOR PUBLIC VIEWING. THE MEDICAL CENTER HAS ELECTED NOT TO CAPITALIZE THEIR COLLECTION AS PERMITTED BY STATEMENT OF FINANCIAL ACCOUNTING STANDARDS (SFAS) NO. 116, ACCOUNTING FOR CONTRIBUTIONS RECEIVED AND CONTRIBUTIONS MADE. THE MEDICAL CENTER'S COLLECTIONS THAT HAVE BEEN DONATED ARE NOT RECOGNIZED AS ASSETS ON THE BALANCE SHEETS. NONE OF THE ARTWORK HAS BEEN SOLD TO RAISE FUNDS. PART V, LINE 4: MERCY HOSPITAL, CEDAR RAPIDS, IA ENDOWMENT FOUNDATION, INC., A RELATED ORGANIZATION, HOLDS THE ENDOWMENT FUNDS. THE FOUNDATION'S ENDOWMENT FUNDS ARE USED FOR THE HALL-PERRINE CANCER CENTER AND CANCER CENTER PROGRAMS, HALL RADIATION CENTER, OLDORF HOSPICE HOUSE, HOSPICE OF MERCY PROGRAMS, HALLMAR, WATTS LIBRARY, CAREGIVERS CENTER, ESPECIALLY FOR YOU RACE AGAINST BREAST CANCER, MERCY MEDICAL CENTER OPERATING AND CAPITAL PROJECTS, AND GENERAL ENDOWMENT FUNDS TO BE USED AT THE BOARD OF DIRECTOR'S DISCRETION. IN FY22, MERCY HOSPITAL, CEDAR RAPIDS, IA ENDOWMENT FOUNDATION, INC., A RELATED ORGANIZATION, RESTATED ITS ENDOWMENT DISCLOSURE IN THE AUDIT REPORT TO BETTER ALIGN WITH THE ORGANIZATION'S FINANCIALS. TO BE CONSISTENT WITH THE AUDIT REPORT, FORM 990, SCHEDULE D, PART V HAS BEEN RESTATED. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HOSPITALS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX EXEMPT STATUS OF BONDS ISSUED BY THE OBLIGATED GROUP, THE NATURE, THE CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2022 AND 2021, THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990 AND 990T FILED BY THE HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 4,268,123. CHANGE IN UNRECOGNIZED FUNDED STATUS OF RETIREMENT PLAN 12,017,000. GRANT TO MERCYARE SERVICE CORPORATION INCLUDED WITH REVENUES -6,750,000. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAFETERIA COST OF GOODS SOLD NETTED WITH REVENUES -2,699,671. GAIN ON SALE OF ASSETS 7,820. BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME(LOSS) 2,342,947. AUXILIARY REVENUE NOT INCLUDED IN AUDIT REPORT 21,695. REVENUE INCLUDED WITH EXPENSES ON AUDIT REPORT 3,447,487. PART XII, LINE 2D - OTHER ADJUSTMENTS: CAFETERIA COST OF GOODS SOLD NETTED WITH REVENUES 2,699,671. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO MERCYCARE SERVICE CORPORATION INCLUDED WITH REVENUES 6,750,000. GAIN ON SALE OF FIXED ASSETS 7,820. REVENUES INCLUDED WITH EXPENSES ON AUDIT REPORT 3,447,487. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 82926762 0 0 0 0 0 0 82926762 0 82926762 1 0 1 1 1 0 PART III ACCOUNTING METHOD: 1 1 X 1 X 1 X 1 1 0 1 1 51294422 37593352 13701070 0.03320 48986774 35834577 13152197 0.03190 100281196 73427929 26853267 0.06510 356051 356051 0.00090 150300 1250282 0 0.00000 4126345 8447082 0 0.00000 316017 209961 106056 0.00030 4948713 9907325 462107 0.00120 105229909 83335254 27315374 0.06630 377267 377267 0.00090 42749 42749 0.00010 420016 420016 0.00100 1 6036964 161639301 189714417 -28075116 X 1 1 1 MR ASSOCIATES LLP MRI SERVICES 0.33000 0.00000 0.33000 2 EASTERN IOWA SLEEP CENTER LLC SLEEP STUDIES 0.33000 0.00000 0.33000 3 CEDAR RAPIDS PHYSICIANS-HOSP ORG LC (DBA PARAMOUNT HEALTH OPTIONS) PAYOR CONTRACTING 0.52000 0.00000 0.50000 4 PCI REGIONAL MED MALL LLC MEDICAL SERVICES 0.10000 0.00000 0.80000 5 MERCY SURGERY CENTER AMBULATORY SURGERY CENTER 0.60000 0.00000 0.40000 1 1 MERCY MEDICAL CENTER 701 10TH STREET SE CEDAR RAPIDS IA 52403 WWW.MERCYCARE.ORG 570036H X X X MERCY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V X 1 21 1 SEE PART V 0 1 X 200.000000000000 400.000000000000 X 1 1 X X X 1 X HTTPS://WWW.MERCYCARE.ORG/FINANCIAL-ASSISTANCE-POLICY X HTTPS://WWW.MERCYCARE.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MERCYCARE.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 MERCY MEDICAL CENTER PART V, SECTION B, LINE 5: THE 2021 ITERATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS FACILITATED BY LINN COUNTY PUBLIC HEALTH WITH OVERSIGHT PROVIDED BY THE TOGETHER! HEALTHY LINN STEERING COMMITTEE. THE CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) INCLUDE PARTNERSHIPS WITH A MULTITUDE OF COMMUNITY STAKEHOLDERS, INCLUDING MERCY MEDICAL CENTER, UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL, AND EASTERN IOWA HEALTH CENTER. THE ALIGNMENT OF THE CHA AND CHIP FOR ALL FOUR ENTITIES IN LINN COUNTY MINIMIZES DUPLICATION AND MAXIMIZES IMPACT, AS ALL AFOREMENTIONED ORGANIZATIONS ARE REQUIRED UNDER LAW, OR BY FUNDERS, TO ASSESS THE HEALTH OF THE COMMUNITY AND DEVELOP AN IMPLEMENTATION PLAN FOR MEETING IDENTIFIED COMMUNITY NEEDS.THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONSISTS OF THE FOLLOWING PARTNERS: ABBEHEALTH, BETHANY LUTHERAN CHURCH, CEDAR RAPIDS CITY COUNCIL, CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT, CITY OF CEDAR RAPIDS, CITY OF MARION POLICE DEPARTMENT, EASTERN IOWA HEALTH CENTER, GREATER CEDAR RAPIDS COMMUNITY FOUNDATION, IOWA STATE UNIVERSITY EXTENSION & OUTREACH, KIRKWOOD COMMUNITY COLLEGE, LINN COUNTY BOARD OF SUPERVISORS, LINN COUNTY PUBLIC HEALTH, MERCY MEDICAL CENTER, STATE OF IOWA REPRESENTATIVE, STATE OF IOWA SENATOR, UNITED WAY OF EAST CENTRAL IOWA, AND UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL.IN ADDITION, MERCY MEDICAL CENTER CONTACTED THE SECONDARY SERVICE AREA PUBLIC HEALTH DEPARTMENTS TO BETTER UNDERSTAND THEIR COUNTY'S NEEDS THROUGH UTILIZING THEIR MOST RECENT CHNA.THE TOGETHER! HEALTHY LINN COLLABORATIVE USES THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) FRAMEWORK TO GUIDE THE CHA AND CHIP PROCESS. MAPP IS A NATIONALLY RECOGNIZED FRAMEWORK FOR CONDUCTING COMMUNITY-WIDE STRATEGIC PLANNING TO IMPROVE COMMUNITY HEALTH. THIS FRAMEWORK BALANCES QUANTITATIVE DATA ABOUT HEALTH TRENDS WITH THE EXPERIENCES OF COMMUNITY MEMBERS AND INSIGHT FROM CONTENT EXPERTS IN THE AGENCIES WITHIN THE LOCAL PUBLIC HEALTH SYSTEM. MAPP CURRENTLY CONSISTS OF SIX PHASES AND EMPHASIZES SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY AS KEY FACTORS THAT INFLUENCE THE OVERALL HEALTH OF THE COMMUNITY.THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) IS A QUANTITATIVE ANALYSIS THAT ANSWERS THE QUESTIONS, "HOW HEALTHY IS OUR COMMUNITY? AND "WHAT DOES THE HEALTH STATUS OF OUR COMMUNITY LOOK LIKE?" RESULTS OF THE CHSA PROVIDE AN UNDERSTANDING OF THE COMMUNITY'S HEALTH STATUS AND ENSURE THAT THE COMMUNITY'S PRIORITIES CONSIDER SPECIFIC HEALTH STATUS ISSUES, SUCH AS RATES OF INCREASING CHRONIC DISEASE, SEXUALLY TRANSMITTED INFECTIONS, AND HEALTH INEQUITIES.LINN COUNTY CONDUCTED THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) BETWEEN MAY AND NOVEMBER OF 2021. THE CTSA IS A QUALITATIVE ANALYSIS OF PERCEPTIONS, THOUGHTS, AND OPINIONS COMMUNITY MEMBERS HAVE REGARDING HEALTH. OF PARTICULAR INTEREST WAS IDENTIFYING NEEDS OF THE COMMUNITY, PERCEIVED QUALITY OF LIFE, AND ASSETS AVAILABLE THAT MAY BE USED TO IMPROVE COMMUNITY HEALTH. THE ASSESSMENT PROCESS WAS GUIDED BY A CTSA SUBCOMMITTEE WITH REPRESENTATION FROM MULTIPLE ENTITIES AND ORGANIZATIONS WITHIN THE LOCAL PUBLIC HEALTH SYSTEM AND IS ASSOCIATED WITH THE LARGER TOGETHER! HEALTHY LINN STEERING COMMITTEE. THE TARGET AUDIENCE FOR THIS ASSESSMENT IS COMMUNITY MEMBERS WHO WORK, RESIDE, WORSHIP, GO TO SCHOOL, OR SEEK ENTERTAINMENT IN LINN COUNTY. AN INITIAL SUBCOMMITTEE MEETING WAS HELD ON OCTOBER 15, 2020, TO PLAN THE ASSESSMENT. OVERALL, IT WAS DECIDED THAT THE ASSESSMENT SHOULD HAVE A GREATER EMPHASIS ON UNDERLYING FACTORS OF POOR HEALTH RATHER THAN A FOCUS ON HEALTH CONDITIONS, AS WELL AS A NEED TO REACH THOSE PREVIOUSLY MISSED THROUGH TRADITIONAL SURVEYING. THE GROUP DECIDED TO MOVE FORWARD WITH DEVELOPING A COMMUNITY HEALTH SURVEY AS THE PRIMARY METHOD FOR COLLECTING COMMUNITY INPUT, STICKER BOARDS FOR QUICKLY ENGAGING COMMUNITY MEMBERS IN COMMON SPACES WHERE SOCIAL DISTANCING COULD STILL OCCUR AND FOCUS GROUPS TO TARGET POPULATIONS NOT CAPTURED THROUGH THE BROADER SURVEY. IN ADDITION, THE ASSESSMENT INCLUDED TARGETED QUESTIONS EVALUATING THE CURRENT HEALTH PRIORITIES THAT WERE SELECTED IN THE 2019-2023 CHIP INCLUDING MENTAL HEALTH, OBESITY, AND COMMUNITY SAFETY. THIS WILL HELP THE TOGETHER! HEALTHY LINN COLLABORATIVE DIG DEEPER INTO THESE ISSUES AS WELL AS IDENTIFY THE NEED FOR CONTINUED PRIORITIZATION.ASSESSMENT ACTIVITIES TOOK PLACE BETWEEN MAY AND DECEMBER OF 2021. AFTER PRELIMINARY ASSESSMENT OF THE SURVEY RESULTS, POPULATIONS THAT WERE UNDERREPRESENTED IN THE SURVEY WERE IDENTIFIED, INCLUDING THOSE 65 YEARS AND OLDER, IMMIGRANT/REFUGEES, COMMUNITIES OF COLOR, LOW TO MIDDLE INCOME, AND RURAL RESIDENTS. THROUGH AN IDENTIFIED NEED TO HOLD FOCUS GROUPS, THE MAPP CORE TEAM COLLABORATED WITH THE COMMUNITY IMPACT ASSESSMENT TEAM FROM UNITED WAY TO HOLD JOINT FOCUS GROUPS. OVERALL, THREE FOCUS GROUPS AND ONE INFORMANT INTERVIEW WAS HELD TO GAIN ADDITIONAL INFORMATION FROM THE UNDERREPRESENTED POPULATIONS. FOCUS GROUPS INCLUDED MEMBERS FROM THE YOUNG PARENTS NETWORK, NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE (NAACP), AND THE AFRICAN AMERICAN MEN'S GROUP. AN ADDITIONAL INFORMANT INTERVIEW WAS CONDUCTED WITH LEADERSHIP FROM UNITED WE MARCH FORWARD, TO CAPTURE THE NEEDS AND PERSPECTIVES OF IMMIGRANT AND REFUGEE RESIDENTS. DATA OBTAINED THROUGH THIS COMPREHENSIVE COMMUNITY ASSESSMENT WERE SYNTHESIZED INTO A SINGLE REPORT AND BROKEN DOWN INTO LOGICAL CATEGORIES TO RELAY ASSESSMENT FINDINGS. THE 2021 COMMUNITY HEALTH ASSESSMENT IDENTIFIED MENTAL HEALTH, LIFESTYLE BARRIERS, INCLUDING ACCESS TO FOOD AND EQUITABLE OPPORTUNITIES TO BE ACTIVE; COMMUNITY SAFETY; SAFE AND AFFORDABLE HOUSING; ACCESS TO HEALTHCARE; CHRONIC DISEASE; SEXUALLY TRANSMITTED INFECTIONS; AND SUBSTANCE USE. SINCE THE DEVELOPMENT OF THE 2019-2021 CHIP, LINN COUNTY HAS EXPERIENCED SIGNIFICANT CHANGES; INCREASED LEVELS OF STRESS, ANXIETY, DEPRESSION, AND SUICIDAL IDEATION WERE DESCRIBED FOLLOWING THE ONSET OF THE COVID-19 PANDEMIC AND THE 2020 DERECHO. LIKEWISE, THESE EVENTS EXACERBATED THE ACCESSIBILITY OF HEALTHY AND AFFORDABLE FOODS, PARTICULARLY FOR MIDDLE TO LOW-INCOME RESIDENTS, AND THE DERECHO PLACED AN EMPHASIS ON AN ALREADY STRUGGLING SYSTEM OF SAFE AND AFFORDABLE HOUSING.DURING THE LAST ROUND OF THE CHA IN 2018, THE TOGETHER! HEALTHY LINN STEERING COMMITTEE USED A SERIES OF PRIORITIZATION TOOLS IN COMBINATION WITH DATA REFLECTION; ASSET AND COMMUNITY MAPPING; SMALL AND LARGE GROUP DISCUSSION; AND AN AGREED UPON SET OF PRIORITIZATION CRITERIA TO DETERMINE WHICH THREE ISSUES NEEDED TO BE ADDRESSED BEFORE THE COMMUNITY VISION COULD BE REALIZED. THE STEERING COMMITTEE WAS LIMITED TO THE TOP THREE ISSUES TO MAINTAIN A REALISTIC, FOCUSED SCOPE OF WORK. THE PRIORITIZATION CRITERIA FOR STRATEGIC ISSUES WERE: -THE ISSUE IS DATA DRIVEN, APPEARING IN TWO OR MORE OF THE ASSESSMENTS -ADDRESSING THE ISSUE REQUIRES A COLLABORATIVE, MULTI-SECTOR APPROACH -ALIGNMENT WITH THE TOGETHER! HEALTHY LINN VISION -ASSETS ARE AVAILABLE WITHIN THE LOCAL PUBLIC HEALTH SYSTEM TO AFFECT THE ISSUE -THE ISSUE REFLECTS A NEED THAT TOGETHER! HEALTHY LINN CAN INFLUENCE THE SIZE AND SIGNIFICANCE OF THE ISSUE HAS SIGNIFICANT IMPACTAT THE END OF THIS PRIORITIZATION SESSION, THREE BROAD ISSUES WERE IDENTIFIED IN RANK ORDER: MENTAL HEALTH, OBESITY, AND SAFETY. USING DATA FROM THE MID-CYCLE ASSESSMENT CONDUCTED IN 2021, THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONVENED ON MARCH 10, 2022, TO REVIEW RESULTS OF THE ASSESSMENT AND EVALUATE WHAT ADJUSTMENTS, IF ANY, SHOULD BE APPLIED TO THE EXTENDED 2019-2023 COMMUNITY HEALTH IMPROVEMENT PLAN. FOLLOWING REVIEW OF THE ASSESSMENT FINDINGS, THE MAPP CORE TEAM PRESENTED SOME RECOMMENDATIONS FOR THE STEERING COMMITTEE TO CONSIDER FOR MODIFICATIONS, INCLUDING EXTENDING THE 2019-2021 PLAN TO 2023; HONE IN ON THE UNDERLYING FACTORS DRIVING THE ISSUES OF OBESITY AND SAFETY; GATHER ADDITIONAL DATA TO TARGET PLANNED STRATEGIES, POPULATIONS IMPACTED AND GEOGRAPHIC LOCATION; AND MAKE MODIFICATIONS TO THE PLAN BASED ON THE ADDITIONAL DATA FINDINGS. RECOMMENDATIONS WERE UNANIMOUSLY ACCEPTED FOR CONTINUATION AND ADJUSTMENT OF THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIZED SIGNIFICANT NEEDS FOR THE 2021 LINN COUNTY CHA ARE MENTAL HEALTH, LIFESTYLE BARRIERS (INCLUDING ACCESS TO FOOD AND OPPORTUNITIES TO BE ACTIVE), COMMUNITY SAFETY, AND SAFE AND AFFORDABLE HOUSING. MERCY MEDICAL CENTER PART V, SECTION B, LINE 6A: LINN COUNTY PUBLIC HEALTH FACILITATED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL AND MERCY MEDICAL CENTER. BOTH HOSPITALS ARE LOCATED IN CEDAR RAPIDS, IA. MERCY MEDICAL CENTER PART V, SECTION B, LINE 6B: THE 2021 ITERATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS FACILITATED BY LINN COUNTY PUBLIC HEALTH WITH OVERSIGHT PROVIDED BY THE TOGETHER! HEALTHY LINN STEERING COMMITTEE. THE CHA AND CHIP INCLUDE PARTNERSHIPS WITH A MULTITUDE OF COMMUNITY STAKEHOLDERS, INCLUDING MERCY MEDICAL CENTER, UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL, AND EASTERN IOWA HEALTH CENTER. THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONSISTS OF THE FOLLOWING PARTNERS: ABBEHEALTH, BETHANY LUTHERAN CHURCH, CEDAR RAPIDS CITY COUNCIL, CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT, CITY OF CEDAR RAPIDS, CITY OF MARION POLICE DEPARTMENT, EASTERN IOWA HEALTH CENTER, GREATER CEDAR RAPIDS COMMUNITY FOUNDATION, IOWA STATE UNIVERSITY EXTENSION & OUTREACH, KIRKWOOD COMMUNITY COLLEGE, LINN COUNTY BOARD OF SUPERVISORS, LINN COUNTY PUBLIC HEALTH, MERCY MEDICAL CENTER, STATE OF IOWA REPRESENTATIVE, STATE OF IOWA SENATOR, UNITED WAY OF EAST CENTRAL IOWA, AND UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL.ADDITIONALLY, MERCY MEDICAL CENTER REQUESTED INPUT FROM THE PUBLIC HEALTH DEPARTMENTS OF BENTON, BUCHANAN, CEDAR, DELAWARE, IOWA, JOHNSON, JONES, AND TAMA COUNTIES REGARDING HEALTH PRIORITIES IN THEIR AREA. MERCY MEDICAL CENTER PART V, SECTION B, LINE 11: MERCY MEDICAL CENTER IS ADDRESSING THE FOUR PRIORITIZED SIGNIFICANT NEEDS IDENTIFIED IN THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN A VARIETY OF WAYS. MERCY MEDICAL CENTER IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF MENTAL HEALTH BY EXPLORING OPTIONS FOR MORE PSYCHIATRIC CONSULTATIVE ROLES WITHIN MERCYCARE CLINICS, PROVIDING AREA SCHOOL DISTRICTS WITH MENTAL HEALTH SERVICES, OFFERING TELEHEALTH MENTAL HEALTH APPOINTMENTS, PARTICIPATING IN THE STEERING COMMITTEE OF THE LINN COUNTY MENTAL HEALTH ACCESS CENTER, INCREASING EARLY INTERVENTION SERVICES FOR SUICIDE THROUGH A SCREENING TOOL AND CREATION OF SAFETY PLAN/INTERVENTIONS AND PROVIDING SCREENING, ONGOING SUPPORT, AND TREATMENT AT SEDLACEK TREATMENT CENTER.MERCY IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF FOOD INSECURITY BY PROVIDING NUTRITION EDUCATION AND COUNSELING, PROVIDING A WELLNESS PROGRAM FOR EMPLOYEES, PURCHASING AND OFFERING LOCAL FRESH PRODUCE FOR PATIENTS, VISITORS AND STAFF, SCREENING PATIENTS FOR FOOD INSECURITY AND PARTNERING WITH HACAP FOOD RESERVOIR TO PROVIDE SHORT AND LONG TERM SUPPORTS, PROVIDING FOOD RESOURCES AT CATHERINE'S CUPBOARD FOR EMPLOYEES AND VOLUNTEERS, AND PROVIDING IN-KIND SPACE TO METRO CATHOLIC OUTREACH, A FOOD PANTRY IN ONE OF MERCY'S BUILDINGS FOR $1 RENT/YEAR. MERCY IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF COMMUNITY SAFETY BY ENHANCING MERCY'S ANTI-HUMAN TRAFFICKING EFFORTS, PARTICIPATING IN COMMUNITY EFFORTS TO REDUCE GUN VIOLENCE, INCLUDING RESTORATIVE JUSTICE PROGRAMMING AT A LOCAL SCHOOL, ASSESSING PATIENTS FOR ABUSE OR ASSAULT AND CONNECTING TO COMMUNITY RESOURCES, IMPLEMENTING PHYSICAL ENVIRONMENT SAFETY IMPROVEMENTS HOSPITAL-WIDE, AND OFFERING TRAINING RELATED TO SAFETY BOTH INTERNALLY AND EXTERNALLY TO MERCY MEDICAL CENTER. MERCY IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF SAFE AND AFFORDABLE HOUSING THROUGH PARTICIPATING IN COMMUNITY INITIATIVES FOCUSED ON AFFORDABLE HOUSING AND EXPLORING OPTIONS TO FURTHER SUPPORT THESE EFFORTS. ADDITIONALLY, MERCY IS SCREENING FOR HOUSING NEEDS AND PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS TO PROVIDE HOUSING ASSISTANCE. WHEN APPROPRIATE, MERCY OCCUPATIONAL THERAPY DEPARTMENTS COMPLETES A SAFETY ASSESSMENT AT HOME FOR PATIENTS. HISTORICALLY, MERCY HAS INCREASED ACCESS TO AND PROVIDED SUPPORT OF AFFORDABLE HOUSING COMMUNITY DEVELOPMENT INITIATIVES, INCLUDING THE PROCUREMENT OF PROPERTY AND/OR PROVIDING FINANCIAL ASSISTANCE IN THE DEVELOPMENT OF LOW-INCOME HOUSING. MERCY MEDICAL CENTER DESCRIBES IN ITS MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY HOW IT IS ADDRESSING OTHER NEEDS IDENTIFIED IN THE CHNA. THESE INCLUDE ACCESS TO HEALTH CARE, A CHRONIC DISEASE, NATURAL ENVIRONMENT, SEXUAL HEALTH, SUBSTANCE USE, AND TRANSPORTATION. MERCY MEDICAL CENTER PART V, SECTION B, LINE 13B: PATIENTS THAT EXCEED 400% OF FPL TABLE ARE ELIGIBLE FOR DISCOUNTS ON ALL BALANCES IN EXCESS OF 10% OF GROSS PERSONAL EARNINGS PER CALENDAR YEAR. SCHEDULE H, PART V, SECTION B, LINE 5, CONTINUED: FOR THE FULL COMMUNITY HEALTH ASSESSMENT REPORTS PREPARED BY LINN COUNTY PUBLIC HEALTH, PLEASE VISIT: HTTP://WWW.LINNCOUNTY.ORG/613/REPORTS-AND-PUBLICATIONS. MERCY MEDICAL CENTER DID NOT RECEIVE ANY WRITTEN COMMENTS ON THE HOSPITAL FACILITY'S MOST RECENTLY CONDUCTED CHNA OR IMPLEMENTATION STRATEGY. HOWEVER, ON THE CHNA AND IMPLEMENTATION STRATEGY WEBPAGE OF THE MERCY WEBSITE, THERE IS A "QUESTIONS?" FORM THAT CAN BE FILLED OUT BY ANY INDIVIDUAL. THE SUBMITTED ONLINE FORM GOES TO MERCY'S MARKETING DEPARTMENT AND WOULD BE FORWARDED TO MERCY'S COMMUNITY BENEFIT OFFICE. ANY MAILED WRITTEN COMMENTS WOULD BE FORWARDED TO THE COMMUNITY BENEFIT OFFICE. SCHEDULE H, PART V, SECTION B, LINE 7A: HTTPS://WWW.MERCYCARE.ORG/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART V, SECTION B, LINE 10A: HTTPS://WWW.MERCYCARE.ORG/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART I, LINE 3C: DISCOUNTED CARE IS AVAILABLE TO ALL MERCY MEDICAL CENTER PATIENTS WHO DO NOT HAVE ACTIVE MEDICAL INSURANCE COVERAGE, NOT JUST THOSE WITHIN A FEDERAL POVERTY GUIDELINE FAMILY INCOME LIMIT. IF PATIENTS STILL FIND THEMSELVES UNABLE TO PAY, THEY MAY APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE. PART I, LINE 6A: NOT APPLICABLE PART I, LINE 7: MERCY MEDICAL CENTER UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO, AND THIS RATIO WAS USED IN COMPUTING THE INFORMATION REPORTED IN PART I, LINE 7. PART I, LINE 7G: NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC WERE REPORTED IN SUBSIDIZED HEALTH SERVICES. PART I, LN 7 COL(F): BAD DEBT EXPENSE WAS NOT INCLUDED IN THE DENOMINATOR BECAUSE IT WAS REPORTED ON LINE 2D OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 25.49%. THIS PERCENTAGE INCREASES TO 71.46% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN THE TOTAL COMMUNTY BENEFIT EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: MERCY MEDICAL CENTER PARTICIPATED IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTED THE HEALTH OF THE COMMUNITIES MERCY SERVES. THIS INCLUDED MERCY STAFF REPRESENTATION ON COALITIONS, COMMITTEES, AND BOARDS SUCH AS BIG BROTHERS BIG SISTERS OF CEDAR RAPIDS. MERCY MADE CASH CONTRIBUTIONS TO NON-PROFIT ORGANIZATIONS THAT SUPPORT COMMUNITY-BUILDING EFFORTS THROUGH THEIR MENTOR, EDUCATIONAL, OR AFTER SCHOOL PROGRAMMING FOR YOUTH. PART III, LINE 2: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS REVENUE IN THE AUDITED FINANCIAL STATEMENTS. THEREFORE, NO BAD DEBT EXPENSE IS RECOGNIZED FOR UNCOLLECTED AMOUNTS ON PATIENT ACCOUNTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 3: NOT APPLICABLE PART III, LINE 4: SEE PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE. PART III, LINE 8: THE COSTS SHOWN FOR THE MEDICARE SHORTFALL ARE BASED ON TOTAL CHARGES OF ALL MEDICARE AND MEDICARE REPLACEMENT (PART C) PATIENTS. THE SHORTFALL IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES BY THE COST TO CHARGE RATIO CALCULATED ON WORKSHEET 2, LESS PAYMENTS WE RECEIVED FOR THESE SERVICES.THE MEDICARE COST REPORT IS NOT AN APPROPRIATE SOURCE TO DETERMINE THE COSTS FOR THESE PATIENTS. MANY ITEMS, INCLUDING ALL OUTPATIENT SERVICES FOR PATIENTS WHO ARE COVERED BY A MEDICARE REPLACEMENT PLAN (PART C) AND MANY SERVICES SUCH AS LABORATORY, PHYSICAL AND OCCUPATIONAL THERAPY, AND OTHERS PAID ON A FEE FOR SERVICE BASIS, ARE NOT INCLUDED ON THE MEDICARE COST REPORT. IN ADDITION, HOSPICE, HOME HEALTH, AND DIALYSIS SERVICES, ALTHOUGH INCLUDED IN MEDICARE COST REPORT, DO NOT SHOW THE COSTS AND PAYMENTS ASSOCIATED WITH THESE SERVICES FOR MEDICARE BENEFICIARIES. FOR MERCY MEDICAL CENTER, THE VAST MAJORITY OF OUR GROSS CHARGES ARE GENERATED BY PATIENTS WITH MEDICARE AND MEDICARE REPLACEMENT (PART C) COVERAGE OR MEDICAID. NEITHER GOVERNMENT PROGRAM HAS HISTORICALLY REIMBURSED ENOUGH TO COVER THE COSTS OF THE SERVICES PROVIDED TO THESE PATIENTS. IF WE DID NOT SERVE THESE PATIENT POPULATIONS, ANOTHER FACILITY WOULD HAVE TO PROVIDE THE SERVICE. PART III, LINE 9B: MERCY MEDICAL CENTER UNDERSTANDS PATIENTS MAY NOT HAVE THE ABILITY TO PAY FOR SERVICES NOR RECOGNIZE THE OPPORTUNITY THEY MAY HAVE TO RECEIVE FINANCIAL ASSISTANCE. TO AID IN THIS PROCESS, MERCY MEDICAL CENTER HAS IMPLEMENTED A PRESUMPTIVE CHARITY ELIGIBILITY PROGRAM (PCEP). PATIENTS WHO QUALIFY FOR THIS PROGRAM DO NOT COMPLETE PAPERWORK. MERCY MEDICAL CENTER UTILIZES AN OUTSIDE VENDOR TO ASSIST IN DETERMINING A PATIENT'S FINANCIAL RISK. MERCY MEDICAL CENTER USES BILLING AND COLLECTION RECOMMENDATIONS FROM THE IOWA HOSPITAL ASSOCIATION. THESE RECOMMENDATIONS INCLUDE: - MERCY MEDICAL CENTER WILL PROVIDE THE SAME INFORMATION CONCERNING SERVICES AND CHARGES TO ALL PATIENTS. - MERCY MEDICAL CENTER WILL NOT KNOWINGLY SEND A PATIENT'S BILL TO A COLLECTION AGENCY BEFORE INITIAL FINANCIAL ELIGIBILITY ASSISTANCE DETERMINATION HAS BEEN MADE. - MERCY MEDICAL CENTER WILL REVIEW THE PATIENT'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS APPROPRIATE BEFORE ANY COLLECTION AGENCY ASSIGNMENT. PART VI, LINE 2: MERCY MEDICAL CENTER UNDERSTANDS THE NEED FOR ONGOING ASSESSMENT AND USES DATA AND INFORMATION OBTAINED FROM COMPLETED SOCIAL DETERMINANT OF HEALTH SCREENINGS ON PATIENTS, THE COMMUNITY FREE CLINICS, COMMUNITY COALITIONS, COMMUNITY-BASED ORGANIZATIONS, AND THE LOCAL PUBLIC HEALTH DEPARTMENTS TO MODIFY CURRENT ACTIVITIES AND CREATE INNOVATIVE PROGRAMS TO ADDRESS HEALTH NEEDS. ADDITIONALLY, MERCY MEDICAL CENTER RECEIVES REQUESTS FROM LOCAL NON-PROFIT ORGANIZATIONS FOR FINANCIAL AND IN-KIND SUPPORT TO ADDRESS COMMUNITY NEEDS FOR WHICH THEY PROVIDE PROGRAMS AND SERVICES. MERCY MEDICAL CENTER UTILIZES ALL THIS INFORMATION, IN ADDITION TO THE CHNA TO COMPLETE A COMMUNITY BENEFIT PLAN FOR THE HOSPITAL. PART VI, LINE 3: EDUCATION: MERCY MEDICAL CENTER POSTS SIGNAGE AND PROVIDES BROCHURES REGARDING FINANCIAL ASSISTANCE INFORMATION AT ALL POINTS OF ENTRY. THERE IS A NOTIFICATION ON THE BACK OF ALL STATEMENTS INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ASSIST QUALIFYING PATIENTS. TRAINING: MERCY MEDICAL CENTER HAS EDUCATED AND TRAINED STAFF MEMBERS AT ALL REGISTRATION LOCATIONS ABOUT OUR FINANCIAL ASSISTANCE POLICY AND LISTENING TO INDIVIDUALS THAT MAY NEED ASSISTANCE. OUR EMERGENCY DEPARTMENT STAFF IS TRAINED ON MEDICAID APPLICATIONS. MERCY HAS HIRED PATIENT MATTERS TO ASSIST PATIENTS WITH THE MEDICAID APPLICATION PROCESS. PATIENT MATTERS AND OUR FINANCIAL ADVOCATE TEAM KEEP IN COMMUNICATION TO ENSURE PATIENT NEEDS ARE MET. PART VI, LINE 4: MERCY MEDICAL CENTER SERVES A PRIMARY SERVICE AREA (PSA) OF LINN COUNTY AND A SECONDARY SERVICE AREA (SSA) OF EIGHT COUNTIES (BENTON, BUCHANAN, CEDAR, DELAWARE, IOWA, JOHNSON, JONES AND TAMA). THE MAJORITY OF MERCY'S PATIENTS FOR BOTH INPATIENT AND OUTPATIENT SERVICES LIVE IN LINN COUNTY. THE COMMUNITY ADDITIONALLY INCLUDES THOSE COUNTIES ADJACENT TO LINN COUNTY AND WITHIN A REASONABLE DRIVING TIME TO THE HOSPITAL. THE TOTAL POPULATION OF LINN COUNTY IN 2020 WAS 230,299. THE TOTAL POPULATION OF BOTH PRIMARY AND SECONDARY SERVICE AREAS WAS 519,749. DEMOGRAPHICS FOR THE COMBINED SERVICE AREA ARE AS FOLLOWS: 50.1% MALE, 49.9% FEMALE 93.3% CAUCASIAN 2.3% AFRICAN AMERICAN 1.2% NATIVE AMERICAN 1.0% ASIAN/PACIFIC 1.6% TWO OR MORE RACES 3.6% HISPANIC 18.5% OF PERSONS LIVING IN MERCY'S COMBINED SERVICE AREA ARE AGE 65 OR OLDER 93.6% ARE HIGH SCHOOL GRADUATES WHILE 24.7% HOLD A BACHELOR'S DEGREE OR HIGHER THE MEDIAN HOUSEHOLD INCOME IS $62,954 THE PERCENTAGE OF PEOPLE LIVING BELOW POVERTY LEVEL IS 9.0% AS COMPARED TO 10.2% FOR ALL OF IOWA 13% OF MERCY'S PATIENTS USE MEDICAID AND THE NUMBER OF UNINSURED INDIVIDUALS UNDER AGE 65 IN IOWA IS 6.0% ACCORDING TO THE US CENSUS BUREAUS THE AVERAGE PERSONS PER HOUSEHOLD ARE 2.43 FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS ARE PRESENT IN BENTON, BUCHANAN, DELAWARE, IOWA, JONES, LINN AND TAMA COUNTIES (HTTPS://DATAWAREHOUSE.HRSA.GOV/TOOLS/ANALYZERS/MUAFIND.ASPX)AS OF DECEMBER 2021, THE UNEMPLOYMENT RATE FOR LINN COUNTY IS 3.3%. THE EIGHT CONTIGUOUS UNEMPLOYMENT RATES RANGE FROM 2.3-4.3%. LINN COUNTY FEATURES A DIVERSE EMPLOYER BASE INCLUDING MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE, AND AGRICULTURE.UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL IS IN LINN COUNTY AND SERVES A SIMILAR GEOGRAPHIC SERVICE AREA AS MERCY MEDICAL CENTER. ADDITIONALLY, THE UNIVERSITY OF IOWA AND MERCY IOWA CITY ARE IN JOHNSON COUNTY, REGIONAL MEDICAL CENTER IS IN DELAWARE COUNTY, UNITYPOINT HEALTH - JONES REGIONAL MEDICAL CENTER IS IN JONES COUNTY, AND VIRGINIA GAY HOSPITAL IS IN BENTON COUNTY. PART VI, LINE 5: MERCY MEDICAL CENTER'S BOARD OF TRUSTEES IS MADE UP OF VOLUNTEERS, THE MAJORITY OF WHOM ARE RESIDENTS WITHIN THE PRIMARY SERVICE AREA. THE BOARD CONSISTS OF 23 MEMBERS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE CEO OF THE CORPORATION AND THE PRESIDENT OF THE MEDICAL STAFF ADDITIONALLY SERVE AS EX-OFFICIO, VOTING MEMBERS. IN THE EVENT THAT THE PRESIDENT OF THE MEDICAL STAFF IS ALSO AN EMPLOYEE OF THE ORGANIZATION, HE OR SHE WILL SERVE AS AN EX-OFFICIO, NON-VOTING MEMBER. THE GOVERNANCE STRUCTURE ENSURES THAT COMMUNITY INTERESTS ARE REPRESENTED IN DECISION-MAKING FOR THE ORGANIZATION. IN ADDITION, THREE SEATS ARE ALLOCATED TO WOMEN RELIGIOUS WHO ENSURE THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION. THERE ARE CURRENTLY FOUR WOMEN RELIGIOUS SERVING ON THE BOARD.MERCY MEDICAL CENTER MAINTAINS AN OPEN MEDICAL STAFF, AS PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS.FOLLOWING IN THE FOOTSTEPS OF THE SISTERS OF MERCY, MERCY MEDICAL CENTER IS COMMITTED TO ADDRESSING THE NEEDS THAT IMPACT THE HEALTH OF POOR AND VULNERABLE INDIVIDUALS IN OUR COMMUNITY. MERCY ACKNOWLEDGES THE HEALTH OF EVERY INDIVIDUAL IS INFLUENCED BY THE CONDITIONS IN THE PLACES WHERE INDIVIDUALS LIVE, LEARN, WORK AND AGE, ALONG WITH THEIR SOCIOECONOMIC STATUS AND RACE. IN FEBRUARY 2022, MERCY'S CHNA AND STRATEGIC PLAN WAS SHARED WITH THE PLANNING COMMITTEE OF MERCY'S BOARD OF TRUSTEES. MERCY'S COMMITMENT TO ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND ADVANCING HEALTH EQUITY WAS REVIEWED. FOR THE REMAINDER OF 2022 AND INTO 2023, MERCY PLANS TO WORK TO UNDERSTAND ON A DEEPER LEVEL THE AVAILABLE COMMUNITY DATA AND MAKE A CONCERTED EFFORT TO LISTEN TO COMMUNITY MEMBERS IN THE AREAS MERCY SERVES. THESE STEPS WILL INFORM OUR NEXT ACTIONS RELATED TO HEALTH EQUITY.TO ADVANCE HEALTH EQUITY, IN 2022, MERCY ESTABLISHED THE HEALTH EQUITY FUND AND PROVIDED SUPPORT TO EIGHT LOCAL NONPROFIT ORGANIZATIONS WITH INITIATIVES FOCUSED ON ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES, FOOD INSECURITY, AND SAFE AND AFFORDABLE HOUSING. MERCY EXPANDED SCREENING TO ASSESS PATIENTS FOR NONMEDICAL NEEDS, SUCH AS FOOD, TRANSPORTATION, AND HOUSING. PATIENTS WHO IDENTIFY AS HAVING A NEED ARE CONNECTED TO RESOURCES WITHIN THE COMMUNITY.MERCY PARTNERED WITH HACAP FOOD RESERVOIR. PATIENTS ARE SCREENED FOR FOOD INSECURITY DURING VISITS WITH HEALTHCARE PROVIDERS. PATIENTS WHO SCREEN POSITIVE ARE PROVIDED A FOOD BOX AND CONNECTED TO OTHER COMMUNITY RESOURCES.IN PARTNERSHIP WITH THE CATHERINE MCAULEY CENTER AND LINN COUNTY PUBLIC HEALTH, MERCY PARTICIPATES IN NEW REFUGEE'S INITIAL HEALTH ASSESSMENT BY COLLECTING LABS AND RADIOLOGY SERVICES.MERCY PROVIDED IN-KIND LAB, RADIOLOGY, AND PROVIDERS TO THE COMMUNITY HEALTH FREE CLINIC (CHFC). THE NUMBER OF PATIENTS SEEN BY A MERCY PROVIDER AT THE CLINIC FROM JULY 2021 TO JUNE 2022 WAS 4,085. ADDITIONALLY, MERCY PARTNERED WITH CHFC TO OFFER OUTREACH AND SCREENINGS FOR PROSTATE CANCER, COLON CANCER, AND BREAST CANCER.MERCY FAMILY COUNSELING PARTNERS WITH LINN-MAR AND PRAIRIE SCHOOL DISTRICTS TO PLACE STUDENTS ON THE FAST TRACK TO MENTAL HEALTH SUPPORTS. MERCY OFFERS EPIC TO THE CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT'S METRO CARE CONNECTION SCHOOL-BASED HEALTH CENTERS AND THE EPIC TRAINING ENVIRONMENT TO KIRKWOOD COMMUNITY COLLEGE FOR THEIR NURSING PROGRAMS.DURING MISSION WEEK, MERCY STAFF DONATED THREE LINEN CARTS AND SIX FLAT BEDS FULL OF SUPPLIES, AS WELL AS ALMOST $2,000 IN MONETARY DONATIONS TO ST. JOHN OF THE CROSS CATHOLIC WORKER HOUSE, WAYPOINT, AND WILLIS DADY HOMELESS SERVICES. THIS INCLUDED ITEMS THAT EACH OF THE SHELTERS RELY ON HEAVILY TO HELP THEIR CLIENTS LIVE EACH DAY. ITEMS INCLUDED TOILET PAPER, PAPER TOWELS, CLEANING SUPPLIES, HYGIENE PRODUCTS, LAUNDRY SOAP, AND BEDDING.IN JANUARY 2022, MERCY HOSTED A "HEAD, SHOULDERS, KNEES & TOES" DRIVE IN PARTNERSHIP WITH OLIVET NEIGHBORHOOD MISSION AND THE EASTERN IOWA HEALTH CENTER TO COLLECT ITEMS TO HELP THE GROWING NUMBER OF HOMELESS INDIVIDUALS IN OUR COMMUNITY GET THROUGH THE WINTER. ALTOGETHER, MERCY STAFF AND VOLUNTEERS DONATED FIVE LINEN CARTS OF WINTER GEAR.SISTER ORGANIZATIONS MOUNT MERCY UNIVERSITY, THE CATHERINE MCAULEY CENTER AND MERCY CONTINUED THE TRADITION OF SPREADING MERCY IN OUR COMMUNITY WITH CIRCLE THE CITY WITH MERCY - A ONE-DAY COMMUNITY SERVICE PROJECT. IN JULY 2021, MEMBERS OF EACH ORGANIZATION PUT TOGETHER A COMBINED 500 SHOE COVERINGS AND DONATED TO OLIVET NEIGHBORHOOD MISSION. THE SHOE COVERINGS KEEP FEET DRY FROM THE ELEMENTS OF WEATHER AND ARE MADE FROM BLUE WRAPS FROM MERCY'S SURGICAL AREAS, WHERE THEY ARE USED TO WRAP STERILE INSTRUMENT TRAYS. THE FAMILY CAREGIVERS CENTER OF MERCY HAS HAD CONTACT WITH 1,661 FAMILY CAREGIVERS: 1,291 FEMALE CAREGIVERS AND 370 MALE CAREGIVERS. OUT OF OUR CAREGIVERS, 937 OF THEM ARE CARING FOR SOMEONE LIVING WITH DEMENTIA AND 235 ARE CARING FOR SOMEONE WITH MULTIPLE HEALTH ISSUES. THE CENTER SUPPORTS 767 SPOUSAL CAREGIVERS; 743 ARE ADULT CHILDREN CARING FOR THEIR PARENTS.MERCY MEDICAL CENTER PROVIDES REPRESENTATION ON COMMUNITY BOARDS, COALITIONS AND COMMITTEES ADDRESSING HEALTH NEEDS. EXAMPLES INCLUDE: -THE ARC OF EAST CENTRAL IOWA BOARD -COMMUNITY HEALTH FREE CLINIC BOARD -FOUR OAKS -HAWKEYE AREA COMMUNITY ACTION PROGRAM -HERITAGE AREA AGENCY ON AGINGMERCY EMPLOYEES HAVE PARTICIPATED IN THE TRAINING OF HEALTH CARE PROFESSIONS STUDENTS, PROVIDING HEALTH EDUCATION TO THE COMMUNITY, OFFERING SUPPORT OF HEALTH PREVENTION AND PROMOTION ACTIVITIES, THROUGH SCREENINGS AND SUPPORT GROUPS, PROVIDING IN-KIND PRINTING TO MULTIPLE NONPROFITS, AND COORDINATING ACTIVITIES TO SUPPORT LOCAL NONPROFITS.THE ESPECIALLY FOR YOU RACE AGAINST BREAST CANCER SUPPORTS FREE MAMMOGRAMS, AS WELL AS BREAST-CARE AND GYNECOLOGICAL SERVICES, FOR AREA INDIVIDUALS IN NEED THROUGH THE ESPECIALLY FOR YOU FUND. THE EFY RACE MARKED ITS 31ST YEAR WITH A RACE HELD IN OCTOBER 2021 WITH 12,806 REGISTRANTS FROM 483 CITIES IN 37 STATES, RAISING MORE THAN $385,000.SR. MARY LAWRENCE HALLAGAN COMMUNITY CENTER PROVIDES SIX NON-PROFITS WITH SPACE FOR THEIR SERVICES. TENANTS INCLUDE GEMS OF HOPE; KIDS FIRST LAW CENTER; YOUNG PARENTS NETWORK AND BOYS & GIRLS CLUB; CATHOLIC CHARITIES; AND METRO CATHOLIC OUTREACH. THESE AGENCIES SHARE MERCY'S VISION TO ENHANCE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. MERCY LEASES THE SPACE FOR $1 PER YEAR, PLUS THE COST OF MONTHLY UTILITIES.MERCY SUPPORTS THE CEDAR RAPIDS MEDICAL SELF-SUPPORTED MUNICIPAL IMPROVEMENT DISTRICT - THE MEDICAL QUARTER REGIONAL MEDICAL DISTRICT (MEDQUARTER) TO ENHANCE OUR COMMUNITY'S NATIONALLY RECOGNIZED REPUTATION FOR HIGH-QUALITY, LOW-COST CARE WITH A CONCENTRATED AREA OF MEDICAL SERVICES THAT ARE EASILY ACCESSIBLE. MERCY MEDICAL CENTER HAS COMMITTED A FULL-TIME EQUIVALENT TO THE ROLE OF DIRECTOR OF COMMUNITY BENEFIT AND GIFT SHOP SERVICES. THE POSITION REPORTS TO THE VICE PRESIDENT OF MISSION INTEGRATION & PASTORAL CARE, WHO REPORTS TO THE PRESIDENT & CHIEF EXECUTIVE OFFICER (CEO). PART VI, LINE 7, REPORTS FILED WITH STATES IA 1 MERCYCARE SERVICE CORPORATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 421199429 501(C)(3) 6750000 0 FOR USE IN CONTINUING OPERATIONS MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 510233180 501(C)(3) 1218025 0 FOR USE IN CONTINUING OPERATIONS WILLIS DADY EMERGENCY SHELTER INC 1247 4TH AVE SE CEDAR RAPIDS IA 52403 421311668 501(C)(3) 45000 0 GENERAL SUPPORT JUNIOR ACHIEVEMENT 324 3RD STREET SE STE 200 CEDAR RAPIDS IA 52401 420919209 501(C)(3) 25700 0 GENERAL SUPPORT MATTHEW 25 201 THIRD AVE SW CEDAR RAPIDS IA 52404 260467321 501(C)(3) 25000 0 GENERAL SUPPORT ESPECIALLY FOR YOU RACE AGAINST BREAST CANCER 701 10TH ST SE CEDAR RAPIDS IA 52403 420698295 501(C)(3) 20000 0 GENERAL SUPPORT TANAGER PLACE 2309 C ST SW CEDAR RAPIDS IA 52404 420688079 501(C)(3) 20000 0 GENERAL SUPPORT CATHERINE MCAULEY CENTER 1220 5TH AVENUE SE CEDAR RAPIDS IA 52403 421342872 501(C)(3) 15000 0 GENERAL SUPPORT LINN COUNTY PUBLIC HEALTH 501 13TH STREET NW CEDAR RAPIDS IA 52405 426004338 LINN COUNTY 15000 0 GENERAL SUPPORT HIS HANDS FREE MEDICAL CLINIC 1245 2ND AVE SE CEDAR RAPIDS IA 52403 391878606 501(C)(3) 15000 0 GENERAL SUPPORT FOUR OAKS 5400 KIRKWOOD BOULEVARD SW CEDAR RAPIDS IA 52404 420998726 501(C)(3) 12500 0 GENERAL SUPPORT OLIVET NEIGHBORHOOD MISSION 230 10TH STREET NW CEDAR RAPIDS IA 52405 420757412 501(C)(3) 12500 0 GENERAL SUPPORT KIDS FIRST LAW CENTER 420 6TH STREET SE STE 160 CEDAR RAPIDS IA 52401 202199649 501(C)(3) 12500 0 GENERAL SUPPORT HAWKEYE AREA COMMUNITY ACTION PROGRAM INC 1515 HAWKEYE DR HIAWATHA IA 52233 420898405 501(C)(3) 10000 0 GENERAL SUPPORT HORIZONS A FAMILY SERVICE ALLIANCE 819 5TH STREET SE PO BOX 667 CEDAR RAPIDS IA 52046 421135083 501(C)(3) 10000 0 GENERAL SUPPORT ORCHESTRA IOWA 119 THIRD AVENUE SE CEDAR RAPIDS IA 52401 420772544 501(C)(3) 10000 0 GENERAL SUPPORT UNITED WAY OF EAST CENTRAL IOWA 317 7TH AVENUE SE SUITE 401 CEDAR RAPIDS IA 52401 420861239 501(C)(3) 7500 0 GENERAL SUPPORT ZACH JOHNSON FOUNDATION PO BOX 2336 CEDAR RAPIDS IA 52406 242683100 501(C)(3) 6500 0 GENERAL SUPPORT COMMUNITY HEALTH FREE CLINIC 947 14TH AVE SE CEDAR RAPIDS IA 52401 134228071 501(C)(3) 6000 0 GENERAL SUPPORT 19 0 PART I, LINE 2: ALL CHECKS ARE ISSUED DIRECTLY TO THE ORGANIZATION TO BE USED AT THEIR DISCRETION. 1 X X X X 0 1 0 0 0 0 0 0 0 CHONG C LEE MD PHYSICIAN 1446515 0 40500 0 16499 0 7250 0 30318 0 1541082 0 0 0 SHANE A GAILUSHAS MD PHYSICIAN 678865 0 738277 0 810 0 7250 0 29318 0 1454520 0 0 0 TIMOTHY L CHARLES PRESIDENT & CHIEF EXECUTIVE OFFICER 754177 0 513621 0 21683 0 60412 0 18261 0 1368154 0 0 0 RYAN D HOLLENBECK MD PHYSICIAN 647376 0 490297 0 540 0 5109 0 34318 0 1177640 0 0 0 BHAVYA AKHAURI MD PHYSICIAN 813761 0 284712 0 28230 0 1599 0 25594 0 1153896 0 0 0 SHINY MATTHEWKUTTY MD PHYSICIAN 672495 0 360518 0 486 0 7250 0 15622 0 1056371 0 0 0 TIMOTHY QUINN MD CHIEF OF CLINICAL OPERATIONS 516545 0 304344 0 10492 0 44085 0 29188 0 904654 0 0 0 NATHAN VAN GENDEREN EXECUTIVE VICE PRESIDENT/CHIEF FINAN 397379 0 234992 0 8191 0 35639 0 29289 0 705490 0 0 0 MARY BROBST CHIEF NURSING OFFICER 290150 0 146373 0 12293 0 25322 0 24691 0 498829 0 0 0 JEFFREY CASH CHIEF INFORMATION OFFICER 280751 0 145430 0 12078 0 26314 0 25943 0 490516 0 0 0 NANCY HILL-DAVIS CHIEF TALENT OFFICER 279212 0 148557 0 8805 0 25255 0 9222 0 471051 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN 2021: MARY BROBST - $20,807, JEFFREY CASH - $19,780, TIMOTHY L CHARLES - $53,162, NANCY HILL-DAVIS - $19,329, TIMOTHY QUINN M.D. - $36,835, AND NATHAN VAN GENDEREN - $28,389. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY THE ORGANIZATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2021. A CITY OF CEDAR RAPIDS IOWA 426004336 150543AA4 2003-04-10 30000000 REIMBURSE HOSPITAL FOR COSTS OF ACQUIRING AND CONSTRUCTING FACILITIES 0 0 0 B CITY OF CEDAR RAPIDS IOWA 426004336 150543AB2 2005-11-17 58405000 ADVANCE REFUND OF 1999 BONDS 0 0 0 C IOWA FINANCE AUTHORITY 521699886 4624466EQ 2012-12-13 45604359 REIMBURSE HOSPITAL FOR CAPITAL 0 0 0 A 7800000 30000000 1288620 28711380 2003 0 0 1 1 B 31485000 58405000 1552500 56852500 2005 0 1 1 1 C 13155000 45604359 604359 45000000 2013 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 UBS AG 29.000000000000 0 0 0 0 1 B 0 0 0 1 1 1 UBS AG 24.000000000000 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF CEDAR RAPIDS, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 10/01/2008 ISSUER NAME: CITY OF CEDAR RAPIDS, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2009 MERCY CARE MANAGEMENT INC SEE BELOW IN PART V 1644598 MERCY CARE MANAGEMENT, INC. PAID MERCY MEDICAL CENTER RENT. 0 FORM 990, SCHEDULE L, PART IV, COLUMN B TIMOTHY L. CHARLES IS AN OFFICER AND BARRIE ERNST, RUE PATEL, FRED PILCHER, M.D. AND KYLE SKOGMAN ARE MEMBERS OF THE BOARD OF TRUSTEES OF MERCY MEDICAL CENTER AND ARE REPORTED ON THE FORM 990, PART VII. DURING THE TAX YEAR, ALL THE AFOREMENTIONED INDIVIDUALS WERE OFFICERS OR MEMBERS OF THE BOARD OF DIRECTORS OF MERCY CARE MANAGEMENT, INC. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCY MEDICAL CENTER IS MERCYCARE SERVICE CORPORATION, AN IOWA NONPROFIT CORPORATION. THE SOLE MEMBER HAS THE EXCLUSIVE POWER TO APPOINT, AFTER CONSIDERATION OF ANY RECOMMENDATIONS FROM THE CORPORATION'S BOARD OF TRUSTEES, ANY TRUSTEE TO THE CORPORATION'S BOARD AND TO REMOVE ANY TRUSTEE FROM THE CORPORATION'S BOARD AT ANY TIME FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF MERCY MEDICAL CENTER, MERCYCARE SERVICE CORPORATION HAS THE EXCLUSIVE POWER TO APPOINT, AFTER CONSIDERATION OF ANY RECOMMENDATIONS FROM THE CORPORATION'S BOARD OF TRUSTEES, ANY TRUSTEE TO THE CORPORATION'S BOARD AND TO REMOVE ANY TRUSTEE FROM THE CORPORATION'S BOARD AT ANY TIME FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER OF MERCY MEDICAL CENTER, MERCYCARE SERVICE CORPORATION HAS THE POWER TO APPROVE THE FOLLOWING ACTIONS: 1. AMEND, REPEAL, OR RESTATE THE ARTICLES OF INCORPORATION; 2. ANY MATTER DIRECTLY RELATED TO THE RELIGIOUS PRINCIPLES AND MORAL PHILOSOPHY OF THE SISTERS OF MERCY; 3. ADOPT OR CHANGE THE PHILOSOPHY AND MISSION OF THE CORPORATION; 4. SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, AND MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER ENTITY; 5. DISSOLUTION OF THE CORPORATION; 6. ADOPTION OR AMENDMENT TO LONG-TERM STRATEGIC PLANS; 7. ADOPTION OR AMENDMENT TO ANNUAL CAPITAL OR OPERATING BUDGETS; AND 8. APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED WITH THE EXECUTIVE COMMITTEE (SUBCOMMITTEE OF THE BOARD OF TRUSTEES) PRIOR TO FILING THE FORM. THE COMMITTEE IS PROVIDED WITH GENERAL BACKGROUND INFORMATION REGARDING THE FORM 990, AND THE FORM ITSELF (INCLUDING ATTACHMENTS) IS REVIEWED. UPON REQUEST, THE TAX RETURN WILL BE AVAILABLE FOR REVIEW BY THE BOARD OF TRUSTEES. MEMBERS OF THE EXECUTIVE COMMITTEE AND MANAGEMENT ARE AVAILABLE TO ANSWER QUESTIONS FROM THE TRUSTEES ON THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES, AS WELL AS EACH EMPLOYEE TO DISCLOSE ANY INTEREST IN, OBLIGATION OR DUTY TO, OR ACTIVITY FOR ANY CONCERN IN WHICH A DIRECTOR, OFFICER, KEY EMPLOYEE, OR EMPLOYEE OR THEIR FAMILY MEMBER MAY BE INVOLVED THAT: MIGHT CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST OR MIGHT HAVE THE APPEARANCE OF ADVERSELY AFFECTING THE DIRECTOR'S, OFFICER'S, KEY EMPLOYEE'S, OR EMPLOYEE'S JUDGMENT OR ACTIONS IN PERFORMING HIS/HER DUTIES TOWARDS MERCY. ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EMPLOYEES SHALL FILE AN INITIAL CONFLICT OF INTEREST REPORT UPON HIRE AND SHALL BE REQUIRED TO FILE AN UPDATED REPORT IMMEDIATELY IF ANY CHANGES OCCUR WHICH RESULT IN A CONFLICT OF INTEREST OR FINANCIAL INTEREST. ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EMPLOYEES (SUPERVISOR AND ABOVE), PHYSICIANS, AND ANY EMPLOYEE IN A POSITION TO INFLUENCE A PURCHASE DECISION SHALL RE-SUBMIT A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WITH ANY NECESSARY CHANGES, EACH YEAR AND IMMEDIATELY IF ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISE. ALL BOARD MEMBERS SHALL SUBMIT IN WRITING A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. THE STATEMENT SHALL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR AND AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISE. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS WITH A MERCY MEDICAL CENTER BOARD MEMBER: -UPON DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, THE BOARD MEMBER, THE CORPORATE OFFICER, OR THE CEO MAKING SUCH DISCLOSURE MAY BE ASKED TO LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. -THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. -IN THE CASE OF DISCLOSURE BY A MEDICAL STAFF MEMBER, PHYSICIAN, EXECUTIVE STAFF MEMBER, DEPARTMENT DIRECTOR, SUPERVISOR, OR OTHER INDIVIDUAL, THE PRESIDENT/CEO OF ENTITY SHALL DETERMINE, BASED ON THE FACTS AND CIRCUMSTANCES DISCLOSED, IF A CONFLICT OF INTEREST EXISTS. -THE PRESIDENT/CEO OF ENTITY SHALL REPORT THE RESULTS OF ALL DETERMINATIONS, WITH REGARD TO CONFLICT OF INTEREST, TO THE CHAIR OF THE BOARD. PENALTIES FOR NON-COMPLIANCE: FAILURE TO COMPLY WITH THIS POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL FROM OFFICE AND, IN THE CASE OF MERCY MEDICAL CENTER KEY PERSONNEL, EMPLOYEES, OR OTHER AFFECTED PARTIES, TERMINATION OF EMPLOYMENT. RETENTION PERIOD: ALL CERTIFICATES AND DISCLOSURE SUMMARY DOCUMENTS OF CURRENT OR FORMER EMPLOYEES (AND RELATED CORRESPONDENCE) WILL BE RETAINED IN ACCORDANCE WITH MERCY'S RECORD RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT IS SET BY THE MERCYCARE SERVICE CORPORATION'S HUMAN RESOURCES COMMITTEE. THE COMMITTEE USES MERCER (US) INC. FOR THE REVIEW OF SALARIES AND COMPARES THEM TO COMPARABLE ENTITIES IN THE REGION. THIS PROCESS WAS LAST COMPLETED AND DOCUMENTED ON FEBRUARY 23, 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME(LOSS) -2,342,947. CHANGE IN ADDITIONAL MINIMUM LIABILITY FOR RETIREMENT BENEFITS 12,017,000. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 4,268,123. CHANGE IN INTEREST IN NET ASSETS OF AUXILIARY -21,695. FORM 990, PART XI, LINE 2C THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. MERCYCARE ACCOUNTABLE CARE ORGANIZATION LLC 701 10TH STREET SE CEDAR RAPIDS IA 52403 833158753 ACCOUNTABLE CARE ORGANIZATION IA 2468988 1155349 MERCY MEDICAL CENTER MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION INC 701 10TH STREET SE CEDAR RAPIDS IA 52403 510233180 FUNDRAISING FOR MERCY MEDICAL CENTER IA 501(C)(3) LINE 12B, TYPE II MERCY MEDICAL CENTER 1 MERCYCARE SERVICE CORPORATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 421199429 HEALTHCARE OVERSIGHT IA 501(C)(3) LINE 12B, TYPE II N/A 0 MERCY-PHS SENIOR HOUSING INC 701 10TH STREET SE CEDAR RAPIDS IA 52403 843118573 APPROPRIATE AND DEVELOP SENIOR HOUSING PROJECT IA 501(C)(3) LINE 10 MERCY MEDICAL CENTER 1 MR ASSOCIATES LLP 1956 1ST AVE NE CEDAR RAPIDS IA 52402 421260463 MEDICAL IMAGING IA MERCY MEDICAL CENTER RELATED 1653696 589960 0 1 0.33330 CEDAR RAPIDS PHYSICIANS-HOSP ORG LC 1715 1ST AVE SE STE 200 CEDAR RAPIDS IA 52402 421445014 PHYSICIAN CREDENTIALING IA N/A RELATED 265026 2795406 0 116773 0 0.52000 EASTERN IOWA SLEEP CENTER 275 10TH ST SE STE 3330 CEDAR RAPIDS IA 52403 260310416 SLEEP STUDIES IA N/A RELATED 50902 363386 0 1 0.33330 USRC EASTERN IOWA LLC 5851 LEGACY CIRCLE STE 900 PLANO TX 75024 844628073 DIALYSIS TX N/A RELATED 560390 691998 0 560390 1 0.49000 MERCY SURGERY CENTER LLC 701 10TH STREET SE CEDAR RAPIDS IA 52403 841875159 OUTPATIENT SURGERY CENTER IA MERCY MEDICAL CENTER RELATED -249999 8315798 0 1 0.60000 MERCY CARE MANAGEMENT INC PO BOX 786 CEDAR RAPIDS IA 52406 421198970 MEDICAL CLINICS IA N/A C 0 MERCY PHYSICIANS ASSOCIATES (SUB OF MERCY CARE MANAGEMENTINC) PO BOX 786 CEDAR RAPIDS IA 52406 421442443 MEDICAL SERVICES IA N/A C 0 MERCY PHYSICIAN SERVICES (SUB OF MERCY CARE MANAGEMENTINC) PO BOX 786 CEDAR RAPIDS IA 52406 421442442 SUPPORT SERVICES IA N/A C 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 MERCY CARE MANAGEMENT INC A 1644598 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION A 1 FAIR MARKET VALUE MERCYCARE SERVICE CORPORATION B 6750000 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION B 1218025 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION C 6306074 FAIR MARKET VALUE MERCYCARE SERVICE CORPORATION C 317997 FAIR MARKET VALUE MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION Q 737043 FAIR MARKET VALUE