2022-05-16T15:31:55-05:00 2021-06-30 390859910 BAKER TILLY US LLP 500 MIDLAND COURT PO BOX 8130 JANESVILLE WI 535478130 990 2020-07-01 362167847 JAVON BEA HOSPITAL JAVO 8159715000 2400 N ROCKTON AVE ROCKFORD IL 61103 JAVON BEA PRESIDENT/CEO 8159715000 2022-05-16 1 JAVON BEA XXX-XX-XXXX TROY MARINE CPA P00187863 6087525835 2022-05-16 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAVON BEA 2400 N ROCKTON AVE ROCKFORD IL 61103 455716077 0 X WWW.MERCYHEALTHSYSTEM.ORG X 1883 IL TO IMPROVE AND PROTECT THE HEALTH AND WELFARE OF THE COMMUNITY IN ACCORDANCE WITH OUR MISSION, THE MISSION OF JAVON BEA HOSPITAL IS "EXCEPTIONAL HEALTH CARE SERVICES WITH A PASSION FOR MAKING LIVES BETTER". WITH A VISION OF QUALITY - EXCELLENCE IN PATIENT CARE, SERVICE - EXCEPTIONAL PATIENT AND CUSTOMER CARE, PARTNERING - BEST PLACE TO WORK AND COST - COST-EFFECTIVE CARE AND A COMMITMENT TO THE VALUES OF: HEALING IN THE BROADEST SENSE, PATIENTS COME FIRST, TREAT EACH OTHER LIKE FAMILY AND ALWAYS SEEK EXCELLENCE. 8 6 2924 140 518913 0 11802342 21041187 426188016 395600410 928926 4753918 5455326 3940407 444374610 425335922 427408 179545 0 0 179007594 146978814 0 0 0 298803051 297373964 478238053 444532323 -33863443 -19196401 768876966 764323993 635650039 612995444 133226927 151328549 X THE MISSION OF JAVON BEA HOSPITAL IS "EXCEPTIONAL HEALTH CARE SERVICES WITH A PASSION FOR MAKING LIVES BETTER". WITH A VISION OF QUALITY - EXCELLENCE IN PATIENT CARE, SERVICE - EXCEPTIONAL PATIENT AND CUSTOMER CARE, PARTNERING - BEST PLACE TO WORK AND COST - COST-EFFECTIVE CARE AND A COMMITMENT TO THE VALUES OF: HEALING IN THE BROADEST SENSE, PATIENTS COME FIRST, TREAT EACH OTHER LIKE FAMILY AND ALWAYS SEEK EXCELLENCE. 1 1 208380147 299377246 JAVON BEA HOSPITAL (JBH) IS A NOT-FOR-PROFIT CHARITABLE HEALTHCARE INSTITUTION THAT FUNCTIONS IN ACCORDANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. IN THE COURSE OF OPERATIONS, JBH IS COMMITTED TO PROVIDING SUPERIOR CARE EVERY DAY FOR ALL ITS PATIENTS. JBH IS A 285 LICENSED BED, REGIONAL REFERRAL HOSPITAL WHICH INCLUDES A LEVEL 1 TRAUMA CENTER, LEVEL III NEONATAL INTENSIVE CARE UNIT AND LEVEL III REGIONAL PERINATAL CENTER. IN FISCAL YEAR 2021, PATIENT CARE WAS RENDERED TO 8,456 INDIVIDUALS WHO PRESENTED THEMSELVES FOR SERVICE INCLUDING 1,083 DELIVERIES AND 1,728 INPATIENT SURGERIES ALONG WITH SUPPORTING 32,717 EMERGENCY ROOM VISITS. IN ADDITION, A SUBACUTE LONG-TERM CARE INPATIENT DEPARTMENT BEGAN TO CARE FOR PATIENTS IN MAY 2021. THE SUBACUTE CARE UNIT PROVIDES LONG-TERM CARE TO PATIENTS RELEASED FROM BASIC HOSPITAL CARE BUT NOT READY TO GO HOME OR TO MOVE ON TO A REHAB OR NURSING FACILITY. 155586385 94222215 JAVON BEA HOSPITAL (JBH) IS DESIGNATED BY THE IL DEPT OF PUBLIC HEALTH AS THE DISASTER POD HOSPITAL FOR THE NORTHERN IL EMS REGION. AS A LEVEL I TRAUMA CENTER, JBH PROVIDES PATIENT CARE AND DIAGNOSTIC SERVICES 24/7 TO ALL WHO PRESENT THEMSELVES FOR SERVICE. IN FISCAL YEAR 2021, THAT INCLUDED 1,428 VISITS TO THE SLEEP LAB; 86,075 DIAGNOSTIC RADIOLOGY PROCEDURES; 6,797 RADIATION ONCOLOGY TREATMENTS; 37,744 CARDIAC PROCEDURES OR TESTS; 6,449 VISITS TO THE PAIN CLINIC; AND 125,866 RESPIRATORY THERAPY TREATMENTS.JBH HAS AN IN-HOUSE LABORATORY THAT PROVIDES TESTING FOR ALL WHO PRESENT THEMSELVES AT THE HOSPITAL FOR TREATMENT. IN FISCAL YEAR 2021, JBH PERFORMED 925,698 TESTS. 5157526 150267 1379062 JBH HAS PROVIDED HEALTH EDUCATION AND OUTREACH IN A VARIETY OF FORMS WITHIN THE ELEVEN COUNTY AREA THAT INCLUDES SEVERAL SCHOOL PARTNERSHIPS, MENTORING, HEALTH PROGRAMS, TEACHING, JOB SHADOWING AND VOLUNTEERING. JBH HOSTS SUPPORT GROUPS, TRAINING CLASSES AND LECTURES SERIES FOR HEALTH AND SAFETY RELATED TOPICS. EMPLOYEES STAFF COMMUNITY HEALTH FAIRS AND OPEN HEALTH SCREENINGS. IN A PROGRAM JOINTLY SPONSORED WITH RONALD MCDONALD CHARITIES, JBH STAFFS THE CAREMOBILE WHICH PROVIDED 28 HEALTH CHECKUPS, 35 IMMUNIZATIONS AND BASIC HEALTH SERVICES TO 16 UNDERINSURED AND UNINSURED CHILDREN. JBH ALSO PROVIDES LANGUAGE ASSISTANCE TO PATIENTS AND THEIR FAMILIES WHO NEED TO COMMUNICATE WITH MEDICAL PERSONNEL FOR TREATMENT AND MEETING SPACE FOR VARIOUS MEDICAL AND SOCIAL SERVICE SUPPORT GROUPS. FUNDS WERE ALSO USED TO SUPPORT HEALTHCARE CONDITIONS THROUGHOUT THE STATE OF ILLINOIS. 124675 29278 103207 THROUGH JAVON BEA HOSPITAL AUXILIARY, JBH IS ABLE TO PROVIDE EXTRA FUNDS AND SERVICES TO SUPPORT ITS MISSION.THE AUXILIARY HAS 445 VOLUNTEERS WHO LOGGED APPROXIMATELY 33,029 HOURS WHILE ASSISTING WITH GREETING VISITORS, TRANSPORTING PATIENTS, FLORAL OR GIFT DELIVERIES, THRIFT SHOP AND GIFT SHOP ACTIVITIES, AND OTHER SERVICES AS REQUESTED.THE VOLUNTEERS' EFFORTS PROVIDE EXTRA FUNDS AND ENHANCE THE OVERALL HOSPITAL EXPERIENCE FOR PATIENTS, VISITORS, AND STAFF. 124675 29278 103207 369248733 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 183 0 1 2924 1 1 1 1 BD 0 0 0 0 0 0 0 0 0 0 X 8 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 1 IL X TODD ANDERSON 8159716738 2400 N ROCKTON AVE ROCKFORD IL 61103 JAVON R BEA PRESIDENT & CEO (SEE PAGES 74-77) 1.00 66.00 X X 0 5057986 7074160 JOHN DORSEY VP CLINICAL INTERGRATION 40.00 0.00 X 614588 0 51816 TODD ANDERSON VP & CFO (AS OF 05/2020) 1.00 56.00 X 0 542858 18158 MARK L GOELZER MD DIRECTOR/PHYSICIAN 1.00 45.00 X 0 501965 29148 ROBERT WALTERS VP HOME CARE 40.00 0.00 X 295804 0 42785 SHANNON DUNPHY-ALEXANDER SR EXECUTIVE DIRECTOR 1.00 56.00 X 0 313241 15917 WENDI AUBRY REGIONAL PHARMACY MANAGER 40.00 0.00 X 200227 0 88091 PAUL VAN DEN HEUVEL FORMER VICE PRESIDENT (THROUGH 04/2020) 0.00 55.00 X 0 240858 27557 MATTHEW PYCIOR PERFUSIONIST 40.00 0.00 X 220528 0 36495 SUE SCHRIEBER VP BUSINESS INTELLIGENCE 40.00 0.00 X 220895 0 21272 ROWLAND J MCCLELLAN CHAIR & DIRECTOR 1.00 6.00 X X 0 15634 0 WESLEY M JOST DIRECTOR 1.00 6.00 X 0 15557 0 THOMAS D BUDD SECRETARY & TREASURER 1.00 6.00 X X 0 15308 0 DAVE L SYVERSON DIRECTOR 1.00 6.00 X 0 15110 0 KATHERINE A SCHACK DIRECTOR 1.00 6.00 X 0 15000 0 THOMAS R POOL VICE CHAIR & DIRECTOR 1.00 6.00 X X 0 15000 0 1552042 6748517 7405399 127 1 1 0 BAKER TILLY US LLP PO BOX 78975 MILWAUKEE WI 532788975 TAX AND CONSULTING 1384786 RED DOT MANAGEMENT LLC 1401 SOUTH VIRGINIA ST SUITE 225 RENO NV 89502 ACCOUNTS RECEIVABLE MANAGEMENT 1283841 ACCELERATED SOLUTIONS LLC 725 COOL SPRINGS BOULEVARD SUITE 3 FRANKLIN TN 37067 ACCOUNTS RECEIVABLE MANAGEMENT 1281115 MED ONE CAPITAL FUNDING LLC PO BOX 35145 SEATTLE WA 981245145 CLAIMS PROCESSING 1222302 ROCK VALLEY INDUSTRIES LLC 5549 INTERNATIONAL DRIVE ROCKFORD IL 61109 JANITORIAL SERVICE 639470 16 330421 20710766 21041187 MEDICARE/MEDICAID 621110 178981673 178981673 OUTPATIENT & EMERGENCY 621400 107859637 107340957 518680 INPATIENT ROUTINE & ANCILLARY 621110 79017441 79017441 ALL OTHER PROGRAM REVENUE 900099 26730126 26730126 DIAGNOSTIC & MEDICAL LABORATORY 621500 3011533 3011533 395600410 442297 442297 402090 219392 182698 182698 182698 31112501 3359883 27668631 2492132 3443870 867751 4311621 4311621 INTEREST ON IL MEDICAID PAYMENTS 621110 1344936 1344936 CAFETERIA/FOOD SERVICE/CATERING 722210 1222410 233 1222177 CLINICAL FLIGHT CREW AND MARKETIN 621990 1014798 1014798 175565 175565 3757709 425335922 395081730 518913 8694092 179545 179545 119790609 94291085 25499524 5840928 4675092 1165836 12954852 10440710 2514142 8392425 6849374 1543051 978355 978355 171294 171294 150874 150874 1664980 34067 1630913 1968949 413922 1555027 6935173 2575214 4359959 13288716 2291842 10996874 14706658 10549774 4156884 144858 79843 65015 282409 135228 147181 19506441 15605153 3901288 36078691 24986892 11091799 16655530 14757904 1897626 SUPPLIES/DRUGS 63332601 62992817 339784 HEALTHCARE SERVICES 57980617 57654408 326209 BAD DEBT EXPENSE 36528032 36528032 MEDICAID ASSESSMENT TAX 14790065 14790065 12209721 9417766 2791955 444532323 369248733 75283590 0 15347351 23379433 4498940 24493806 568104 2895787 76475679 26824907 1736431 2733516 11892356 11580220 3168478 2349269 855405999 380917752 503096143 474488247 136134533 172459455 9247880 12844829 6711071 10274524 768876966 764323993 52557459 43784637 11084577 655440 572008003 568555367 635650039 612995444 X 121039715 138466567 12187212 12861982 133226927 151328549 768876966 764323993 X -19196401 32099310 5198713 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 0 0 1 105848 105848 0 PART II-B, LINE 1: A PERCENTAGE OF THE 2021 ILLINOIS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION DUES WERE USED FOR LOBBYING. TWO CONSULTING FIRMS WERE ENGAGED TO REVIEW LEGISLATION AFFECTING HOSPITALS. APPROXIMATELY 50% OF TOTAL PAYMENTS TO THE CONSULTANTS WERE ALLOCABLE TO LOBBYING ACTIVITIES. 11197286 200 1182560 107994 708 12271344 10816953 37162 359599 15545 883 11197286 10051014 3382 1190683 423923 4203 10816953 9434350 2045 861213 232378 14217 10051014 8795769 11630 773001 132571 13479 9434350 0.04400 0.42300 0.53300 0 1 1 65484 8103281 8168765 401570198 66084976 335485222 13925003 8844522 5080481 431126058 305988254 125137804 615975 615975 474488247 ACCRUED PENSION -32620 ACCRUED POST RETIREMENT MEDICAL BENEFITS 4057684 DUE TO THIRD PARTY PAYORS 18590164 DUE TO MERCY HEALTH CORPORATION 513936903 ACCRUED LIABILITY, SELF INSURANCE LESS CURRENT 23809221 OTHER LIABILITIES 8194015 568555367 PART V, LINE 4: FUNDS WERE USED TO PROVIDE A LECTURE SERIES, FOR CONTINUING EDUCATION FOR EMPLOYEES WANTING TO IMPROVE THEIR CREDENTIALS OR TO FOCUS ON A NEW SKILL OR SOME TECHNOLOGY NOT CURRENTLY AVAILABLE IN THE ROCKFORD COMMUNITY. THERE WERE ALSO MISCELLANEOUS PROJECTS DESIGNATED BY THE FOUNDATION BOARD IN ACCORDANCE WITH THE SPECIFIC ENDOWMENT. ALL FUNDS WERE EXPENDED PER THE SPECIFIC DIRECTION OF EACH ENDOWMENT. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 4230266 0 0 0 0 0 0 4230266 0 4230266 0 0 1 0 0 0 PART III ACCOUNTING METHOD: SCHEDULE F, PART I: METHOD USED TO REPORT ENDING BALANCE: EQUITY METHOD 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 1901658 1901658 0.00430 73519583 71035651 2483932 0.00560 75421241 71035651 4385590 0.00990 1270706 146270 1124436 0.00250 9768569 972414 8796155 0.01980 25591916 18954944 6636972 0.01490 166851 166851 0.00040 36798042 20073628 16724414 0.03760 112219283 91109279 21110004 0.04750 1 36231669 64378965 71045849 -6666884 X 1 1 2 1 JAVON BEA HOSPITAL 2400 N ROCKTON AVE ROCKFORD IL 61103 HTTPS://MERCYHEALTHSYSTEM.ORG/ 0002048 X X X X X 2 VANMATRE HEALTH SOUTH 950 S MULFORD RD ROCKFORD IL 61108 WEBSITE: SEE SCH H, PART VI (PAGE 63) 0005215 X REHABILITATION JAVON BEA HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X MERCYHEALTHSYSTEM.ORG/COMMUNITY-NEEDS/ X WCHD.ORG 1 19 1 MERCYHEALTHSYSTEM.ORG/COMMUNITY-NEEDS/ 0 1 X 200.000000000000 600.000000000000 X X X X X 1 1 X X X 1 X MERCYHEALTHSYSTEM.ORG/FINANCIAL-POLICIES X MERCYHEALTHSYSTEM.ORG/FINANCIAL-POLICIES X MERCYHEALTHSYSTEM.ORG/FINANCIAL-POLICIES X X X X X X 1 X X X X X 0 X X X X 1 X 0 0 VANMATRE HEALTH SOUTH 2 0 0 1 X X X X X X X X X 19 1 0 1 1 X MERCYHEALTHSYSTEM.ORG/COMMUNITY-NEEDS/ X WCHD.ORG 1 19 1 MERCYHEALTHSYSTEM.ORG/COMMUNITY-NEEDS/ 0 1 X 200.000000000000 400.000000000000 1 1 X X X 1 X SEE PART VI X SEE PART VI X SEE PART VI X X X X 1 X 0 X 0 X X 0 0 JAVON BEA HOSPITAL PART V, SECTION B, LINE 5: JAVON BEA HOSPITAL COMPLETED AN INDEPENDENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ROCKFORD REGIONAL HEALTH COUNCIL 2020 HEALTHY COMMUNITY STUDY WAS A KEY SOURCE OF DATA USED TO INFORM THE ASSESSMENT AND IMPLEMENTATION PLAN. THE ROCKFORD REGIONAL COUNCIL IS A NON-PARTISAN ORGANIZATION THAT FOCUSES ON IMPROVING THE QUALITY OF OUR REGION'S HEALTH. THE COUNCIL RECEIVED THE MAJORITY OF THE INFORMATION FOR THE 2020 COMMUNITY ANALYSIS FROM THE CENTER FOR APPLIED RESEARCH & ENGAGEMENT SYSTEMS (CARES). CARES IS A TECHNOLOGY ORGANIZATION HOUSED IN EXTENSION AT THE UNIVERSITY OF MISSOURI WHICH PROVIDES COMPREHENSIVE REPORTS IN A STANDARDIZED FORMAT SO THAT RESEARCHERS NO LONGER HAVE TO DOWNLOAD INDIVIDUAL PIECES OF INFORMATION TO PREPARE THESE REPORTS. THE FOCUS OF THE COUNCIL IS ON IMPROVING THE QUALITY OF OUR REGION'S HEALTH THROUGH DATA GATHERING AND ANALYSIS, EDUCATION, ACTION, AND ADVOCACY. THE DATA AND FINDINGS FROM THIS COMPREHENSIVE STUDY PROVIDE THE FRAMEWORK FOR OUR ASSESSMENT AND IMPLEMENTATION PLAN WITH IDENTIFIED GOALS AND PRIORITIES. THE ROCKFORD REGIONAL HEALTH COUNCIL WORKED WITH A STEERING COMMITTEE CONSISTING OF BOONE COUNTY HEALTH DEPARTMENT, MERCYHEALTH, OSF HEALTHCARE, SWEDISHAMERICAN HEALTH SYSTEM, UNITED WAY OF ROCK RIVER VALLEY, UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE ROCKFORD, DEPARTMENT OF FAMILY & COMMUNITY MEDICINE, AND THE DIVISION OF HEALTH POLICY AND SOCIAL SCIENCE RESEARCH TO PREPARE THE COMMUNITY ANALYSIS 2020 HEALTHY COMMUNITY STUDY. THIS IS A WIDE ARRAY OF ORGANIZATIONS WHO SPECIALIZE IN HEALTHCARE AND IN MEETING COMMUNITY NEEDS IN A LARGE PORTION OF THE WINNEBAGO COMMUNITY WHO PARTNERED TOGETHER TO PREPARE THIS REPORT AND TO IDENTIFY AREAS OF THE COMMUNITY WHERE THERE ARE PUBLIC HEALTH CONCERNS. THE 2020 STUDY INCLUDED THE FOLLOWING FOUR COMPONENTS: 1) A COMMUNITY ANALYSIS - FROM THE CENTER FOR APPLIED RESEARCH AND ENGAGEMENT SYSTEMS (CARES) - A COMPILATION OF DATA ON THE REPORT LOCATION (WINNEBAGO AND BOONE COUNTIES) FOR A WIDE VARIETY OF COMMUNITY HEALTH ISSUES AND TRENDS. 2) A QUICK FACTS HEALTH INDICATORS REPORT - A "GAS GAUGE" CHART THAT SHOWS DATA POINTS FOR VARIOUS METRICS FOR THE REPORT LOCATION COMPARED TO THE STATE AND THE U.S. THIS VISUALIZATION PROVIDED A SUPERIOR "DATA AT A GLANCE" FORMAT IN COMPARISON TO THE REST OF THE STATE AND THE NATION. 3) THE 2019 ILLINOIS REPORT FOR COUNTY HEALTH RANKINGS (CHR) AND ROADMAPS INCLUDING KEY COMPONENTS OF DEMOGRAPHICS, PHYSICAL ENVIRONMENT, SOCIAL AND ECONOMIC FACTORS, CLINICAL CARE, HEALTH BEHAVIORS, AND HEALTH OUTCOMES. COMMUNITIES USE THE RANKINGS TO GARNER SUPPORT FOR LOCAL HEALTH IMPROVEMENT INITIATIVES AMONG GOVERNMENT AGENCIES, HEALTH CARE PROVIDERS, COMMUNITY ORGANIZATIONS, BUSINESS LEADERS, POLICYMAKERS, AND THE PUBLIC. 4) AN ALTERNATIVE ANALYSIS FOR THE CHR METHODOLOGY USING COMPARABLE COUNTIES AND MSAS FROM ACROSS THE U.S. THAT WAS SELECTED BY TRANSFORM ROCKFORD (A LOCAL ROCKFORD ORGANIZATION). VANMATRE HEALTH SOUTH PART V, SECTION B, LINE 5: VAN MATRE ENCOMPASS HEALTH REHABILITATION HOSPITAL COMPLETED AN INDEPENDENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE ROCKFORD REGIONAL HEALTH COUNCIL 2020 HEALTHY COMMUNITY STUDY WAS A KEY SOURCE OF DATA USED TO INFORM THE ASSESSMENT AND IMPLEMENTATION PLAN. THE ROCKFORD REGIONAL COUNCIL IS A NON-PARTISAN ORGANIZATION THAT FOCUSES ON IMPROVING THE QUALITY OF OUR REGION'S HEALTH. THE COUNCIL RECEIVED THE MAJORITY OF THE INFORMATION FOR THE 2020 COMMUNITY ANALYSIS FROM THE CENTER FOR APPLIED RESEARCH & ENGAGEMENT SYSTEMS (CARES). CARES IS A TECHNOLOGY ORGANIZATION HOUSED IN EXTENSION AT THE UNIVERSITY OF MISSOURI WHICH PROVIDES COMPREHENSIVE REPORTS IN A STANDARDIZED FORMAT SO THAT RESEARCHERS NO LONGER HAVE TO DOWNLOAD INDIVIDUAL PIECES OF INFORMATION TO PREPARE THESE REPORTS. THE FOCUS OF THE COUNCIL IS ON IMPROVING THE QUALITY OF OUR REGION'S HEALTH THROUGH DATA GATHERING AND ANALYSIS, EDUCATION, ACTION, AND ADVOCACY. THE DATA AND FINDINGS FROM THIS COMPREHENSIVE STUDY PROVIDE THE FRAMEWORK FOR OUR ASSESSMENT AND IMPLEMENTATION PLAN WITH IDENTIFIED GOALS AND PRIORITIES. THE ROCKFORD REGIONAL HEALTH COUNCIL WORKED WITH A STEERING COMMITTEE CONSISTING OF BOONE COUNTY HEALTH DEPARTMENT, MERCYHEALTH, OSF HEALTHCARE, SWEDISHAMERICAN HEALTH SYSTEM, UNITED WAY OF ROCK RIVER VALLEY, UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE ROCKFORD, DEPARTMENT OF FAMILY & COMMUNITY MEDICINE, AND THE DIVISION OF HEALTH POLICY AND SOCIAL SCIENCE RESEARCH TO PREPARE THE COMMUNITY ANALYSIS 2020 HEALTHY COMMUNITY STUDY. THIS IS A WIDE ARRAY OF ORGANIZATIONS THAT SPECIALIZE IN HEALTHCARE AND IN MEETING COMMUNITY NEEDS IN A LARGE PORTION OF THE WINNEBAGO COMMUNITY WHO PARTNERED TOGETHER TO PREPARE THIS REPORT AND TO IDENTIFY AREAS OF THE COMMUNITY WHERE THERE ARE PUBLIC HEALTH CONCERNS. THE 2020 STUDY INCLUDED THE FOLLOWING FOUR COMPONENTS: 1) A COMMUNITY ANALYSIS - FROM THE CENTER FOR APPLIED RESEARCH AND ENGAGEMENT SYSTEMS (CARES) - A COMPILATION OF DATA ON THE REPORT LOCATION (WINNEBAGO AND BOONE COUNTIES) FOR A WIDE VARIETY OF COMMUNITY HEALTH ISSUES AND TRENDS. 2) A QUICK FACTS HEALTH INDICATORS REPORT - A "GAS GAUGE" CHART THAT SHOWS DATA POINTS FOR VARIOUS METRICS FOR THE REPORT LOCATION COMPARED TO THE STATE AND THE U.S. THIS VISUALIZATION PROVIDED A SUPERIOR "DATA AT A GLANCE" FORMAT IN COMPARISON TO THE REST OF THE STATE AND THE NATION. 3) THE 2019 ILLINOIS REPORT FOR COUNTY HEALTH RANKINGS (CHR) AND ROADMAPS INCLUDING KEY COMPONENTS OF DEMOGRAPHICS, PHYSICAL ENVIRONMENT, SOCIAL AND ECONOMIC FACTORS, CLINICAL CARE, HEALTH BEHAVIORS, AND HEALTH OUTCOMES. COMMUNITIES USE THE RANKINGS TO GARNER SUPPORT FOR LOCAL HEALTH IMPROVEMENT INITIATIVES AMONG GOVERNMENT AGENCIES, HEALTH CARE PROVIDERS, COMMUNITY ORGANIZATIONS, BUSINESS LEADERS, POLICYMAKERS, AND THE PUBLIC. 4) AN ALTERNATIVE ANALYSIS FOR THE CHR METHODOLOGY USING COMPARABLE COUNTIES AND MSAS FROM ACROSS THE U.S. THAT WAS SELECTED BY TRANSFORM ROCKFORD (A LOCAL ROCKFORD ORGANIZATION). JAVON BEA HOSPITAL PART V, SECTION B, LINE 6B: ROCKFORD REGIONAL HEALTH COUNCIL VANMATRE HEALTH SOUTH PART V, SECTION B, LINE 6B: ROCKFORD REGIONAL HEALTH COUNCILWINNEBAGO COUNTY HEALTH DEPARTMENT JAVON BEA HOSPITAL PART V, SECTION B, LINE 11: THE HOSPITAL USED THE ROCKFORD REGIONAL HEALTH COUNCIL'S 2020 HEALTHY COMMUNITY STUDY FOR THE LOCAL ASSESSMENT OF NEEDS AND THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WAS COMPLETED IN 2020 BASED ON THIS STUDY. THE PLAN IS TO DEVELOP AND IMPLEMENT A MULTIFACETED COMMUNITY BENEFIT PLAN TO IMPROVE THE HEALTH AND WELL BEING OF RESIDENTS IN THE PRIMARY SERVICE AREA.THE SURVEY IDENTIFIED MULTIPLE NEEDS WITHIN THE COMMUNITY. THE NEEDS IDENTIFIED INCLUDED ALCOHOL, OPIOID & OTHER SUBSTANCE ABUSE ISSUES, CHRONIC DISEASE, MATERNAL/PRENATAL/EARLY CHILDHOOD HEALTH, GERIATRIC HEALTH NEEDS, HEALTH EQUITY, AND A SHORTAGE OF MENTAL HEALTH SERVICES, JOB TRAINING AND EMPLOYMENT FOR PEOPLE WITH DISABILITIES.THE IMPLEMENTATION PLAN FOCUSES ON MANY OF THE AREAS IDENTIFIED TO HELP TO IMPROVE THE GENERAL HEALTH OF INDIVIDUALS LIVING IN THE PRIMARY SERVICE AREA INCLUDING:IMPROVE HEALTH CARE ACCESS BY DEVELOPING AND OFFERING VARIOUS ACCESS SITES AND VENUES FOR PRIMARY CARE MEDICAL SERVICES. ESTABLISH PHYSICIAN RESIDENCY PROGRAMS IN ROCKFORD. SUPPORT BRIDGE CLINIC SERVICES AND THE RONALD MCDONALD CARE MOBILE FOR NON- AND UNDER-INSURED PATIENTS AND CHILDREN.SAFE CARE COMMITMENT - IN RESPONSE TO COVID-19 AND TO EFFECTIVELY CARE FOR THE NEEDS OF THE COMMUNITY, JAVON BEA HOSPITAL PROVIDED ALTERNATIVE EDUCATION TO EMERGENCY MEDICAL SERVICE (EMS) PERSONNEL FOR ENHANCED SAFETY AND TREATMENT PROTOCOLS. JAVON BEA HOSPITAL EXPANDED TELEMEDICINE SERVICES TO INCREASE VIRTUAL ACCESS FOR OUR PATIENTS AND ALLOW EMS CREWS TO BE AVAILABLE FOR THOSE WITH CRITICAL ILLNESSES. JAVON BEA HOSPITAL PROVIDED COMMUNITY EDUCATION VIDEOS ADDRESSING COVID-19 QUESTIONS AND CONCERNS ALONG WITH HOW TO SAFELY WEAR A MASK.JAVON BEA HOSPITAL PARTNERS WITH MULTIPLE COMMUNITY-BASED ORGANIZATIONS IN WINNEBAGO COUNTY TO ACCOMPLISH SUCCESSFUL IMPLEMENTATION OF THESE STRATEGIES. DURING THE COURSE OF THIS TAX YEAR 2020 (FISCAL YEAR JULY 1, 2020-JUNE 30, 2021), AND THE PRIOR TAX YEARS, JAVON BEA HOSPITAL PARTICIPATED IN NUMEROUS COMMUNITY HEALTH FAIRS, PROVIDED FREE SCREENINGS AT OUR CLINICS AND IN CONJUNCTION WITH COMMUNITY-BASED ORGANIZATIONS, OFFERED SCREENINGS TO FREE AND SLIDING FEE SCHEDULE PRIMARY CARE CLINICS, AND SCHOOL DISTRICTS IN THE COUNTY. JAVON BEA HOSPITAL ALSO PROVIDES FINANCIAL INCENTIVES FOR THEIR EMPLOYEES TO PARTICIPATE IN SMOKING CESSATION PROGRAMS. ALL OF THESE EFFORTS ARE SUPPORTED THROUGH BROAD BASED MARKETING AND ADVERTISING PROGRAMS DIRECTED TO AUDIENCES IN BOTH COUNTIES PROMOTING THESE PROGRAMS.THE IMPLEMENTATION PLAN DOES NOT ADDRESS ISSUES AROUND VIOLENCE IN THE COMMUNITY, AS THIS NEED IS BETTER ADDRESSED BY ORGANIZATIONS MORE VERSED IN THE MULTIDIMENSIONAL FACTORS AFFECTING COMMUNITY VIOLENCE & CRIME. VANMATRE HEALTH SOUTH PART V, SECTION B, LINE 11: THE HOSPITAL USED THE ROCKFORD REGIONAL HEALTH COUNCIL'S 2020 HEALTHY COMMUNITY STUDY FOR THE LOCAL ASSESSMENT OF NEEDS AND THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WAS COMPLETED IN 2020 BASED ON THIS STUDY. THE PLAN IS TO DEVELOP AND IMPLEMENT A MULTIFACETED COMMUNITY BENEFIT PLAN TO IMPROVE THE HEALTH AND WELL BEING OF RESIDENTS IN THE PRIMARY SERVICE AREA.THE SURVEY IDENTIFIED MULTIPLE NEEDS WITHIN THE COMMUNITY. THE NEEDS IDENTIFIED INCLUDED ALCOHOL, OPIOID & OTHER SUBSTANCE ABUSE ISSUES, CHRONIC DISEASE, MATERNAL/PRENATAL/EARLY CHILDHOOD HEALTH, GERIATRIC HEALTH NEEDS, HEALTH EQUITY, AND A SHORTAGE OF MENTAL HEALTH SERVICES, JOB TRAINING AND EMPLOYMENT FOR PEOPLE WITH DISABILITIES.THE IMPLEMENTATION PLAN FOCUSES ON MANY OF THE AREAS IDENTIFIED TO HELP TO IMPROVE THE GENERAL HEALTH OF INDIVIDUALS LIVING IN THE PRIMARY SERVICE AREA INCLUDING:IMPROVE HEALTH CARE ACCESS BY DEVELOPING AND OFFERING VARIOUS ACCESS SITES AND VENUES FOR PRIMARY CARE MEDICAL SERVICES. ESTABLISH FAMILY PRACTICE AND INTERNAL MEDICINE PHYSICIAN RESIDENCY PROGRAMS IN ROCKFORD. SUPPORT BRIDGE CLINIC SERVICES AND THE RONALD MCDONALD CARE MOBILE FOR NON- AND UNDER-INSURED PATIENTS AND CHILDREN AND OFFER A WIDE VARIETY OF COMMUNITY EDUCATION HEALTH AND SCREENING PROGRAMS.SAFE CARE COMMITMENT - IN RESPONSE TO COVID-19 TO EFFECTIVELY CARE FOR THE NEEDS OF OUR COMMUNITY AND TO ENSURE UP-TO-DATE EDUCATION AND PREPAREDNESS DURING A PANDEMIC. COORDINATE WITH LOCAL, REGIONAL AND STATE ORGANIZATIONS REGARDING EMS SURGE PLANNING, RESPONSE AND INFORMATION SHARING. PROVIDE ALTERNATIVE EDUCATION FOR EMERGENCY MEDICAL SERVICES. INCLUDING ENHANCED SAFETY AND TREATMENT PROTOCOLS BY OUR EMS SYSTEM AND THE REACT AIR MEDICAL CRITICAL CARE TRANSPORT PROGRAM. EXPANDED TELEMEDICINE SERVICES TO INCREASE VIRTUAL ACCESS FOR OUR PATIENTS AND ALLOW EMS CREWS TO BE AVAILABLE FOR THOSE WITH CRITICAL ILLNESSES DURING PANDEMIC. EXPANDED COVID 19 RESPONSE, SCREENING, AND EFFECTIVE TRANSPORT OF PATIENTS SUSPECTED OR CONFIRMED FOR COVID-19. REASSURE PATIENTS OF EXTRA SAFETY PRECAUTIONS TAKEN TO ENSURE THE HEALTH AND SAFETY OF OUR PATIENTS INCLUDING ENHANCED CLEANING, MASKING, SCREENING AND SOCIAL DISTANCING AT ALL FACILITIES.THE IMPLEMENTATION PLAN DOES NOT ADDRESS ISSUES AROUND VIOLENCE IN THE COMMUNITY, AS THIS NEED IS BETTER ADDRESSED BY ORGANIZATIONS MORE VERSED IN THE MULTIDIMENSIONAL FACTORS AFFECTING COMMUNITY VIOLENCE & CRIME. VANMATRE HEALTH SOUTH PART V, SECTION B, LINE 16J: HTTPS://ENCOMPASSHEALTH.COM/LOCATIONS/VANMATREREHAB/FINANCIAL-ASSISTANCE JAVON BEA HOSPITAL PART V, SECTION B, LINE 18E: DEFERRING, DENYING OR REQUIRING A PAYMENT BEFORE PROVIDING MEDICALLY NECESSARY CARE DUE TO NONPAYMENT OF A PREVIOUS BILL FOR CARE COVERED UNDER THE HOSPITAL FACILITY'S FAP. PART V, SECTION B, LINE 22D: JAVON BEA HOSPITALTHE HOSPITAL FACILITY USED A LOOK-BACK METHOD BASED ON CLAIMS ALLOWED BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE HOSPITAL FACILITY DURING A PRIOR 12-MONTH PERIOD. PART V, SECTION B, LINE 22D: VANMATRE HEALTH SOUTHTHE HOSPITAL FACILITY USED A PROSPECTIVE MEDICARE OR MEDICAID METHOD. PART I, LINE 7: THE HOSPITAL UTILIZED BOTH THE MEDICARE COST REPORT CCR (COST-TO-CHARGE RATIO) AND OUR COST ACCOUNTING SYSTEM TO DETERMINE THE COST OF CHARGES, BAD DEBT AND CHARITY CARE EXPENSE INCLUDED IN LINE 7. THE SUBSIDIZED PROGRAMS ALSO INCLUDE THE COSTS (BASED ON A CALCULATED CCR) FROM THE RELATED COMPANY ROCKFORD HEALTH PHYSICIANS (RHPH) BECAUSE THERE ARE NO PHYSICIANS COSTS INCLUDED IN THE HOSPITAL COST ACCOUNTING ANALYSIS. BAD DEBT AND CHARITY AT COST HAVE BEEN REMOVED FROM LINES 7A/7F/7G SINCE THOSE COSTS WERE PREVIOUSLY INCLUDED. PART III, LINE 2: ALL CHARGES FOR ANY SERVICE PROVIDED BY JAVON BEA HOSPITAL ARE THE VERY SAME FOR EVERY INDIVIDUAL, REGARDLESS OF WHETHER IT IS FOR EMERGENCY OR STANDARD CARE AND REGARDLESS OF THE PATIENT'S ABILITY TO PAY. EACH PATIENT IS THEN ASSESSED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BASED ON PREDEFINED CRITERIA OF FINANCIAL STATUS AND INCOME LEVEL. IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE EXPECTED REIMBURSEMENT IS BASED ON CHARITY CARE POLICY GUIDELINES. IF THE PATIENT HAS NO INSURANCE AND DOESN'T QUALIFY FOR FINANCIAL ASSISTANCE, THE EXPECTED REIMBURSEMENT IS 75% OF BILLED CHARGES. THE ORGANIZATION MAINTAINS A BAD DEBT RESERVE ON THE BALANCE SHEET. ANY BAD DEBT WRITE-OFFS OF PATIENT ACCOUNTS WILL GO AGAINST THE BAD DEBT RESERVE. AT EACH MONTH END BASED ON THE ACCOUNTS RECEIVABLE BY FINANCIAL CLASS AND AGING BUCKET, THE RESERVE AMOUNT IS RE- EVALUATED. THE AMOUNT NEEDED TO MAINTAIN THE APPROPRIATE RESERVE LEVEL IS THE BAD DEBT EXPENSE. ANY PAYMENTS RECEIVED ON PATIENT ACCOUNTS PREVIOUSLY WRITTEN OFF TO BAD DEBT WILL OFFSET THE BAD DEBT EXPENSE. PART III, LINE 4: BAD DEBT EXPENSE IS ACCOUNTED FOR IN THE FOLLOWING MANNER (AS DETAILED IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH CORPORATION, INC.) MERCY HEALTH CORPORATION, INC. IS THE PARENT COMPANY OF JAVON BEA HOSPITAL.PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE CORPORATION ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE CORPORATION ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENT, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE.CONSISTENT WITH THE CORPORATION'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE CORPORATION HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE CORPORATION EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. THE CORPORATION'S POLICY IS TO PROVIDE A DISCOUNT FROM ESTABLISHED CHARGES TO UNINSURED PATIENTS. THIS POLICY DID NOT CHANGE IN 2021 AND 2020. PART III, LINE 8: REPORTED ON LINE 6 ARE ALLOWABLE MEDICARE COSTS PROVIDED BY THE COST REPORT. MEDICARE COSTS ARE ELIMINATED FROM THE SUBSIDIZED PROGRAMS ON PART 1, LN 7G AS CALCULATED BY OUR COST ACCOUNTING ANALYSIS. A COMBINATION OF COST ACCOUNTING AND THE MEDICARE CCR WAS USED FOR THE COMPUTATION OF SUBSIDIZED PROGRAMS. PART III, LINE 9B: JAVON BEA HOSPITAL HAS A STRONG COMMITMENT TO PROVIDE QUALITY PATIENT CARE FOR ALL INDIVIDUALS. OUR MISSION IS TO PROVIDE HEALTH CARE TO EVERYONE WHO COMES TO OUR DOOR, REGARDLESS OF THEIR ABILITY TO PAY. WE WILL SUBMIT A CLAIM TO ALL 3RD PARTY PAYORS ON BEHALF OF THE PATIENT. WE HELP PATIENTS APPLY FOR ALL POSSIBLE INSURANCE OR ASSISTANCE SUCH AS CRIME VICTIMS, AN AUTOMOBILE ACCIDENT, WORKERS COMPENSATION, MEDICAID, COBRA, LOCAL ASSISTANCE AND/OR HOSPITAL FINANCIAL ASSISTANCE. IF THEY DO NOT QUALIFY FOR ANY OF THESE, WE CAN EXTEND PAYMENT OPTIONS SUCH AS MONTHLY PAYMENTS, CREDIT CARD PAYMENTS OR FINANCIAL ASSISTANCE. THIS IS OFFERED TO PATIENTS WHO ARE EXPERIENCING LEGITIMATE FINANCIAL HARDSHIPS AND ARE UNABLE TO PAY FOR ALL OR PART OF THE PATIENT'S MEDICAL CARE. FORGIVENESS MAY APPLY TO AN AMOUNT AFTER APPLYING ALL PAYMENTS SUCH AS AN INSURNACE COMPANY, HEALTH PLAN OR PERSONAL PAYMENTS, ANY NEGOTIATED DISCOUNTS OR ANY UNINSURED DISCOUNTS. IF A PATIENT ELIGIBLE FOR CHARITY CARE OR PARTIAL FINANCIAL ASSISTANCE STILL HAS A PORTION OF THE OUTSTANDING BALANCE DUE, OTHER ARRANGEMENTS ARE MADE. MONTHLY STATEMENTS ARE SENT AS PAYMENT REMINDERS FOR CONTRACTED ARRANGEMENTS. IN CASE OF DEFAULT, ADDITIONAL LETTERS AND CALLS ARE MADE TO BRING IT TO A CURRENT STATUS. AN ACCOUNT IS TURNED OVER TO A COLLECTION AGENCY ONLY AFTER NON-PAYMENT OR NO CONTACT IN 120 DAYS ALTHOUGH JBH WILL SUSPEND COLLECTION EFFORTS ONCE A COMPLETED APPLICATION HAS BEEN RECIEVED AND IS PENDING APPROVAL OR DENIAL. PART V, SECTION A, LINE 3 FOOTNOTE VANMATRE: VANMATRE HEALTH SOUTHDUE TO MAJOR COMPLICATIONS WITH COVID-19 ISSUES, THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DID NOT GET POSTED ON TIME AND ONLINE. BUT IT IS POSTED NOW. PART V, SECTION A VANMATRE WEBSITE: VANMATRE HEALTH SOUTHHTTPS://MERCYHEALTHSYSTEM.ORG/LOCATION/VAN-MATRE-ENCOMPASS-HEALTH-REHABILITATION-HOSPITAL/ PART VI, LINE 2: IN ADDITION TO THE HEALTH NEEDS ASSESSMENT - MERCY HEALTH IS WORKING TO: WORK WITH OTHER COMMUNITY SERVICES AND THROUGH MEDICARE ACO TO PROACTIVELY MANAGE AND IMPROVE THE CHRONIC DISEASE STATE OF OUR PATIENTS, AND TO CONTINUE MEDICARE ACO WELLNESS VISITS TO PROACTIVELY MANAGE THE HEALTH OF MEDICARE PATIENTS, MAINTAIN CLINICAL TEAMS TO WORK WITH SELECTED NURSING HOME PATIENTS TO ENSURE APPROPRIATE TRANSITIONAL CARE AND MANAGE AND PROVIDE INTERVENTIONS AS NECESSARY FOR VARIOUS ACUTE AND CHRONIC DISEASES. IN ADDITION, SUB ACUTE CARE WAS ADDED TO ALLOW PATIENTS TO TRANSITION AFTER A MAJOR ILLNESS OR INJURY AND MAINTAIN A HEALTHY LIFESTYLE.MAINTAIN MULTIDISCIPLINARY PALLIATIVE CARE SERVICES FOR ADULTS TO FORMULATE PLANS OF CARE, IDENTIFY RESOURCES, AND PROVIDE SUPPORT FOR BOTH PATIENTS AND FAMILIES FOR VARIOUS CHRONIC AND ACUTE DISEASES.IMPROVE THE HEALTH OF PATIENTS WITH SPECIFIC NEEDS, INCLUDING GERIATRIC HEALTH NEEDS AND SUBSTANCE ABUSE BY OFFERING A WIDE ARRAY OF COMMUNITY EDUCATIONAL HEALTH & SCREENING PROGRAMS.REDUCE THE LIKELIHOOD OF OPIOID ADDICTION BEGINNING OR CONTINUING BY MONITORING OPIOID PRESCRIPTIONS AMONG PHYSICIANS, OFFERING PROVIDER EDUCATION AND OFFERING ADDICTION COUNSELING.MAINTAIN OUR COMMITMENT TO THE WOMEN AND CHILDREN OF THE COMMUNITY AS A PROVIDER OF COMPREHENSIVE TERTIARY SERVICES AND TO ENSURE EXCELLENT OUTCOMES FOR MOTHERS AND INFANTS BY REMAINING THE STATE OF IL REGIONAL PERINATAL CENTER FOR 11 COUNTIES AND PARTICIPATING IN ILPQC (ILLINOIS PERINATAL QUALITY COLLABORATIVE) INITIATIVES. LIKE PROMOTING VAGINAL BIRTH FOR LOW RISK FIRST PREGNANCY WOMEN, MAINTAINING THE HYPERTENSION BUNDLE TO ASSESS QUICK RESPONSE TO INCREASED BLOOD PRESSURES OF PERIPARTUM MOTHERS AND THE NEONATAL ABSTINENCE SYNDROME (NAS) BUNDLE FOCUSING ON INTERVENTION FOR BABIES OF ADDICTED MOTHERS.PROVIDE JOB TRAINING AND EMPLOYMENT OPPORTUNITIES TO DISABLED YOUNG ADULT COMMUNITY MEMBERS IN COLLABORATION WITH RAMP AND THE ILLINOIS DEPARTMENT OF HUMAN SERVICES BY ESTABLISHING PROJECT SEARCH. PART VI, LINE 3: ALL UNINSURED PATIENTS ARE NOTIFIED OF MERCY'S FINANCIAL ASSISTANCE POLICY UPON REGISTRATION. INFORMATION IS ALSO AVAILABLE AT THE HEALTH SYSTEMS' WEBSITE, IN OUR EMERGENCY ROOMS, FINANCIAL ASSISTANCE OFFICES, AND WITH THE PATIENT FINANCIAL COUNSELORS. APPROPRIATE PERSONNEL HAVE BEEN TRAINED ON HOW TO INTERACT WITH PATIENTS ABOUT FINANCIAL AID AVAILABILITY, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL AID STAFF. THE HOSPITALS AND CLINICS HAVE TRANSLATION SERVICES AVAILABLE AS NEEDED. PART VI, LINE 4: JAVON BEA HOSPITAL IS LOCATED IN ROCKFORD, IL (WINNEBAGO COUNTY). ACCORDING TO THE US CENSUS BUREAU FROM THE 2020 CENSUS THE POPULATION OF WINNEBAGO COUNTY WAS MEASURED AT 285,350. LOCATED IN NORTHERN ILLINOIS, THE COUNTY IS CHARACTERIZED AS LARGELY RURAL AND POPULATED WITH VERY SMALL COMMUNITIES WITH THE EXCEPTION OF THE NEIGHBORING CITIES OF ROCKFORD, LOVES PARK, AND MACHESNEY PARK WHICH COMPRISE MORE THAN 195,000 INDIVIDUALS. THE VAST MAJORITY OF THE POPULATION RESIDE IN URBAN AREAS AND THE MAJORITY OF PATIENTS RESIDE IN WINNEBAGO COUNTY. AS A COMMUNITY THAT RELIES HEAVILY ON MANUFACTURING COMPANIES AND SMALL BUSINESSES, THE AREA WAS PARTICULARLY HARD HIT IN RECENT YEARS. CURRENTLY, THE LARGEST EMPLOYERS INCLUDE THE ROCKFORD PUBLIC SCHOOLS AND THE THREE ROCKFORD HEALTH CARE PROVIDERS. THE MOST RECENT MEDIAN HOUSEHOLD INCOMES IN WINNEBAGO COUNTY WERE $55,310 COMPARED TO THE STATE MEDIAN HOUSEHOLD INCOME OF $68,428 AND THE NATIONAL MEDIAN INCOME OF $64,994. THESE DISPARITIES ARE ALSO REFLECTED IN EDUCATION AND POVERTY RATES. UNEMPLOYMENT RATES HAVE IMPROVED WITH MOST RECENT FIGURES FOR WINNEBAGO COUNTY AT 8.1% BUT ARE STILL HIGH COMPARED TO THE STATE AT 7.1% AND THE NATION AT 6.0%. ONLY 23.0% OF WINNEBAGO COUNTY RESIDENTS ATTAIN A BACHELOR'S DEGREE OR HIGHER COMPARED WITH THOSE IN THE STATE AT 35.5% AND 32.9% IN THE NATION. MORE THAN 15.64% OF THE RESIDENTS IN WINNEBAGO COUNTY LIVE BELOW THE POVERTY LINE COMPARED TO STATE LEVELS OF 11.0% AND NATIONAL LEVELS OF 14.6%. THIS IS IMPORTANT BECAUSE POVERTY CREATES BARRIERS TO ACCESS INCLUDING HEALTH SERVICES, HEALTHY FOOD, AND OTHER NECESSITIES THAT CONTRIBUTE TO POOR HEALTH STATUS AS WELL THE LACK OF INTERNET ACCESS FOR AN ESTIMATED 15.7% OF THE HOUSEHOLDS IN WINNEBAGO COUNTY. PART VI, LINE 5: LED BY A GOVERNING BODY COMPRISED OF A MAJORITY OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY, JAVON BEA HOSPITAL (JBH) AND ITS AFFILIATES ARE VERY INVOLVED IN PROMOTING A HEALTHIER COMMUNITY. AS ONE OF ROCKFORD'S LARGEST EMPLOYERS, THE ORGANIZATION TAKES A LEADING ROLE IN FINANCIALLY SUPPORTING NOT ONLY HEALTH-RELATED INITIATIVES, BUT ALSO COMMUNITY-BUILDING ACTIVITIES ACROSS THE REGION. THIS INCLUDES PROVIDING FINANCIAL SUPPORT AND TALENT FOR ECONOMIC DEVELOPMENT AND BUSINESS-RELATED ACTIVITIES. AS WELL AS QUALITY OF LIFE AND EDUCATIONAL INITIATIVES. EMPLOYEES PARTICIPATE ON COMMUNITY BOARDS AND ARE ACTIVELY INVOLVED IN PROMOTING THE REGION AND ITS ASSETS. BASED ON THE RESULTS OF THE ROCKFORD HEALTH COUNCILS 2020 HEALTHY COMMUNITY STUDY, THE COMMUNITY BENEFIT IMPLEMENTATION PLAN IDENTIFIED SEVERAL KEY AREAS TO FOCUS EFFORTS. FOR EXAMPLE, AS THE PREDOMINANT PROVIDER OF PEDIATRIC SERVICES, JBH MAINTAINS ITS COMMITMENT TO THE CHILDREN OF OUR COMMUNITY. THIS IS EVIDENT IN OUR SUPPORT OF THE RONALD MCDONALD CARE MOBILE WHICH PROVIDES FREE MEDICAL CARE TO UNINSURED AND UNDERINSURED CHILDREN IN FIVE NORTHERN COUNTIES. THE 40-FOOT, 26,000 POUND MOBILE UNIT HOUSES TWO PATIENT EXAM ROOMS, A CENTRAL WAITING ROOM, AND A STERILIZATION AREA AND HAS PROVIDED CARE TO MORE THAN 9,301 CHILDREN SINCE THE INCEPTION OF THE PROGRAM IN 2003. THIS TOTALS MORE THAN $3.17 MILLION IN FREE CARE OVER THE LIFE OF THE PROGRAM. THE CARE MOBILE IS COMPLETELY FUNDED BY PHILANTHROPY FROM THE MERCYHEALTH DEVELOPMENT FOUNDATION, JAVON BEA HOSPITAL AUXILIARY AND THE RONALD MCDONALD CHARITIES OF MADISON. THE BRIDGE CLINIC IS YET ANOTHER VENUE FOR UN- AND UNDER-INSURED ADULTS TO RECEIVE FREE MEDICAL TREATMENT FOR CHRONIC MEDICAL ISSUES. SINCE ITS OPENING IN 2008, HUNDREDS OF PEOPLE FROM OUR COMMUNITY HAVE RECEIVED CARE. MANY PHYSICIANS AND OTHER HEALTH CARE PROVIDERS GIVE FREELY OF THEIR TIME TO PROVIDE THESE SERVICES TO THE LESS FORTUNATE INDIVIDUALS IN OUR COMMUNITY TO BETTER MANAGE THEIR CHRONIC CONDITIONS. SINCE 2012, JBH CONTINUES TO PARTNER WITH A SILVER LINING FOUNDATION TO PROVIDE FREE BREAST HEALTH SERVICES TO THE UN- UNDER-INSURED WOMEN IN THE COMMUNITY. OVER 640 WOMEN HAVE RECEIVED FREE SCREENING MAMMOGRAMS AND OTHER BREAST RELATED SERVICES AND PROCEDURES SINCE THE PROGRAM'S INCEPTION. THESE ARE ONLY SOME OF THE MANY CONTRIBUTIONS THAT JBH MAKES TO PROMOTE AND IMPROVE THE HEALTH OF THE COMMUNITY. JBH REMAINS COMMITTED TO EDUCATING THE PUBLIC ABOUT VARIOUS HEALTH CARE ISSUES AND INITIATIVES AND IMPROVING THE LIVES OF OUR CITIZENS. JBH DOES NOT RESTRICT ADMISSION OF PROVIDERS AND PROVIDES AN OPEN MEDICAL STAFF. PART VI, LINE 7, REPORTS FILED WITH STATES IL PART V, LINE 16A, FAP WEBSITE: VANMATRE HEALTH SOUTHVANMATREREHAB.COM/EN/PATIENTS-AND-FAMILY/FINANCIAL-ASSISTANCE PART V, LINE 16B, FAP APPLICATION WEBSITE: VANMATRE HEALTH SOUTHVANMATREREHAB.COM/EN/PATIENTS-AND-FAMILY/FINANCIAL-ASSISTANCE PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: VANMATRE HEALTH SOUTHVANMATREREHAB.COM/EN/PATIENTS-AND-FAMILY/FINANCIAL-ASSISTANCE 1 AMERICAN CANCER SOCIETY 255 N MICHIGAN AVE STE 1200 CHICAGO IL 60601 131788491 501(C)(3) 5000 PROGRAM SUPPORT THE HAVEN NETWORK 124 N WATER ST ROCKFORD IL 61107 200620800 501(C)(3) 5000 PROGRAM SUPPORT REGIONAL ACCESS MOBILIZATION PROJECT INC 202 MARKET ST ROCKFORD IL 61107 363149827 501(C)(3) 5000 PROGRAM SUPPORT ROCKFORD UNIVERSITY 5050 E STATE ST ROCKFORD IL 61107 362167842 501(C)(3) 5000 PROGRAM SUPPORT UNIVERSITY OF IL FOUNDATION 1305 W GREEN ST URBANA IL 618012900 376006007 501(C)(3) 50000 PROGRAM SUPPORT ROCK RIVER DEVELOPMENT PARTNERSHIP 124 N WATER ST ROCKFORD IL 611073960 271153597 501(C)(3) 40000 PROGRAM SUPPORT WINNEBAGO COUNTY ETSB (PULSEPOINT) - CITY OF ROCKFORD FIRE DEPT 204 SOUTH FIRST STREET ROCKFORD IL 61104 366006082 501(C)(3) 13000 PROGRAM SUPPORT REMEDIES RENEWING LIVES 220 EASTON PARKWAY ROCKFORD IL 61108 362464898 501(C)(3) 5000 PROGRAM SUPPORT 8 0 PART I, LINE 2: APPLICATIONS ARE SUBMITTED TO THE HOSPITAL VERIFYING A NEED FOR FUNDS OR PRODUCTS (IE AUTOMATIC ELECTRONIC DEFIBRILLATORS-AED). A DETERMINATION IS MADE THROUGH A PREDETERMINED SCORING METHOD AS TO WHAT ORGANIZATIONS WILL BE RECIPIENTS OF THE FUNDS OR PRODUCTS. CASH CONTRIBUTIONS ARE MADE ONLY TO RECOGNIZED CHARITIES FOR WHICH GOOD FAITH REGARDING FUND USE HAS BEEN ESTABLISHED. THE CONTRIBUTION IS ONLY FOR THE AMOUNT OF THE APPEAL AND FOR A SPECIFIED NEED. 1 1 0 0 0 0 0 0 0 JAVON R BEA PRESIDENT & CEO (SEE PAGES 74-77) 0 1471858 0 0 0 3586128 0 7056412 0 17748 0 12132146 0 0 JOHN DORSEY VP CLINICAL INTERGRATION 448378 0 161638 0 4572 0 34353 0 17463 0 666404 0 0 0 TODD ANDERSON VP & CFO (AS OF 05/2020) 0 355005 0 182313 0 5540 0 0 0 18158 0 561016 0 0 MARK L GOELZER MD DIRECTOR/PHYSICIAN 0 355312 0 142289 0 4364 0 11400 0 17748 0 531113 0 0 ROBERT WALTERS VP HOME CARE 217148 0 77410 0 1246 0 8687 0 34098 0 338589 0 0 0 SHANNON DUNPHY-ALEXANDER SR EXECUTIVE DIRECTOR 0 237151 0 75861 0 229 0 11400 0 4517 0 329158 0 0 WENDI AUBRY REGIONAL PHARMACY MANAGER 185615 0 13765 0 847 0 12772 0 75319 0 288318 0 0 0 PAUL VAN DEN HEUVEL FORMER VICE PRESIDENT (THROUGH 04/2020) 0 141873 0 66244 0 32741 0 17847 0 9710 0 268415 0 0 MATTHEW PYCIOR PERFUSIONIST 213898 0 0 0 6630 0 35568 0 927 0 257023 0 0 0 SUE SCHRIEBER VP BUSINESS INTELLIGENCE 81343 0 5436 0 134116 0 5668 0 15604 0 242167 0 0 0 PART I, LINE 3 THE CEO IS PAID FROM A RELATED ORGANIZATION, MERCY HEALTH SYSTEM CORPORATION (MHSC). MHSC USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE MERCY COMPENSATION COMMITTEE OF MHSC IS COMPRISED OF THE BOARD CHAIRPERSON, VICE CHAIR, AND SECRETARY/TREASURER. THE COMPENSATION COMMITTEE IS ASSISTED BY INDEPENDENT LEGAL COUNSEL AND AN INDEPENDENT COMPENSATION CONSULTANT. THE COMPENSATION COMMITTEE, LEGAL COUNSEL, AND THE COMPENSATION CONSULTANT MEET THROUGHOUT THE YEAR AND REPORT DIRECTLY TO THE BOARD OF DIRECTORS ANNUALLY. THIS PROCESS WAS COMPLETED FOR 2020. PART I, LINES 4A-B PAUL VAN DEN HEUVEL RECEIVED SEVERANCE OF $27,693 IN 2020 FROM MERCY HEALTH SYSTEM CORPORATION, A RELATED ORGANIZATION. INCENTIVE PLAN DISTRIBUTION: JAVON R. BEA - $2,627,335. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING FY2021 THAT WAS SPONSORED BY THE ORGANIZATION: JOHN DORSEY AND SUE SCHRIEBER. THERE WERE NO AMOUNTS PAID TO ANY PARTICIPANTS DURING THE YEAR UNDER THE PLAN. PART II, LINE 2: JAVON R. BEA - DEFERRED COMPENSATION PAYMENT MR. BEA HAS BEEN EMPLOYED BY MHSC AS PRESIDENT AND CEO OVER THE PAST 30 YEARS. DURING THIS TIME, MR. BEA HAS LED AN INCREDIBLE TRANSFORMATION TAKING A SMALL, SINGLE, STAND-ALONE COMMUNITY HOSPITAL AND CREATING A VERTICALLY INTEGRATED HEALTH SYSTEM WITH 85 FACILITIES IN 50 COMMUNITIES THROUGHOUT SOUTHERN WISCONSIN AND NORTHERN ILLINOIS, INCREASING GROSS REVENUE FROM $33 MILLION TO OVER $3.3 BILLION IN FY2021. THIS HAS ALLOWED THE HEALTH SYSTEM TO GO FROM SERVING 89,000 PATIENTS IN 1989 TO OVER 2.1 MILLION PATIENTS TODAY WORKING TOGETHER WITH OVER 7,300+ PARTNERS IN HEALTH CARE. TODAY, MHSC HAS BECOME THE LARGEST EMPLOYER IN SOUTHERN WISCONSIN AND NORTHERN ILLINOIS. THIS GROWTH CAN BE ATTRIBUTED TO MR. BEA'S VISIONARY LEADERSHIP. LEADERSHIP THAT HAS LED TO MHSC RECEIVING NUMEROUS NATIONAL RECOGNIZED AWARDS INCLUDING BEING NAMED THE FIRST FULLY INTEGRATED HEALTH SYSTEM TO RECEIVE THE MALCOLM BALDRIGE NATIONAL QUALITY AWARD, THE MAGNET RECOGNITION AWARD, BEING RANKED #1 AND #2 ON AARP'S TOP 100 BEST PLACES TO WORK FOR WORKERS OVER 50, AND BEING RANKED IN THE TOP 25 ON THE TOP 100 INTEGRATED HEALTHCARE NETWORKS LIST BY MODERN HEALTHCARE FOR OVER 11 STRAIGHT YEARS. THE TURNAROUND OF MHSC IMPLEMENTED BY MR. BEA IS UNPARALLELED. BY PIONEERING A "PARTNERSHIP MODEL" OF COMPENSATION AND DESIGNING A CUSTOM CULTURE OF EXCELLENCE, MR. BEA IS VITAL TO THE DECADES-LONG AND CONTINUING GROWTH AT MHSC. THIS SUCCESS HAS MADE MR. BEA A HIGHLY SOUGHT AFTER SPEAKER AND CONSULTANT AS HE IS NOW WELL-RENOWNED FOR HIS INNOVATIONS IN THE AREAS OF INTEGRATED HEALTHCARE AND PHYSICIAN PARTNERSHIP MODELS. THE TREMENDOUS SUCCESS OF MHSC UNDER THE LEADERSHIP OF MR. BEA HAS ALLOWED HIM TO RECEIVE PAYOUTS FROM A DEFERRED COMPENSATION PACKAGE WHICH MHSC HAS BEEN PAYING INTO OVER MANY YEARS. THESE PAYMENTS ONLY BECAME PAYABLE IF MHSC ATTAINED CERTAIN DEFINED FINANCIAL AND STRATEGIC GOALS AND THE AMOUNTS ARE AT RISK EVERY SINGLE YEAR. AS INDICATED ABOVE, MANY OF THESE GOALS WERE ACHIEVED WITHIN THE PAST TWO YEARS RESULTING IN A RELEASE OF THESE DEFERRED PAYMENTS WHICH IMPACTED MR. BEA'S COMPENSATION REPORTING. THE SETTING OF THESE GOALS WERE LAID OUT BY THE BOARD OF DIRECTORS IN COOPERATION WITH NATIONALLY RECOGNIZED COMPENSATION ATTORNEYS AND CONSULTANTS TO MAKE SURE ALL FACTORS WERE TAKEN INTO CONSIDERATION. MR. BEA'S COMPENSATION HAS ALSO BEEN SCRUTINIZED BY NUMEROUS OUTSIDE ORGANIZATIONS AND MOST IMPORTANTLY, THE INTERNAL REVENUE SERVICE; AND HAS PASSED INSPECTION IN EACH CASE. TOTAL COMPENSATION IS APPROVED ANNUALLY BY THE BOARD OF DIRECTORS OF MHSC. FORM 990, PART III, LINE 2 IN MAY 2021, THE LONG-TERM CARE DEPARTMENT (SUB-ACUTE CARE) OPENED. FORM 990, PART III, LINE 3 AFTER OPENING THE LONG-TERM CARE DEPARTMENT (SUB-ACUTE CARE) IN MAY 2021, JBH REDUCED THE LICENSE FOR PSYCHIATRIC BEDS. FORM 990, PART VI, SECTION A, LINE 1 THE VOTING MEMBERS OF THE EXECUTIVE COMMITTEE CONSISTS OF SEVEN INDIVIDUALS, EACH OF WHOM SHALL HAVE A VOTE, INCLUDING THE CEO, THE CHAIRMAN, VICE-CHAIRMAN, IMMEDIATE PAST CHAIRMAN, TREASURER, AND TWO ADDITIONAL DIRECTORS OF THE BOARD. AT LEAST ONE MEMBER OF THE EXECUTIVE COMMITTEE SHALL BE A PHYSICIAN. THE EXECUTIVE COMMITTEE SHALL IN ALL INSTANCES BE COMPRISED OF AT LEAST 51% COMMUNITY MEMBERS. IN THE EVENT THAT ONE OR MORE OF THE AFOREMENTIONED VOTING MEMBERS OF THE EXECUTIVE COMMITTEE IS UNABLE TO SERVE IN SUCH CAPACITY, THEN THE CHAIRMAN OF THE CORPORATION SHALL DESIGNATE A REPLACEMENT FROM AMONG THE BOARD MEMBERS. THE EXECUTIVE COMMITTEE SHALL MEET AS NEEDED. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS, DUTIES, RESPONSIBILITIES AND AUTHORITY OF THE BOARD, EXCEPT AS PROHIBITED BY LAW. FORM 990, PART VI, SECTION A, LINE 6 MERCY HEALTH CORPORATION (MHC) IS THE SOLE CORPORATE MEMBER OF JAVON BEA HOSPITAL (JBH). THE SOLE MEMBER SHALL HAVE POWERS AND VOTING RIGHTS TO DO THE FOLLOWING: (A) APPOINT ALL THE DIRECTORS OF THE CORPORATION. (B) NOMINATE TO CORPORATION'S BOARD OF DIRECTORS ALL CANDIDATES FOR SELECTION AS THE CORPORATION PRESIDENT. (C) APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. (D) APPROVE ANNUAL BUDGETS, AND STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS OF THE CORPORATION. (E) REQUIRE THE CORPORATION'S BOARD OF DIRECTORS TO TAKE ANY ACTION (INCLUDING AUTHORIZING THE PLEDGE OR TRANSFER OF ASSETS TO MHC OR AS DIRECTED BY MHC, OR THE EXECUTION OF CONTRACTS) WHICH WOULD IMPROVE THE CREDIT WORTHINESS OR OTHERWISE RESULT IN FINANCIAL BENEFIT TO MHC AND ITS TAX-EXEMPT AFFILIATED CORPORATIONS (PROVIDED THAT UNDER NO CIRCUMSTANCES MAY MHC REQUIRE TRANSFER OF ASSETS IN VIOLATION OF LAW OR THE TERMS OF ANY CHARITABLE TRUST OR DONATION). (F) APPROVE ALL CONTRACTS OF INDEBTEDNESS EFFECTIVE FOR LONGER THAN EIGHTEEN MONTHS. (G) APPROVE ALL PLANS OF MERGER OR CONSOLIDATION. (H) APPROVE THE SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION. (I) APPROVE A VOLUNTARY DISSOLUTION OF THE CORPORATION. (J) APPROVE MATERIAL AMENDMENTS TO THE CORPORATIONS STANDARD FORM OF PHYSICIAN EMPLOYMENT AGREEMENT, PROVIDED THE CORPORATION SHALL HAVE THE AUTHORITY TO NEGOTIATE THE TERMS AND CONDITIONS OF INDIVIDUAL PHYSICIAN EMPLOYMENT AGREEMENTS SO LONG AS THE NEGOTIATED TERMS AND CONDITIONS ARE CONSISTENT WITH THE REQUIREMENTS OF APPLICABLE LAW AND THE STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENT PLANS APPROVED BY MHC. (K) APPROVE MATERIAL AMENDMENTS TO THE STANDARD COMPENSATION SYSTEM USED BY THE CORPORATION TO ESTABLISH INDIVIDUAL PHYSICIAN COMPENSATION. (L) REQUIRE THE CORPORATION'S BOARD OF DIRECTORS TO TAKE ANY ACTION (INCLUDING AMENDING THE ARTICLES OF INCORPORATION OR BYLAWS), OR TO MODIFY OR RESCIND AN ACTION ALREADY TAKEN, IF MHC DETERMINES THAT FAILURE TO TAKE THE ACTION, OR TO MODIFY OR RESCIND AN ACTION ALREADY TAKEN, MAY RESULT IN THE CORPORATIONS FAILURE TO OBTAIN OR MAINTAIN ITS EXEMPTION AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE CODE. FORM 990, PART VI, SECTION A, LINE 7A SEE NARRATIVE FOR PART VI, LINE 6. FORM 990, PART VI, SECTION A, LINE 7B SEE NARRATIVE FOR PART VI, LINE 6. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT REVIEWS THE FORM 990 BEFORE FILING AND IT IS AVAILABLE TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C BY WRITTEN POLICY, MHC SENDS OUT, ON AN ANNUAL BASIS, THE CORPORATE CONFLICT AND DUALITY OF INTEREST POLICY TO ALL BOARD MEMBERS, CORPORATE OFFICERS AND OTHER KEY INDIVIDUALS (THOSE HAVING RESPONSIBILITY AND AUTHORITY TO MAKE FINAL DECISIONS REGARDING THE ACQUISITION OF PRODUCTS OR SERVICES). EACH RECIPIENT IS REQUIRED TO COMPLETE A FINANCIAL INTEREST DISCLOSURE STATEMENT, WHICH IS SUBMITTED TO THE MHC COMPLIANCE DEPARTMENT FOR REVIEW. WITH RESPECT TO PHYSICIANS AND MANAGERS WHO ARE KEY INDIVIDUALS, ANY POTENTIAL CONFLICT OF INTEREST IS REVIEWED WITH THE APPROPRIATE EXECUTIVE STAFF MEMBER FOR FOLLOW UP WITH THE DISCLOSING PARTY IN ORDER TO REVIEW THE MATTER IN MORE DETAIL. THIS INCLUDES EMPHASIZING THAT THE DISCLOSING PARTY IS NOT PERMITTED TO PARTICIPATE IN ANY NEGOTIATIONS FOR THE PURCHASE OF ANY PRODUCTS OR SERVICES WHERE THE CONFLICT IS DEEMED MATERIAL OR AUTHORIZE THE SUBSEQUENT PURCHASE OF RELATED GOODS AND SERVICES. THE DISCLOSING PARTY IS ALSO REQUIRED TO IDENTIFY EACH AND EVERY INSTANCE OF A POTENTIAL CONFLICT AS THEY MAY ARISE IN THE ORDINARY COURSE OF BUSINESS. A SIMILAR PROCESS IS FOLLOWED FOR THE BOARD OF DIRECTORS, EXCEPT THAT ANY POTENTIAL CONFLICT IS REVIEWED BY THE BOARD'S GOVERNANCE COMMITTEE. BOARD MEMBERS MAY COMMENT ON TRANSACTIONS WHERE THERE IS A POTENTIAL CONFLICT BUT CANNOT VOTE ON THE RELATED MATTER AND MAY BE REQUIRED TO LEAVE ANY MEETING WHERE THE POTENTIAL CONFLICT IS REVIEWED BY THE BOARD OR WHERE THE BOARD TAKES ACTION TO EITHER APPROVE OR NOT APPROVE THE PROPOSED TRANSACTION. A BOARD MEMBER ALSO HAS A CONTINUING DUTY TO REPORT ANY CONFLICTS AS THEY MAY ARISE IN THE ORDINARY COURSE OF BUSINESS. IN THE EVENT THAT A POTENTIAL CONFLICT OF INTEREST IS REPORTED OR DISCOVERED OUTSIDE THE ESTABLISHED PROCESS, APPROPRIATE REVIEW AND ACTION WOULD BE TAKEN. THIS PROCESS WAS LAST COMPLETED IN 2021, WHEN THE QUESTIONNAIRES WERE SENT TO ADDRESS ANY 2020 CONFLICTS IDENTIFIED. MHC AND JBH HAVE THE SAME BOARD, AND THEREFORE THE MHC QUESTIONNAIRE IS USED TO ALSO ADDRESS POTENTIAL AND ACTUAL CONFLICTS FOR THE FILING ORGANIZATION. THE MHC CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC FORM 990, PART XI, LINE 9: CHANGES IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE 11,356,503. POST RETIREMENT MEDICAL BENEFIT ADJUSTMENT -426,093. NET TRANSFERS TO AFFILIATES -6,137,281. UPMIFA 143,693. NET CHANGE IN BENEFICIAL INTEREST IN TRUST 531,077. MISCELLANEOUS ADJUSTMENT -274,224. RHIL TRANSFER 5,038. ROCKFORD HEALTH SYSTEM VENTURES LLC 2400 N ROCKTON AVE ROCKFORD IL 61103 364366881 HEALTHCARE IL 3499732 12691768 JAVON BEA HOSPITAL MERCYHEALTH VISITING NURSES ASSOCIATION 4223 E STATE STREET ROCKFORD IL 61108 362167945 HEALTHCARE IL 501(C)(3) LINE 10 MERCY HEALTH CORPORATION 0 MERCYHEALTH DEVELOPMENT FOUNDATION 2400 N ROCKTON AVEYUP ROCKFORD IL 61103 363197918 SUPPORT OF HEALTHCARE IL 501(C)(3) LINE 12A, I MERCY HEALTH CORPORATION 0 ROCKFORD HEALTH PHYSICIANS 2400 N ROCKTON AVE ROCKFORD IL 61103 363907436 HEALTHCARE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCY HEALTH CORPORATION 2400 N ROCKTON AVE ROCKFORD IL 61103 472158680 SUPPORT OF HEALTHCARE IL 501(C)(3) LINE 12B, II N/A 0 MERCY HEALTH ASSOCIATION OF VOLUNTEERS 1000 MINERAL POINT AVE JANESVILLE WI 53548 390912682 SUPPORT OF HEALTHCARE WI 501(C)(3) LINE 12C, III-FI MERCY HEALTH SYSTEM CORPORATION 0 MERCY HEALTH SYSTEM CORPORATION 1000 MINERAL POINT AVE JANESVILLE WI 53548 390816848 HEALTHCARE WI 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCY ASSISTED CARE INC 901 MINERAL POINT AVE JANESVILLE WI 53548 391035110 HEALTHCARE WI 501(C)(3) LINE 10 MERCY HEALTH CORPORATION 0 MERCY HARVARD HOSPITAL INC 901 GRANT STREET HARVARD IL 60033 311551871 HEALTHCARE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER 200 LAKE AVE WOODSTOCK IL 60098 201673011 NONE IL 501(C)(3) LINE 3 MERCY HEALTH CORPORATION 0 ROCKFORD HEALTH INSURANCE LTD WELLESLEY HOUSE SO 2ND FL PEMBROKE HM BD INSURANCE BD JAVON BEA HOSPITAL C -584106 4230266 1.00000 1 JANESVILLE MEDICAL CENTER INC 1000 MINERAL POINT AVE JANESVILLE WI 53548 391520130 MANAGEMENT OF UNION EMPLOYEES WI N/A C 0 MERCYCARE INSURANCE COMPANY 580 N WASHINGTON ST JANESVILLE WI 53546 391768192 INSURANCE WI N/A C 0 MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO 580 N WASHINGTON ST JANESVILLE WI 53546 201482553 INSURANCE WI N/A C 0 0 0 1 0 1 0 0 0 0 1 0 0 0 1 1 1 1 1 0 ROCKFORD HEALTH INSURANCE LTD R 153061 NET BOOK VALUE ROCKFORD HEALTH INSURANCE LTD R 836000 AMOUNTS PAID