2019-11-15T12:34:18-06:00 2018-12-31 990 2018-01-01 420698265 ALLEN MEMORIAL HOSPITAL CORPORATION ALLE 3192353995 1825 LOGAN AVE WATERLOO IA 507031916 STEVE PALMERSHIEM VP FINANCE 3192353544 2019-11-14 205.167.2.34 2019-11-14 13:12:44 CS P 4949FBDB2613D44DD524226BE936F6A9962DEEB1 4949FBDB2613D44DD524226BE936F6A9962DEEB1 2018 2020-03-31 21:24:44Z PAM DELAGARDELLE 1825 LOGAN AVE WATERLOO IA 507031916 300997419 0 X WWW.UNITYPOINT.ORG/WATERLOO X 1938 IA IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING. 14 11 2603 365 3662386 0 3143672 4590033 252930438 268167850 8092557 8435141 2737008 1903713 266903675 283096737 24628909 12513874 0 0 119066741 122751336 0 0 0 121650072 132975224 265345722 268240434 1557953 14856303 342186453 339314585 125704854 122812145 216481599 216502440 X THE MISSION OF ALLEN MEMORIAL HOSPITAL CORPORATION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING. 0 0 216451249 6150075 269996455 HEALTH-CARE SERVICES`ALLEN MEMORIAL HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE GREATER CEDAR VALLEY COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH-CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. ALLEN MEMORIAL HOSPTIAL CORPORATION PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PHARMACEUTICAL DRUGS, WOUND CARE, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2018, ALLEN MEMORIAL HOSPITAL CORPORATION ADMITTED 9,394 PATIENTS WITHOUT NEWBORNS AND NICU AND 10,416 PATIENTS WITH NEWBORNS AND NICU; RESULTING IN A TOTAL OF 34,329 PATIENT DAYS WITHOUT NEWBORNS AND NICU, AND 36,374 PATIENT DAYS WITH NEWBORNS AND NICU. OUTPATIENT VISITS TOTALED 222,662 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 10,762. THERE WERE ALSO 34,183 EMERGENCY ROOM VISITS AND 1,102 BABIES DELIVERED. 20057963 6363799 0 CHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: ALLEN MEMORIAL HOSPITAL CORPORATION PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $1,728,311 IN 2018. OFTEN TIMES, ALLEN MEMORIAL HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ALLEN MEMORIAL HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. ALLEN MEMORIAL HOSPITAL CORPORATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $7,095,937 FOR 2018. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $8,824,248.OTHER BENEFITS: ALLEN MEMORIAL HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. ALLEN MEMORIAL HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. ALLEN MEMORIAL HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $11,233,715. 236509212 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 X 0 0 2603 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X STEVE PALMERSHEIM VP FINANCE 3192353932 1825 LOGAN AVE WATERLOO IA 50703 STACEY BENTLEY BOARD TREASURER 1.00 1.00 X X 0 0 0 BOB BUCKLEY BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 KYLE CHRISTIASON MD BOARD MEMBER 1.00 40.00 X 0 389497 25447 DARREL COLSON MD BOARD MEMBER 1.00 1.00 X 0 0 0 PAMELA DELAGARDELLE BOARD MEMBER/PRESIDENT/CEO 40.00 1.00 X X 502636 15226 94602 MATT GARCIA BOARD MEMBER 1.00 1.00 X 0 782 0 BETH HANSEN BOARD MEMBER 1.00 1.00 X 0 0 0 JOAN HEADINGTON BOARD MEMBER 1.00 1.00 X 0 0 0 LANCE HORBACH BOARD MEMBER 1.00 1.00 X 0 0 0 BEV SMITH BOARD SECRETARY 1.00 1.00 X X 0 0 0 KALYANA SUNDARAM MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOSEPH TRIPP-RIEKS BOARD MEMBER 1.00 1.00 X 0 0 0 BISHOP STEVE ULLESTAD BOARD CHAIR 1.00 1.00 X X 0 7500 0 MIKE WILLIAMS BOARD MEMBER 1.00 1.00 X 160 14693 0 CRAIG FLANAGAN TO 918 VP, CSO & CFO 20.00 20.00 X 0 442827 20973 CHRISTOPHER CLAYTON DIRECTOR - PHARMACY 40.00 0.00 X 179437 0 36796 JENNIFER FRIEDLY VP COO/PRESIDENT UPHM 16.00 24.00 X 324838 1038 50520 MARY HAGEN VP CHIEF NURSE EXECUTIVE 40.00 0.00 X 300127 0 47787 CHRISTOPHER HILL DO PHYSICIAN-ER/PHYSICIAN DYAD LEADER 12.00 28.00 X 401364 0 23254 TIMOTHY HORRIGAN MD TO 818 PHYSICIAN/CQO 20.00 20.00 X 0 180556 23549 STEVEN SESTERHENN VP HUMAN RESOURCES 40.00 0.00 X 202917 1606 23072 RAJEEV ANUGU MD PHYSICIAN- RADIOLOGY 40.00 0.00 X 913244 0 40542 RUSSELL BUCHANAN MD NEURO SURGEON 40.00 0.00 X 1296909 0 41007 JOHN HALLORAN MD PHYSICIAN- RADIOLOGY 40.00 0.00 X 719004 0 38057 CHARLES HEGGEN MD PHYSICIAN- RADIOLOGY 40.00 0.00 X 693264 0 31590 PAUL MCCAUGHEY DO PHYSICIAN-ER 40.00 0.00 X 609128 0 38796 RENEE RASMUSSEN TO 1214 FORMER SR VP FIN/CFO/COO 0.00 40.00 X 0 358885 38598 JAMES WATERBURY VP INSTITUTIONAL DEVELOP 40.00 0.00 X 117359 0 13370 DAN CARPENTER VP CSO CFO TO 117 SENIOR VP & CFO-UPH CORP (FR 02/17) 0.00 40.00 X 0 856481 156826 6260387 2269091 744786 148 1 1 0 CEDAR VALLEY MEDICAL SPECIALISTS PO BOX 2758 WATERLOO IA 50704 MEDICAL SERVICES 3595184 ARAMARK SERVICES INC 2402 39TH AVE MOLINE IL 61625 MANAGEMENT SERVICES 1981419 MAYO COLLABORATIVE SERVICES LLC 3050 SUPERRIOR DR NW ROCHESTER MN 55901 LABORATORY SERVICES 1724759 XYGENT INC 9961 VALLEY VIEW RD EDEN PRAIRIE MN 55344 MEDICAL SERVICES 1653879 WEATHERBY LOCUMS INC 6451 N FEDERAL HWY FORT LAUDERDALE FL 33308 MANAGEMENT SERVICES 1450103 110 3466718 661603 461712 4590033 NET PATIENT REVENUE 900099 251779005 251779005 PHARMACY REVENUE 446110 8014831 4450377 3564454 RENTAL INCOME 531120 4218680 4213755 4925 MANAGEMENT, IT AND SUPPORT SVCS 561000 2440261 2347254 93007 LABORATORY SERVICES 621500 1656936 1656936 58137 58137 268167850 3269301 -10794 3280095 22708639 169615 17615314 97100 5093325 72515 5165840 5165840 186031 188268 -2237 -2237 SHARED SAVINGS REVENUE 900099 1152146 1152146 MISCELLANEOUS REVENUE 900099 382543 382543 DEFINED BENEFIT PENSION COST 900099 304499 304499 66762 211 66551 1905950 283096737 266334069 3662386 8510249 12513874 12513874 2305630 2305630 171360 171360 98161500 85684737 12476763 3935913 3435852 500061 12066011 10531915 1534096 6110922 5334183 776739 22534192 12991582 9542610 838377 3122 835255 770567 211101 559466 17740905 15873911 1866994 488804 273761 215043 1780965 1304656 476309 1872881 1872881 6162921 5711084 451837 175403 129747 45656 68470 62063 6407 3870803 3870803 16412188 16273790 138398 3134574 3134074 500 MEDICAL SUPPLIES 57350423 57287225 63198 BAD DEBT EXPENSE 2278 2278 SALES/USE TAXES 122 122 MISCELLANEOUS EXPENSE -228649 6451 -235100 268240434 236509212 31731222 0 2850901 3754999 523612 596614 35283855 35993722 16485336 24349976 6402528 7144513 1102646 1150933 301519322 182645184 124314955 118874138 145097814 139560639 4639 7629063 6791065 2491104 1097986 342186453 339314585 17663325 16977145 4905 322 827209 1103400 107209415 104731278 125704854 122812145 X 208778720 209608346 4977197 4303205 2725682 2590889 216481599 216502440 342186453 339314585 X 14856303 -13798084 -1037378 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 150286764 2173179 -7455183 459300 144545460 132409368 2341693 15939423 403720 150286764 120193040 2200699 10363690 348061 132409368 119266226 214681 985479 273346 120193040 111695899 34 7737320 167027 119266226 0.95230 0.01790 0.02980 0 1 1 4437662 4437662 169520165 93971633 75548532 2535394 2535394 0 113686722 79492794 34193928 11339379 6645363 4694016 118874138 ASBESTOS REMOVAL LIABILITY 6563113 DUE TO AFFILIATES 84901433 LONG-TERM RETENTION INCENTIVES 2475998 SELF-INSURANCE RESERVE 6169527 HEALTH AND WELFARE BENEFITS RESERVE 1467859 DEFINED BENEFIT RETIREMENT PLAN LIABILITY 1560351 MISCELLANEOUS LIABILITY 1592997 104731278 X 266014000 -13798084 188268 -13609816 279623816 502803 2970118 3472921 283096737 252690000 188268 188268 252501732 502803 15235899 15738702 268240434 PART V, LINE 4: THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2015. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 188,268. PART XI, LINE 4B - OTHER ADJUSTMENTS: IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 1,293,539. REVENUES IN UNRESTRICTED FUND BALANCE 1,675,864. ROUNDING 715. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 188,268. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN UNRESTRICTED FUND BALANCE 13,941,430. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 1,293,539. ROUNDING 930. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 1728311 1728311 0.00640 35497714 28401777 7095937 0.02650 37226025 28401777 8824248 0.03290 1210418 704747 505671 0.00190 643589 398585 245004 0.00090 17114834 14664178 2450656 0.00910 13128624 5096240 8032384 0.02990 32097465 20863750 11233715 0.04180 69323490 49265527 20057963 0.07470 17108 17108 0.00010 17108 17108 0.00010 0 1543204 0 57121379 51239872 5881507 X 1 1 1 1 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 WWW.UNITYPOINT.ORG/WATERLOO 070034H X X X ALLEN MEMORIAL HOSPITAL CORPORATION 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTP://WWW.UNITYPOINT.ORG/WATERLOO/FINANCES X 1 16 1 HTTP://WWW.UNITYPOINT.ORG/WATERLOO/FINANCES 0 1 X 200.000000000000 600.000000000000 X X X X X X X 1 1 X X X X 1 X HTTPS://WWW.UNITYPOINT.ORG/WATERLOO/FINANCIAL-ASSISTANCE.ASPX X HTTPS://WWW.UNITYPOINT.ORG/WATERLOO/FINANCIAL-ASSISTANCE.ASPX X HTTPS://WWW.UNITYPOINT.ORG/WATERLOO/FINANCIAL-ASSISTANCE.ASPX X X X X X X 1 X 0 X X X X 1 X 0 0 ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 5: DATA AND OTHER INFORMATION USED IN THE 2017-2019 ASSESSMENT ARE DRAWN FROM INTERVIEWS, FOCUS GROUPS, THE COMMUNITY INTERVIEWS SURVEY, THE COMMUNITY ONLINE SURVEY, EXTERNAL COMMUNITY HEALTH NEEDS SURVEYS FROM THE DEFINED SURVEY AREA, AND EXTERNAL RESOURCES INCLUDING NEWSPAPERS, ONLINE SOURCES, MEETING NOTES, TELEVISION, WHITE PAPERS AND REPORTS.THE CORE OF THE COMMUNITY INTERVIEW SURVEY IS DATA GATHERED DURING 24 INTERVIEWS AND FOCUS GROUPS WITH LEADERS OF ORGANIZATIONS PROVIDING SOCIAL SERVICES, EDUCATION, PHILANTHROPY AND HEALTHCARE TO THE CEDAR VALLEY. INTERVIEWS WERE MADE FACE-TO-FACE ON SITE WITH EACH ORGANIZATION'S LEADER OR LEADERSHIP TEAM. INTERVIEWERS FRAMED THE SESSIONS WITH STANDARD QUESTIONS FOR CONTINUITY AND ENCOURAGED PARTICIPANTS TO OFFER THEIR OWN QUESTIONS, ANSWERS AND RECOMMENDATIONS. PARTICIPANTS IN EACH MEETING DEFINED AND PRIORITIZED COMMUNITY HEALTH NEEDS WITHOUT PROMPTING OR SUGGESTION. INTERVIEWS WERE CONDUCTED FROM DECEMBER 2015 - SEPTEMBER 2016 IN SESSIONS LASTING 60-90 MINUTES. SURVEY PARTICIPANTS REPRESENT THE INTERESTS OF AFRICAN AMERICAN, HISPANIC, BOSNIAN, ASIAN, INDIAN, BURMESE, AMERICAN INDIAN AND CONGOLESE POPULATIONS LIVING IN THE SURVEY AREA, PREDOMINATELY IN BLACK HAWK COUNTY. THEY ALSO REPRESENT THE INTERESTS AND SERVE RESIDENTS LIVING IN POVERTY; WOMEN AND CHILDREN; WOMEN AND CHILDREN AT RISK; PRE-SCHOOL CHILDREN; ADULTS 65+; THE DISABLED; THE UNDEREMPLOYED AND UNEMPLOYED; THE MEDICALLY-UNDERSERVED AND UNSERVED; RESIDENTS SUFFERING FROM MENTAL HEALTH AND/OR ADDICTION; RESIDENTS LIVING WITH FOOD INSECURITY; ENGLISH LANGUAGE LEARNERS AND THE LGBT COMMUNITIES. COMMUNITY SURVEY PARTICIPANTS WERE RECRUITED SPECIFICALLY FOR THEIR KNOWLEDGE AND RECORD OF SUCCESSFUL SERVICE TO ONE OR MORE MEDICALLY-UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THEY INCLUDE ALLEN CHILD PROTECTION CENTER; ALLEN COLLEGE ENGAGEMENT-SALVATION ARMY PARTNERSHIP FREE CLINIC; ALLEN WOMEN'S HEALTH CENTER; BIG BROTHERS BIG SISTERS OF NORTHEAST IOWA; BLACK HAWK COUNTY GAMING ASSOCIATION; BLACK HAWK-GRUNDY MENTAL HEALTH CENTER; CEDAR VALLEY FRIENDS OF THE FAMILY; CEDAR VALLEY'S PROMISE; CEDAR VALLEY UNITED WAY; COVENANT MIDWIVES AND WOMEN'S HEALTH CENTER; FAMILY AND CHILDREN'S COUNCIL; GUERNSEY CHARITABLE FOUNDATION; HAWKEYE COMMUNITY COLLEGE; HEALTHY CEDAR VALLEY COALITION; I-HOPE FREE CLINIC; KWWL-TV FOCUS GROUPS 1 AND 2; R.J. MCELROY TRUST; NORTHEAST IOWA FOOD BANK; SALVATION ARMY; SUCCESS LINK INC.; UNIVERSITY OF NORTHERN IOWA; WATERLOO COMMUNITY SCHOOLS; YWCA OF BLACK HAWK COUNTY.EXTERNAL RESOURCES FOR THIS REPORT ALSO INCLUDE 45 NEWSPAPER ARTICLES, 50 ONLINE ARTICLES, 2 TELEVISION REPORT TRANSCRIPTS AND 23 WHITE PAPERS AND REPORTS.THE ASSESSMENT ALSO INCLUDES RESULTS OF THE COMMUNITY ONLINE SURVEY CONDUCTED DECEMBER 1 - DECEMBER 20, 2015. THE SURVEY WAS SPONSORED AND IMPLEMENTED BY THE BLACK HAWK COUNTY HEALTH DEPARTMENT, UNITYPOINT HEALTH - WATERLOO (ALLEN HOSPITAL) AND WHEATON FRANCISCAN HEALTHCARE - IOWA (COVENANT MEDICAL CENTER AND SARTORI MEMORIAL HOSPITAL. THE ONLINE SURVEY DREW RESPONSES FROM 617 CEDAR VALLEY RESIDENTS, WHO INDIVIDUALLY IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. RESULTS WERE COLLATED, TRANSCRIBED AND TABULATED FOR THIS REPORT. ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 6A: MERCY ONE WATERLOO & SATORI MEMORIAL HOSPITAL ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 6B: BLACK HAWK COUNTY DEPARTMENT OF HEALTH ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 11: THE 2017-2019 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED EIGHT HEALTH NEEDS. SURVEY PARTICIPANTS RANKED THEM IN THIS PRIORITY: MENTAL HEALTH ACCESS AND SERVICES; HEALTHCARE ACCESS AND TRANSPORTATION; WOMEN AND CHILDREN'S HEALTH; NUTRITION, OBESITY AND WELLNESS; CHILD ABUSE AND NEGLECT; HEALTHCARE INSURANCE AND FINANCE; IMPROVING HIGH SCHOOL GRADUATION RATES IN WATERLOO; REDUCING TEEN GUN VIOLENCE IN WATERLOO.THE ALLEN HOSPITAL BOARD OF DIRECTORS DISCUSSED EIGHT COMMUNITY HEALTH NEEDS AT THE MARCH 28, 2017 BOARD MEETING. DIRECTORS THEN CAST INDIVIDUAL VOTES TO DECIDE WHICH THREE NEEDS TO PRIORITIZE IN THE 2017-2019 COMMUNITY HEALTH NEEDS IMPLEMENTATION PLAN. MENTAL HEALTH ACCESS AND SERVICES AND WOMEN'S AND CHILDREN'S HEALTH RANKED FIRST AND SECOND, WHILE NUTRITION, OBESITY AND WELLNESS RANKED THIRD. DIRECTORS VOTED TO EMPHASIZE THREE COMMUNITY HEALTH NEEDS.MENTAL HEALTH: THESE PROGRAMS AND INITIATIVES HAVE BEEN ADDED IN 2017-2019 TO HELP THE COMMUNITY MEET MENTAL HEALTH SERVICE NEEDS:- STEPPING UP (LOCAL AFFILIATION WITH NATIONAL EFFORT TO KEEP MENTALLY ILL OUT OF JAIL)- JAIL DIVERSION (IN PARTNERSHIP WITH STEPPING UP AND BLACK HAWK COUNTY)- COLLABORATION AMOUNT COURTS, LAW ENFORCEMENT, SUBSTANCE ABUSE, MENTAL HEALTH PROVIDERS- ADULT CRISIS STABILIZATION CENTER ESTABLISHED AND FUNDED- PATHWAYS DETOXIFICATION PROGRAM ESTABLISHED AND FUNDED- MEDICATION ASSISTED TREATMENT PROGRAMS ESTABLISHED AND FUNDED- BEHAVIORAL HEALTH CONSULTANTS ADDED TO THE ALLEN HOSPITAL EMERGENCY DEPARTMENT- BROADER, FASTER ACCESS TO ELECTRONIC HEALTH RECORDS TO IMPROVE CARE COORDINATION FOR MENTAL HEALTH PARTNERS PRESENTING TO THE ER OR OFF-CAMPUS SITES- MENTAL HEALTH RECOVERY CENTER BEDS ADDED TO ALLEN HOSPITAL ED (SEPARATE UNIT)- CRISIS INTERVENTION TRAINING ADDED FOR LOCAL LAW ENFORCEMENT- SUPPORT LENT TO PASS CHANGES IOWA CODE CHAPTER 228 (DISCLOSURE OF MH INFORMATION)- SUPPORT LENT TO PASS CHANGES TO IOWA CODE 229 (HOSPITALIZATION OF MH PATIENTS)- COMPLEX NEEDS IMPLEMENTED INTO LAW- CHILDREN'S MENTAL HEALTH SYSTEM PASSED INTO LAW BY GOVERNOR REYNOLDS- INCREASED MH ARNPS GRADUATING FROM ALLEN COLLEGE AND PRACTICING LOCALLY- CONTINUED SCHOOL-BASED MH SERVICES, ALTHOUGH DEMAND OUTSTRIPS SUPPLY- INTEGRATED MH SERVICES WITH UNITYPOINT AT HOME- ADDED OPEN-ACCESS SCHEDULING TO BLACK HAWK-GRUNDY MENTAL HEALTH CENTER, SERVING 6,000 MH OUTPATIENTS- ADDED MOBILE CRISIS SERVICES WITH AREA LAW ENFORCEMENT- PARTNERING WITH CEDAR VALLEY UNITED WAY TO IDENTIFY/ADDRESS ADVERSE CHILDHOOD EXPERIENCES (ACES); ADDED ACES SURVEY TO 2020-2022 CHNAWOMEN AND CHILDREN'S HEALTH: THESE PROGRAMS AND INITIATIVES HAVE BEEN ADDED IN 2017-2019 TO HELP THE COMMUNITY MEET WOMEN AND CHILDREN'S SERVICES- ALIGNED ALLEN WOMEN'S HEALTH, OB AND NICU TO CARE FOR MORE HIGH-RISK PREGNANCIES; - PLACED CASE WORKERS WITH SUCCESS STREET IN METROPOLITAN SCHOOLS.- RAISED FUNDS TO ADD THREE LABOR/DELIVERY/RECOVERY SUITES AND THREE ADDITIONAL NICU SUITES- ADDING SIX POSTPARTUM ROOMS- ADDED TWO NEW PROVIDERS TO MEET PATIENT DEMAND- CONTINUED PROGRAM TO KEEP BABIES AS YOUNG AS 30 WEEKS GESTATION AT ALLEN HOSPITAL NICU, WITH EXCELLENT RESULTS- GREATLY EXPANDED PEDIATRIC SERVICES TO THE MARKET WITH THE OPENING OF PRAIRIE PARKWAY IN CEDAR FALLS- LAUNCHED LGBTQ CLINIC AT PRAIRIE PARKWAY IN CEDAR FALLS- REDESIGNED AND EXPANDED FOUR URGENT CARE CLINICS IN THE MARKET, WITH AVERAGE DOOR-TO-DOOR TIMES OF LESS THAN 30 MINUTES- ADDED 3D BREAST TOMOSYNTHESIS MAMMOGRAPHY ON A WALK-IN BASIS AT THREE LOCATIONS:ALLEN HOSPITAL, UNITED MEDICAL PARK, PRAIRIE PARKWAY- CO-SPONSORED VISION TO LEARN TO DIAGNOSE AND PROVIDE GLASSES TO WATERLOO SCHOOL CHILDREN WITH VISION PROBLEMS (PROGRAM IS BEING EXPANDED SYSTEM-WIDE IN 2019-2020 SCHOOL YEAR)- CARED FOR 2,643 PATIENTS AT ALLEN WOMEN'S HEALTH IN 2018 * 79% OF PATIENTS SEEN IN 2017 LIVE IN EXTREME POVERTY (INCOME OF JUST $12,000) * 1,752 RECEIVED STD TEST (BLACK HAWK COUNTY HAS HIGHEST CHLAMYDIA AND GONORRHEA RATES IN IOWA) * 343 PATIENTS RECEIVED NEW BIRTH CONTROL, INCLUDING 23% WHO ASKED FOR AND RECEIVED A LARC (LONG-ACTING REVERSIBLE CONTRACEPTION) * FUNDED FOR 9 COUNTIES, PROVIDING SERVICES TO 24- SERVED 547 CHILDREN FROM 27 COUNTIES AT THE ALLEN CHILD PROTECTION CENTER * 77% WERE ALSO GIVEN A MEDICAL EVALUATION * PROVIDED 499 FORENSIC INTERVIEWS TO AREA COURTS AND LAW ENFORCEMENT * 93% OF OFFENDERS WERE KNOWN TO THE CHILD IN 2018 * 86% OF ALLEGATIONS WERE SEXUAL ABUSE; 7% PHYSICAL ABUSE; 2% NEGLECT * PROVIDED 25 COMMUNITY TRAINING SESSIONS TO 753 PARTICIPANTS IN 2018NUTRITION, OBESITY, WELLNESS: THESE PROGRAMS AND INITIATIVES HAVE BEEN ADDED OR EXPANDED IN 2017-2019 TO HELP COMMUNITY NEEDS REGARDING NUTRITION, OBESITY, AND WELLNESS:- ADDED A COMMUNITY DEMONSTRATION KITCHEN TO NEW PRAIRIE PARKWAY OUTPATIENT CENTER, WITH PERIODIC HEALTHY COOKING AND NUTRITION CLASSES- ADDED GET GROWING: EATING HEALTHY FOR LIFE HANDS-ON, SUMMER-LONG GARDENING AND NUTRITION PROGRAM FOR KIDS AT PRAIRIE PARKWAY- EXPANDED ALLEN EAP SERVICES TO CONTRACT WITH 60 AREA COMPANIES. EAP FOCUS IS ON PREVENTION AND EARLY INTERVENTION IN WORK, FAMILY AND PERSONAL ISSUES THAT MIGHT OTHERWISE DERAIL EMPLOYEES AND CAUSE PREVENTABLE DISRUPTION TO THEMSELVES, THEIR FAMILIES AND EMPLOYERS- EXPANDED CORPORATE/OCCUPATIONAL HEALTH WELLNESS SERVICES: * ADDED OCCUPATIONAL HEALTH CLINIC IN CEDAR FALLS * PROVIDE ONSITE WELLNESS SCREENINGS * PROVIDE HEALTH-RISK ASSESSMENTS * DESIGN AND IMPLEMENT QUARTERLY WELLNESS CHALLENGES * PROVIDE EDUCATIONAL PRESENTATIONS, COOKING DEMONSTRATIONS * PROVIDE ONSITE WEIGHT MANAGEMENT PROGRAMS- EXPANDED UNITYPOINT CLINIC WELLNESS THERAPIES: * EXERCISE * BIOFEEDBACK * MINDFULNESS AND RELAXATION TECHNIQUES * FOOD, MOOD AND COGNITION EDUCATION * ADDED INTENSIVE BEHAVIOR THERAPY FOR WEIGHT MANAGEMENT PROGRAM (IBT) * ADDED HEALTHY EATING ACTIVE LIFESTYLE PROGRAM (HEAL) * ADDED SCULPSURE TO SHED BODY FAT * CONTINUED NUTRITION SERVICES: - INPATIENT NUTRITION ASSESSMENT, MENU, EDUCATION - OUTPATIENT 60-MINUTE NUTRITION CONSULTATION, FOLLOW-UP - EDUCATION SPECIFIC TO DISEASE STATES INCLUDING CARDIAC, CELIAC, DIABETES, FOOD ALLERGIES, FRUCTOSE INTOLERANCE, WEIGHT LOSS * PUBLIC SPEAKING ENGAGEMENTS AND EDUCATION ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND, IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE 7 1 - ALLEN CHILD PROTECTION CENTER 212 W DALE ST SUITE 102 WATERLOO IA 50703 OUTPATIENT ONLY - CHILD PROTECTION 2 - ALLEN OCCUPATIONAL HEALTH SERVICES 1825 LOGAN AVENUE WATERLOO IA 50703 OUTPATIENT ONLY - OCCUPATIONAL HEALTH 3 - ALLEN WOMEN'S HEALTH CENTER 233 VOLD STREET WATERLOO IA 50703 OUTPATIENT ONLY - WOMEN'S HEALTH CENTER 4 - ALLEN WOMEN'S HEALTH CENTER 1600 1ST STREET E INDEPENDENCE IA 50644 OUTPATIENT ONLY - WOMEN'S HEALTH CENTER 5 - CENTER FOR UROLOGY 1717 W RIDGEWAY AVE WATERLOO IA 50701 OUTPATIENT ONLY - UROLOGY 6 - PMP OCCUPATIONAL HEALTH 4612 PRAIRIE PARKWAY SUITE 102 CEDAR FALLS IA 50613 OUTPATIENT ONLY - OCCUPATIONAL HEALTH 7 - CEDAR VALLEY COMMUNITY HEALTHCARE LLC 999 HOME PLAZA SUITE 210B WATERLOO IA 50701 REGIONAL HEALTH INSURANCE POOL PART I, LINE 6A: ALLEN MEMORIAL HOSPITAL'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,273. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THE HOSPITAL CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION AND MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. THE HOSPITAL EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, THE HOSPITAL EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COLLABORATE TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH. PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR ALLEN MEMORIAL HOSPITAL. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. PART VI, LINE 2: COMMUNITY HEALTH IS INEXTRICABLY TIED TO SOCIAL HEALTH. ALLEN HOSPITAL REACHES OUT TO IDENTIFY THE SOCIAL DETERMINANTS OF HEALTHCARE AND AFFECT DETERMINANTS IN REAL TIME. WE DO THAT THROUGH ONGOING PARTNERSHIPS, FORMAL AND INFORMAL, WITH OTHER ORGANIZATIONS SERVING THE COMMUNITY. EXAMPLES INCLUDE:THE ALLEN COLLEGE ENGAGEMENT SALVATION ARMY PARTNERSHIP, WHICH PROVIDES A FREE, COMMUNITY CLINIC THROUGHOUT THE YEAR. THE CLINIC PROVIDES CHECKUPS, SCREENINGS, TREATMENT OF MINOR ILLNESS, MEDICATION ASSISTANCE AND REFERRALS TO 1,200 RESIDENTS PER YEAR. IT ALSO PROVIDES ALLEN HOSPITAL WITH REAL-TIME INDICATORS OF CHANGING HEALTHCARE NEEDS OR OUR UNDERSERVED POPULATIONS.THE CEDAR VALLEY ADVERSE CHILDHOOD EXPERIENCES (ACES) COALITION, IN PARTNERSHIP WITH OTHER AREA PROVIDERS, MAJOR PHILANTHROPIC FOUNDATIONS IN OUR AREA, AND THE CEDAR VALLEY UNITED WAY, THE LEAD AGENCY. THE ACES EFFORT IS BOTH BROAD AND DEEP, REACHING ACROSS THE COMMUNITY TO IDENTIFY ROOT CAUSES OF ADULT HEALTH PROBLEMS. THE GOAL OF THE WORK IS TO LESSEN ADULT HEALTH CONCERNS BY REDUCING ACES IN AREA FAMILIES. THE AREA CHNA COALITION INCLUDED ACES QUESTIONS IN ITS 2019 SURVEY TO HELP ADVANCE THE PROJECT.THE BLACK HAWK COUNTY CHILD CARE COALITION, WHICH HAS IDENTIFIED CHILD CARE AS AN ABSOLUTE HEALTH, SOCIAL AND EMPLOYMENT PRIORITY FOR THE ENTIRE REGION. AFFORDABLE CHILD CARE IS PARTICULARLY CRITICAL FOR FAMILIES STRUGGLING TO GET OUT OF POVERTY AND FOR SINGLE-PARENT FAMILIES.THE CEDAR VALLEY MENTAL HEALTH SUMMIT, A BI-ANNUAL CONVOCATION OF AREA AGENCIES, PROVIDERS, AND FUNDERS TO ADDRESS MENTAL HEALTH CARE AS AN ESSENTIAL PART OF COMMUNITY HEALTH. LIKE THE ACES COALITION, IT BRINGS MANY ORGANIZATIONS TOGETHER TO FOCUS COLLECTIVE EFFORT ON A COMMON PROBLEM.PROJECT SEARCH, WHICH TEAMS ALLEN HOSPITAL WITH THE WATERLOO SCHOOLS TO GIVE SPECIAL NEEDS HIGH-SCHOOL SENIORS ON THE JOB TRAINING AND EXPERIENCE. THE PROGRAM IS ENTERING ITS FOURTH RATE WITH A GRADUATION RATE OF ALMOST 100% AND AN EQUALLY HIGH PLACEMENT RATE INTO PERMANENT JOBS FOR GRADUATES. PROJECT SEARCH ADDRESSES AN OFT-OVERLOOKED POPULATION COHORT WHO CAN BE SEMI-INDEPENDENT AND SELF-SUPPORTING WITH THE RIGHT START AND COMMUNITY SUPPORT.THE CEDAR VALLEY EQUITY INITIATIVE WORKSHOP ON RACISM AND HEALTH. THIS IS ANOTHER INITIATIVE THAT FOCUSES ON ROOT CAUSES OF HEALTHCARE OUTCOMES, INCLUDING BOTH RACIAL AND ECONOMIC DISPARITIES IN PRIMARY CARE AND CONSEQUENT HEALTH ISSUES.SUCCESS STREET AND HEALTH EDUCATION IN THE WATERLOO SCHOOLS. ALLEN WOMEN'S HEALTH PROVIDES SEX EDUCATION THROUGHOUT THE WATERLOO SCHOOLS AND OFFERS BOTH THE TOGETHER FOR YOUTH AND YOUNG PARENTS TOGETHER COMMUNITY GROUPS TO HELP TEENS AND YOUNG PARENTS NAVIGATE HEALTHCARE ISSUES FOR THEMSELVES AND THEIR BABIES. ALL THREE PROGRAMS FOSTER FRANK, TWO-WAY DISCUSSION AMONG AREA TEENS AND PROVIDERS AND PROVIDE A CLEAR, CURRENT LOOK AT COMMUNITY HEALTH NEEDS. PART VI, LINE 3: THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ALL PATIENTS AND WITHIN THE COMMUNITY. COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. THE CENTRAL BILLING OFFICE IS AVAILABLE BY PHONE TO ANSWER QUESTIONS ABOUT THE POLICY, OR PATIENTS SHOULD GO TO THE CASHIER'S OFFICE AT THE HOSPITAL TO OBTAIN THIS INFORMATION. THE PLAIN LANGUAGE SUMMARY IS OFFERED AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS AND INCLUDED WHEN A PATIENT IS SENT WRITTEN NOTICE THAT EXTRAORDINARY COLLECTION ACTIONS MAY BE TAKEN AGAINST HIM/HER. THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY, AND ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE IN WHICH LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS CONSTITUTE THE LESSER OF 1,000 PERSONS OR MORE THAN 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE TRANSLATED DOCUMENTS WILL BE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. PART VI, LINE 4: ALLEN MEMORIAL HOSPITAL IS A 201-BED COMMUNITY HOSPITAL SERVING THE CEDAR VALLEY OF IOWA. ALLEN MEMORIAL HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF ALLEN MEMORIAL HOSPITAL'S MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF BLACK HAWK, BREMER, BUCHANAN, FAYETTE, TAMA AND BUTLER. ALLEN MEMORIAL HOSPITAL ADMITS APPROXIMATELY 10,700 INPATIENTS AND CARES FOR 33,500 EMERGENCY PATIENTS PER YEAR. ALLEN MEMORIAL HOSPITAL CARES FOR MORE INPATIENTS, OUTPATIENTS, EMERGENCY PATIENTS AND CARDIAC PATIENTS THAN ANY OTHER HOSPITAL IN THE CEDAR VALLEY OF IOWA. THERE ARE 5 OTHER HOSPITALS WITHIN THE 6-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $48,412 TO $65,440 AND THE AVERAGE POVERTY RATE IS 10.8%. 62.1% OF ALLEN MEMORIAL HOSPITAL INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. BLACK HAWK COUNTY, THE ONLY COUNTY IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATION, IS 85% CAUCASIAN AMERICAN AND BOSNIAN, 9% AFRICAN-AMERICAN, 4% HISPANIC AND 1% ALL OTHER MINORITY POPULATIONS. PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD OF DIRECTORS OF THE HOSPITAL IS COMPOSED OF CIVIC LEADERS WHO RESIDE IN THE SERVICE AREA OF THE HOSPITAL. THE BOARD ACTIVELY DEBATES AND SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL BUT DOES NOT GET INVOLVED IN ISSUES RELATED TO THE DIRECT OPERATIONS OF THE HOSPITAL. THE BOARD TAKES A BALANCED APPROACH WHEN ADDRESSING COMMUNITY AND BUSINESS/FINANCIAL CONCERNS. THE BOARD IS ALSO THE PRIMARY GROUP FOR DETERMINING THE USE OF HOSPITAL SURPLUS FUNDS, WHICH ARE ALL USED TO FURTHER OUR CHARITABLE PURPOSE. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THROUGH RELATIONSHIPS WITH 36 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 280 PHYSICIAN CLINICS, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS, AND SOUTHERN WISCONSIN.UNITYPOINT HEALTH ENTITIES EMPLOY A LARGE NONPROFIT WORKFORCE, WITH MORE THAN 30,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 6.5 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $4.4 BILLION, UNITYPOINT HEALTH IS THE FIFTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2018, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $559 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. PART VI, LINE 7, REPORTS FILED WITH STATES IA 1 AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501 C(3) 9500 PROGRAM SUPPORT CEDAR VALLEY UNITED WAY 425 CEDAR ST 300 WATERLOO IA 50701 420801846 501 C(3) 8650 PROGRAM SUPPORT IOWA HEALTH SYSTEM 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421435199 501 C(3) 9971647 PROGRAM SUPPORT MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVE WATERLOO IA 50703 421201138 501 C(3) 763994 PROGRAM SUPPORT NORTHWEST IOWA MEDICAL EDUCATION FOUNDATION 2055 KIMBALL AVE 101 WATERLOO IA 50702 421058745 501 C(3) 1542780 PROGRAM SUPPORT 5 0 PART I, LINE 2: ALLEN MEMORIAL HOSPITAL CORPORATION MONITORS THE USE OF GRANT FUNDS ACCORDING TO THE STANDARD FINANCIAL POLICIES OF THE ORGANIZATION AND AS REQUIRED BY THE GRANT OR GRANTOR. THE POLICIES AND PROTOCOLS OF THE FUNDING SOURCE ARE ENFORCED AND MONITORED BY THE ORGANIZATION AND REPORTED AS REQUIRED. X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 KYLE CHRISTIASON MD BOARD MEMBER 0 346167 0 41505 0 1825 0 145 0 25302 0 414944 0 0 PAMELA DELAGARDELLE BOARD MEMBER/PRESIDENT/CEO 403903 15226 52633 0 46100 0 67550 0 26318 734 596504 15960 0 0 CRAIG FLANAGAN TO 918 VP, CSO & CFO 0 203686 0 24227 0 214914 0 4866 0 16107 0 463800 0 129444 CHRISTOPHER CLAYTON DIRECTOR - PHARMACY 159940 0 12794 0 6703 0 8676 0 28120 0 216233 0 0 0 JENNIFER FRIEDLY VP COO/PRESIDENT UPHM 282000 1038 27600 0 15238 0 33006 53 17408 53 375252 1144 0 0 MARY HAGEN VP CHIEF NURSE EXECUTIVE 249731 0 31056 0 19340 0 39733 0 8054 0 347914 0 0 0 CHRISTOPHER HILL DO PHYSICIAN-ER/PHYSICIAN DYAD LEADER 382739 0 18193 0 432 0 13601 0 9653 0 424618 0 0 0 TIMOTHY HORRIGAN MD TO 818 PHYSICIAN/CQO 0 160822 0 17523 0 2211 0 5233 0 18316 0 204105 0 0 STEVEN SESTERHENN VP HUMAN RESOURCES 186165 1606 15970 0 782 0 10374 81 12595 22 225886 1709 0 0 RAJEEV ANUGU MD PHYSICIAN- RADIOLOGY 912224 0 0 0 1020 0 13024 0 27518 0 953786 0 0 0 RUSSELL BUCHANAN MD NEURO SURGEON 1294545 0 0 0 2364 0 13750 0 27257 0 1337916 0 0 0 JOHN HALLORAN MD PHYSICIAN- RADIOLOGY 716640 0 0 0 2364 0 13750 0 24307 0 757061 0 0 0 CHARLES HEGGEN MD PHYSICIAN- RADIOLOGY 686868 0 0 0 6396 0 12464 0 19126 0 724854 0 0 0 PAUL MCCAUGHEY DO PHYSICIAN-ER 605960 0 0 0 3168 0 11228 0 27568 0 647924 0 0 0 RENEE RASMUSSEN TO 1214 FORMER SR VP FIN/CFO/COO 0 278275 0 45159 0 35451 0 14763 0 23835 0 397483 0 0 JAMES WATERBURY VP INSTITUTIONAL DEVELOP 108762 0 8597 0 0 0 12341 0 1029 0 130729 0 0 0 DAN CARPENTER VP CSO CFO TO 117 SENIOR VP & CFO-UPH CORP (FR 02/17) 0 641195 0 109824 0 105462 0 135724 0 21102 0 1013307 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: IF AN INDIVIDUAL IS PROVIDED SOMETHING FROM THE EMPLOYER OF VALUE, SUCH AS A PAID BENEFIT, GIFT CARD OR GIFT, WHICH IS CONSIDERED TAXABLE INCOME, THEN THE EMPLOYER WILL ADD IMPUTED AMOUNTS TO PAYCHECK IN ORDER TO TAX APPROPRIATELY. PART I, LINES 4A-B SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: CRAIG FLANAGAN $62,354. NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: KYLE CHRISTIASON, MD -$13,605, DAN CARPENTER $121,974 PAMELA DELAGARDELLE $57,944, CRAIG FLANAGAN -$5,669, JENNIFER FRIEDLY $20,766, MARY HAGEN $25,983, TIMOTHY HORRIGAN $1,546 AND RENEE RASMUSSEN $26,800. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: CRAIG FLANAGAN $129,444. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. ABIGAIL DELAGARDELLE FAMILY MEMBER OF OFFICER PAMELA DELAGARDELLE 49357 EMPLOYMENT 0 ANN HORRIGAN FAMILY MEMBER OF KEY EMPLOYEE TIMOTHY HORRIGAN 52801 EMPLOYMENT 0 ANNALISE BOLT FAMILY MEMBER OF OFFICER PAMELA DELAGARDELLE 45475 EMPLOYMENT 0 KATHERINE APPEL FAMILY MEMBER OF OFFICER PAMELA DELAGARDELLE 13670 EMPLOYMENT 0 SHAWNA BUCKLEY FAMILY MEMBER OF BOARD MEMBER BOB BUCKLEY 10057 EMPLOYMENT 0 FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 2 STACEY BENTLEY; ROBERT BUCKLEY; BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 ALLEN HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, ALLEN HEALTH SYSTEMS, INC., HAS THE POWER TO NOMINATE AND APPOINT BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, ALLEN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE CHANGES IN ARTICLES AND BYLAWS, DISSOLUTIONS OR MERGER, AND APPOINT BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMMITTEE WILL BE THE SAME AS ALLEN HEALTH SYSTEMS, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE CEO FORUM GROUP AND SVP POSITIONS FOR THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2018 FOR THE FOLLOWING INDIVIDUALS: PAMELA DELAGARDELLE THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST OF MEMORIAL FOUNDATION OF ALLEN HOSPITAL -808,786. TERMINATION OF ALLEN HEALTH SYSTEM FROZEN RETIREMENT INCOME PLAN (#002) -228,592. ABBE CENTER FOR COMMUNITY MENTAL HEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421045257 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) ABBEHEALTH INC 0 ABBEHEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421373123 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'S HEALTHCARE 0 AGING SERVICES INC 740 N 15TH AVE NO A HIAWATHA IA 52233 237085316 SENIOR SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) ABBEHEALTH INC 0 ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO IA 50703 421351526 EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS IA 501(C)(3) 170(B)(1) (A)(II) ALLEN HEALTH SYSTEMS INC 0 ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO IA 50703 421201924 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 420698265 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ALLEN HEALTH SYSTEMS INC 0 ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA IA 52205 421466284 PROVIDE AMBULANCE SERVICES IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'SJONES REGIONAL MEDICAL CENTER 0 BLACK HAWK-GRUNDY MENTAL HEALTH CENTER INC 3251 WEST NINTH STREET WATERLOO IA 50702 420733463 MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 CENTER FOR ALCOHOL AND DRUG SERVICES INC 4869 FOREST GROVE DRIVE BETTENDORF IA 52722 421134273 SUBSTANCE ABUSE SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 0 CENTRAL IOWA HEALTH PROPERTIES CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 421233759 PROPERTY HOLDING COMPANY IA 501(C)(2) CENTRAL IOWA HEALTH SYSTEM 0 CENTRAL IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES IA 50309 421189791 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 CENTRAL IOWA HOSPITAL CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 420680452 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 CHATHAM OAKS 740 N 15TH AVE NO A HIAWATHA IA 52233 421302928 MENTAL HEALTH AND/OR DISABILITY RESIDENTIAL TREATMENT SERVICES IA 501(C)(3) 509(A)(2) ABBEHEALTH INC 0 DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC 1415 WOODLAND AVE SUITE 130 DES MOINES IA 50309 421412497 COORDINATION OF MEDICAL EDUCATION PROGRAMS IA 501(C)(3) 509(A)(3), TYPE III 0 EYERLY-BALL COMMUNITY MENTAL HEALTH SERVICES 945 19TH STREET DES MOINES IA 50314 420942273 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) CENTRAL IOWA HEALTH SYSTEM 0 EYERLY-BALL FOUNDATION INC 945 19TH STREET DES MOINES IA 50314 352515479 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) EYERLY-BALL COMMUNITY MENTAL HEALTH SERVICES 0 FINLEY TRI-STATES HEALTH GROUP INC 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 421307495 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 FRIENDS OF THE BLACK HAWK-GRUNDY MENTAL HEALTH CENTER 3820 HILLSIDE DRIVE CEDAR FALLS IA 50613 421372380 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 GRINNELL REGIONAL MEDICAL CENTER 210 FOURTH AVENUE GRINNELL IA 50112 420933383 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 GRINNELL REGIONAL MEDICAL CENTER AUXILIARY 210 FOURTH AVENUE GRINNELL IA 50112 237075505 CHARITABLE FUNDRAISING AND VOLUNTEER SERVICES IA 501(C)(3) 509(A)(3), TYPE I GRINNELL REGIONAL MEDICAL CENTER 0 GRINNELL REGIONAL MEDICAL CENTER FOUNDATION 210 FOURTH AVENUE GRINNELL IA 50112 421454737 CHARITABLE FUNDRAISING IA 501(C)(3) 509(A)(3), TYPE I GRINNELL REGIONAL MEDICAL CENTER 0 HANCOCK COUNTY SENIOR SERVICES ASSOCIATION PO BOX 160 CARTHAGE IL 62321 370902248 SENIOR SERVICES IL 501(C)(3) 509(A)(2) MEMORIAL HOSPITAL ASSOCIATION 0 HULT CENTER FOR HEALTHY LIVING INC 5409 N KNOXVILLE AVE PEORIA IL 61614 363510390 HEALTH EDUCATION TO THE COMMUNITY IL 501(C)(3) 170(B)(1) (A)(VI) PROCTOR HOSPITAL 0 IOWA HEALTH FOUNDATION 1415 WOODLAND AVE SUITE E-200 DES MOINES IA 50309 421467682 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) CENTRAL IOWA HEALTH SYSTEM 0 IOWA HEALTH SYSTEM 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421435199 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III 0 IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 8101 BIRCHWOOD COURT JOHNSTON IA 50131 421411630 PRIMARY HEALTH CARE SERVICES IA 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM 0 KEOKUK AREA HOSPITAL 1600 MORGAN STREET KEOKUK IA 52632 420710268 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) KEOKUK HEALTH SYSTEMS INC 0 KEOKUK AREA HOSPITAL FOUNDATION 1600 MORGAN STREET KEOKUK IA 52632 421202608 CHARITABLE FUNDRAISING IA 501(C)(3) 509(A)(3) TYPE II KEOKUK HEALTH SYSTEMS INC 0 KEOKUK HEALTH SYSTEMS INC 1600 MORGAN STREET KEOKUK IA 52632 421237361 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVENUE WATERLOO IA 50703 421201138 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 MEMORIAL HOSPITAL ASSOCIATION PO BOX 160 CARTHAGE IL 62321 370684691 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM 0 MERITER FOUNDATION INC 202 SOUTH PARK STREET MADISON WI 53715 237098688 CHARITABLE FUNDRAISING WI 501(C)(3) 170(B)(1) (A)(VI) MERITER HEALTH SERVICES INC 0 MERITER HEALTH SERVICES INC 202 SOUTH PARK STREET MADISON WI 53715 391412318 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE WI 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 53715 390806367 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) MERITER HEALTH SERVICES INC 0 MERITER MEDICAL GROUP INC 202 SOUTH PARK STREET MADISON WI 53715 050545222 SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES WI 501(C)(3) 509(A)(3), TYPE III MERITER HOSPITAL INC 0 METHODIST HEALTH SERVICES CORPORATION 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 371111135 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 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IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 36 HOSPITAL FACILITIES AND OVER 400 OUTPATIENT SITES IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A).