2018-11-14T15:50:51-06:00 2017-12-31 990 2017-01-01 421009175 TRINITY REGIONAL MEDICAL CENTER TRIN 5155733101 802 KENYON RD FORT DODGE IA 50501 BRENT FEICKERT CFO 5155746608 2018-11-06 205.167.2.34 2018-11-06 14:37:16 CS P C69FFE27EEBC8ABCAB3DAA7C573007FFE9EEA434 0BFB9BC94ADA8AF3BF63F4A24AA84C65C722C205 2017 2019-02-21 02:37:17Z MIKE J DEWERFF 802 KENYON RD FORT DODGE IA 50501 108537995 0 X WWW.UNITYPOINT.ORG/FORTDODGE X 1973 IA TO IMPROVE THE HEALTH OF OUR COMMUNITY AND REGION THROUGH HEALING, CARING AND EDUCATION. 11 7 955 127 0 0 1413740 869277 98068166 92990462 175952 2586862 4858542 3322907 104516400 99769508 123895 9870961 0 0 56382941 56120013 0 0 0 44185901 42309941 100692737 108300915 3823663 -8531407 165567185 159235132 31594480 28756017 133972705 130479115 X TO IMPROVE THE HEALTH OF THE CITIZENS OF OUR COMMUNITIES AND REGIONS BY PROVIDING QUALITY HEALTHCARE IN AN EFFICIENT AND COST-EFFECTIVE MANNER. 0 0 77263402 5643285 96285617 HEALTH-CARE SERVICESTRINITY REGIONAL MEDICAL CENTER IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE NORTH CENTRAL IOWA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTHCARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. TRINITY REGIONAL MEDICAL CENTER 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, CRITICAL CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, MATERNAL/CHILD CARE, PEDIATRIC CARE, LABORATORY SERVICES, PHARMACEUTICAL DRUGS, RADIOLOGY AND MANY OTHER ROUTINE AND ANCILLARY SERVICES. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2017, TRINITY REGIONAL MEDICAL CENTER ADMITTED 3,959 PATIENTS RESULTING IN A TOTAL OF 13,856 PATIENT DAYS. OUTPATIENT REGISTRATIONS TOTALED 67,085 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 3,150. THERE WERE ALSO 20,015 EMERGENCY ROOM VISITS AND 484 BABIES DELIVERED. 16904528 4227676 0 COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: TRINITY REGIONAL MEDICAL CENTER 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 $788,857 IN 2017. OFTENTIMES, TRINITY REGIONAL MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. TRINITY REGIONAL MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. TRINITY REGIONAL MEDICAL CENTER'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $3,843,573 FOR 2017. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $4,632,430.OTHER BENEFITS: TRINITY REGIONAL MEDICAL CENTER PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS 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. TRINITY REGIONAL MEDICAL CENTER COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. TRINITY REGIONAL MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $12,272,098. 94167930 1 1 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 1 0 1 X 0 0 1 955 1 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X BRENT FEICKERT CFO 5155746608 802 KENYON ROAD FORT DODGE IA 50501 KENNETH ADAMS DO BOARD CHAIR 1.00 40.00 X X 0 747420 876384 NEVEN CONRAD BOARD MEMBER 1.00 1.00 X 0 0 0 MIKE DEWERFF BOARD MEMBER & PRESIDENT/CEO 1.00 40.00 X X 0 573395 116602 CHRIS FRIDERES BOARD MEMBER 1.00 1.00 X 0 0 0 MIKE FRISCHMEYER BOARD MEMBER 1.00 1.00 X 0 0 0 DEBRA JOHNSON BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 TOM SCHNURR BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN TAETS BOARD MEMBER 1.00 1.00 X 0 16004 0 ALAN VIAENE BOARD MEMBER 1.00 1.00 X 0 0 0 LINCOLN WALLACE MD BOARD SECRETARY/TREASURER 1.00 40.00 X X 0 447485 41538 MICHAEL WILLERTH MD BOARD MEMBER 1.00 40.00 X 0 565352 206198 BRENT FEICKERT CFO 1.00 40.00 X 0 207433 52182 TROY MARTENS COO 40.00 1.00 X 0 252574 103135 DEBRA SHRIVER CHIEF NURSING EXECUTIVE 40.00 0.00 X 214522 0 26092 LINDA WHALEY VP CLIN & ANCILLARY SVCS 40.00 0.00 X 168461 0 18713 CHRISTOPHER CARZOLI DO PHYSICIAN-EMERGENCY 40.00 0.00 X 446126 0 30504 DANIEL COLE MD PHYSICIAN-EMERGENCY 40.00 0.00 X 323134 0 29866 CHAD T RENNIE MD PHYSICIAN-EMERGENCY 40.00 0.00 X 450994 0 33709 ELIZABETH W STOEBE DO PHYSICIAN-EMERGENCY 40.00 0.00 X 337746 0 15270 EDWARD TOUNEY DO PHYSICIAN-ED PHYSN SVCS 40.00 0.00 X 397897 0 25519 SUSAN THOMPSON FORMER BOARD MEMBER & PRESIDENT/CEO 0.00 40.00 X 0 562488 334111 2338880 3372151 1909823 40 1 1 0 AMN HEALTHCARE INC 4441 COLLECTIONS CENTER DR CHICAGO IL 60693 STAFFING SERVICES 1104483 WOODRUFF CONSTRUCTION 1920 PHILADELPHIA ST AMES IA 50010 CONSTRUCTION 1039622 PHILIPS ELECTRONICS PO BOX 100355 ATLANTA GA 303840355 HEALTHCARE EQUIPMENT 714868 HEALOGICS WOUND CARE 3087 MOMENTUM PLACE CHICAGO IL 60689 WOUND & HYPERBARIC SERVICES 681394 MERCY MEDICAL CENTER 11111 6TH AVE DES MOINES IA 50314 LAB TESTING 542632 43 828727 40550 869277 NET PATIENT REVENUE 900099 91857564 91857564 LABORATORY SERVICES 900099 617728 617728 RENTAL INCOME 531110 401042 401042 MGMT & SUPPORT SVCS 561000 348651 348651 SUBS & JOINT VENTURES 900099 8659 8659 -243182 -243182 92990462 837474 -319 837793 10517875 8764822 3665 1753053 -3665 1749388 1749388 MISCELLANEOUS REVENUE 900099 2513857 2513857 SHARED SAVINGS REVENUE 900099 781616 781616 CAFETERIA/FOOD SVCS 722210 27434 27434 3322907 99769508 96285616 0 2614615 9849642 9849642 21319 21319 972406 972406 47891 47891 46665634 42527544 4138090 1206959 1099927 107032 4607406 4198825 408581 2619717 2387401 232316 10854295 5195082 5659213 558450 -53765 612215 337618 203478 134140 6805774 5438968 1366806 220128 134397 85731 1668544 1515120 153424 -614805 -614805 1871875 1861216 10659 101410 68165 33245 85850 66323 19527 881723 881723 5549939 5488627 61312 100436 71401 29035 MEDICAL SUPPLIES 13775920 13744807 31113 MISCELLANEOUS EXPENSE 114874 80726 34148 BAD DEBT EXPENSE 1809 1809 INCOME TAXES -3899 -3899 108300915 94167930 14132985 0 3776716 938374 155507 36021 13520450 12687098 20425257 10379810 3102496 2719329 392101 291714 166413844 104003965 61304304 62409879 41748164 46664448 21012778 23146807 115045 -38348 14367 0 165567185 159235132 7778588 6524518 490743 918809 23325149 21312690 31594480 28756017 X 127363151 122194814 3231446 4399766 3378108 3884535 133972705 130479115 165567185 159235132 X -8531407 2858788 2179029 X 0 1 X 1 0 X 47733327 1918141 5429145 243392 133456 54703765 47277000 2363837 683589 2473171 117928 47733327 46840277 606450 76836 152413 94150 47277000 44317758 513306 2693741 626914 57614 46840277 39984852 1025367 4405777 1011453 86785 44317758 0.84860 0.07100 0.08040 0 1 1 1872918 1872918 98642117 50971653 47670464 2571976 2571976 0 57662517 46991260 10671257 5664316 3469076 2195240 62409879 IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC 5000 C BENEFICIAL INTEREST IN TRINITY HEALTH FOUNDATION 23141807 F 23146807 ASBESTOS REMOVAL LIABILITY 111148 CONTINGENCY LIABILITY/SELF-INSURANCE RESERVE 1013709 IOWA HEALTH SYSTEM NOTE PAYABLE 14400000 HEALTH AND WELFARE BENEFITS RESERVE 588164 DUE TO AFFILIATES 4447680 MISCELLANEOUS LIABILITY 647630 LONG-TERM RETENTION INCENTIVES 104359 21312690 X 101858000 2858788 2858788 98999212 134117 636179 770296 99769508 97727000 0 97727000 134117 10439798 10573915 108300915 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 2014. 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. H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACT (THE ACT), WAS SIGNED INTO LAW ON DECEMBER 22, 2017. THE ACT CONTAINS VARIOUS PROVISIONS AFFECTING BOTH TAXABLE AND TAX-EXEMPT ENTITIES. TAX EXEMPT ENTITIES ARE IMPACTED IN PART BY THE INCLUSION OF A NEW EXCISE TAX ON EXCESS COMPENSATION FOR COVERED EMPLOYEES, CHANGES TO UNRELATED BUSINESS INCOME, CHANGES TO TAX RATES, AS WELL AS THEIR ABILITY TO ADVANCE REFUND BONDS. IN ADDITION, TAX-EXEMPT ENTITIES MAY BE IMPACTED THROUGH CERTAIN FOR-PROFIT SUBSIDIARIES AND/OR JOINT VENTURES BASED ON THE ACT'S PROVISIONS FOR TAX RATES, ELIMINATION OF THE CORPORATE ALTERNATIVE MINIMUM TAX, CHANGES TO NET OPERATING LOSS UTILIZATION AND CARRYOVER/CARRYBACK PERIOD, AND MEASUREMENT OF DEFERRED TAXES AS WELL AS OTHER LIMITATIONS ON DEDUCTIONS. THE ACT'S PROVISIONS MAY ALSO IMPACT DONOR TAX INCENTIVES FOR CHARITABLE GIVING. THE SYSTEM IS CURRENTLY ASSESSING THE OVERALL IMPACT OF THE ACT AND ITS IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC REBATES 585,334. REVENUES IN UNRESTRICTED FUND BALANCE 50,425. ROUNDING 420. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN UNRESTRICTED FUND BALANCE 9,853,785. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC REBATES 585,334. ROUNDING 679. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 788857 788857 0.00730 15988890 12145317 3843573 0.03550 16777747 12145317 4632430 0.04280 447888 59370 388518 0.00360 1274549 1274549 0.01180 11828881 5455299 6373582 0.05890 10038904 5803455 4235449 0.03910 23590222 11318124 12272098 0.11340 40367969 23463441 16904528 0.15620 5853 5853 0.00010 2161 2161 0.00000 3578 3578 0.00000 380574 59370 321204 0.00300 114 114 0.00000 55608 55608 0.00050 447888 59370 388518 0.00360 0 670070 0 34950844 36049572 -1098728 X 1 1 1 1 TRINITY REGIONAL MEDICAL CENTER 802 KENYON ROAD FORT DODGE IA 50501 WWW.UNITYPOINT.ORG/FORTDODGE 940001H X X X TRINITY REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 1 1 X WWW.UNITYPOINT.ORG/FORTDODGE X 1 16 1 WWW.UNITYPOINT.ORG/FORTDODGE 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/FORTDODGE/FINANCIAL-ASSISTANCE X HTTPS://WWW.UNITYPOINT.ORG/FORTDODGE/FINANCIAL-ASSISTANCE X HTTPS://WWW.UNITYPOINT.ORG/FORTDODGE/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 TRINITY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: THE COMMITTEE GATHERED COMMUNITY INPUT. COMMUNITY INPUT WAS GARNERED IN A VARIETY OF WAYS. THE COMMITTEE DEVELOPED A 15-QUESTION SURVEY, CONSISTING OF EIGHT DEMOGRAPHIC QUESTIONS AND SEVEN HEALTH-RELATED QUESTIONS. THE SURVEY WAS AVAILABLE IN BOTH ENGLISH AND SPANISH. A POSTCARD CONTAINING INFORMATION ABOUT THE SURVEY AND HOW TO ACCESS IT WAS MAILED TO EVERY WEBSTER COUNTY RESIDENT. THE SURVEY WAS AVAILABLE ONLINE AND PAPER HARDCOPY AT THE HOSPITAL, PUBLIC LIBRARY, PUBLIC HEALTH, LOCAL FOOD PANTRY AND COMMUNITY HEALTH CENTER. THE SURVEY WAS PROMOTED IN THE NEWSPAPER, ON THE RADIO, FACEBOOK, TWITTER, CHURCH BULLETINS, E-NEWSLETTERS, POSTERS IN PROMINENT BUSINESSES THROUGHOUT THE COUNTY, PRESENTED AT SERVICE GROUP MEETINGS, AND AT VARIOUS COMMUNITY EVENTS. IN ADDITION TO THE COMMUNITY SURVEY, BUSINESS AND COMMUNITY LEADERS AND CITY AND COUNTY OFFICIALS WERE INTERVIEWED REGARDING COMMUNITY HEALTH NEEDS. INTERVIEWS WERE ALSO CONDUCTED WITH A VARIETY OF PRIMARY CARE PROVIDERS IN WEBSTER COUNTY REGARDING THEIR OPINIONS OF THE COMMUNITY'S HEALTH NEEDS. TRINITY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: WEBSTER COUNTY HEALTH DEPARTMENT ; UNITED WAY AND THE GREATER FORT DODGE COMMUNITY FOUNDATION ; UPPER DES MOINES OPPORTUNITY AND THE FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER. TRINITY REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE NUMBER ONE HEALTH CONCERN IDENTIFIED DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE. A SIGNIFICANT FOCUS HAS BEEN PLACED ON EXPANDING SERVICES AT TRINITY REGIONAL MEDICAL CENTER'S OUTPATIENT MENTAL HEALTH CENTER, BERRYHILL CENTER. BERRYHILL IS PARTNERING WITH OTHER ORGANIZATIONS TO PROVIDE CARE TO PATIENTS OUTSIDE OF THEIR WALLS, DEVELOPING SATELLITE CLINICS IN SMALLER RURAL COMMUNITIES IN WEBSTER COUNTY, SERVICES IN THE SCHOOLS AS WELL AS ADDING ADDITIONAL STAFF WITHIN THE CLINIC TO OPEN ACCESS AND GREATER AVAILABILITY FOR PATIENTS. ACCESS TO CARE IS THE NUMBER TWO HEALTH CONCERN, PREDOMINATELY AS IT RELATES TO ACCESS TO PRIMARY CARE PROVIDERS. IN RESPONSE TO THIS NEED, TRINITY REGIONAL MEDICAL CENTER HAS SIGNIFICANTLY INVESTED IN THE PROVIDER RECRUITMENT INITIATIVES BY CREATING THE OFFICE OF MEDICAL EDUCATION (OME). OME COORDINATES THE EDUCATIONAL OPPORTUNITIES FOR RESIDENTS, MEDICAL STUDENTS AND ADVANCED PRACTITIONERS, GIVING TRINITY THE OPPORTUNITY TO RECRUIT EARLY AND SECURE COMMITMENTS FOR STUDENTS TO RETURN TO THE ORGANIZATION ONCE THE STUDENTS' TRAINING IS COMPLETE. TRINITY ALSO BEGAN OFFERING STIPENDS TO THESE STUDENTS WHILE STILL IN TRAINING TO INCENTIVE THEM FOR SIGNING A CONTRACT TO COMMIT TO PRACTICE IN THE AREA AFTER COMPLETING THEIR TRAINING. THIS INITIATIVE WILL IMPACT THE COMMUNITY OVER THE LONG TERM BUT COULD BE THE ANSWER TO THE REGION'S PROVIDER SHORTAGE ISSUES. ADDITIONALLY, FINANCIAL INCENTIVES FOR HOSPITAL EMPLOYEES/PHYSICIANS AND COMMUNITY MEMBERS FOR REFERRING A QUALIFIED PHYSICIAN TO THE ORGANIZATION HAVE BEEN CREATED AND PROMOTED TO ASSIST WITH RECRUITMENT. THE SHORT-TERM SOLUTION TO THE PROVIDER ACCESS ISSUES IS TO EXPAND THE HOURS OF URGENT CARE CLINIC IN FORT DODGE. ADDITIONALLY, VIRTUAL CARE IS NOW BEING OFFERED TO ASSIST WITH ACCESS FOR LOW ACUITY HEALTH ISSUES. THIS HAS HAD A SIGNIFICANT IMPACT ON PROVIDER ACCESS IN THE AREA. WHILE WE STILL NEED PRIMARY CARE PROVIDERS IN OUR AREA, THE URGENT CARE CLINIC FREED UP A NUMBER OF APPOINTMENTS DAILY.THE NUMBER THREE HEALTH CONCERN WAS REGARDING OBESITY AND WEIGHT CONTROL. TRINITY CONTINUES TO TARGET THREE AREAS: THE OVERALL COMMUNITY, YOUTH AND TRINITY'S EMPLOYEE POPULATION (TRINITY IS THE LARGEST EMPLOYER IN THE REGION). TO ENCOURAGE HEALTHY BEHAVIORS IN THE COMMUNITY TRINITY OFFERS A NUMBER OF WELLNESS ACTIVITIES: HEALTH WEIGHT 4 LIFE (A WEIGHT LOSS/WEIGHT MAINTENANCE PROGRAM THAT ENCOURAGES HEALTHY CHOICES AND EXERCISE), REDUCE COST HEALTH SCREENINGS AND COMMUNITY HEALTH EVENTS THAT PROVIDE EDUCATION REGARDING DISEASE AND ILLNESS PREVENTION. TO HELP PROMOTE WELLNESS TO THE YOUTH IN OUR COMMUNITY, TRINITY OFFERS THE THRIVE PROGRAM. THE THRIVE PROGRAM IS INTEGRATED INTO THE FORT DODGE AREA SCHOOLS AND PROVIDES CURRICULUM AROUND NUTRITION AND PHYSICAL ACTIVITY. THROUGH THRIVE, TRINITY OFFERS FREE SWIMMING LESSONS TO ALL 3RD AND 4TH GRADERS, G3 (GOOD TO GREAT GIRLS) PROGRAM THAT PROVIDES 5TH GRADE GIRLS WITH INFORMATION REGARDING WELLNESS AND POSITIVE SELF-IMAGE PROMOTION, THE GIRLS THAT PARTICIPATE IN THE PROGRAM COMPLETE A 5K, AS WELL AS MANY MORE PROGRAMS. THROUGH A PARTNERSHIP WITH WEBSTER COUNTY HEALTH DEPARTMENT THRIVE HAS EXPANDED TO ADDITIONAL SCHOOLS AND GRADE LEVELS IN WEBSTER COUNTY. AND FINALLY TRINITY'S EMPLOYEE POPULATION, TO ENCOURAGE HEALTH BEHAVIORS AMONG TRINITY EMPLOYEES WEIGHT LOSS/WEIGHT MAINTENANCE PROGRAMS ARE OFFERED FREE TO EMPLOYEES, FREE AND REDUCED COST HEALTH SCREENINGS ARE MADE AVAILABLE AND WELL AS ACTIVITIES LIKE YOGA, WALKING CLUBS AND AEROBICS ARE OFFERED. FINALLY, THE LAST PRIORITY WAS WOMEN'S HEALTH, SPECIFICALLY FEMALE CANCERS AND PRE-NATAL CARE. TRINITY CANCER CENTER, UNITYPOINT CLINIC AND THE LOCAL CHARTER OF THE AMERICAN CANCER SOCIETY ARE WORKING TOGETHER TO PROVIDE ADDITIONAL EDUCATION OF FEMALE CANCERS, PROMOTION OF PREVENTATIVE SCREENINGS AND EXPANSION OF NECESSARY RESOURCES. THE PRE-NATAL CARE INITIATIVE IS LED BY THE WEBSTER COUNTY HEALTH DEPARTMENT AND WIC AS WELL AS SUPPORTED BY A NUMBER OF OTHER ORGANIZATIONS, INCLUDING TRINITY REGIONAL MEDICAL CENTER. THROUGH THIS PARTNERSHIP THE GROUP WILL EVALUATE OPPORTUNITIES FOR EDUCATION, GAPS IN CARE AND AVAILABLE RESOURCES FOR THE AT RISK POPULATION. TRINITY REGIONAL MEDICAL CENTER 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. PART I, LINE 6A: TRINITY REGIONAL MEDICAL CENTER'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 $ 1,809. 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 FREE CLINICS OR AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. TRINITY REGIONAL MEDICAL CENTER (TRMC) 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. OTHER DONATIONS SUCH AS FOOD OR OTHER DURABLE GOODS PROVIDE AREA SHELTERS AND OTHER ORGANIZATIONS IN THE AREA. THIS ALLOWS THESE ORGANIZATIONS TO MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. TRMC EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, TRMC EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COMMUNITY COLLABORATIVE COLLECTIVELY WORKING TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT TRMC HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A VERY WELL 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 TRINITY REGIONAL MEDICAL CENTER. 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 MEDICARESURPLUS 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: TRINITY REGIONAL MEDICAL CENTER (TRMC) CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN CENTRAL IOWA TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, TRMC IS A SPONSORING PARTNER OF SEVERAL HEALTH SCREENINGS AND FAIRS WHICH ARE A COMMUNITY COLLABORATIVE CONVENED BY PARTNERS SUCH AS IOWA CENTRAL COMMUNITY COLLEGE AND SURROUNDING NURSING HOMES TO ASSESS, ADDRESS AND MONITOR THE HEALTH NEEDS OF WEBSTER COUNTY AND SURROUNDING AREAS. A HEALTH AGENDA WAS DEVELOPED BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY THROUGH THESE VARIOUS HEALTH SCREENS.TRMC WORKS CLOSELY WITH OTHER COMMUNITY GROUPS TO ASSESS THE AREA NEED. THEY WORK CLOSELY WITH THE UNITED WAY AND THE CHARACTER COUNTS PROGRAM. TRMC AND THE UNITED WAY ARE SPONSORING PARTNERS, ALONG WITH THE CITY OF FORT DODGE FOR THIS WORTHY PROGRAM. 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: TRINITY REGIONAL MEDICAL CENTER (TRMC) IS A 200-BED PRIVATE, NON-PROFIT HOSPITAL THAT SERVES FORT DODGE, WHICH IS LOACTED IN WEBSTER COUNTY, AND SURROUNDING COMMUNITIES. TRMC IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.AS A DESIGNATED REGIONAL REFERRAL CENTER, TRMC SERVES AN EIGHT COUNTY AREA WITH A POPULATION OF APPROXIMATELY 100,000. ROUGHLY 25% OF TRMC MARKET RESIDENTS LIVE WITHIN THE CITY LIMITS OF FORT DODGE. THE REMAINING MARKET SHARE LIVES IN THE RURAL AREAS OR SMALL TOWNS SURROUNDING FORT DODGE. IN 2017 TRMC ADMITTED 3,150 INPATIENTS AND SAW APPROXIMATELY 20,015 PATIENTS IN THE EMERGENCY ROOMMEDIAN HOUSEHOLD INCOMES FOR TRMC'S PATIENT POPULATION RANGE FROM $42,196 TO $47,478, AND THE AVERAGE POVERTY RATE IS 14.7%. WEBSTER COUNTY, THE ONLY COUNTY IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATION, IS 90% CAUCASIAN, 5% AFRICAN-AMERICAN, 1% ASIAN, AND 4% HISPANIC. 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 400 OUTPATIENT SITES, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS, AND SOUTHERN WISCONSIN.UNITYPOINT HEALTH ENTITIES EMPLOY THE STATE'S LARGEST 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 6.2 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $4.2 BILLION, UNITYPOINT HEALTH IS THE FOURTH 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 2017, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $526 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 IOWA HEALTH SYSTEM 1776 WEST LAKES PARKWAY1776 WEST LAKES PARKWAY WEST DES MOINES IA 50266 421435199 501(C)(3) 9606346 PROGRAM SERVICES IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 8101 BIRCHWOOD CT JOHNSTON IA 50131 421411630 501(C)(3) 155633 PROGRAM SERVICES NORTH CENTRAL IOWA MENTAL HEALTH CLINIC 720 KENYON RD FORT DODGE IA 50501 420937390 501(C)(3) 35443 PROGRAM SERVICES UNITYPOINT AT WORK 1776 WEST LAKES PARKWAY WEST DES MOINES IA 50266 810872241 501(C)(3) 45000 PROGRAM SERVICES 4 0 MEDICAL 46 21319 PART I, LINE 2: TRINITY REGIONAL MEDICAL CENTER REQUIRES EACH RECIPIENT OF THE GRANTS (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINE A SERIES OF ELIGIBILITY STANDARDS THAT ARE REQUIRED TO BE MET. TRINITY REGIONAL MEDICAL CENTER THEN REVIEWS THESE APPLICATIONS, AND BASED ON NEED AND ELIGIBILITY, A COMMITTEE MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS. X X X X X 0 1 0 0 0 0 0 0 0 KENNETH ADAMS DO BOARD CHAIR 0 727940 0 15475 0 4005 0 846763 0 29621 0 1623804 0 0 MIKE DEWERFF BOARD MEMBER & PRESIDENT/CEO 0 321878 0 22838 0 228679 0 94948 0 21654 0 689997 0 181920 LINCOLN WALLACE MD BOARD SECRETARY/TREASURER 0 406209 0 33422 0 7854 0 13500 0 28038 0 489023 0 0 MICHAEL WILLERTH MD BOARD MEMBER 0 543916 0 18107 0 3329 0 184693 0 21505 0 771550 0 0 BRENT FEICKERT CFO 0 186519 0 19838 0 1076 0 33502 0 18680 0 259615 0 0 TROY MARTENS COO 0 216897 0 15287 0 20390 0 86147 0 16988 0 355709 0 0 DEBRA SHRIVER CHIEF NURSING EXECUTIVE 186558 0 13288 0 14676 0 10987 0 15105 0 240614 0 0 0 LINDA WHALEY VP CLIN & ANCILLARY SVCS 156920 0 3980 0 7561 0 8627 0 10086 0 187174 0 0 0 CHRISTOPHER CARZOLI DO PHYSICIAN-EMERGENCY 405324 0 40250 0 552 0 13500 0 17004 0 476630 0 0 0 DANIEL COLE MD PHYSICIAN-EMERGENCY 296649 0 20250 0 6235 0 13500 0 16366 0 353000 0 0 0 CHAD T RENNIE MD PHYSICIAN-EMERGENCY 431485 0 19125 0 384 0 9980 0 23729 0 484703 0 0 0 ELIZABETH W STOEBE DO PHYSICIAN-EMERGENCY 313274 0 20625 0 3847 0 13500 0 1770 0 353016 0 0 0 EDWARD TOUNEY DO PHYSICIAN-ED PHYSN SVCS 373544 0 21750 0 2603 0 13500 0 12019 0 423416 0 0 0 SUSAN THOMPSON FORMER BOARD MEMBER & PRESIDENT/CEO 0 406486 0 109441 0 46561 0 326029 0 8082 0 896599 0 0 PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: KENNETH ADAMS, MD $833,263, MIKE DEWERFF $63,185, BRENT FEICKERT $22,772, TROY MARTENS $74,020, SUSAN THOMPSON $311,871, AND MICHAEL WILLERTH, MD $171,193. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: MIKE DEWERFF $181,920. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. NICHOLE FEICKERT FAMILY MEMBER OF OFFICER BRENT FEICKERT 47891 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 SYSTEM). 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 6 TRINITY HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B TRINITY HEALTH SYSTEMS, INC., AS SOLE MEMBER, AND IOWA HEALTH SYSTEM, AS SOLE MEMBER OF TRINITY HEALTH SYSTEMS, APPROVE BOARD OF DIRECTORS, BUDGETS, APPOINT PRESIDENT, APPROVE ESTABLISHING SUBSIDIARIES, AFFILIATES AND JOINT VENTURES, APPROVE MERGERS, CONSOLIDATIONS OR DISSOLUTIONS, APPROVE CHANGES IN PURPOSE, AND APPROVE PURCHASE, SALE, LEASE TRANSFER OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY FUNCTIONAL AREA WITH RESPONSIBILITY 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 TOP EXECUTIVES IN 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 2017 FOR THE FOLLOWING INDIVIDUALS: MICHAEL DEWERFF, BRENT FEICKERT, TROY MARTENS, DEBRA SHRIVER, SUSAN THOMPSON, LINCOLN WALLACE, M.D., AND LINDA WHALEY. 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 TRINITY HEALTH FOUNDATION 2,179,029. 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)(2) 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 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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).