2025-11-13T14:05:07-06:00 2024-12-31 990 2024-01-01 421487967 ST LUKE'SJONES REGIONAL MEDICAL CENTER STLU 3194626131 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 ERIC BRIESEMEISTER PRESIDENT 3194626131 2025-11-04 0 2024 2025-03-06 01:10:19Z JONES REGIONAL MEDICAL CENTER ERIC BRIESEMEISTER 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 83847706 0 X WWW.UNITYPOINT.ORG (SEE SCH O) X 1998 IA TO PROVIDE QUALITY SERVICES AND TO PROMOTE HEALTHY LIFESTYLES TO OUR CUSTOMERS. 9 5 390 252 0 0 288755 614127 53519044 62029986 1253618 2858808 1595494 20786 56656911 65523707 117906 96893 0 0 26111318 28437379 0 0 0 18309632 21697756 44538856 50232028 12118055 15291679 82177281 96965855 7509543 6533748 74667738 90432107 X TO PROVIDE QUALITY SERVICES IN AN EFFICIENT, COST-EFFECTIVE MANNER AND TO PROMOTE HEALTHY LIFESTYLES TO OUR CUSTOMERS. 0 0 48102377 96893 61975795 HEALTH-CARE SERVICESST. LUKE'S/JONES 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, MENTAL HEALTH CARE, REHABILITATION, SKILLED NURSING, LABORATORY, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2023, ST. LUKE'S/JONES REGIONAL MEDICAL CENTER DISCHARGED 345 PATIENTS RESULTING IN A TOTAL OF 1,775 PATIENT DAYS. OUTPATIENT VISITS TOTALED 168,305 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 1,246. THERE WERE ALSO 7,551 EMERGENCY ROOM VISITS. 420276 0 0 COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: ST. LUKE'S/JONES 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 $168,783 IN 2024. OFTENTIMES, ST. LUKE'S/JONES REGIONAL MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $0. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $203,961.OTHER BENEFITS: ST. LUKE'S/JONES 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. ST. LUKE'S/JONES 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. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $216,315. 48522653 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 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 390 1 0 0 0 0 0 0 0 0 0 0 0 X 9 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X X ERIC BRIESEMEISTER PRESIDENT 3194816232 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 CHARLIE BECKER BOARD MEMBER 1.00 0.00 X 0 0 0 ERIC BRIESEMEISTER BOARD MEMBER/PRESIDENT - JRMC 40.00 1.00 X X 0 232727 47165 CASEY GREENE BOARD SECRETARY & MKT PRES 1.00 40.00 X X 0 426171 82779 PHILIP HANNA BOARD MEMBER 1.00 0.00 X 0 0 0 LUCAS HICKS BOARD MEMBER & MKT VP FINANCE 1.00 40.00 X 0 276565 24496 AIMEE HOSPODARSKY BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID KEHOE BOARD CHAIR 1.00 0.00 X X 0 0 0 JANINE SULZNER BOARD MEMBER 1.00 0.00 X 0 0 0 JAY WILLEMS BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 AMBER COLLUM PHYSICIAN ASSISTANT 40.00 0.00 X 202039 0 31533 KARL HOLMES PHYSICIAN ASSISTANT 40.00 0.00 X 285313 0 17928 ALISSA SCHEPANSKI PHYSICIAN ASSISTANT 40.00 0.00 X 206383 0 35313 ANNA PRUESS NURSE PRACTITIONER 40.00 0.00 X 203163 0 32357 MICHELLE VANDEBERG NURSE PRACTITIONER 40.00 0.00 X 239893 0 14262 MICHAEL HEINRICH TO 1223 FORMER BOARD MEMBER/CFO 0.00 40.00 X 0 941690 113114 MICHELLE NIERMANN TO 1223 FORMER PRESIDENT/CEO 0.00 40.00 X 0 799714 143169 1136791 2676867 542116 28 1 1 0 EAST CENTRAL IOWA ACUTE CARE 1026 A AVE NE CEDAR RAPIDS IA 52402 ER DOCTOR STAFFING 2634498 AMN HEALTHCARE INC 2999 OLYMPUS BLVD DALLAS TX 75019 HEALTHCARE STAFFING 646267 IOWA ANESTHESIA LC 5825 DRY CREEK LN NE CEDAR RAPIDS IA 52402 MEDICAL SERVICES 290241 EASTERN IOWA SLEEP CENTER 275 10TH ST SE SUITE 3330 CEDAR RAPIDS IA 52403 MEDICAL SERVICES 247260 ORGANOGENESIS INC 85 DAN RD CANTON MA 02021 MEDICAL SERVICES 238026 6 468826 145301 614127 NET PATIENT REVENUE 900099 61469094 61469094 MGMT & SUPPORT SVCS 561000 470113 470113 RENTAL INCOME 531100 90554 90554 EDUCATION & RESEARCH 621510 225 225 62029986 2013187 2013187 19149270 20350 18319991 4008 829279 16342 845621 845621 MISCELLANEOUS 900099 101643 101643 CAFETERIA/FOOD SVCS 722210 74977 74977 SHARED SAVINGS REVENUE 900099 -155834 -155834 20786 65523707 61975795 0 2933785 X 95293 95293 1600 1600 279891 279891 22937556 22232813 704743 618860 599846 19014 3320038 3218032 102006 1281034 1241675 39359 5465278 5215065 250213 2994 2994 33771 33771 104058 58006 46052 5612588 5498256 114332 38401 13278 25123 136204 78947 57257 1054391 1050437 3954 38105 34252 3853 28847 25334 3513 1426256 1417063 9193 -3215 -3215 MEDICAL SUPPLIES 7711278 7704676 6602 MISCELLANEOUS EXPENSE 47267 39785 7482 BAD DEBT EXPENSE 1510 1510 INCOME TAXES 23 23 50232028 48522653 1709375 0 14651996 15741063 11777610 8921314 4612020 5539697 6435418 3299878 641464 747530 77078 71741 38610668 20293251 18841348 18317417 22481518 41795031 1727650 1727650 931179 804534 82177281 96965855 3243343 3349430 15000 26999 1368063 284480 2883137 2872839 7509543 6533748 X 72944373 88708742 1723365 1723365 74667738 90432107 82177281 96965855 15291679 472690 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1723365 145221 145221 1723365 1723365 284433 284433 1723365 1723365 1469905 1469905 1723365 1723365 626038 626038 1723365 1723365 49615 49615 1723365 0.00000 0.00000 1.00000 0 1 1 377707 377707 19679069 7710522 11968547 18155416 12493570 5661846 398476 89159 309317 18317417 DUE TO AFFILIATES 1466985 HEALTH AND WELFARE BENEFITS RESERVE 241185 MISCELLANEOUS LIABILITY 365318 OPERATING LEASE LIABILITY 799351 2872839 X 65849000 472690 384 473074 65375926 46052 101729 147781 65523707 50186000 24 24 50185976 46052 46052 50232028 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 2021. 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: ROUNDING 384. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN NET ASSETS WITHOUT DONOR RESTRICTION 101,729. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 24. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 203961 203961 0.00410 5853528 11649344 0 0.00000 6057489 11649344 203961 0.00410 216315 216315 0.00430 216315 216315 0.00430 6273804 11649344 420276 0.00840 0 644113 0 12120268 13032148 -911880 X 1 1 1 1 ST LUKE'SJONES REGIONAL MEDICAL CENTER 1795 HIGHWAY 64 EAST SUITE 2 ANAMOSA IA 52205 WWW.UNITYPOINT.ORG/ANAMOSA 530110H X X X X ST LUKE'SJONES REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, PAGE 8 X 1 22 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 600.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X 1 X 0 0 ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: FACILITATED BY LINN COUNTY PUBLIC HEALTH WITH OVERSIGHT PROVIDED BY THE TOGETHER! HEALTHY LINN STEERING COMMITTEE, THE CHA AND CHIP INCLUDE PARTNERSHIPS WITH A MULTITUDE OF COMMUNITY STAKEHOLDERS, INCLUDING MERCY MEDICAL CENTER, UNITYPOINT HEALTH-ST. LUKE'S HOSPITAL, AND EASTERN IOWA HEALTH CENTER. THE ALIGNMENT OF THE CHA AND CHIP FOR ALL FOUR ENTITIES IN LINN COUNTY MINIMIZES DUPLICATION AND MAXIMIZES IMPACT, AS ALL ORGANIZATIONS ARE REQUIRED UNDER LAW, OR BY FUNDERS, TO ASSESS THE HEALTH OF THE COMMUNITY AND DEVELOP AN IMPLEMENTATION PLAN FOR MEETING IDENTIFIED COMMUNITY NEEDS.THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONSISTS OF THE FOLLOWING PARTNERS: ABBEHEALTH, BETHANY LUTHERAN CHURCH, CEDAR RAPIDS CITY COUNCIL, CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT, CITY OF CEDAR RAPIDS, CITY OF MARION POLICE DEPARTMENT, EASTERN IOWA HEALTH CENTER, GREATER CEDAR RAPIDS COMMUNITY FOUNDATION, IOWA STATE UNIVERSITY EXTENSION & OUTREACH, KIRKWOOD COMMUNITY COLLEGE, LINN COUNTY BOARD OF SUPERVISORS, LINN COUNTY PUBLIC HEALTH, MERCY MEDICAL CENTER, STATE OF IOWA REPRESENTATIVE, STATE OF IOWA SENATOR, UNITED WAY OF EAST CENTRAL IOWA, AND UNITYPOINT HEALTH-ST. LUKE'S HOSPITAL.THE JONES COUNTY PUBLIC HEALTH CHNA HIP WORKGROUP MEMBERS INCLUDE REPRESENTATIVES FROM JRMC, PUBLIC HEALTH, SCHOOLS, DAYCARES, COMMUNITY AGENCIES, EXTENSION SERVICES, LAW ENFORCEMENT, AND GOVERNMENT OFFICIALS. IN ADDITION, THE SSA PUBLIC HEALTH DEPARTMENTS WERE CONTACTED BY ST. LUKE'S HOSPITAL TO BETTER UNDERSTAND THEIR COUNTY NEEDS THROUGH UTILIZING THEIR MOST RECENT CHNA. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: MERCY MEDICAL CENTER AND UNITYPOINT - ST. LUKE'S HOSPITAL ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: LINN COUNTY PUBLIC HEALTH AND EASTERN IOWA HEALTH CENTER ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE FOLLOWING IS AN EVALUATION OF IMPACT OF THE PRIORITIES IDENTIFIED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT & ACTIONS TAKEN AS PART OF THE 2023-25 IMPROVEMENT PLAN (REPORTING ON YEARS 2023 & 2024),PRIORITY ONE - FOOD INSECURITY UNITYPOINT HEALTH CEDAR RAPIDS LEADERSHIP TEAM MEMBERS VOLUNTEER FOR MEALS ON WHEEL'S WEEKLY TO DELIVER MEALS TO COMMUNITY MEMBERS IN THE WELLINGTON HEIGHTS NEIGHBORHOOD WHICH ST. LUKE'S HOSPITAL IS LOCATED. DELIVERING APPROXIMATELY 1800 MEALS TO INDIVIDUALS IN OUR NEIGHBORHOOD THROUGH EFFORTS OVER THE COURSE OF THE NEEDS ASSESSMENT & IMPROVEMENT PLAN CYCLE. INCREASE UTILIZATION & AWARENESS OF ELIGIBILITY RELATED TO FOOD RESOURCES IN LINN COUNTY: UNITYPOINT HEALTH-CEDAR RAPIDS (UPH-CR) UTILIZES A SOCIAL DETERMINANTS OF HEALTH SCREENING/ASSESSMENT IN BOTH INPATIENT & OUTPATIENT SETTINGS. IN YEARS 2023-24, 39,416 PATIENTS WERE SCREENED FOR SOCIAL DETERMINANTS OF HEALTH WITH 6% OF INDIVIDUALS REFERRED TO COMMUNITY AGENCIES. PRIORITY TWO - MENTAL HEALTH/ACCESS HEALTH INSURANCE ENROLLMENT: ACCESS TO HEALTH INSURANCE DECREASE HEALTH DISPARITY RATE OF UNINSURED INDIVIDUALS WHO IDENTIFY AS BLACK/AFRICAN AMERICAN, HISPANIC/LATINO, & INDIVIDUALS WHO IDENTIFY AS TWO OR MORE RACED. IN 2023-24, OUR UPH-CR FINANCIAL COUNSELORS ASSISTED OVER 10,200 INDIVIDUALS IN ACCESSING INSURANCE. ACCESS CENTER LEADERSHIP: THROUGH OUR ABBE HEALTH CENTER'S LEADERSHIP AT THE LINN COUNTY ACCESS CENTER THAT OPENED IN '23 & GUIDELINK IN JOHNSON COUNTY, PROVIDING OVERNIGHT CRISIS CARE, SERVED 1172 INDIVIDUALS IN '23, CREATING NEW ACCESS FOR INDIVIDUALS IN OUR COMMUNITY. SERVING 1132 INDIVIDUALS IN '24. INCREASED ACCESS FOR INDIVIDUALS WITH MEDICAID: WITH MEDICAID, IN '23, 601 ADULT BEHAVIORAL HEALTH PATIENTS (50.04% OF PATIENTS SERVED IN 2023) WERE SERVED IN OUR INPATIENT UNITS & 442 ADOLESCENT BEHAVIORAL HEALTH PATIENTS (OR 61.22% OF ADOLESCENT PATIENTS SERVED) WERE SERVED. WITH MEDICAID, IN '24, 446 ADULT BEHAVIORAL HEALTH PATIENTS (42.76% OF PATIENTS) WERE SERVED IN OUR INPATIENT UNITS & 441 ADOLESCENT BEHAVIORAL HEALTH PATIENTS (63.27% OF PATIENTS) WERE SERVED. TELEMEDICINE: VIRTUAL OPTIONS CONTINUE TO BE OFFERED IN OUR BEHAVIORAL HEALTH SERVICES. SUBSTANCE ABUSE SERVICES ACCESS: UPH-CR SUPPORTED COMMUNITY NEEDS THROUGH PROVIDING SUBSTANCE ABUSE COUNSELING & RESOURCES TO 2493 CLIENTS FROM 2023-24. CLIENTS WITH MEDICAID INSURANCE WERE 46.13% OF THE INDIVIDUALS SERVED. INCREASE AWARENESS OF MENTAL HEALTH RESOURCES: UPH-CR SUPPORTED COMMUNITY EFFORTS IN INCREASING AWARENESS THROUGH PARTICIPATING IN THE PLANNING OF DISTRIBUTING COMMUNITYWIDE & DEMOGRAPHIC SPECIFIC MESSAGING THROUGH MAKE IT OK EDUCATION MATERIALS. ST. LUKE'S HOSPITAL THROUGH PARTNER AGENCIES HELPED PROVIDE TRANSPORTATION TO OVER 4000 PATIENT TRANSPORTS FROM 2023-24. PRIORITY THREE - HEALTH EQUITY CLINICAL DATA REFLECTING POPULATION DEMOGRAPHICS TO IDENTIFY HEALTH DISPARITIES FOR IMPROVEMENT: UPH-CR MEETS CMS HOSPITAL INPATIENT QUALITY REPORTING GUIDELINES FOR HEALTH EQUITY MEASURE FOR '23 & '24. WE HAVE IMPLEMENTED A HEALTH EQUITY DASHBOARD THAT IS REVIEWED BY OUR HEALTH ENGAGEMENT COUNCIL. POTENTIAL IMPACT IS AN OPPORTUNITY IN REDUCTION OF 147 READMISSIONS. IMPLEMENTATION OF COMMUNITY HEALTH WORKERS TO ADDRESS BARRIERS TO CARE: IN '24, UPH-CR INITIATED THE COMMUNITY HEALTH WORKER MODEL AT 2 CLINICS, TRAINING 2 COMMUNITY HEALTH CARE WORKERS IN THIS MODEL. STARTING IN NOVEMBER OF '24, FROM NOV-DEC '24, 174 WERE IDENTIFIED & OUTREACH WAS PROVIDED. IN '24, CLINICAL COMPETENCIES TO PROVIDE EDUCATION & AWARENESS ON HEALTH EQUITY & CULTURALLY RESPONSIVE CARE WAS ROLLED OUT TO ALL TEAM MEMBERS ACROSS THE ACUTE NURSING AREAS, SURGICAL SERVICES & EMERGENCY DEPT. SERVICES. REDUCE DISPARITIES IN OBSTETRIC HEALTH EQUITY FOR PATIENTS OF COLOR: TRAINED 15 WOMEN'S & CHILDREN'S SERVICES LEADERS IN IMPLICIT BIAS & THE IMPACT ON CLINICAL CARE. IMPROVE CARE FOR SICKLE CELL TREATMENT FOR PATIENTS OF COLOR: IMPLEMENTED A SICKLE CELL PROTOCOL FOR PAIN MANAGEMENT & TRAINED THE EMERGENCY DEPT., MEDICALLY COMPLEX UNIT & A GRAND ROUND EDUCATIONAL SESSION ON SICKLE CELL MANAGEMENT. IMPACT TRAINED 140 INDIVIDUALS. PARTICIPATED IN THE AFRICAN AMERICAN MUSEUM OF IA HEALTHCARE FAIR & PROVIDED CANCER INFO & SCREENINGS TO APPROXIMATELY 75 PARTICIPANTS. DECREASE DISPARITY OF PERCENT OF INDIVIDUALS LIVING IN POVERTY. PARTNERED WITH AREA EDUCATION ENTITIES FOR CAREER EXPLORATION & VOCATIONAL TRAINING OPPORTUNITIES. INITIATED PATIENT CARE APPRENTICE PROGRAM IN DEC. '23 FOR 30 HIGH SCHOOL STUDENTS. FROM HOSTED A CAREER EXPLORATION CONFERENCE FOR IJAG, A HIGH SCHOOL PROGRAM SERVING STUDENTS FROM MARGINALIZED POPULATIONS & SERVED APPROXIMATED 110 STUDENTS. IN 2023-24, UPH-CR TEAM MEMBERS PROVIDED HEALTH CAREER INFORMATION TO OVER 3000 AREA HIGH SCHOOLERS THROUGH THE JUNIOR ACHIEVEMENT CAREER DAY. IN ADDITION, APPROXIMATELY 100 JOB SHADOWS HAVE BEEN PROVIDED THROUGH KIRKWOOD COMMUNITY COLLEGE'S WORKPLACE LEARNING. WE PROVIDED EXPLORATION, SHADOWS & CLINICAL EXPERIENCES TO MORE THAN 3600 STUDENTS FROM 2023-24.PRIORITY 4 LIFESTYLE/EQUITABLE OPPORTUNITIES TO BE PHYSICALLY ACTIVE IN '23, ST. LUKE'S AS PART OF ITS PARTICIPATION IN THE MEDQUARTER, INVESTING IN THE DEVELOPMENT OF THE MEDQ GREEN SPACE, INCLUDING A PARK IN OUR NEIGHBORHOOD. THIS NEIGHBORHOOD HAS A VARIATION IN DECREASED LIFE EXPECTANCY OF 10-13 YEARS COMPARED TO OTHER NEIGHBORHOODS IN CEDAR RAPIDS. PROMOTE AGE RELATED INFORMATION ON THE IMPACT OF SCREEN TIME. EVERY ADOLESCENT RECEIVING CARE FROM OUR CLINICS RECEIVES AN AFTER VISIT SUMMARY THAT INCLUDES GUIDANCE ON AGE APPROPRIATE SCREEN TIME WITH EDUCATION ON HOW TO MONITOR & REDUCE SCREEN USAGE. COMMUNITY FIRST AID & HEART PREVENTION: ST. LUKE'S HOSPITAL PARTNERS COMMUNITY ENTITIES TO PROVIDE FIRST AID TRAINING & PREVENTION, HEART ATTACK & STROKE PREVENTION. ONE EFFORT IS STOP THE BLEED TO INCREASE ABILITIES OF COMMUNITY MEMBERS TO RESPOND TO FIRST AID INCIDENTS. THE TEAM PROVIDES CPR TRAINING & BLOOD PRESSURE SCREENINGS AT COMMUNITY EVENTS, DISSEMINATES & EDUCATES INDIVIDUALS ON QUICK ACTION FOR HEART ATTACKS & STROKE CARE. SERVING 505 INDIVIDUALS.JONES REGIONAL MEDICAL CENTER SPECIFIC NEEDS / ACTIONS CHRONIC CONDITIONS & DISEASE MANAGEMENT CARE MANAGEMENT SUPPORT IN THE JRMC CLINICS FOR RISING RISK PATIENTS. CARE MANAGEMENT IN OUR PRIMARY CARE CLINICS HAS IMPROVED OUTCOMES FOR PATIENTS WITH RISING HEALTH RISKS BY PROVIDING PROACTIVE SUPPORT, PERSONALIZED CARE PLANNING, & CONSISTENT FOLLOW-UPHELPING PATIENTS BETTER MANAGE CHRONIC CONDITIONS & AVOID UNNECESSARY HOSPITALIZATIONS. SUPPORT FOR OLDER ADULTS: SUPPORT FOR OLDER ADULTS IMPLEMENTATION OF TELESITTER MONITORS INPATIENT: MONITORS ARE UTILIZED FOR ONGOING MONITORING FOR PATIENTS THAT MAY BE AT HIGHER RISK FOR THINGS LIKE FALLS. ALZHEIMER'S CAREGIVER SUPPORT GROUP: MEETS ONCE A MONTH & IS DONE IN CONJUNCTION WITH THE ALZHEIMER'S ASSOCIATION. PARKINSON'S SUPPORT & EXERCISE GROUP: JRMC HOSTS THIS FREE COMMUNITY CLASS 2X/WEEK WITH AN AVERAGE ATTENDANCE OF 12 PEOPLE. PRIORITY 5 COMMUNITY SAFETY/PREVENTION OF GUN VIOLENCE IMPLEMENT GUN VIOLENCE INTERVENTION (GVI)HOSPITAL INTERVENTION THAT INCLUDES REFERRAL OF A PATIENT/FAMILY WHO IS VICTIM OF GUN VIOLENCE TO THE COMMUNITY'S WAYPOINT/ FOUNDATION 2 RESOURCES PRIOR TO DISCHARGE FROM THE HOSPITAL. ST. LUKE'S PARTICIPATES IN THE COMMUNITY'S STAND UP FOR PEACE COALITION, A COLLABORATIVE GROUP TO REDUCE ENGAGEMENT IN GUN VIOLENCE IN THE COMMUNITY. THE ST. LUKE'S 10 MEMBERS OF THE ST. LUKE'S SOCIAL WORK TEAM TRAINED ON THE EVIDENCED BASED GVI MODEL & INTERVENTION. IMPACT IN '23 COMPARED TO '22, THERE WAS A REDUCTION IN SHOTS FIRED FROM 120 IN '22 TO 81 IN '23 & RESULTING INJURIES DECREASED FROM 38 TO 31 (9 DEATHS). IN '24 COMPARED TO '23, THERE WAS A REDUCTION IN SHOTS FIRED FROM 83 TO 58 & RESULTING INJURIES 12 (2 DEATHS). ADDRESS DOMESTIC VIOLENCE DISPARITY IN WOMEN: PATIENTS IN THE EMERGENCY DEPT. ARE ASKED AN ASSESSMENT QUESTION, "DO YOU FEEL SAFE AT HOME." IN ADDITION WE HAVE THE BLUE DOT SCREENING & REFERRAL FOR INTIMATE PARTNER VIOLENCE. ST. LUKE'S PARTNERS WITH WAYPOINT PROVIDING DOMESTIC PARTNER VIOLENCE RESOURCES WITH A BASIC NECESSITY DRIVE IN '23 & '24 TO GATHER HYGIENE PRODUCTS FOR INDIVIDUALS THAT HAVE FLED ABUSIVE RELATIONSHIPS & RECEIVING SERVICES THROUGH WAYPOINT.PRIORITY 6-PREVENT EPIDEMICS & SPREAD OF DISEASE/PUBLIC HEALTH EMERGENCY PREPAREDNESS & RECOVERY VACCINE PROMOTION: THROUGH INCREASED PROMOTION & ON-SITE PROVISION OF VACCINES IN PRIMARY CARE CLINICS, OUR HEALTH SYSTEM HAS IMPROVED ACCESS TO PREVENTIVE CARE & REDUCED PREVENTABLE ILLNESS. EMERGENCY PREPAREDNESS: UPH-CR CONDUCTS EMERGENCY MANAGEMENT DRILLS YEARLY AT THEIR HOSPITAL FACILITIES. ADDITIONAL PLANNING SESSIONS INVOLVING MULTIDISCIPLINE LEADERS FOR SPECIFIC EMERGENCY PREPAREDNESS WERE INITIATED IN '24 & WILL CONTINUE. THESE SESSIONS WALK THROUGH ASSESSMENT QUESTIONS TO IDENTIFY STRENGTHS & OPPORTUNITIES. ST. LUKE'S/JONES 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. STATE LAW REQUIREMENTS THAT OFFER ADDITIONAL AND/OR MORE STRINGENT ELIGIBILITY REQUIREMENTS WILL BE FOLLOWED FOR THOSE STATES. FACILITY REPORTING GROUP A - PART V, LINE 7A, CHNA REPORT: THE CHNA REPORT WAS WIDELY AVAILABLE ON A WEBSITE FACILITY'S WEBSITE (LIST URL):HTTPS://WWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS FACULTY REPORTING GROUP A - PART V, LINE 10A, IMPLEMENTATION STRATEGY: HE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY WAS WIDELY AVAILABLEON A WEBSITE (LIST URL):HTTPS://WWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS FACULTY REPORTING GROUP A - PART V, LINE 16A, FAP WEBSITE: THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):HTTPS://WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE FACULTY REPORTING GROUP A - PART V, LINE 16B, FAP WEBSITE: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):HTTPS://WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE FACULTY REPORTING GROUP A - PART V, LINE 16C, FAP WEBSITE: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):HTTPS://WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART I, LINE 6A: THE HOSPITAL'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM'S COMMUNITY BENEFIT REPORT (DBA AS UNITYPOINT HEALTH) WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. 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 $ 1,510. PART II, COMMUNITY BUILDING ACTIVITIES: JONES REGIONAL MEDICAL CENTER PARTNERS WITH SEVERAL COMMUNITY ORGANIZATIONS TO PROMOTE HEALTH. A SAMPLING OF OUR COMMUNITY BUILDING ACTIVITIES FROM OUR COMMUNITY BENEFIT REPORTING INCLUDE: CAREER CAMP - HIGH SCHOOL STUDENTS WERE OFFERED A DAY CAMP OF GETTING TO LISTEN TO EXPERTS IN THEIR RESPECTIVE HEALTHCARE FIELD AND GIVING THEM TOURS THROUGHOUT THE SIM LAB AND HOSPITAL, AS WELL AS HANDS ON TYPE ACTIVITIES TO ENLIGHTEN THEM OF HEALTH CAREERS. TOTAL: 15 STUDENTS FIRST AID STATION AT COUNTY FAIR - HOSPITAL CLINICAL STAFF STAFFED THE STATION TO OFFER FIRST AID SUCH AS BAND-AIDS, GAUZE, ICE PACKS, ETC. FOR SCRAPES AND ACCIDENTS, AS WELL AS SERVED AS A RESOURCE FOR A CONDUIT TO HIGHER LEVEL CARE IF NEEDED FOR ANY OTHER REASONS. THE FAIR'S ATTENDANCE EXCEEDS 100,000 EACH YEAR THE NUMBER THAT WERE HELPED WITHIN THE STATION WAS NOT NOTED. PARKINSON'S EXERCISE CLASS (2 CLASSES HELD/WEEK) - AVERAGE ATTENDANCE IS 12 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 ST. LUKE'S JONES 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 MEDICARE SHORTFALL 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. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE AND OFFSETTING REVENUE.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: IN ADDITION TO ASSESSING HEALTHCARE NEEDS FROM INDIVIDUALS THAT WERE DESCRIBED IN PART V, JONES REGIONAL MEDICAL CENTER ALSO REVIEWS PATIENT CLINICAL DATA BY DEMOGRAPHICS. THIS INCLUDES CLINICAL DATA FOR READMISSIONS, INPATIENT MORTALITY, AND FALLS. WE ALSO LOOK AT OUR AGGREGATED DATA FROM OUR SOCIAL DETERMINANTS ASSESSMENT THAT IS PART OF OUR ELECTRONIC HEALTH RECORD BOTH FOR INPATIENT AND OUTPATIENT. 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: ST. LUKE'S JONES REGIONAL MEDICAL CENTER IS A 22-BED COMMUNITY HOSPITAL SERVING EAST CENTRAL IOWA. ST. LUKE'S JONES REGIONAL MEDICAL CENTER IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.78.7% OF ST. LUKE'S JONES REGIONAL MEDICAL CENTER MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF JONES. ST. LUKE'S JONES REGIONAL MEDICAL CENTER ADMITS APPROXIMATELY 345 INPATIENTS AND CARES FOR 7,551 EMERGENCY PATIENTS PER YEAR. THE MEDIAN HOUSEHOLD INCOME IS $75,677 AND THE AVERAGE POVERTY RATE IS 9.0%.88.2% OF ST. LUKE'S JONES REGIONAL MEDICAL CENTER INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. ST. LUKE'S JONES REGIONAL DEMOGRAPIC REGION IS COMPRISED OF 94% CAUCASION, 3% AFRICAN AMERICAN AND 3% HISPANIC. PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH AN OPEN MEDICAL STAFF AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD APPROVES THE COMMUNITY NEEDS ASSESSMENT AND COMMUNITY BENFEFIT PLAN FOR THE HOSPITAL. THE HOSPITAL IS PART OF AN INTEGRATED HEALTH SYSTEM AND ITS ULTIMATE PARENT UNITYPOINT HEALTH ALONG WITH ITS SUBSIDIARIES THAT INCLUDE THE HOSPITAL HAVE A STANDARD MODEL OF GOVERNANCE THAT ALLOWS THE HOSPITAL TO MAINTAIN A STRONG CLINICAL, FINANCIAL, STRATEGIC AND OPERATIONAL PROFILE THAT INCLUDES SURPLUS FUNDS USED TO FURTHER ITS CHARITABLE PURPOSE. PART VI, LINE 6: THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $5.3B IN OPERATING REVENUE AND 29,000 TEAM MEMBERS. AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 400 CLINICS; 17 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THEIR REGIONS. IN 2024, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $281 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 0 1 0 0 0 0 0 0 0 MICHAEL HEINRICH TO 1223 FORMER BOARD MEMBER/CFO 0 559102 0 77630 0 304958 0 100904 0 12210 0 1054804 0 277474 MICHELLE NIERMANN TO 1223 FORMER PRESIDENT/CEO 0 629784 0 138313 0 31617 0 112246 0 30923 0 942883 0 0 CASEY GREENE BOARD SECRETARY & MKT PRES 0 378846 0 43619 0 3706 0 55706 0 27073 0 508950 0 0 KARL HOLMES PHYSICIAN ASSISTANT 284440 0 0 0 873 0 5737 0 12191 0 303241 0 0 0 LUCAS HICKS BOARD MEMBER & MKT VP FINANCE 0 253530 0 21149 0 1886 0 13954 0 10542 0 301061 0 0 ERIC BRIESEMEISTER BOARD MEMBER/PRESIDENT - JRMC 0 221321 0 11148 0 258 0 11947 0 35218 0 279892 0 0 MICHELLE VANDEBERG NURSE PRACTITIONER 239189 0 0 0 704 0 11731 0 2531 0 254155 0 0 0 ALISSA SCHEPANSKI PHYSICIAN ASSISTANT 201551 0 0 0 4832 0 10543 0 24770 0 241696 0 0 0 ANNA PRUESS NURSE PRACTITIONER 202509 0 0 0 654 0 10405 0 21952 0 235520 0 0 0 AMBER COLLUM PHYSICIAN ASSISTANT 197508 0 0 0 4531 0 9443 0 22090 0 233572 0 0 0 PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: CASEY GREEN $38,757; MICHAEL HEINRICH $83,654 AND MICHELLE NIERMANN $94,996. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: MICHAEL HEINRICH $288,863. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. SCHEDULE J, PART I, LINE 3 - ESTABLISHING COMPENSATION 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. JACKIE SCHMIT FAMILY MEMBER OF BOARD MEMBER PHILLIP HANNA 36666 EMPLOYMENT 0 FORM 990, LINE J, WEBSITE WWW.UNITYPOINT.ORG/LOCATIONS/UNITYPOINT-HEALTH---JONES-REGIONAL-MEDICAL- CENTER 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 ST. LUKE'S HEALTHCARE, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A ST. LUKE'S HEALTHCARE CAN APPOINT SEVEN BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B ST. LUKE'S HEALTHCARE, AS SOLE MEMBER SHALL APPROVE ARTICLE AND BYLAW AMENDMENTS, DISSOLUTIONS, APPOINT SEVEN BOARD MEMBERS AND APPROVE APPOINTMENT OF PRESIDENT. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY UNITYPOINT HEALTH'S CORPORATE SERVICES TAX DEPARTMENT AND GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE DEPARTMENT WITH ULTIMATE APPROVAL BY THE DIRECTOR OF TAX SERVICES. THE DIRECTOR OF TAX SERVICES MEETS WITH THE FINANCE EXECUTIVE AND REVIEWS KEY PARTS OF THE FORM 990 UTILIZING A PRESENTATION SUMMARY. A COPY OF THE FORM 990 IS GIVEN TO EACH MEMBER OF THE BOARD VIA THE BOARD PORTAL ALONG WITH A REVIEW GUIDE. 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 2024 FOR THE FOLLOWING INDIVIDUALS: ERIC BRIESEMEISTER, MICHAEL HEINRICH, CASEY GREENE, LUCAS HICKS, AND MICHELLE NIERMANN. 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 IX, LINE 11G HEALTHCARE PROFESSIONALS: PROGRAM SERVICE EXPENSES 1,938,619. MANAGEMENT AND GENERAL EXPENSES 16,270. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,954,889. PURCHASED HOUSEKEEPING AND LAUNDRY: PROGRAM SERVICE EXPENSES 161,289. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 161,289. MISC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,398,348. MANAGEMENT AND GENERAL EXPENSES 98,062. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,496,410. 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AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 400 CLINICS; 17 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS.