2015-11-12T13:43:44-06:00 2014-12-31 990 2014-01-01 370681540 PROCTOR HOSPITAL PROC 3096911064 5409 N KNOXVILLE AVENUE PEORIA IL 61614 ROB QUIN VP FINANCE/CFO 3096725565 2015-11-11 2014 2016-04-25 22:37:26Z DEBORAH SIMON 5409 N KNOXVILLE AVENUE PEORIA IL 61614 90064811 0 X WWW.UNITYPOINT.ORG/PEORIA X 1958 IL PROVIDES A BROAD RANGE OF HEALTHCARE SERVICES AND ACTIVITIES TO THE COMMUNITY. 17 12 543 204 534699 -1272 0 459168 101836674 88865515 -26829 -455284 163639 734326 101973484 89603725 0 0 0 0 47568346 42763062 0 0 0 69906819 54182743 117475165 96945805 -15501681 -7342080 88218639 87367416 78018169 97675451 10200470 -10308035 X PROCTOR HOSPITAL PROVIDES A BROAD RANGE OF HEALTHCARE SERVICES AND ACTIVITIES TO THE COMMUNITY. 0 0 79077902 0 89599841 HEALTH-CARE SERVICESPROCTOR HOSPITAL IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE PEORIA, ILLINOIS, COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. PROCTOR HOSPITAL 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, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY AND A NATIONALLY UNIQUE ADDICTION RECOVERY CENTER. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2014, PROCTOR HOSPITAL ADMITTED 5,143 PATIENTS RESULTING IN A TOTAL OF 25,597 PATIENT DAYS. OUTPATIENT VISITS TOTALED 59,687 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 3,813. THERE WERE ALSO 18,103 EMERGENCY ROOM VISITS AND 516 BABIES DELIVERED. 7680472 0 0 COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: PROCTOR HOSPITAL 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 $707,025 IN 2014. OFTENTIMES, PROCTOR HOSPITAL RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. PROCTOR HOSPITAL PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. PROCTOR HOSPITAL'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $3,452,857 FOR 2014. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $4,159,882.OTHER BENEFITS: PROCTOR HOSPITAL 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; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; SUBSIDIZED HEALTH SERVICES; RESEARCH; AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. PROCTOR HOSPITAL COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. PROCTOR HOSPITAL HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $3,520,590. 86758374 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 183 0 1 543 1 1 1 0 0 0 0 0 0 0 0 0 X 17 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X X TONY MOORE 3096725914 221 NORTHEAST GLEN OAK AVE PEORIA IL 61636 BRUCE ALKIRE BOARD CHAIR 1.00 1.00 X X 0 0 0 KEVIN BARBIER DIRECTOR 1.00 1.00 X 0 0 0 BRIAN COHEN MD DIRECTOR 1.00 40.00 X 0 400855 28468 FRANK CRESPO DIRECTOR 1.00 1.00 X 0 0 0 JILL DAUGHERTY DIRECTOR 1.00 1.00 X 0 0 0 JOHN ERWIN PHD TO 0514 DIRECTOR 1.00 1.00 X 0 0 0 GREG GERSTNER DIRECTOR 1.00 1.00 X 0 0 0 VAUGHN HANNA MD DIRECTOR 1.00 1.00 X 0 263103 55551 PETER JOHNSEN PHD DIRECTOR 1.00 1.00 X 0 13352 0 ALEXIS KHAZZAM DIRECTOR 1.00 1.00 X 0 0 0 KEITH KNEPP MD DIRECTOR 1.00 40.00 X 0 451606 84735 MEGHAN LUNDEEN FR 0614 DIRECTOR 1.00 1.00 X 0 0 0 JAY MARINO EDD TO 0314 DIRECTOR 1.00 1.00 X 0 0 0 PATRICK O'LEARY MD BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 JAMES MAXEY MD DIRECTOR 1.00 0.00 X 0 0 0 DEBORAH SIMON DIRECTOR/PRESIDENT & CEO 1.00 40.00 X X 0 731927 182332 JAMES VERGON DIRECTOR 1.00 1.00 X 0 0 0 DAVID WALTY DIRECTOR 1.00 1.00 X 0 0 0 ROBERT QUIN TREASURER/CFO 1.00 40.00 X 0 365707 66980 PAUL MACEK PRESIDENT & CEO 14.00 26.00 X 55705 394640 18808 JAYALAKSHMI ATTALURI PHYSICIAN 40.00 0.00 X 286370 0 7221 JAMES AUSFAHL PHYSICIAN 40.00 0.00 X 355637 0 19439 TIMOTHY LAWLESS PHYSICIAN 40.00 0.00 X 433523 0 24292 ROBERT MEISTER PHYSICIAN 40.00 0.00 X 381084 0 18162 KIRK MOBERG PHYSICIAN 40.00 0.00 X 255316 0 22279 1767635 2621190 528267 10 0 1 0 EMERGENCY PHYSICIAN STAFFING SOLUTIONS 1528 SR 78 HVANA IL 62644 ED PHYSICIANS 1464752 PROFESSIONAL THERAPY SERVICES INC 2810 FRANK SCOTT PARKWAY BELLEVILLE IL 62223 THERAPY SERVICES 1397528 UNIDINE CORPORATION 1000 WASHINGTON STREET STE 510 BOSTON MA 02118 CAFETRIA CONTRACT SERVICES 777070 ASSOCIATED ANESTHESIOLOGISTS SC 8600 N STATE ROUTE 91 PEORIA IL 61615 ANESTESIA SERVICES 680457 SIGNET HEALTH 235 W HICKORY ST ST 201 DENTON TX 76201 CONTRACT SERVICES 427721 9 37742 47211 374215 459168 NET PATIENT REVENUE 900099 83274075 83136406 137669 MISCELLANEOUS REVENUE 900099 4005843 3992472 13371 OTHER HEALTHCARE SVCS 900099 1585597 1585597 88865515 5802 5802 461086 -461086 -461086 -461086 CHILDCARE AND ADULTCARE SERVICES 624410 585845 350667 235178 CAFETERIA/FOOD SVCS 722210 148481 148481 734326 89603725 89065142 534699 -455284 X 473403 473403 32822339 30494165 2328174 96791 89925 6866 6999129 6527751 471378 2371400 2203190 168210 -88715 -88715 27003 27003 14567643 12110357 2457286 185155 177858 7297 1802599 1653132 149467 6250672 6183255 67417 3006671 1393998 1612673 135424 123042 12382 1156858 1156858 5661671 4388671 1273000 1257353 1257353 MEDICAL SUPPLIES 15873027 15873027 MEDICAID PROVIDER ASSES 4113032 4113032 MISCELLANEOUS EXPENSE 234350 169618 64732 96945805 86758374 10187431 0 4185560 8521041 298559 12213306 11384729 21091898 19931659 3498104 2606660 2652168 625549 144715665 111625926 35655962 33089739 1865735 3847386 7055906 7062094 88218639 87367416 29990276 9260171 46581 30026540 26878672 4956069 6472726 13045284 55017301 78018169 97675451 X 3072942 -17455220 6651778 6665955 475750 481230 10200470 -10308035 88218639 87367416 X -7342080 2527 -13168952 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27003 27003 0 PART II-B, LINE 1: PROCTOR HOSPITAL PAYS DUES TO IHA. THE AMOUNT OF DUES PAID IN 2014 WAS $79,423 OF WHICH 34% OR $27,003 WAS USED FOR LOBBYING. 6081907 6081907 65073727 47916543 17157184 429739 179953 249786 73083492 63529430 9554062 46800 46800 33089739 DEFERRED CHARGES 13330 BENEFICIAL INTEREST IN PERPETUAL TRUST 7048764 7062094 CAPITAL LEASE OBLIGATIONS 707682 RETIREMENT PLAN ACCRUAL 20799269 SELF-INSURANCE RESERVE 1037691 ASBESTOS REMOVAL LIABILITY 347000 DUE TO AFFILIATES 29783150 MISCELLANEOUS LIABILITY 2342509 55017301 X 89257401 0 89257401 346324 346324 89603725 92633394 0 92633394 4312411 4312411 96945805 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 2011. 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 4B - OTHER ADJUSTMENTS: TAX REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 11,650. TAX REVENUES IN PERMANENTLY RESTRICTED FUND BALANCE 5,480. REVENUES NETTED IN EXPENSES 329,194. PART XII, LINE 4B - OTHER ADJUSTMENTS: TAX EXPENSES IN UNRESTRICTED FUND BALANCE 3,983,217. REVENUES NETTED IN EXPENSES 329,194. 1 1 X 1 X 1 X 1 1 0 1 1 706219 706219 0.00730 8631701 5178844 3452857 0.03560 9337920 5178844 4159076 0.04290 6846854 3770199 3076655 0.03170 443935 443935 0.00460 7290789 3770199 3520590 0.03630 16628709 8949043 7679666 0.07920 80000 80000 0.00080 20920 20920 0.00020 100920 100920 0.00100 1 1460405 0 25320828 34897113 -9576285 X 1 1 1 1 PROCTOR HOSPITAL 5409 N KNOXVILLE AVENUE PEORIA IL 61614 WWW.UNITYPOINT.ORG/PEORIA 0001925 X X X PROCTOR HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X WWW.UNITYPOINT.ORG/PEORIA X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X X X X X 1 X 0 X X X X 1 X 0 0 PROCTOR HOSPITAL PART V, SECTION B, LINE 5: THE CHNA INCLUDED DETAILED ANALYSES OF SECONDARY DATA TO ASSESS INFORMATION REGARDING THE HEALTH STATUS OF THE COMMUNITIES. IN ORDER TO PERFORM THESE ANALYSES, INFORMATION WAS COLLECTED FROM NUMEROUS SECONDARY SOURCES, INCLUDING PUBLICALLY AVAILIABLE SOURCES, SUCH AS COUNTY-BASED DATA, AS WELL AS PRIVATE SOURCES OF DATA, SUCH AS HOSPITAL-SPECIFIC DATA. SPECIFICALLY, FINDINGS FROM THE SECONDARY SOURCES OF DATA HIGHLIGHTED SEVERAL CRITICAL AREAS OF COMMUNITY NEEDS. TO COLLECT DATA, THREE SURVEYING TECHINQUES WERE USED - ONLINE, PAPER, AND STRUCTURED INTERVIEWS.THE HOSPITALS THEN IDENTIFIED AND PRIORITIZED THE MOST IMPORTANT HEALTH-RELATED ISSUES IN THE TRI-COUNTY REGION. AFTER SUMMARIZING ALL OF THE ISSUES OF THE CHNA, A COMPREHENSIVE ASSESSMENT OF EXISTING COMMUNITY RESOURCES WAS PERFORMED TO IDENTIFY THE EFFICACY TO WHICH HEALTH-RELATED ISSUES WERE ALREADY BEING ADDRESSED. FINALLY, A COLLABORATIVE EFFORT OF LEADERS IN THE HEALTHCARE COMMUNITY USED AN IMPORTANCE/URGENCY METHODOLOGY TO IDENTIFY THE MOST CRITICAL ISSUES IN THE AREA.TEAM MEMBERS FOR THIS NEEDS ASSESSMENT INCLUDED TWO REPRESENTATIVES FROM EACH OF THE THREE PEORIA HOSPITALS, ADMINISTRATORS FROM THE THREE COUNTY HEALTH DEPARTMENTS, PHYSICIANS/ADMINISTRATORS FROM CLINICS SERVING THE AT-RISK POPULATION, REPRESENTATION FROM THE UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AND THE HEART OF ILLINOIS UNITED WAY. PROCTOR HOSPITAL PART V, SECTION B, LINE 6A: PROCTOR HOSPITAL'S CHNA WAS A COLLABORATIVE UNDERTAKING BY PROCTOR HOSPITAL, METHODIST MEDICAL CENTER OF ILLINOIS AND OSF SAINT FRANCIS MEDICAL CENTER TO HIGHLIGHT THE HEALTH NEEDS AND WELL-BEING OF RESIDENTS IN PEORIA, TAZEWELL, AND WOODFORD COUNTIES. PROCTOR HOSPITAL PART V, SECTION B, LINE 11: PUBLIC LAW REQUIRES CHARITABLE HOSPITAL ORGANIZATIONS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST ONCE EVERY THREE YEARS AND TO ADOPT AN IMPLEMENTATION STRATEGY TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. UPH METHODIST AND UPH PROCTOR ARE IN THE THIRD YEAR OF AN IMPLEMENTATION PLAN TO ADDRESS THE COMMUNITY NEEDS IDENTIFIED IN THE LOCAL ASSESSMENT THAT WAS DONE IN 2013. A COPY OF THE PLAN IS ATTACHED IN 10B. A STEERING COMMITTEE COMPRISED OF MEMBERS FROM THE THREE LOCAL HOSPITALS, COUNTY HEALTH DEPARTMENT REPRESENTATIVES FROM THE THREE COUNTIES IN THE PRIMARY SERVICE AREA, AND REPRESENTATIVES FROM THE UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AT PEORIA, THE HEART OF ILLINOIS UNITED WAY, AND THE HEARTLAND COMMUNITY HEALTH CLINIC IDENTIFIED EIGHT CRITICAL HEALTH RELATED ISSUES THAT NEEDED ADDRESSED:- ACCESS TO HEALTHCARE- RISKY BEHAVIORS- ASTHMA- DIABETES- HEALTHY BEHAVIORS- LUNG CANCER- MENTAL HEALTH- OBESITYUPH - METHODIST AND UPH - PROCTOR CHOSE TO DEPLOY RESOURCES TO ADDRESS ALL EIGHT ISSUES. BY PROVIDING FINANCIAL AND MANPOWER SUPPORT AND THROUGH UNITYPOINT CLINICS, THE IN-SCHOOL HEALTH PROGRAM, THE WELLMOBILE, THE HULT EDUCATION CENTER AND OTHER RESOURCES, THE TWO HOSPITALS HAVE IMPROVED THE HEALTH AND LIVES OF AREA RESIDENTS. A SUMMARY OF THE EFFORTS BEING MADE IS PROVIDED BELOW:ACCESS:PRIMARY CARE, DENTAL CARE AND COUNSELING SERVICES WERE IDENTIFIED AS ACCESS ISSUES. THROUGH THE DEPLOYMENT OF THE RESOURCES LISTED, ACCESS WAS EXPANDED IN ALL THREE AREAS. FOR EXAMPLE, ED DENTAL VISITS DECLINED FROM 1,380 IN 2012 TO 1,281 IN 2014. RISKY BEHAVIORS:TO ADDRESS RISKY BEHAVIORS, UPH - METHODIST AND UPH - PROCTOR IDENTIFIED A GOAL OF DECREASING THE RATE OF ADULT SMOKING BY 1% AND EDUCATING YOUTH ON THE DANGERS OF ALCOHOL, TOBACCO, AND DRUG USE. A SMOKER REGISTRY WAS DEVELOPED IN THE UNITYPOINT CLINICS ALONG WITH CESSATION PROGRAMS AND HEALTH INSURANCE INCENTIVES FOR PLAN PARTICIPANTS THAT ARE NON-SMOKERS. THE KIDS KONNECTED PROGRAM OFFERS EDUCATION ON THE DANGERS OF TOBACCO AND DRUG USAGE AND PSYCHOSOCIAL COUNSELING IS OFFERED TO YOUTH THROUGH IN-SCHOOL HEALTH AT NO COST.ASTHMA:OUR IN-SCHOOL HEALTH COLLABORATED WITH THE LOCAL PEORIA SCHOOL DISTRICT TO PROVIDE ASTHMA EDUCATION TO STUDENTS AND FAMILIES TO HELP IMPROVE ADHERENCE TO TREATMENT PROTOCOLS AND HELP WITH EARLY IDENTIFICATION AND DIAGNOSIS OF ASTHMATIC CHILDREN.DIABETES:MANAGEMENT OF ADULT AND CHILDHOOD DIABETES IS BEING ADDRESSED WITH THE DEVELOPMENT OF A DIABETIC REGISTRY IN THE UNITYPOINT CLINICS AND THROUGH EDUCATION PROGRAMS OFFERED THROUGH THE DIABETIC CENTER AND HULT. HGBA1C MEASURES ARE TRACKED FOR AT-RISK PATIENTS AND LIFESTYLE COACHING AND NUTRITION EDUCATION ARE PROVIDED.HEALTHY BEHAVIORS:EXERCISE AND DIET WERE IDENTIFIED AS HEALTHY BEHAVIORS THAT NEEDED IMPROVEMENT. COACHING IS PROVIDED FOR AT RISK PATIENTS THROUGH THE UNITYPOINT CLINICS AND THE IMPORTANCE OF EXERCISE AND GOOD NUTRITION IS EMPHASIZED THROUGH EDUCATIONAL PROGRAMS FOR YOUTH THROUGH IN-SCHOOL HEALTH AND THROUGH HULT.LUNG CANCER:BOTH LOW COST AND FREE SCREENINGS ARE OFFERED TO HELP EARLY DIAGNOSE LUNG CANCER AND DECREASE LUNG CANCER MORTALITY. OVER 80 STAGE I LUNG CANCER CASES HAVE BEEN DIAGNOSED SINCE THE PROGRAM BEGAN THAT MAY HAVE OTHERWISE GONE UNDETECTED.MENTAL HEALTH:ACCESS TO GOOD MENTAL HEALTH CARE IS AN ISSUE IN THE SERVICE AREA. 25% OF AREA RESIDENTS SURVEYED IDENTIFIED THAT THEY EXPERIENCED POOR MENTAL HEALTH BETWEEN 1 AND 7 DAYS EACH MONTH. UPH COLLABORATED WITH THE FAYETTE COMPANIES AND UICOMP TO REDUCE ACUTE CARE UTILIZATION FOR BEHAVIORAL DISORDERS THROUGH IMPROVED ACCESS TO COMMUNITY-BASED MENTAL HEALTH PROVIDERS AND THROUGH PRIMARY CARE SCREENING FOR DEPRESSION. THIRTY DAY READMISSION RATES FOR BEHAVIORAL HEALTH DIAGNOSIS HAVE DECREASED FROM 13.6% IN 2012 TO 12.8% IN 2015.OBESITY:OBESITY IN THE AREA POPULATION IS SLIGHTLY HIGHER THAN THE ILLINOIS AVERAGE. ILLINOIS, HOWEVER, HAS THE 6TH HIGHEST OBESITY RATE IN THE U.S. OBESITY IS LINKED TO MANY CHRONIC DISEASES INCLUDING DIABETES, HYPERTENSION, HIGH BLOOD PRESSURE AND ORTHOPEDIC PROBLEMS. UPH METHODIST AND UPH PROCTOR SET OUT TO REDUCE THE INCIDENCE OF OBESITY AMONG UNITYPOINT CLINIC PATIENTS AND UNITYPOINT HEALTH METHODIST | PROCTOR EMPLOYEES THROUGH CLINIC EDUCATION, HEALTH PLAN PREMIUM INCENTIVES AND FREE LIFESTYLE COACHING AND COUNSELING FOR AT RISK PATIENTS. THE GOAL WAS TO ASSURE THAT 95% OF ALL UPC PATIENTS HAD A CURRENT BMI RECORDED SO THAT PROGRESS TOWARD WEIGHT LOSS COULD BE MONITORED. 98.7% OF ALL UPC PATIENTS HAVE A BMI DOCUMENTED WITHIN THE LAST YEAR.MORE DETAIL IS AVAILABLE IN THE CURRENT CHNA IMPLEMENTATION PLAN DOCUMENT ATTACHED IN 10B. A NEW COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE CONDUCTED IN 2016. PROCTOR HOSPITAL 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 U.S. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM, FAMILY INVESTMENT PROGRAM, BARNABAS UPLIFT, MISSION HEALTH, AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. PART III, LINE 4: PATIENT RECEIVABLES DUE FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS AND BY CONSIDERING THE PATIENT'S FINANCIAL HISTORY, CREDIT HISTORY, AND CURRENT ECONOMIC CONDITIONS. INTEREST IS NOT CHARGED ON PATIENT RECEIVABLES. PATIENT RECEIVABLES ARE WRITTEN OFF AS A BAD DEBT WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. 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 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.METHODIST IS PAID BELOW LEVELS THAT FULLY COMPENSATE IT FOR THE UNDERLYING COSTS OF CARE TO MEDICARE BENEFICIARIES. METHODIST TREATS ITS MEDICARE SHORTFALL AS A COMMUNITY BENEFIT DUE TO THE LARGE POPULATION OF SENIORS THE HOSPITAL SERVES. THE POPULATION AT AGE 65 OR ABOVE IS MUCH HIGHER FOR METHODIST'S SERVICE AREA COMPARED TO THE REST OF ILLINOIS. THE MEDICARE SHORTFALL IS CALCULATED USING A COST ACCOUNTING SYSTEM. PART III, LINE 9B: NO COLLECTION EFFORTS WILL BE MADE BY PROCTOR HOSPITAL OR ITS DESIGNATED AGENTS ON ACCOUNTS WHERE PATIENTS HAVE COMPLETED THE FINANCIAL ASSISTANCE APPLICATION PROCESS AND ESTABLISHED THEIR ELIGIBILITY FOR CHARITY CARE. PART VI, LINE 2: PROCTOR HOSPITAL'S BOARD OF TRUSTEES AND MANAGEMENT TEAM DEVELOPED GOALS FOR THE COMMUNITY BENEFIT PLAN USING FEEDBACK FROM EMPLOYEES, PATIENTS, FAMILIES, PHYSICIANS, FOCUS GROUPS, STUDIES OF LOCAL AND REGIONAL HEALTH TRENDS, AND REVIEWS OF CENSUS DATA TO PROVIDE THE NECESSARY EVIDENCE FROM WHICH TO CONCENTRATE OUR EFFORTS. FROM THE RESEARCH, THREE PRIMARY GOALS WERE ESTABLISHED AND ARE NOW REVIEWED ANNUALLY. NO SUBSTANTIVE CHANGES TO THE PRIMARY GOALS WERE MADE IN 2013. PROCTOR'S MOST SIGNIFICANT GOAL WORKS TO IMPROVE ACCESS TO THE DELIVERY OF HEALTHCARE SERVICES, INCLUDES MAKING OUR FACILITIES AND STAFF AVAILABLE TO ANYONE WHO HAS A NEED FOR HEALTH CARE. THE SECOND GOAL, ENHANCING THE QUALITY OF LIFE THROUGH EDUCATION AND PREVENTION, WAS DEVELOPED TO FURTHER THE ABILITY OF PEOPLE OF ALL AGES IN OUR COMMUNITY TO LEARN ABOUT HEALTH ISSUES THAT MAY IMPACT THEIR LIVES. OUR THIRD, AND FINAL PRIMARY GOAL, IS FOR PROCTOR HOSPITAL TO ENHANCE ITS REPUTATION AS A VIRTUAL "CORPORATE" CITIZEN OF PEORIA AND THE SURROUNDING AREA. AS A MAJOR EMPLOYER IN OUR PRIMARY AND SECONDARY SERVICE AREAS, PROCTOR IS COMMITTED TO PROVIDING RESOURCES TO ASSIST OTHER COMMUNITY BASED, NOT-FOR-PROFIT ORGANIZATIONS THAT DEMONSTRATE NEEDS RELATING TO SOME ASPECT OF HEALTH OR QUALITY OF LIFE. REQUESTS FOR ASSISTANCE IN NON-HEALTH/PERSONAL DEVELOPMENT COMMUNITY ENDEAVORS (I.E., ZOOS, MUSEUMS, ETC.) MAY BE CONSIDERED IF ADEQUATE RESOURCES ARE AVAILABLE BUT WILL BE SECONDARY TO CAUSES THAT RELATE SPECIFICALLY TO THE HOSPITAL'S MISSION, VISION AND VALUES. PART VI, LINE 3: PROCTOR HOSPITAL HAS POSTED A SIGN IN ALL ADMISSION AND REGISTRATION AREAS WITH THE FOLLOWING NOTICE: "YOU MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE TERMS AND CONDITIONS THE HOSPITAL OFFERS TO QUALIFIED PATIENTS. FOR MORE INFORMATION CONTACT A PATIENT FINANCIAL SERVICE REPRESENTATIVE AT 309-691-1083." THE SIGN IS IN ENGLISH AND ANY OTHER LANGUAGE THAT IS THE PRIMARY LANGUAGE OF AT LEAST 5% OF THE PATIENTS SERVICED BY THE HOSPITAL ANNUALLY. A NOTICE WAS PLACED ON THE PROCTOR HOSPITAL WEBSITE IN A PROMINENT LOCATION THAT (1)NOTIFIED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AT THE HOSPITAL, (2)DESCRIBED THE FINANCIAL ASSISTANCE APPLICATION PROCESS, AND (3)PROVIDED A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. PART VI, LINE 4: FROM A DEMOGRAPHIC STANDPOINT, PROCTOR SERVES A POPULATION THAT DIFFERS SIGNIFICANTLY FROM ITS LARGER DOWNTOWN COMPETITORS. THE RACIAL AND ETHNIC MIX OF PROCTOR PATIENTS IS IMPACTED BY THE HOSPITAL'S NORTHSIDE LOCATION. PART VI, LINE 5: WE BELIEVE THAT GENERAL KNOWLEDGE OF HEALTH RELATED ISSUES IS LACKING. OUR FOCUS ON EDUCATION AND PREVENTION, THROUGH AN IMPRESSIVE ARRAY OF OPPORTUNITIES, WILL HELP PROVIDE INDIVIDUALS WITH INFORMATION NEEDED TO ASSIST IN MAKING NECESSARY LIFESTYLE CHANGES TO PREVENT DISEASE WHEN POSSIBLE. IF DISEASE CANNOT BE PREVENTED, OUR PLAN IS TO PROVIDE METHODS THAT PROVIDE OPTIONS FOR SOUND DECISION MAKING. RESEARCH CLEARLY STATES THAT EARLY DETECTION IS IMPERATIVE TO DISEASE PREVENTION AND THAT HEALTHY LIFESTYLE CHANGES POSITIVELY IMPACT ATTITUDES OF INDIVIDUALS AND FAMILIES. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). INITIALLY FORMED IN 1994, UNITYPOINT HEALTH IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 32 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 280 PHYSICIAN CLINICS, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, 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 4.5 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $3.7 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 2014, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $443 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 IL X X X X 0 1 0 0 0 0 0 0 0 BRIAN COHEN MD DIRECTOR 0 386383 0 2371 0 12101 0 28099 0 369 0 429323 0 0 VAUGHN HANNA MD DIRECTOR 0 242765 0 0 0 20338 0 35447 0 20104 0 318654 0 0 KEITH KNEPP MD DIRECTOR 0 355735 0 51102 0 44769 0 64791 0 19944 0 536341 0 0 DEBORAH SIMON DIRECTOR/PRESIDENT & CEO 0 420945 0 137181 0 173801 0 161016 0 21316 0 914259 0 0 ROBERT QUIN TREASURER/CFO 0 253029 0 42435 0 70243 0 57932 0 9048 0 432687 0 0 PAUL MACEK PRESIDENT & CEO 51630 292767 0 0 4075 101873 876 0 0 17932 56581 412572 0 0 JAYALAKSHMI ATTALURI PHYSICIAN 252401 0 10000 0 23969 0 0 0 7221 0 293591 0 0 0 JAMES AUSFAHL PHYSICIAN 335416 0 0 0 20221 0 4255 0 15184 0 375076 0 0 0 TIMOTHY LAWLESS PHYSICIAN 408012 0 0 0 25511 0 1845 0 22447 0 457815 0 0 0 ROBERT MEISTER PHYSICIAN 358429 0 0 0 22655 0 1958 0 16204 0 399246 0 0 0 KIRK MOBERG PHYSICIAN 254105 0 0 0 1211 0 0 0 22279 0 277595 0 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN 457(F): KEITH KNEPP $26,022, PAUL MACEK $53,845, ROBERT QUIN $50,206 AND DEBORAH SIMON $88,809. THE PLAN'S FUNDS ARE VESTED QUARTERLY, TWO YEARS AFTER EACH CONTRIBUTION OR EARLIER BASED ON THE PARTICIPANT'S AGE AND YEARS OF SERVICE. A ILLINOIS FINANCE AUTHORITY-SERIES 2006A 861091967 45200BYW2 2006-05-11 22525000 REFUND 1991 BONDS 0 0 0 B ILLINOIS FINANCE AUTHORITY-SERIES 2010A 861091967 2010-12-16 15500000 PAYOFF 2006B AND NEW MONEY 0 0 0 A 22323401 2252500 19564161 506740 2008 1 0 1 1 B 11625000 15500000 11805754 178659 3515588 2012 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 6 PROCTOR HEALTH CARE INCORPORATED, A TAX-EXEMPT ILLINOIS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A PROCTOR HEALTH CARE INCORPORATED, AS SOLE MEMBER, HAS THE RIGHT TO "ELECT, REPLACE OR REMOVE AT ANY TIME AND FROM TIME TO TIME, AND WITHOUT CAUSE, MEMBERS OF THE BOARD OF TRUSTEES OF THE CORPORATION." FORM 990, PART VI, SECTION A, LINE 7B PROCTOR HEALTH CARE INCORPORATED, AS SOLE MEMBER, APPROVES ALL DECISIONS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 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 ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL 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 APPROXIMATELY THE TOP FIFTY 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 ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2014 FOR THE FOLLOWING INDIVIDUALS: KEITH KNEPP, ROBERT QUIN AND DEBORAH SIMON. 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 HEALTH-CARE PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 8,676,971. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,676,971. MISCELLANEOUS PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 3,425,886. MANAGEMENT AND GENERAL EXPENSES 2,048,263. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,474,149. OUTSIDE CONSULTANT FEES : PROGRAM SERVICE EXPENSES 7,500. MANAGEMENT AND GENERAL EXPENSES 189,327. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 196,827. CBO COLLECTION FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 219,696. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219,696. FORM 990, PART XI, LINE 9: CHANGES IN PENSION LIABILITY -13,168,952. 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)(2) ST LUKE'SJONES REGIONAL MEDICAL CENTER 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 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 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 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 1 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 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 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 II 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 II 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 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 METHODIST MEDICAL CENTER FOUNDATION 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 510186460 CHARITABLE FUNDRAISING IL 501(C)(3) 170(B)(1) (A)(VI) METHODIST HEALTH SERVICES CORPORATION 0 METHODIST MEDICAL CENTER OF ILLINOIS 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 370661223 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 METHODIST SERVICES INC 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 371111134 OFFICE RENTAL IL 501(C)(3) 509(A)(2) METHODIST HEALTH SERVICES CORPORATION 0 NELLIE R SHERWOOD TRUST 1026 A AVENUE NE CEDAR RAPIDS IA 52402 426061621 PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY IA 501(C)(3) 509(A)(3), TYPE I ST LUKE'S METHODIST HOSPITAL 0 NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED 720 KENYON DRIVE FORT DODGE IA 50501 420937390 MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(III) TRINITY HEALTH SYSTEMS INC 0 NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY IA 51104 421019872 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM 0 PROCTOR HEALTH CARE INCORPORATED 5409 N KNOXVILLE AVE PEORIA IL 61614 371133412 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 PROCTOR HEALTH SYSTEMS 5409 N KNOXVILLE AVE PEORIA IL 61614 364147437 PRIMARY HEALTH CARE SERVICES IL 501(C)(3) 170(B)(1) (A)(III) PROCTOR HEALTH CARE INCORPORATED 0 PROCTOR HOSPITAL 5409 N KNOXVILLE AVE PEORIA IL 61614 370681540 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) PROCTOR HEALTH CARE INCORPORATED 0 SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 376181831 FUND SELF-INSURANCE PLAN IL 501(C)(3) 509(A)(3), TYPE I METHODIST MEDICAL CENER OF ILLINOIS 0 SHARED MAGNETIC RESONANCE IMAGING FACILITY INC 1104 JOHN NOLEN DRIVE MADISON WI 53713 391534744 MEDICAL TECHNOLOGY WI 501(C)(3) 509(A)(3), TYPE I 0 SIOUXLAND PACE INC 313 COOK STREET SIOUX CITY IA 51103 261120134 ALL-INCLUSIVE CARE FOR THE ELDERLY IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTH SYSTEM INC 0 ST LUKE'S HEALTH RESOURCES 2720 STONE PARK BLVD SIOUX CITY IA 51104 421059182 OUTPATIENT CLINICS AND HEALTHCARE SERVICES IA 501(C)(3) 509(A)(2) ST LUKE'S HEALTH SYSTEM INC 0 ST LUKE'S HEALTH SYSTEM INC 2720 STONE PARK BLVD SIOUX CITY IA 51104 421294091 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 ST LUKE'S HEALTHCARE 1026 A AVENUE NE CEDAR RAPIDS IA 52402 421487968 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ST LUKE'S METHODIST HOSPITAL 1026 A AVENUE NE CEDAR RAPIDS IA 52402 420504780 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ST LUKE'S HEALTHCARE 0 ST LUKE'SJONES 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SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM SEVENTEEN HOSPITAL FACILITIES AND VARIOUS AMBULATORY SERVICE AND CLINIC LOCATIONS 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).