2023-11-14T11:56:00-06:00 2022-12-31 990 2022-01-01 370681540 PROCTOR HOSPITAL PROC 3096911064 5409 N KNOXVILLE AVENUE PEORIA IL 61614 KEN DICKEN VP FINANCE-WEST REGION 3096725565 2023-11-08 KEN DICKEN XXX-XX-XXXX 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KEITH KNEPP MD 5409 N KNOXVILLE AVENUE PEORIA IL 61614 137870732 0 X SEE SCHEDULE O X 1958 IL PROVIDES A BROAD RANGE OF HEALTHCARE SERVICES AND ACTIVITIES TO THE COMMUNITY. 17 15 1290 103 441676 0 712406 2110102 142469906 133951762 420085 -10259 1363135 705860 144965532 136757465 2444 3085 0 0 39364541 43210246 0 0 0 68196416 66091979 107563401 109305310 37402131 27452155 109212123 83914225 49193013 25557125 60019110 58357100 X PROCTOR HOSPITAL PROVIDES A BROAD RANGE OF HEALTHCARE SERVICES AND ACTIVITIES TO THE COMMUNITY. 0 0 99612328 3085 133915727 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, 2022, PROCTOR HOSPITAL ADMITTED 2,899 PATIENTS RESULTING IN A TOTAL OF 16,187 PATIENT DAYS. OUTPATIENT VISITS TOTALED 61,224 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 7,427. THERE WERE ALSO 20,850 EMERGENCY ROOM VISITS. 5417371 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 $369,221 IN 2022. 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 $2,550,478 FOR 2022. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $2,919,699.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: $2,497,672. 105029699 1 1 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1290 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X X MARCY BECKER 3096712100 221 NORTHEAST GLEN OAK AVE PEORIA IL 61636 KEVIN BARBIER BOARD MEMBER 1.00 1.00 X 0 0 0 JERRY BELL PHD BOARD MEMBER 1.00 1.00 X 0 0 0 RONALD CHAMPAGNE MD BOARD MEMBER 1.00 1.00 X 0 0 0 JENNA CICCIARELLI-WIESNER BOARD MEMBER 1.00 1.00 X 0 0 0 AMY DARLING BOARD MEMBER 1.00 1.00 X 0 0 0 RUSTY DUNN BOARD MEMBER 1.00 1.00 X 0 0 0 PETER JOHNSEN PHD BOARD MEMBER 1.00 1.00 X 0 0 0 AARON KILGORE BOARD MEMBER 1.00 1.00 X 0 0 0 KEITH KNEPP MD BOARD MEMBER/PRESIDENT & CEO 1.00 40.00 X X 0 739283 143880 RICH KRIEGSMAN BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 DAVID MUELLER BOARD MEMBER 1.00 1.00 X 0 0 0 DIRK ROECKER BOARD MEMBER 1.00 1.00 X 0 0 0 JAMIE STEVENSON BOARD MEMBER 1.00 1.00 X 0 11000 0 KAREN STUMPE BOARD MEMBER 1.00 1.00 X 0 2500 0 DENNIS TRIGGS BOARD MEMBER 1.00 1.00 X 0 11000 0 JOHN WIELAND BOARD CHAIR 1.00 1.00 X X 0 0 0 MELISSA YODER BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN PETERS SECRETARY/TREASURER/CFO 1.00 40.00 X 0 445945 36450 JAYALAKSHMI ATTALURI MD PHYSICIAN 40.00 0.00 X 528439 0 38955 TATE HOHULIN CLINICAL STAFF PHARMACIST 40.00 0.00 X 146360 0 7512 DIANA JONES NURSING SUPERVISOR 40.00 0.00 X 162841 2850 15471 THERESA SKIBBA REGISTERED NURSE CARDIAC CARE 40.00 0.00 X 161531 23598 31517 DANIELLE SNODGRASS CLINICAL STAFF PHARMACIST 40.00 0.00 X 144816 0 12225 1143987 1236176 286010 24 0 1 0 AMERICAN HEALTHCARE STAFFING ASSOCIATION 226 E SIXTEENTH ST STE A TRAVERSE CITY MI 62223 HEALTHCARE STAFFING SERVICES 1862251 FIDELITY ON CALL LTD 9006 N INDUSTRIAL RD PEORIA IL 62223 STAFFING SERVICES 996315 PROFESSIONAL THERAPY SERVICES INC 2810 FRANK SCOTT PARKWAY BELLEVILLE IL 62644 THERAPY SERVICES 913393 EMERGENCY PHYSICIAN STAFFING 12528 SR 78 HAVANA IL 45209 STAFFING SERVICES 906765 HEALTH CAROUSEL LLC 3805 EDWARDS RD CINCINNATI OH 61603 STAFFING SERVICES 270630 24 209161 1531995 368946 2110102 NET PATIENT REVENUE 900099 133914004 133914004 RENTAL INCOME 531120 103097 103097 MGMT & SUPPORT SVCS 561000 661 661 SUBS & JOINT VENTURES 900099 -66000 -66000 133951762 387109 1075 386034 715899 412681 700586 -412681 15313 -397368 -397368 CHILDCARE AND ADULTCARE SERVICES 624410 727741 436564 291177 CAFETERIA/FOOD SVCS 722514 451793 451793 MISCELLANEOUS 900099 52591 47479 5112 -526265 -526265 705860 136757465 133474051 441676 731636 3085 3085 36837071 33858809 2978262 850260 850260 3452135 4048510 -596375 2070780 1927232 143548 13245000 13245000 94547 98123 -3576 5624779 5602122 22657 2415 2415 1330163 1292960 37203 2793853 2026837 767016 15757 13349 2408 5836 5836 353625 353625 3826083 3783356 42727 1674293 1674293 MEDICAL SUPPLIES 26291569 26260958 30611 MISCELLANEOUS EXPENSE 6694936 6693721 1215 MEDICAID PROVIDER ASSES 4139550 4139550 BAD DEBT EXPENSE 2333 2333 -2760 -2760 109305310 105029699 4275611 0 3165043 2561885 1335481 1710314 6706360 5755613 17298935 18572772 30999478 10050830 4494857 4500232 289577 801493 163015680 124240815 40737035 38774865 2957420 1186221 1227937 109212123 83914225 7098869 7685516 7741503 11825453 209673 22527188 17661936 49193013 25557125 X 53312750 52601487 6706360 5755613 60019110 58357100 109212123 83914225 X 27452155 -876765 -28237400 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6081907 6081907 75864542 55345738 20518804 6864028 6502093 361935 73614648 62392984 11221664 590555 590555 38774865 SELF-INSURANCE RESERVE 9036215 ASBESTOS REMOVAL LIABILITY 334100 DUE TO AFFILIATES 7935819 HEALTH & WELFARE BENEFITS RESERVE 355802 17661936 X 136821000 73982 187 74169 136746831 -3576 14210 10634 136757465 109309000 114 114 109308886 -3576 -3576 109305310 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 2019. 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 187. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN NET ASSETS WITHOUT DONOR RESTRICTIONS 14,210. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 114. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 369221 369221 0.00340 13180145 10629667 2550478 0.02330 13549366 10629667 2919699 0.02670 110761 110761 0.00100 40701 40701 0.00040 4033052 1805480 2227572 0.02040 118638 118638 0.00110 4303152 1805480 2497672 0.02290 17852518 12435147 5417371 0.04960 0 723629 24845832 31089363 -6243531 X 1 1 1 MIDWEST ORTHOPAEDIC HOSPITAL AT UNITYPOINT HEALTH-PROCTOR LLC ORTHOPAEDIC SERVICE LINE MANAGEMENT 0.33330 0.66670 1 1 PROCTOR HOSPITAL 5409 N KNOXVILLE AVENUE PEORIA IL 61614 CARLE.ORG/LOCATIONS/CARLE-HEALTH-PROCT 0001925 X X X PROCTOR HOSPITAL 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 X 1 X 0 0 PROCTOR HOSPITAL PART V, SECTION B, LINE 5: THE PARTNERSHIP FOR A HEALTHY COMMUNITY (PFHC) IS A COMMUNITY-DRIVEN EFFORT TO IMPROVE HEALTH AND WELLNESS IN THE CENTRAL ILLINOIS TRI-COUNTY REGION. MULTIPLE ORGANIZATIONS, SECTORS, AND THE PUBLIC PARTICIPATE IN POPULATION HEALTH PLANNING TO IDENTIFY AND PRIORITIZE HEALTH NEEDS AND QUALITY OF LIFE ISSUES, MAP AND LEVERAGE COMMUNITY RESOURCES, AND FORM EFFECTIVE PARTNERSHIPS TO IMPLEMENT HEALTH IMPROVEMENT STRATEGIES IN PEORIA, TAZEWELL, AND WOODFORD COUNTIES. USING ACTIONABLE DATA TO IDENTIFY HEALTH NEEDS AND PRIORITIES, INCLUDING THOSE RELATED TO HEALTH DISPARITIES, HEALTH INEQUITIES, AND THE SOCIAL DETERMINANTS OF HEALTH, MEMBERS OF THE PFHC DEVELOP SUBSEQUENT COMMUNITY HEALTH IMPROVEMENT PLANS. THIS COLLABORATIVE EFFORT ALLOWS MEMBERS OF THE PFHC TO SHARE RESOURCES, TO ALIGN STRATEGIES TO ADDRESS HEALTH NEEDS AND TO WORK AS PARTNERS IN IMPROVING COMMUNITY HEALTH. A TEAM OF PROFESSIONALS FROM THE PFHC WAS CREATED TO GUIDE THE CHNA PROCESS. MEMBERS OF THE PFHC WERE CAREFULLY SELECTED TO ENSURE REPRESENTATION OF THE BROAD INTERESTS OF THE COMMUNITY. IN ADDITION, MEMBERS OF THE COLLABORATIVE TEAM CONSISTED OF INDIVIDUALS WITH SPECIAL KNOWLEDGE OF AND EXPERTISE IN THE HEALTH OF THE COMMUNITY. PROCTOR HOSPITAL PART V, SECTION B, LINE 6A: PROCTOR HOSPITAL, METHODIST MEDICAL CENTER OF ILLINOIS, PEKIN MEMORIAL HOSPITAL, OSF SAINT FRANCIS MEDICAL CENTER, CARLE EUREKA HOSPITAL, AND HOPEDALE MEDICAL COMPLEX. PROCTOR HOSPITAL PART V, SECTION B, LINE 6B: PEORIA CITY/COUNTY HEALTH DEPARTMENT, TAZEWELL COUNTY HEALTH DEPARTMENT, WOODFORD COUNTY HEALTH DEPARTMENT, HEART OF ILLINOIS UNITY WAY, HEARTLAND HEALTH SERVICES AND BRADLEY UNIVERSITY. PROCTOR HOSPITAL PART V, SECTION B, LINE 11: THE 2019 CHNA IDENTIFIED FOUR SIGNIFICANT HEALTH NEEDS AND THE FOLLOWING ACTIONS WERE TAKEN TO ADDRESS THESE NEEDS.HEALTHY BEHAVIORS ACTIVE LIVING, HEALTHY EATING AND OBESITYGOAL 1: REDUCE THE PROPORTION OF ADULTS CONSIDERED OBESE IN THE TRI-COUNTY AREA BY 2%. PROVIDED EVIDENCE-BASED LIFESTYLE INTERVENTIONS USING THE NATIONAL DIABETES PREVENTION PROGRAM (DPP) CURRICULUM TO DECREASE OBESITY AND INCREASE PHYSICAL ACTIVITY AMONG PREDIABETIC INDIVIDUALS TO DECREASE OR DELAY THE ONSET OF TYPE 2 DIABETES. UNITYPOINT HEALTH'S COMMUNITY REGISTERED DIETITIANS PARTICIPATED IN COMMUNITY HEALTH FAIRSEACH YEAR TO REDUCE THE PROPORTION OF ADULTS WHO ARE CONSIDERED OBESE. CONTINUED TO PROVIDE WELL POWER CLASSES THAT FOCUSED ON WEIGHT MANAGEMENT. JOURNEY TO WELLNESS LIFESTYLE COACHING THESE COUNSELING SESSIONS HELP PARTICIPANTS IDENTIFY PERSONAL HEALTH AND WELLNESS GOALS AND ESTABLISH CRITERIA TO MEET THESE GOALS. DISCOVER HEALTHY CONCEPT CLASSES THESE 12-WEEK SESSIONS PAIR EXERCISE WITH DIFFERENT NUTRITION EDUCATION TOPICS EACH WEEK.GOAL 2: REDUCE THE PROPORTION OF YOUTH (GRADES 8-12) IN THE TRI-COUNTY AREA, WHO SELF-REPORT BEING OVERWEIGHT AND OBESE BY 2%. HULT CENTER FOR HEALTHY LIVING'S COLLABORATED WITH PEORIA PUBLIC SCHOOLS TO INCREASE KNOWLEDGE AND HEALTHY BEHAVIORS AMONG YOUTH THROUGH NUTRITION AND PHYSICAL ACTIVITY INTERVENTIONS. UNITYPOINT HEALTH COMMUNITY REGISTERED DIETITIANS PROVIDED ONE-ON-ONE CONSULTATIONS WITH AT RISK STUDENTS ENROLLED IN IN-SCHOOL HEALTH CLINICS TO IMPROVE HEALTHY BEHAVIORS AND DECREASE OBESITY. DISCOVER HEALTHY CONCEPT CLASSES PAIR EXERCISE WITH DIFFERENT NUTRITION EDUCATION TOPICS EACH WEEK. CLINICAL NUTRITION EDUCATION CLASSES-OFFERED FREE OF CHARGE AND TOPICS INCLUDE MYPLATE, LABEL READING, MEAL PLANNING, SMART SNACKING AND GROCERY SHOPPING.GOAL 3: DECREASE FOOD INSECURITY IN POPULATIONS RESIDING IN THE TRI-COUNTY AREA BY 1% PEORIA GROWN PROGRAM PROVIDES FOOD AND EDUCATION TO LOW-INCOME FAMILIES IN PEORIA. PARTICIPANTS RECEIVED WIC CREDIT FOR CERTAIN CLASSES. BOTH SCHOOL-AGED CHILDREN AND ADULTS PARTICIPATE IN SEPARATE CLASSES. FOR THE WIC MOTHERS COOKING CLASSES, THEY ARE SENT HOME WITH INGREDIENTS TO MAKE THE RECIPES THAT WERE MADE IN CLASS. FAMILY MEDICAL CENTER (UPH FMC) PROVIDED A COMMUNITY GARDEN FOR PEORIA COUNTY RESIDENTS.CANCER BREAST, LUNG AND COLORECTALGOAL 1: REDUCE THE FEMALE BREAST CANCER DEATH RATE IN THE TRI-COUNTY AREA BY 1% HULT CENTER FOR HEALTHY LIVING OFFERED SURVIVORSHIP PROGRAMS AT NO CHARGE TO THOSE WITH CANCER DIAGNOSIS, SURVIVORS, AND CAREGIVERS. CONTINUED TO OFFER ONCOLOGY SPECIFIC MEDICAL NUTRITION THERAPY THROUGH HULT CENTER FOR HEALTHY LIVING'S ONCOLOGY SUPPORT PROGRAMS AND SERVICES AT NO CHARGE TO THOSE WITH A CANCER DIAGNOSIS. COLLABORATED WITH TAZEWELL COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS TO IMPLEMENT FREE MAMMOGRAPHY DAY. GOAL 2: REDUCE THE COLORECTAL CANCER DEATH RATE IN THE TRI-COUNTY AREA BY 1%. COLLABORATED WITH COMMUNITY PARTNERS FOR A CANCER SCREENING AND PREVENTION DAY. DIRECT MAILED TO PATIENTS WITH NO DOCUMENTED COLON CANCER SCREENING IN THEIR CHART THAT MEET THE RECOMMENDATIONS FOR COLON CANCER SCREENING.GOAL 3: REDUCE THE LUNG CANCER DEATH RATE IN THE TRI-COUNTY AREA BY 1%. CONTINUED WITH THE LOW-COST CT LUNG SCREENING IN CONJUNCTION WITH SPECIALISTS IN MEDICAL IMAGING. IDENTIFIED UNITYPOINT CLINIC [UPC] PATIENTS WHO MEET THE CRITERIA FOR THE LOW DOSE LUNG CANCER SCREENING. PROMOTED LUNG SCREENING WITH THE AT-RISK POPULATION. DIRECT MAIL TO PATIENTS WITH DOCUMENTED SMOKING HISTORY IN THEIR CHART RECOMMENDING EVALUATION FOR APPROPRIATENESS FOR A LUNG CANCER SCREENING.MENTAL HEALTHGOAL 1: DECREASE THE NUMBER OF SUICIDES IN THE TRI-COUNTY AREA BY 10%. REDUCED EMERGENCY ROOM VISITS THROUGH ACCESS TO SERVICES AT UNITYPLACE. REDUCED HOSPITAL READMISSIONS THROUGH ACCESS TO SERVICES AT UNITYPLACE. ACTIVELY LOBBIED FOR VIRTUAL MENTAL HEALTH CONSULTATIONS AND SERVICES TO INCREASE ACCESS TO MENTAL HEALTH. COLLABORATED WITH EVERFI TO PROVIDE VIRTUAL MENTAL HEALTH EDUCATION AT NO COST TO ALL MIDDLE AND HIGH SCHOOLS IN TRI-COUNTY. PROVIDED SUICIDE PREVENTION EDUCATION PROGRAMMING TO MIDDLE AND HIGH SCHOOL STUDENTS IN TRI-COUNTY. PROVIDED SUICIDE PREVENTION EDUCATION TO ADULTS THROUGH SCHOOLS, BUSINESSES, AND HIGHER EDUCATION INSTITUTIONS.GOAL 2: DECREASE THE NUMBER OF RESIDENTS IN THE TRI-COUNTY AREA WHO REPORTED FEELING DEPRESSED OR ANXIOUS IN THE PAST 30 DAYS BY 10%. DISTRIBUTED AND PROMOTED NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) PARTICIPATION AMONG PATIENTS AND FAMILIES THROUGHOUT ALL OF UNITYPLACE. UNITYPLACE ACCESS CENTER- ASSISTED INDIVIDUALS LOOKING FOR MENTAL HEALTH AND ADDICTION SERVICES. THIS ACCESS CENTER SCHEDULED INDIVIDUALS WITH AN APPROPRIATE PROVIDER WITHIN UNITYPLACE SYSTEM WHICH WILL ALLOW THEM TO FIGURE OUT WHO TO CALL WITHIN OUR SYSTEM AND HELPS THEM NAVIGATE IT MORE EFFECTIVELY. FACILITATED MENTAL HEALTH EDUCATION AT LOCAL BUSINESSES AND GOVERNMENT AGENCIES WITH A FOCUS ON MENTAL WELLNESS, RESILIENCE, SUICIDE AWARENESS AND PREVENTION. SUBSTANCE ABUSEGOAL 1: REDUCE THE RATE OF DRUG INDUCED DEATHS WITHIN THE TRI-COUNTY BY 10%. INTRODUCED VALIDATED ALCOHOL AND DRUG USE SCREENING ON INPATIENT AND ED FLOORS, INCREASE THE PROPORTION OF PERSONS WHO ARE REFERRED FOR FOLLOWED UP CARE FOR ALCOHOL PROBLEMS, DRUG PROBLEMS AFTER DIAGNOSIS, OR TREATMENT FOR ONE OF THESE CONDITIONS IN A HOSPITAL EMERGENCY DEPARTMENT. INCREASED AWARENESS OF NARCAN HOSPITAL DISTRIBUTION PROGRAM TO HOSPITAL STAFF. ADD NARCAN DISTRIBUTION PROGRAMS (FUNDING DEPENDENT) TO OTHER CAMPUSES. UTILIZED WARM HANDOFF PROGRAM TO INITIATE CONTACT WITH PATIENTS ADMITTED TO THE ED OR IN-PATIENT UNITS FOR OPIOID RELATED OVERDOSES TO CONNECT THEM WITH COMMUNITY SERVICES INCLUDING MAT AND SUBSTANCE ABUSE COUNSELING. UNITYPLACE MAT AT ROCHELLE- GRANT FUNDING FOR NALOXONE DISTRIBUTION. MEASURED THE NUMBER OF SUBSTANCE USE CALLS TRANSFER TO CRISIS OR 911AND THE NUMBER OF SUBSTANCE USE ASSESSMENT APPOINTMENTS KEPTGOAL 2: INCREASE THE PROPORTION OF YOUTH REPORTING NEVER USING SUBSTANCES IN THE TRI-COUNTY AREA BY 5%. COLLABORATED WITH EVERFI TO PROVIDE VIRTUAL SUBSTANCE USE EDUCATION AT NO COST TO ALL MIDDLE AND HIGH SCHOOLS IN TRI-COUNTY. PARTICIPATED IN REGIONAL WELLNESS AND CONFERENCE OPPORTUNITIES TO PROVIDE EDUCATION TO TEENS ON THE RISKS OF SUBSTANCE USE. PROVIDED SUBSTANCE USE HEALTH EDUCATION PROGRAMMING TO MIDDLE AND HIGH SCHOOL STUDENTS IN TRI COUNTY. HEALTH EDUCATION SPECIALISTS PROMOTED VOLUNTARY ADOPTION OF STRONGER TOBACCO-FREE POLICIES THROUGHOUT PEORIA, TAZEWELL, AND WOODFORD COUNTIES THROUGH SOCIAL MEDIA CAMPAIGNS AND BANNER ADVERTISEMENTS AT NORTHWOODS MALL. THE REGIONAL ILLINOIS TOBACCO-FREE COMMUNITIES TEAM (TAZWELL COUNTY HEALTH DEPARTMENT, WOODFORD COUNTY HEALTH DEPARTMENT, AND HULT CENTER FOR HEALTHY LIVING) WORKED TOGETHER TO SUCCESSFULLY ASSIST BUSINESS OWNERS, EVENT PLANNERS, AND OTHER STAKEHOLDERS IN IMPLEMENTING TEN NEW TOBACCO-FREE POLICIES IN THE TRI-COUNTY REGION. 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 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 (LIST URL):WWW.CARLE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY REPORTING GROUP A - PART V, LINE 10A, IMPLEMENTATION STRATEGY: THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.CARLE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT FACILITY REPORTING GROUP A - PART V, LINE 16A, FAP WEBSITE: THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL): WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE FACILITY REPORTING GROUP A - PART V, LINE 16B, FAP WEBSITE: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE FACILITY REPORTING GROUP A - PART V, LINE 16C, FAP WEBSITE: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART I, LINE 6A: PROCTOR HOSPITAL'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE UNITYPOINT HEALTH 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, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $2,333. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. 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 THE HOSPITAL. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE 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. 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: 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 2022. 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: 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: UNITYPOINT HEALTH-PROCTOR IS A GENERAL MEDICAL AND SURGICAL HOSPITAL IN PEORIA, IL, WITH 138 BEDS. 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. IN 2022, PROCTOR HOSPITAL ADMITTED 2,899 PATIENTS, 61,224 OUTPATIENT VISITS, 7,427 OUTPATIENT SURGERY REGISTRATIONS AND 20,850 EMERGENCY ROOM VISITS. 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.PHYSICIAN OFFICES ARE SPREAD ACROSS THE REGION TO PROVIDE BETTER ACCESS TO A WIDE NUMBER OF PATIENTS. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). AS THE NATION'S 13TH LARGEST NONPROFIT HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES PROGRESSIVE AND HIGH QUALITY SERVICES ACROSS ITS 9 REGIONS WHICH SPAN IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN. THIS REGIONAL CARE MODEL HAS BEEN SUCCESSFUL IN ACHIEVING STANDARDIZED LEVELS OF PERFORMANCE AND KEEPING CARE LOCAL. WITH $4.9B IN TOTAL OPERATING REVENUE, UNITYPOINT HEALTH EMPLOYS APPROXIMATELY 33,000 TEAM MEMBERS AND OPERATES 20 REGIONAL HOSPITALS, 19 COMMUNITY NETWORK HOSPITALS AND OVER 435 CLINICS. AS A KEY COMPONENT OF UNITYPOINT HEALTH, UNITYPOINT CLINIC IS A 1,180 PROVIDER MULTISPECIALTY GROUP THAT IS BUILT ON THE FOUNDATION OF CARE DELIVERY, INNOVATION AND EXPERIENCE. REPRESENTED BY OVER 40 SPECIALTIES, UPC IS A FORWARD-THINKING DELIVERY PROVIDER AND IS ON THE LEADING EDGE OF CARE DELIVERY WITH ITS TELEHEALTH, AMBULATORY AND URGENT CARE PROGRAMS. THE DIVERSIFIED HEALTH SYSTEM ALSO INCLUDES UNITYPOINT ACCOUNTABLE CARE, UNITYPOINT HEALTH COLLEGES, UNITYPOINT AT HOME AND EXTENDS HEALTH COVERAGE THROUGH THE HEALTHPARTNERS UNITYPOINT INSURANCE PLAN. 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 2022, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $742 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 0 1 0 0 0 0 0 0 0 KEITH KNEPP MD BOARD MEMBER/PRESIDENT & CEO 0 554435 0 167497 0 17351 0 116984 0 26896 0 883163 0 0 JAYALAKSHMI ATTALURI MD PHYSICIAN 519643 0 1500 0 7296 0 15250 0 23705 0 567394 0 0 0 JOHN PETERS SECRETARY/TREASURER/CFO 0 352914 0 81201 0 11830 0 15250 0 21200 0 482395 0 0 THERESA SKIBBA REGISTERED NURSE CARDIAC CARE 153374 14032 6141 0 2016 9566 4856 728 23532 2401 189919 26727 0 0 DIANA JONES NURSING SUPERVISOR 136843 2646 21991 204 4007 0 6166 129 9011 165 178018 3144 0 0 DANIELLE SNODGRASS CLINICAL STAFF PHARMACIST 143055 0 1707 0 54 0 5839 0 6386 0 157041 0 0 0 TATE HOHULIN CLINICAL STAFF PHARMACIST 144237 0 2075 0 48 0 7316 0 196 0 153872 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: KEITH KNEPP, MD $101,734. FORM 990, LINE J - WEBSITE: WWW.CARLE.ORG/LOCATIONS/CARLE-HEALTH-PROCTOR-HOSPITAL FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 METHODIST HEALTH SERVICES CORPORATION, A TAX-EXEMPT ILLINOIS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A METHODIST HEALTH SERVICES CORPORATION, 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 METHODIST HEALTH SERVICES CORPORATION, AS SOLE MEMBER, APPROVES ALL DECISIONS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE 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 2022 FOR THE FOLLOWING INDIVIDUALS: KEITH KNEPP, MD AND JOHN PETERS. 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: FUND BALANCE TRANSFER-METHODIST MEDICAL CENTER OF ILLINOIS -22,000,000. FUND BALANCE TRANSFER-PROCTOR HEALTH SYSTEM -900,000. FUND BALANCE TRANSFER-UNITYPOINT HEALTH JUNCTION MEDICAL, LLC -80,000. FUND BALANCE TRANSFER-BELCREST SERVICES, LTD -5,257,400. 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SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $4.3B IN OPERATING REVENUE AND 27,000 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 370 CLINICS; 19 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS.