2024-05-13T13:06:13-05:00 2023-06-30 990 2022-07-01 311373080 MERCY HEALTH SERVICES - IOWA CORP MERC 5156435300 1000 4TH STREET SW MASON CITY IA 50401 TERRI DONOVAN INTERIM VP FINANCE AND CFO 7343431000 2024-05-13 TERRI DONOVAN 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O FOR LIST ROBERT RITZ 1449 NW 128TH ST BLDG 5 CLIVE IA 50325 884526537 0 X WWW.MERCYONE.ORG X 1993 DE TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 4 2 6504 279 35066462 0 7187974 5575532 828440285 811223737 18077354 9169161 54601075 55217694 908306688 881186124 1325646 1623571 0 0 377014202 387213637 0 0 556310 587709156 578269395 966049004 967106603 -57742316 -85920479 862272475 792336718 474798286 521178785 387474189 271157933 WE, MERCY HEALTH SERVICES-IOWA AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES.MERCY HEALTH SERVICES-IOWA IS A MEMBER OF TRINITY HEALTH. 0 0 867866769 1623571 827364186 MERCY HEALTH SERVICES-IOWA (MHS-IA) IS COMPRISED OF FOUR HOSPITAL DIVISIONS IN THE STATE OF IOWA THAT PROVIDED OVER 125,000 PATIENT DAYS OF HEALTH CARE SERVICES TO THEIR COMMUNITIES THROUGHOUT THE STATE OF IOWA AND SURROUNDING STATES.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS, AND AWARDS: WWW.MERCYONE.ORG 867866769 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 1 0 1 587 54 1 6504 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 4 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MN X BETH GDOWIK 7343431000 20555 VICTOR PARKWAY LIVONIA MI 481527018 LINDA ROSS DIR; CHIEF LEGAL OFFICER TRINITY 1.00 54.00 X 0 1562613 93280 YEN LIU PHYSICIAN, DERMATOLOGY NORTH IOWA 50.00 0.00 X 1322023 0 45910 MICHAEL WEGNER TREASURER; PRESIDENT CENTRAL IOWA 1.00 54.00 X 0 1287604 41869 MIR SUBLA PHYSICIAN, CARDIOLOGIST SIOUX CITY 50.00 0.00 X 0 1056147 18110 ROBERT RITZ DIRECTOR; REGIONAL PRESIDENT & CEO 1.00 54.00 X X 0 827163 24915 GIOVANNI CIUFFO PHYSICIAN, CARDIOLOGIST SIOUX CITY 50.00 0.00 X 0 804607 28086 ALIREZA YARAHMADI PHYSICIAN, NEUROLOGY NORTH IOWA 50.00 0.00 X 753254 0 53410 RODNEY SCHLADER PRES/CEO MERCYONE N. IOWA THRU 6/23 55.00 0.00 X 0 686693 67864 KAY TAKES PRESIDENT EASTERN IOWA REGION 29.00 26.00 X 0 633884 62651 YUVARAJ THANGARAJ PHYSICIAN, NEPHROLOGY NORTH IOWA 50.00 0.00 X 650375 0 24331 HEATHER CAMPBELL SEC; CHIEF LEGAL OFFICER MERCYONE 1.00 49.00 X 0 536062 49441 PAUL MANTERNACH SVP PHYS INTEGRATION/CMO NORTH IOWA 50.00 0.00 X 0 470894 68074 DOUGLAS STRONG INTERIM PRES MERCYONE SC 8/22-2/23 53.00 2.00 X 0 501937 34538 JODIE ROETTGER INTERIM REGIONAL CFO; VP FINANCE 1.00 49.00 X 0 420583 32494 BETH HUGHES PRES MERCYONE SIOUXLAND THROUGH 8/22 52.00 3.00 X 0 391470 31615 JESICA HANSON VP FINANCE MERCYONE SIOUXLAND 46.00 4.00 X 326417 0 45662 MARK TRAMMEL VP FINANCE MERCYONE NORTH IOWA 48.00 2.00 X 0 324865 25096 KIM DUWE VP FINANCE EASTERN IOWA REGION 27.00 23.00 X 0 278632 47971 AMY BERENTES EVP COO EASTERN IOWA REGION THR 8/22 30.00 20.00 X 0 167385 20637 MARY CORITA HEID RSM DIRECTOR; CHAIR 1.00 1.00 X X 0 0 0 MILTON AVERY DIRECTOR THROUGH 12/22 1.00 1.00 X 0 0 0 MAURITA SOUKUP RSM DIRECTOR 1.00 3.00 X 0 0 0 3052069 9950539 815954 498 0 1 0 MASON CITY CLINIC PC 250 S CRESCENT DRIVE MASON CITY IA 50401 MEDICAL SERVICES 54008924 AHSA AMERICAN HEALTHCARE SERVICES ASSOC PO BOX 670529 DALLAS TX 75267 STAFFING SERVICES 8421073 CONLON CONSTRUCTION 501 BELL STREET SUITE 402 DUBUQUE IA 52001 CONSTRUCTION SERVICES 5569416 NORTH IOWA ANESTHESIA ASSOC 1410 6TH STREET SW MASON CITY IA 50401 MEDICAL SERVICES 5405737 GRAPETREE MEDICAL STAFFING LLC 2501 BOJI BEND DRIVE SUITE 100 MILFORD IA 51351 STAFFING SERVICES 5283842 127 3658223 1284090 633219 17808 5575532 NET PATIENT SERVICE REVENUE 622110 741771532 741771532 PHARMACY REVENUE 456110 66009105 37281442 28727663 LABORATORY REVENUE 621500 3443100 3443100 811223737 5725576 5725576 1410836 944279 466557 466557 1208 465349 3444422 25811 0 26648 3444422 -837 3443585 3443585 3449445 2369486 1079959 989332 90627 INTERCOMPANY REVENUE 622110 8745647 8745647 MANAGEMENT REVENUE 541618 6295255 4591964 1703291 CAFETERIA REVENUE 722514 3454807 3454807 35175469 34973601 201868 53671178 881186124 827364186 35066462 13179944 X 1553883 1553883 69688 69688 4186285 4186285 31045 31045 306830794 284887669 21662887 280238 20991177 19375050 1597069 19058 33835098 31281415 2522915 30768 21339238 19933619 1385231 20388 16138174 16138174 210912 210912 66751 66751 722767 722767 136176809 133104684 2934505 137620 1773025 117560 1653609 1856 10817327 7639093 3165178 13056 37858611 30358736 7499875 18855640 17344692 1486920 24028 1429921 1311815 117736 370 574979 552867 12721 9391 13841857 13841857 40355562 30451619 9902671 1272 4891463 4891463 MEDICAL SUPPLIES 189724386 189724386 INTERCO. PURCHASED SVCS 57056405 18776696 38279709 BAD DEBT EXPENSE 25540717 25540717 EQUIPMENT MAINTENANCE 12002887 11956491 46396 10231202 8983550 1229387 18265 967106603 867866769 98683524 556310 1826675 5749835 6228 2611 21028 97678383 105371861 2281709 2547923 24373411 23655664 4062239 4359815 657462895 448288883 256445093 209174012 226635881 198732260 134964871 133983291 113997985 108738418 862272475 792336718 76851765 66415950 792504 403637 27802 25993 3818238 3654986 393307977 450678219 474798286 521178785 X 387418651 271097618 55538 60315 387474189 271157933 862272475 792336718 X -85920479 12884045 -43279822 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 180000 0 0 0 180000 0 PART II-B, LINE 1: MERCY HEALTH SERVICES - IOWA (MHS-IA) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MHS-IA WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. SIMILARLY, THESE HEALTH CARE ORGANIZATIONS WILL ARRANGE CONFERENCES AND SEMINARS FOR MEMBER ORGANIZATIONS AND THEIR EXECUTIVES WHICH INVOLVE LEGISLATORS OR OTHER POLITICAL FIGURES AS GUEST SPEAKERS. OUR FISCAL YEAR 2023 POLICY PRIORITIES INCLUDE: - AFFORDABLE, HIGH-VALUE HEALTH CARE IS ACHIEVABLE WHEN WE EXPAND VALUE-BASED CARE MODELS, DEMAND COMMERCIAL PAYER FAIRNESS, ADDRESS OUTDATED REGULATIONS AND EXPAND THE PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE). - EVERYONE SHOULD HAVE ACCESS TO HIGH-QUALITY, COMPREHENSIVE HEALTH CARE. THIS INCLUDES PROTECTING MEDICAID EXPANSION, HEALTH INSURANCE MARKETPLACE PRODUCTS, AND OTHER ACCESS CREATED BY THE AFFORDABLE CARE ACT (ACA) AS WELL AS INNOVATING RURAL HEALTH FINANCING, EXPANDING TELEHEALTH ACCESS, STRENGTHENING THE HEALTH CARE WORKFORCE AND CREATING NEW ENTRY POINTS FOR IMMIGRANTS. - FAIR PAYMENT SUSTAINS THE MISSION: THE MAJORITY OF HEALTH SYSTEMS ARE OPERATING IN THE RED; MEDICARE AND MEDICAID REIMBURSEMENT SHOULD REFLECT COST OF DELIVERING CARE. STRONG WORKFORCE DELIVERS MISSION-CENTERED CARE: WE ARE IN THE MIDST OF A HEALTH CARE STAFFING CRISIS; PIPELINE GROWTH AND SUPPORT FOR INNOVATIVE CARE DELIVERY MODELS IS NEEDED. - COVERAGE AND SOCIAL CARE ARE MISSION CRITICAL: ELIMINATING HEALTH DISPARITIES AND IMPROVING COMMUNITY HEALTH CAN BE ACCOMPLISHED BY BRIDGING SOCIAL AND CLINICAL CARE. 0 1 X 25000 25000 25000 25000 25000 25000 25000 25000 25000 25000 0.00000 1.00000 0.00000 1 1 1 10223991 10223991 293613518 205332448 88281070 1008336 643585 364751 314386071 242015361 72370710 38230979 297489 37933490 209174012 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 25447627 F EQUITY METHOD INVESTMENTS 88913397 C HEDGE FUNDS 19622267 F 133983291 INTERCOMPANY ACCOUNTS RECEIVABLE 9944928 INTERCOMPANY LT PREPAID INFO SYSTEMS 55431067 INVESTMENT IN AFFILIATES 16394307 OPERATING LEASE RIGHT-OF-USE ASSETS 9277779 OTHER ASSETS 3197516 OTHER RECEIVABLES 14492821 108738418 INTERCOMPANY ACCOUNTS PAYABLE 25097266 DEFERRED COMPENSATION 25515353 LONG TERM ASSET RETIREMENT OBLIGATION 4964903 INTERCOMPANY NOTES PAYABLE 383691475 ANNUITY PAYABLE 37482 OTHER CURRENT LIABILITIES 1040526 INTERCOMPANY OTHER LIABILITIES 386441 OTHER LONG-TERM LIABILITIES 70897 OPERATING LEASE LIABILITIES 9873876 450678219 PART IV, LINE 2B: MERCYONE NORTH IOWA MEDICAL CENTER HOLDS A BANK ACCOUNT FOR THEIR MEDICAL STAFF WHICH IS FUNDED BY DUES AND IS FOR THE BENEFIT OF THE MEDICAL STAFF. THE BALANCE OF THESE FUNDS ARE REPORTED ON FORM 990, PART X, LINE 21. PART V, LINE 4: THE ENDOWMENT FUNDS OF MERCY HEALTH SERVICES - IOWA INCLUDE $25,000 KNOWN AS THE VIANNA HOLSCHLAG SCHOLARSHIP FUND. INTEREST INCOME FROM THE FUND IS MADE AVAILABLE FOR NURSING SCHOLARSHIPS. PART V, LINE 3A: ENDOWMENTS HELD BY DUBUQUE MERCY HEALTH FOUNDATION AND DYERSVILLE HEALTH FOUNDATION FOR THE BENEFIT OF MERCY HEALTH SERVICES - IOWA ARE REPORTED ON THE FORM 990'S OF THE RESPECTIVE FOUNDATIONS. 1 1 X 1 X 1 X 1 1 0 1 1 7425315 7425315 0.00790 115020484 83856874 31163610 0.03310 122445799 83856874 38588925 0.04100 53 41549 3362331 103297 3259034 0.00350 12 778 3961359 1444751 2516608 0.00270 23 27390 28260529 15710471 12550058 0.01330 2 1 2152 2152 0.00000 27 21975 558065 61262 496803 0.00050 117 91693 36144436 17319781 18824655 0.02000 117 91693 158590235 101176655 57413580 0.06100 3 1 9961 9961 0.00000 3 313 30086 30086 0.00000 2 95 1794 1794 0.00000 66 66 0.00000 1 1828 3752 3752 0.00000 4 255 6683 6683 0.00000 13 2492 52342 52342 0.00000 0 25540717 0 248731349 271889270 -23157921 X 1 1 1 FOREST PARK IMAGING LLC IMAGING SERVICES 0.52890 0.47110 2 MAGNETIC RESONANCE SERVICES LLC MRI SERVICES 0.49000 0.51000 3 MASON CITY AMBULATORY SURGERY CENTER LLC AMBULATORY SURGICAL SERVICES 0.51000 0.49000 4 MERCY HEART CENTER OUTPATIENT SERVICES LLC OUTPATIENT ECHOCARDIOGRAPHY AND NUCLEAR MEDICINE SERVICES 0.51000 0.49000 5 SURGICAL CENTER BUILDING ASSOCIATES LLC OWNS AND LEASES SURGICAL CENTER BUILDING 0.35000 0.65000 6 SIOUXLAND SURGERY CENTER LLP (DBA DUNES SURGICAL HOSPITAL) AMBULATORY SURGICAL SERVICES 0.29220 0.47540 7 HEALTH MANAGEMENT SERVICES LLC AMBULATORY SURGICAL SVCS, OCCUPATIONAL HLTH SVCS AND PRIMARY CARE PHYS SVCS 0.50000 0.50000 8 PREFERRED HEALTH CHOICES LLC MANAGEMENT SERVICES 0.50000 0.50000 9 SSC MOB1 LLC MEDICAL OFFICE BUILDING 0.11360 0.55610 6 1 MERCYONE NORTH IOWA MEDICAL CENTER 1000 FOURTH STREET SW MASON CITY IA 50401 WWW.MERCYONE.ORG/NORTHIOWA/ 170023H X X X X X 2 MERCYONE DUBUQUE MEDICAL CENTER 250 MERCY DRIVE DUBUQUE IA 52001 WWW.MERCYONE.ORG/DUBUQUE/ 310003H X X X REHAB,LAB,PHARM, X-RAY,HOME CARE 3 MERCYONE SIOUXLAND MEDICAL CENTER 801 FIFTH STREET SIOUX CITY IA 51101 WWW.MERCYONE.ORG/SIOUXLAND/ 970112H X X X EMPLOYED PHYSICIANS, SKILLED CARE UNIT 4 DUNES SURGICAL HOSPITAL 600 N SIOUX POINT ROAD DAKOTA DUNES SD 57049 WWW.DUNESSURGICALHOSPITAL.COM 10580 X X 5 MERCYONE NEW HAMPTON MEDICAL CENTER 308 NORTH MAPLE AVE NEW HAMPTON IA 50659 WWW.MERCYONE.ORG/NEWHAMPTON/ 190022H X X X EMPLOYED PHYSICIANS 6 MERCYONE DYERSVILLE MEDICAL CENTER 1111 THIRD STREET SW DYERSVILLE IA 52040 WWW.MERCYONE.ORG/DUBUQUE/DYERSVILLE/ 310181H X X X X REHAB,LAB,PHARM, X-RAY,HOME CARE MERCYONE NORTH IOWA MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 22 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 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 MERCYONE SIOUXLAND MEDICAL CENTER 3 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X 1 21 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 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 MERCYONE DUBUQUE MEDICAL CENTER 2 0 0 1 X X X X X X X X X 20 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 20 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 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 DUNES SURGICAL HOSPITAL 4 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X SEE SCHEDULE H, PART V, SECTION C X 1 21 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 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 0 X X 0 0 MERCYONE NEW HAMPTON MEDICAL CENTER 5 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE SCHEDULE H, PART V, SECTION C X 1 21 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 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 MERCYONE DYERSVILLE MEDICAL CENTER 6 0 0 1 X X X X X X X X X 20 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 20 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 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 MERCYONE NORTH IOWA MEDICAL CENTER PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCYONE NORTH IOWA MEDICAL CENTER (MERCYONE NORTH IOWA) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS.THE FOLLOWING ARE THE PRIORITIZED SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED:1. MENTAL HEALTH2. FOOD ACCESS3. AGING SUPPORT MERCYONE SIOUXLAND MEDICAL CENTER PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCYONE SIOUXLAND MEDICAL CENTER (MERCYONE SIOUXLAND) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. PREVENTATIVE CARE2. SUBSTANCE MISUSE3. PHYSICAL HEALTH4. MENTAL HEALTH MERCYONE DUBUQUE MEDICAL CENTER PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCYONE DUBUQUE MEDICAL CENTER (MERCYONE DUBUQUE) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS:1. ACCESS TO HEALTH CARE 2. OBESITY3. BRAIN HEALTH DUNES SURGICAL HOSPITAL PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: THE DUNES SURGICAL HOSPITAL (DUNES) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. PREVENTATIVE CARE2. SUBSTANCE MISUSE3. PHYSICAL HEALTH4. MENTAL HEALTH MERCYONE NEW HAMPTON MEDICAL CENTER PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCYONE NEW HAMPTON MEDICAL CENTER (MERCYONE NEW HAMPTON) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH HAVE BEEN IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS:1. ACCESS TO HEALTH CARE2. AGING POPULATION3. EMERGENCY MEDICAL SERVICES4. KNOWLEDGE OF HEALTH CARE RESOURCES/SERVICES AVAILABLE LOCALLY MERCYONE DYERSVILLE MEDICAL CENTER PART V, SECTION B, LINE 3J: N/APART V, SECTION B, LINE 3E: MERCYONE DYERSVILLE MEDICAL CENTER (MERCYONE DYERSVILLE) INCLUDED IN ITS CHNA WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS:1. ACCESS TO HEALTH CARE 2. OBESITY3. BRAIN HEALTH MERCYONE NORTH IOWA MEDICAL CENTER PART V, SECTION B, LINE 5: MERCYONE NORTH IOWA WORKED TOGETHER WITH CERRO GORDO PUBLIC HEALTH TO DEVELOP THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT/IMPLEMENTATION STRATEGY AND IS A PARTICIPANT IN THE CERRO GORDO COUNTY HEALTH IMPROVEMENT PARTNERSHIP, WHICH IS COMPRISED OF 14 AREA ORGANIZATIONS AND RESIDENTS. WE FEEL THAT WE WILL HAVE THE MOST SUCCESS WHEN WE PARTNER AND WORK COLLABORATIVELY TOGETHER IN IDENTIFYING AND ADDRESSING THE COMMUNITY HEALTH NEEDS. SURVEYS WERE DISPERSED VIA EMAIL, WEBSITE AND IN PERSON STARTING JULY 2022 THROUGH OCTOBER 2022. IN ADDITION TO SURVEYS, FOCUS GROUPS WERE HELD WITH PROFESSIONALS AND CITIZENS UTILIZING SERVICES IN THE CERRO GORDO COMMUNITY THROUGHOUT JANUARY. ON JANUARY 23, 2023, A COMMUNITY HEALTH FORUM WAS HELD AT NIACC, WHERE THE INFORMATION THAT WAS PROVIDED THROUGH THE SURVEYS AND FOCUS GROUPS WAS DISCUSSED. THE FOCUS GROUP IDENTIFIED SEVERAL COMMON THEMES AND FOCUS AREAS.THE STEERING TEAM UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) FRAMEWORK. BASED ON THE ASSESSMENTS, THEMES IN QUALITATIVE AND QUANTITATIVE DATA WERE ANALYZED AND STRATEGIC ISSUES WERE IDENTIFIED. THE STEERING TEAM UTILIZED THE BIG EASY METHOD OF VOTING WHERE MEMBERS PLACED THE HIGHEST IMPACT AND EASE ON EFFORTS FOCUSED TOWARDS IMPROVING FOOD ACCESS, MENTAL HEALTH SERVICES/SUPPORT, AND SERVICES FOR THE AGING POPULATION.IN ADDITION TO CERRO GORDO PUBLIC HEALTH, THE FOLLOWING AGENCIES CONTRIBUTED TO THE DEVELOPMENT AND INFORMATION USED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT: NORTH IOWA COMMUNITY ACTION ORGANIZATION, PRAIRIE RIDGE INTEGRATED HEALTH CARE, UNITED WAY OF NORTH CENTRAL IOWA, NORTH IOWA CHILDREN'S ALLIANCE, MASON CITY YOUTH TASK FORCE, NORTH IOWA AREA COUNCIL OF GOVERNMENTS (NIACOG), RESIDENTS OF THE COMMUNITY, WRIGHT COUNTY PUBLIC HEALTH, PALO ALTO PUBLIC HEALTH, KOSSUTH PUBLIC HEALTH, AND HANCOCK PUBLIC HEALTH. MERCYONE SIOUXLAND MEDICAL CENTER PART V, SECTION B, LINE 5: IN 2021, THE DUNES SURGICAL HOSPITAL, MERCYONE SIOUXLAND MEDICAL CENTER, THE SIOUXLAND DISTRICT HEALTH DEPARTMENT, AND UNITYPOINT HEALTH - ST. LUKE'S PARTNERED TOGETHER TO COMPLETE THE THIRD JOINT CHNA TO DETERMINE THE COMMUNITY'S GREATEST HEALTH NEEDS AND TO COORDINATE EFFORTS TO IMPROVE POPULATION HEALTH OUTCOMES FOR THE SIOUXLAND AREA. THE YEAR-LONG PROCESS INCLUDED COLLABORATION OF REPRESENTATIVES FROM EACH ORGANIZATION, KNOWN AS THE CHNA PLANNING COMMITTEE, AS WELL AS ENGAGEMENT FROM THE COMMUNITY PARTNERS THAT ARE LISTED ON LINE 6B. ALL OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS WERE REPRESENTED BY THE ORGANIZATIONS THAT SERVED THEM.BEGINNING IN EARLY 2021, PRIMARY AND SECONDARY INPUT WAS COLLECTED THROUGH A COMMUNITY MEETING OF FIFTY-TWO COMMUNITY PARTNERS, AS WELL AS THE FOLLOWING SOURCES: U.S CENSUS BUREAU WEBSITE, 2021 NATIONAL COUNTY HEALTH RANKINGS, 2020 IA VITAL STATISTICS, IOWA PUBLIC HEALTH TRACKING PORTAL, 2019 CARES YOUTH SURVEY, 2020 COMPREHENSIVE STRATEGIES DATA BOOKLET, LOCAL HOSPITAL EMERGENCY ROOM DATA, POINT-IN-TIME COUNT FOR IOWA HOMELESS PROGRAMS, CDC 500 CITIES: LOCAL DATA FOR BETTER HEALTH WEBSITE, BUREAU OF LABOR STATISTICS, IOWA POISON CONTROL CENTER. THE DATA WAS ANALYZED BY THE CHNA PLANNING COMMITTEE. A COMMUNITY INPUT MEETING WAS HELD DURING THE SUMMER OF 2021, WHILE FINAL SUBMISSION OF THE CHNA OCCURRED IN 2022. A WRITTEN, COMMUNITY SURVEY WAS ALSO COMPLETED AND FOCUS GROUPS WERE HELD.THE JOINT CHNA LOOKED AT DATA FROM THE FOLLOWING SIX COUNTIES IN THE TRI-STATE SIOUXLAND AREA, AS EACH HOSPITAL SERVES A LARGER TERRITORY OUTSIDE OF JUST WOODBURY COUNTY:-UNION, SD-DAKOTA, DIXON, AND THURSTON, NE-PLYMOUTH AND WOODBURY, IA MERCYONE DUBUQUE MEDICAL CENTER PART V, SECTION B, LINE 5: FOR THE PREVIOUS THREE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CYCLES, MERCYONE DUBUQUE MEDICAL CENTER AND MERCYONE DYERSVILLE MEDICAL CENTER JOINED THE DUBUQUE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT HEALTH IMPROVEMENT PLAN (CHNA-HIP) COALITION. THIS COALITION ASSURED BROAD INVOLVEMENT FROM MANY KEY ORGANIZATIONS ACROSS OUR SERVICE AREA. HOWEVER, DUE TO THE COVID-19 PANDEMIC, THE COALITION FOR THE FISCAL YEAR 2021 CYCLE WAS COMPRISED PRIMARILY OF MERCYONE DUBUQUE MEDICAL CENTER, MERCYONE DYERSVILLE MEDICAL CENTER, UNITY POINT FINLEY HOSPITAL, AND HILLCREST FAMILY SERVICES AS CITY OF DUBUQUE AND DUBUQUE COUNTY HEALTH DEPARTMENT REQUESTED, AND WERE GRANTED, EXTENSIONS TO COMPLETE THEIR CHNA PROCESS. WHILE PANDEMIC SPECIFIC DEMANDS IMPACTED CAPACITY FOR CITY AND COUNTY INVOLVEMENT IN THE COALITION, BOTH CITY OF DUBUQUE AND DUBUQUE COUNTY HEALTH DEPARTMENT DID PROVIDE INPUT FOR THIS CHNA SURVEY AND PLANNING, AS WELL AS INCLUDED THE CHNA SURVEY ON SAID WEBSITES TO ASSIST IN DISSEMINATION OF SURVEYS, ESPECIALLY TO VULNERABLE POPULATIONS. MERCYONE DUBUQUE MEDICAL CENTER AND MERCYONE DYERSVILLE MEDICAL CENTER PARTICIPATED IN ALL ASPECTS OF STEERING, COORDINATING AND COMPLETING THE CURRENT PROCESS. THE STEERING COMMITTEE COLLECTED INFORMATION FROM PRIMARY AND SECONDARY DATA SOURCES. DATA WAS COLLECTED THROUGH A COMMUNITY INPUT SURVEY IN DUBUQUE COUNTY, ADMINISTERED BETWEEN NOVEMBER 17, 2020 AND JANUARY 4, 2021. THE SURVEY WAS OFFERED ONLINE VIA "SURVEY MONKEY AND WAS AVAILABLE IN ENGLISH AND SPANISH LANGUAGES. PAPER COPIES OF THE SURVEY WERE ALSO AVAILABLE FOR THOSE WITHOUT COMPUTER ACCESS. THE STEERING COMMITTEE DEVELOPED A COMMUNICATIONS PLAN TO DISSEMINATE IN THE COMMUNITY AND ULTIMATELY, 1,355 COMPLETED RESPONSES WERE COLLECTED, AN INCREASE IN RESPONSE RATE FROM THE PREVIOUS CYCLE. THE STEERING COMMITTEE SOUGHT AND CONSIDERED THE NEEDS, INPUT, AND CONCERNS OF UNDERREPRESENTED PERSONS AND POPULATIONS THROUGHOUT THIS PROCESS, INCLUDING, THOSE WHO ARE MEDICALLY UNDERSERVED, IN POVERTY; AND/OR FROM MINORITY POPULATIONS. IN ADDITION, REPRESENTATIVES FROM VARIOUS AGENCIES WERE ABLE TO REPRESENT THE UNIQUE NEEDS OF THE POPULATIONS THEY SERVE WITH SPECIFIC EMPHASIS ON THOSE WHO ARE UNDERSERVED. THE STEERING COMMITTEE REVIEWED REPORTED DEMOGRAPHIC INFORMATION OF THOSE WHO COMPLETED THE SURVEY AND FOUND THAT DISTRIBUTION BY ETHNICITY, AGE, INCOME AND ZIP CODE WERE CONSISTENT WITH THE COMMUNITY'S DEMOGRAPHIC PROFILE. THE CHNA PROCESS INCLUDED GATHERING BOTH QUALITATIVE AND QUANTITATIVE DATA. THE STEERING COMMITTEE THEN REVIEWED AND COMPARED THE SURVEY RESULTS TO THE COLLECTED DATA. THE RESULTS AND DATA WERE CONSISTENT WITH EACH OTHER, VALIDATING BOTH FINDINGS. AFTER THE TOP 13 NEEDS WERE IDENTIFIED, THEY WERE PRESENTED TO THE STEERING COMMITTEE. THE STEERING COMMITTEE PRIORITIZED THE TOP HEALTH NEEDS BASED ON A NEED DIFFERENTIAL AND ON THEIR AREA OF EXPERTISE AND KNOWLEDGE OF THE COMMUNITY. THE STEERING COMMITTEE WAS INSTRUMENTAL IN IDENTIFYING THE PRIORITY AREAS SINCE THIS IS THE GROUP THAT COLLECTIVELY CAN HELP ADDRESS THE NEEDS WITH THE MAXIMUM COMMUNITY IMPACT. THE STEERING COMMITTEE FELT IT WAS BEST TO BUNDLE AREAS OF CONCERN AND ADDRESS A SMALLER NUMBER OF AREAS FOCUSING ON QUALITY AND IMMINENT PRIORITY IN PANDEMIC AND PANDEMIC RECOVERY VERSUS QUANTITY. THE TOP THREE NEEDS, BASED ON NEED DIFFERENTIAL, WERE IDENTIFIED BY THE STEERING COMMITTEE. COMMUNITY MEMBERS, EXPERTS, AND LEADERS FROM ACROSS THE COMMUNITY WERE THEN INVITED TO PARTICIPATE ON THE THREE PRIORITY TASKFORCES. EACH TASKFORCE REVIEWED THE DATA, CONDUCTED A SWOT ANALYSIS, AND MADE RECOMMENDATIONS TO THE STEERING COMMITTEE REGARDING STRATEGY FOR OUR HEALTH IMPROVEMENT PLANS. STEERING COMMITTEE MEMBERS PROVIDING INPUT INCLUDED:MALISSA SPRENGER, MICHELLE ARENSDORF, GWEN HALL DRISCOLL, (MERCYONE DUBUQUE MEDICAL CENTER & MERCYONE DYERSVILLE) CAROL CROSS (UNITY POINT FINLEY HOSPITAL)STACEY KILLIAN (UNITY POINT FINLEY HOSPITAL, VISITING NURSE ASSOCIATION)JANAE SCHMITT, MARIAH SCHRACK (HILLCREST FAMILY SERVICES)PATRICE LAMBERT (DUBUQUE COUNTY HEALTH DEPARTMENT) -ADVISORYMARY ROSE CORRIGAN (CITY OF DUBUQUE) -ADVISORY DUNES SURGICAL HOSPITAL PART V, SECTION B, LINE 5: IN 2021, THE DUNES SURGICAL HOSPITAL, MERCYONE SIOUXLAND MEDICAL CENTER, THE SIOUXLAND DISTRICT HEALTH DEPARTMENT, AND UNITYPOINT HEALTH - ST. LUKE'S PARTNERED TOGETHER TO COMPLETE THE THIRD JOINT CHNA TO DETERMINE THE COMMUNITY'S GREATEST HEALTH NEEDS AND TO COORDINATE EFFORTS TO IMPROVE POPULATION HEALTH OUTCOMES FOR THE SIOUXLAND AREA. THE YEAR-LONG PROCESS INCLUDED COLLABORATION OF REPRESENTATIVES FROM EACH ORGANIZATION, KNOWN AS THE CHNA PLANNING COMMITTEE, AS WELL AS ENGAGEMENT FROM THE COMMUNITY PARTNERS THAT ARE LISTED ON LINE 6B. ALL OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS WERE REPRESENTED BY THE ORGANIZATIONS THAT SERVED THEM.BEGINNING IN EARLY 2021, PRIMARY AND SECONDARY INPUT WAS COLLECTED THROUGH A COMMUNITY MEETING OF FIFTY-TWO COMMUNITY PARTNERS, AS WELL AS THE FOLLOWING SOURCES: U.S CENSUS BUREAU WEBSITE, 2021 NATIONAL COUNTY HEALTH RANKINGS, 2020 IA VITAL STATISTICS, IOWA PUBLIC HEALTH TRACKING PORTAL, 2019 CARES YOUTH SURVEY, 2020 COMPREHENSIVE STRATEGIES DATA BOOKLET, LOCAL HOSPITAL EMERGENCY ROOM DATA, POINT-IN-TIME COUNT FOR IOWA HOMELESS PROGRAMS, CDC 500 CITIES: LOCAL DATA FOR BETTER HEALTH WEBSITE, BUREAU OF LABOR STATISTICS, IOWA POISON CONTROL CENTER. THE DATA WAS ANALYZED BY THE CHNA PLANNING COMMITTEE. A COMMUNITY INPUT MEETING WAS HELD DURING THE SUMMER OF 2021, WHILE FINAL SUBMISSION OF THE CHNA OCCURRED IN 2022. A WRITTEN, COMMUNITY SURVEY WAS ALSO COMPLETED AND FOCUS GROUPS WERE HELD.THE JOINT CHNA LOOKED AT DATA FROM THE FOLLOWING SIX COUNTIES IN THE TRI-STATE SIOUXLAND AREA, AS EACH HOSPITAL SERVES A LARGER TERRITORY OUTSIDE OF JUST WOODBURY COUNTY:-UNION, SD-DAKOTA, DIXON, AND THURSTON, NE-PLYMOUTH AND WOODBURY, IA MERCYONE NEW HAMPTON MEDICAL CENTER PART V, SECTION B, LINE 5: MERCYONE NEW HAMPTON INITIATED THE ASSESSMENT PROCESS FOR THE 2022 CHNA, ALONG WITH A PLANNING TEAM CONSISTING OF REPRESENTATIVES FROM HOSPITAL GOVERNANCE, LEADERSHIP AND MEDICAL STAFF, AREA EMPLOYERS, SCHOOL DISTRICTS, AND AREA HEALTH PROFESSIONALS. BETWEEN SEPTEMBER 2021 AND JANUARY 2022, MERCYONE GATHERED COMMUNITY INPUT THROUGH SURVEYS, PATIENT FEEDBACK, AND SERVICE UTILIZATION DATA. DATA SOURCES INCLUDED COUNTY HEALTH RANKINGS, COMMUNITY COMMONS, NORTHEAST IOWA COMMUNITY ACTION CORPORATION CLIENT NEEDS ASSESSMENT SURVEY. IN ADDITION, FOCUS GROUPS, INTERVIEWS AND INDIVIDUAL STORIES PROVIDE A VALUABLE TOOL TO GATHER QUALITATIVE DATA FOR STRATEGIC PLANNING. MERCYONE NEW HAMPTON WAS CAREFUL TO GATHER INPUT FROM REPRESENTATIVES OF VARIOUS MINORITY AND UNDERSERVED INDIVIDUALS INCLUDING: LOW INCOME/UNDERSERVED (SALVATION ARMY, CHICKASAW COUNTY PUBLIC HEALTH, PASTORAL COMMITTEE, SCHOOL ADMINISTRATION AND NORTHEAST IOWA COMMUNITY ACTION); CHRONIC CONDITIONS (AREA NURSING HOME, MENTAL HEALTH, AND HOSPICE REPRESENTATIVES); AND RACIAL/ETHNIC MINORITY (HISPANIC MINISTER FROM HOLY FAMILY AND PUBLIC HEALTH). SEVERAL SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED WITHIN THE MERCYONE NEW HAMPTON COMMUNITY. THOSE NEEDS WERE THEN PRIORITIZED BY THE PLANNING TEAM BASED ON INFORMATION FROM ALL THE SOURCES MENTIONED WHICH WAS DISTILLED INTO A LIST OF OPPORTUNITIES ESTIMATED TO HAVE THE GREATEST POSITIVE IMPACT ON THE IDENTIFIED COMMUNITY HEALTH NEEDS. MERCYONE DYERSVILLE MEDICAL CENTER PART V, SECTION B, LINE 5: FOR THE PREVIOUS THREE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CYCLES, MERCYONE DUBUQUE MEDICAL CENTER AND MERCYONE DYERSVILLE MEDICAL CENTER JOINED THE DUBUQUE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT HEALTH IMPROVEMENT PLAN (CHNA-HIP) COALITION. THIS COALITION ASSURED BROAD INVOLVEMENT FROM MANY KEY ORGANIZATIONS ACROSS OUR SERVICE AREA. HOWEVER, DUE TO THE COVID-19 PANDEMIC, THE COALITION FOR THE FISCAL YEAR 2021 CYCLE WAS COMPRISED PRIMARILY OF MERCYONE DUBUQUE MEDICAL CENTER, MERCYONE DYERSVILLE MEDICAL CENTER, UNITY POINT FINLEY HOSPITAL, AND HILLCREST FAMILY SERVICES AS CITY OF DUBUQUE AND DUBUQUE COUNTY HEALTH DEPARTMENT REQUESTED, AND WERE GRANTED, EXTENSIONS TO COMPLETE THEIR CHNA PROCESS. WHILE PANDEMIC SPECIFIC DEMANDS IMPACTED CAPACITY FOR CITY AND COUNTY INVOLVEMENT IN THE COALITION, BOTH CITY OF DUBUQUE AND DUBUQUE COUNTY HEALTH DEPARTMENT DID PROVIDE INPUT FOR THIS CHNA SURVEY AND PLANNING, AS WELL AS INCLUDED THE CHNA SURVEY ON SAID WEBSITES TO ASSIST IN DISSEMINATION OF SURVEYS, ESPECIALLY TO VULNERABLE POPULATIONS. MERCYONE DUBUQUE MEDICAL CENTER AND MERCYONE DYERSVILLE MEDICAL CENTER PARTICIPATED IN ALL ASPECTS OF STEERING, COORDINATING AND COMPLETING THE CURRENT PROCESS. THE STEERING COMMITTEE COLLECTED INFORMATION FROM PRIMARY AND SECONDARY DATA SOURCES. DATA WAS COLLECTED THROUGH A COMMUNITY INPUT SURVEY IN DUBUQUE COUNTY, ADMINISTERED BETWEEN NOVEMBER 17, 2020 AND JANUARY 4, 2021. THE SURVEY WAS OFFERED ONLINE VIA "SURVEY MONKEY AND WAS AVAILABLE IN ENGLISH AND SPANISH LANGUAGES. PAPER COPIES OF THE SURVEY WERE ALSO AVAILABLE FOR THOSE WITHOUT COMPUTER ACCESS. THE STEERING COMMITTEE DEVELOPED A COMMUNICATIONS PLAN TO DISSEMINATE IN THE COMMUNITY AND ULTIMATELY, 1,355 COMPLETED RESPONSES WERE COLLECTED, AN INCREASE IN RESPONSE RATE FROM THE PREVIOUS CYCLE. THE STEERING COMMITTEE SOUGHT AND CONSIDERED THE NEEDS, INPUT, AND CONCERNS OF UNDERREPRESENTED PERSONS AND POPULATIONS THROUGHOUT THIS PROCESS, INCLUDING, THOSE WHO ARE MEDICALLY UNDERSERVED, IN POVERTY; AND/OR FROM MINORITY POPULATIONS. IN ADDITION, REPRESENTATIVES FROM VARIOUS AGENCIES WERE ABLE TO REPRESENT THE UNIQUE NEEDS OF THE POPULATIONS THEY SERVE WITH SPECIFIC EMPHASIS ON THOSE WHO ARE UNDERSERVED. THE STEERING COMMITTEE REVIEWED REPORTED DEMOGRAPHIC INFORMATION OF THOSE WHO COMPLETED THE SURVEY AND FOUND THAT DISTRIBUTION BY ETHNICITY, AGE, INCOME AND ZIP CODE WERE CONSISTENT WITH THE COMMUNITY'S DEMOGRAPHIC PROFILE. THE CHNA PROCESS INCLUDED GATHERING BOTH QUALITATIVE AND QUANTITATIVE DATA. THE STEERING COMMITTEE THEN REVIEWED AND COMPARED THE SURVEY RESULTS TO THE COLLECTED DATA. THE RESULTS AND DATA WERE CONSISTENT WITH EACH OTHER, VALIDATING BOTH FINDINGS. AFTER THE TOP 13 NEEDS WERE IDENTIFIED, THEY WERE PRESENTED TO THE STEERING COMMITTEE. THE STEERING COMMITTEE PRIORITIZED THE TOP HEALTH NEEDS BASED ON A NEED DIFFERENTIAL AND ON THEIR AREA OF EXPERTISE AND KNOWLEDGE OF THE COMMUNITY. THE STEERING COMMITTEE WAS INSTRUMENTAL IN IDENTIFYING THE PRIORITY AREAS SINCE THIS IS THE GROUP THAT COLLECTIVELY CAN HELP ADDRESS THE NEEDS WITH THE MAXIMUM COMMUNITY IMPACT. THE STEERING COMMITTEE FELT IT WAS BEST TO BUNDLE AREAS OF CONCERN AND ADDRESS A SMALLER NUMBER OF AREAS FOCUSING ON QUALITY AND IMMINENT PRIORITY IN PANDEMIC AND PANDEMIC RECOVERY VERSUS QUANTITY. THE TOP THREE NEEDS, BASED ON NEED DIFFERENTIAL, WERE IDENTIFIED BY THE STEERING COMMITTEE. COMMUNITY MEMBERS, EXPERTS, AND LEADERS FROM ACROSS THE COMMUNITY WERE THEN INVITED TO PARTICIPATE ON THE THREE PRIORITY TASKFORCES. EACH TASKFORCE REVIEWED THE DATA, CONDUCTED A SWOT ANALYSIS, AND MADE RECOMMENDATIONS TO THE STEERING COMMITTEE REGARDING STRATEGY FOR OUR HEALTH IMPROVEMENT PLANS. STEERING COMMITTEE MEMBERS PROVIDING INPUT INCLUDED:MALISSA SPRENGER, MICHELLE ARENSDORF, GWEN HALL DRISCOLL, (MERCYONE DUBUQUE MEDICAL CENTER & MERCYONE DYERSVILLE) CAROL CROSS (UNITY POINT FINLEY HOSPITAL)STACEY KILLIAN (UNITY POINT FINLEY HOSPITAL, VISITING NURSE ASSOCIATION)JANAE SCHMITT, MARIAH SCHRACK (HILLCREST FAMILY SERVICES)PATRICE LAMBERT (DUBUQUE COUNTY HEALTH DEPARTMENT) -ADVISORYMARY ROSE CORRIGAN (CITY OF DUBUQUE) -ADVISORY MERCYONE SIOUXLAND MEDICAL CENTER PART V, SECTION B, LINE 6A: MERCYONE SIOUXLAND'S CHNA WAS CONDUCTED WITH UNITY POINT HEALTH-ST. LUKE'S AND DUNES SURGICAL HOSPITAL. MERCYONE DUBUQUE MEDICAL CENTER PART V, SECTION B, LINE 6A: MERCYONE DUBUQUE CONDUCTED ITS CHNA WITH MERCYONE DYERSVILLE, AND UNITYPOINT HEALTH-FINLEY HOSPITAL, DUBUQUE. DUNES SURGICAL HOSPITAL PART V, SECTION B, LINE 6A: THE DUNES SURGICAL HOSPITAL'S CHNA WAS CONDUCTED WITH MERCYONE SIOUXLAND MEDICAL CENTER AND UNITY POINT HEALTH-ST. LUKE'S. MERCYONE DYERSVILLE MEDICAL CENTER PART V, SECTION B, LINE 6A: MERCYONE DYERSVILLE CONDUCTED ITS CHNA WITH MERCYONE DUBUQUE, AND UNITYPOINT HEALTH-FINLEY HOSPITAL, DUBUQUE. MERCYONE NORTH IOWA MEDICAL CENTER PART V, SECTION B, LINE 6B: MERCYONE NORTH IOWA COLLABORATED WITH THE FOLLOWING ORGANIZATIONS TO CONDUCT THE MOST RECENT CHNA: CERRO GORDO PUBLIC HEALTH, NORTH IOWA COMMUNITY ACTION ORGANIZATION, MASON CITY YOUTH TASK FORCE, UNITED WAY OF NORTH CENTRAL, IOWA PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTH CARE, NORTH IOWA AREA COUNCIL OF GOVERNMENTS, NORTH IOWA COMMUNITY COLLEGE, FLOYD COUNTY PUBLIC HEALTH, KOSSUTH REGIONAL HEALTH CENTER, HANCOCK COUNTY HEALTH SYSTEM, PALO ALTO COUNTY HEALTH SYSTEM, WINNEBAGO COUNTY PUBLIC HEALTH, WRIGHT COUNTY PUBLIC HEALTH, AND RESIDENTS OF THE COMMUNITY MERCYONE SIOUXLAND MEDICAL CENTER PART V, SECTION B, LINE 6B: THROUGHOUT 2021 THE CHNA PLANNING COMMITTEE, MADE UP OF REPRESENTATIVES FROM THE AFOREMENTIONED HOSPITALS, AS WELL AS THE FOLLOWING ORGANIZATIONS; BRIAR CLIFF UNIVERSITY, GROWING COMMUNITY CONNECTIONS, SIOUXLAND COMMUNITY HEALTH CENTER, SIOUXLAND DISTRICT HEALTH DEPARTMENT, AND SOURCE FOR SIOUXLAND, CONDUCTED THE JOINT CHNA IN COLLABORATION WITH: BOYS AND GIRLS HOME AND FAMILY SERVICES, DAKOTA COUNTY JUVENILE DIVERSION, DEPARTMENT OF CORRECTIONAL SERVICES, GIRLS INC., INSTITUTE FOR COMMUNITY ALLIANCE, IOWA POISON CONTROL, IOWA STATE UNIVERSITY EXTENSION, JUNE E. NYLEN CANCER CENTER, MORNINGSIDE UNIVERSITY, NAACP, NORM WAITT SR. YMCA, ONE SIOUXLAND, PROTEUS, ROSECRANCE JACKSON RECOVERY CENTER, SIOUXLAND CARES, SIOUXLAND COMMUNITY HEALTH CENTER, SIOUXLAND HUMAN INVESTMENT PARTNERSHIP, SIOUXLAND MENTAL HEALTH CENTER, THE WARMING SHELTER, AND UNITED WAY OF SIOUXLAND. MERCYONE DUBUQUE MEDICAL CENTER PART V, SECTION B, LINE 6B: MERCYONE DUBUQUE CONDUCTED ITS CHNA WITH THE FOLLOWING NON-HOSPITAL ORGANIZATIONS:CITY OF DUBUQUE HEALTH SERVICES, DUBUQUE COUNTY HEALTH DEPARTMENT, CRESCENT COMMUNITY HEALTH CENTER, GRAND RIVER MEDICAL GROUP, HILLCREST FAMILY SERVICES, VISITING NURSE ASSOCIATION, MEDICAL ASSOCIATES CLINIC, RIVERBEND FOOD BANK, DUBUQUE FOOD POLICY COUNCIL, CONVIVIUM URBAN FARMSTEAD, PROJECT ROOTED, BRAIN HEALTH NOW, ZTM SOBER LIVING, AND SUBSTANCE ABUSE SERVICES CENTER. DUNES SURGICAL HOSPITAL PART V, SECTION B, LINE 6B: THROUGHOUT 2021 THE CHNA PLANNING COMMITTEE, MADE UP OF REPRESENTATIVES FROM THE AFOREMENTIONED HOSPITALS, AS WELL AS THE FOLLOWING ORGANIZATIONS; BRIAR CLIFF UNIVERSITY, GROWING COMMUNITY CONNECTIONS, SIOUXLAND COMMUNITY HEALTH CENTER, SIOUXLAND DISTRICT HEALTH DEPARTMENT, AND SOURCE FOR SIOUXLAND, CONDUCTED THE JOINT CHNA IN COLLABORATION WITH: BOYS AND GIRLS HOME AND FAMILY SERVICES, DAKOTA COUNTY JUVENILE DIVERSION, DEPARTMENT OF CORRECTIONAL SERVICES, GIRLS INC., INSTITUTE FOR COMMUNITY ALLIANCE, IOWA POISON CONTROL, IOWA STATE UNIVERSITY EXTENSION, JUNE E. NYLEN CANCER CENTER, MORNINGSIDE UNIVERSITY, NAACP, NORM WAITT SR. YMCA, ONE SIOUXLAND, PROTEUS, ROSECRANCE JACKSON RECOVERY CENTER, SIOUXLAND CARES, SIOUXLAND COMMUNITY HEALTH CENTER, SIOUXLAND HUMAN INVESTMENT PARTNERSHIP, SIOUXLAND MENTAL HEALTH CENTER, THE WARMING SHELTER, AND UNITED WAY OF SIOUXLAND. MERCYONE DYERSVILLE MEDICAL CENTER PART V, SECTION B, LINE 6B: MERCYONE DYERSVILLE CONDUCTED ITS CHNA WITH THE FOLLOWING NON-HOSPITAL ORGANIZATIONS:CITY OF DUBUQUE HEALTH SERVICES, DUBUQUE COUNTY HEALTH DEPARTMENT, CRESCENT COMMUNITY HEALTH CENTER, GRAND RIVER MEDICAL GROUP, HILLCREST FAMILY SERVICES, VISITING NURSE ASSOCIATION, MEDICAL ASSOCIATES CLINIC, RIVERBEND FOOD BANK, DUBUQUE FOOD POLICY COUNCIL, CONVIVIUM URBAN FARMSTEAD, PROJECT ROOTED, BRAIN HEALTH NOW, ZTM SOBER LIVING, AND SUBSTANCE ABUSE SERVICES CENTER. MERCYONE NORTH IOWA MEDICAL CENTER PART V, SECTION B, LINE 11: IN FY23, MERCYONE NORTH IOWA ADDRESSED MENTAL HEALTH IN THE FOLLOWING WAYS:MERCYONE NORTH IOWA CONTINUED TO STAFF THE PSYCHIATRIC TRIAGE IN OUR EMERGENCY ROOM FOR ALL BEHAVIORAL HEALTH PATIENTS WITH REGISTERED NURSES WHO PROVIDE REFERRAL INFORMATION TO COMMUNITY RESOURCES/AGENCIES. EFFORTS CONTINUE TO RECRUIT A DIRECTOR FOR THE PSYCHIATRIC RESIDENCY PROGRAM. IN FEBRUARY 2023, MERCYONE NORTH IOWA HIRED A NEW CHILD PSYCHIATRIST, DR. DUREGGER, WHO IS ALSO ON-CALL AT THE BEHAVIORAL HEALTH UNIT. IN MAY, MERCYONE NORTH IOWA HIRED A CHILD PSYCHOLOGIST, DR. HAREEL, WHO WORKS IN OUTPATIENT BEHAVIORAL HEALTH AND CONDUCTS PSYCHOLOGICAL TESTING TO HELP ADDRESS THE SIGNIFICANT DEMAND AND LONG WAITLIST FOR PSYCHIATRIC TESTING FOR CHILDREN. MERCYONE NORTH IOWA CONTINUOUSLY LOOKS TO IMPROVE SERVICES AND PROCESSES TO BEST SERVE OUR PATIENTS AND COMMUNITY. DR. JILL BURKLEY, CHILD PSYCHOLOGIST, GOES OVER TO THE RESIDENCY CLINIC TO COMPLETE TESTING. THIS PROCESS HAS BEEN PUT INTO PLACE TO HELP REDUCE THE TIME IT TAKES PATIENTS TO BE SEEN AND HAVE THE TESTING COMPLETE. THIS ALSO ELIMINATES PATIENTS TO HAVE TO SEEK TESTING OUT OF TOWN.MERCYONE NORTH IOWA BEHAVIORAL HEALTH DEPARTMENT HAS ENGAGED IN COMMUNITY EVENTS. IN FY23 WE PARTICIPATED IN 'NATIONAL NIGHT OUT AND 'MAKE IT OK' EVENTS, PROVIDING INFORMATION ON THE AVAILABLE BEHAVIORAL HEALTH SERVICES. MERCYONE NORTH IOWA HAS A DEDICATED COMMUNITY SPACE, JAN AGAIN. THIS IS FOCUSED ON MENTAL HEALTH. WE ARE WORKING TO EXPAND ACCESS AND USE OF THIS SPACE IN FISCAL YEARS 2024 AND 2025. MERCYONE NORTH IOWA EMERGENCY DEPARTMENT WORKS COLLABORATIVELY WITH MASON CITY POLICE DEPARTMENT AND HEALTHIM TO BEST SERVE PERSONS IN THE COMMUNITY EXPERIENCING MENTAL HEALTH ISSUES. MERCYONE NORTH IOWA ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH AND SOCIAL ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THAT REASON, MERCYONE NORTH IOWA DID NOT ADDRESS THE FOLLOWING NEEDS:FOOD ACCESS - MERCYONE NORTH IOWA WILL CONTINUE TO COLLABORATE WITH THE HEALTHIEST STATE INITIATIVE AND THE NORTH IOWA FOOD COALITION WHO ARE ALREADY LEADING INITIATIVES TO ADDRESS THIS NEED.AGING SUPPORT - MERCYONE NORTH IOWA WILL CONTINUE TO PROVIDE SERVICES TO SUPPORT THE AGING POPULATION WITH PROGRAMS SUCH AS SENIOR HEALTH INSURANCE INFORMATION PROGRAM (SHIIP) AND WILL CONTINUE TO PARTICIPATE IN THE AGING SUPPORT WORK TEAM. MERCYONE SIOUXLAND MEDICAL CENTER PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE ADDRESSED BY MERCYONE SIOUXLAND IN FY23:MENTAL HEALTH: RECRUITMENT CONTINUED FOR ADDITIONAL MENTAL HEALTH PROVIDERS. TELEMEDICINE WAS USED TO IMPROVE ACCESS FOR MENTAL HEALTH CARE. THE HOSPITAL CONTINUED TO OPERATE TWO INPATIENT MENTAL HEALTH UNITS. MENTAL HEALTH SERVICES WERE PROVIDED AT THE MERCYONE CHILD ADVOCACY CENTER TO CHILDREN WHO HAD BEEN ABUSED. MERCYONE SIOUXLAND FINANCIALLY SUPPORTED MENTAL HEALTH SERVICES PROVIDED AT CATHOLIC CHARITIES TO VULNERABLE POPULATIONS. PROVIDERS CONTINUED TO SCREEN AND EDUCATE COMMUNITY MEMBERS ABOUT MENTAL HEALTH, AND MADE REFERRALS TO MENTAL HEALTH PROFESSIONALS AS NEEDED.MERCYONE SIOUXLAND CONTINUED TO COLLABORATE WITH OTHER MENTAL HEALTH PROVIDERS TO COORDINATE MENTAL HEALTH CARE. MERCYONE SIOUXLAND PARTICIPATED IN THE MENTAL HEALTH ROUNDTABLE, WHICH WAS COMPRISED OF 18 MENTAL HEALTH COMMUNITY PARTNERS, AND CREATED A MENTAL HEALTH REFERRAL GUIDE THAT WILL BE OPEN TO THE COMMUNITY TO USE TO LOCATE PROVIDERS. PHYSICAL HEALTH:MERCYONE SIOUXLAND CONTINUED TO PROVIDE HEALTH COACHING, EDUCATION ON HEALTHY CHOICES, AND THE IMPORTANCE OF MAINTAINING A HEALTHY WEIGHT. PROVIDERS CONTINUED TO MEASURE BMIS FOR HEALTHY WEIGHT MONITORING AND COUNSELING. DIETICIANS PROVIDED NUTRITION EDUCATION TO THE COMMUNITY THROUGH BLOGS, PODCASTS, AND TELEVISION INTERVIEWS, AND PRESENTATIONS. MERCYONE SIOUXLAND CONTINUED TO PROVIDE CARDIAC REHAB, PULMONARY REHAB, AND ENDOCRINOLOGY SERVICES. THE CARDIAC PROGRAM ALSO PROVIDED VASCULAR AND CHOLESTEROL SCREENINGS TO PROMOTE HEALTHY LIFESTYLE CHOICES. MERCYONE SIOUXLAND CONTINUED COLLABORATING WITH THE SIOUXLAND YMCA BY REFERRING PRE-DIABETIC INDIVIDUALS TO THE DIABETES PREVENTION PROGRAM (DPP). MERCYONE SIOUXLAND ALSO SERVED ON THE FOOD BANK OF SIOUXLAND BOARD OF DIRECTORS, A SOURCE OF HEALTHY FOODS FOR THE VULNERABLE POPULATION IN THE COMMUNITY. MERCYONE SIOUXLAND CREATED SIGNAGE FOR THE EXERCISE PODS IN THE CITY SKYWALK TO ENCOURAGE WALKERS TO STOP AND EXERCISE DURING THEIR COMMUTE.PREVENTATIVE CARE:MERCYONE SIOUXLAND CONTINUED TO OPERATE A PRIMARY CARE CLINIC NETWORK. MERCYONE SIOUXLAND AIDED COMMUNITY MEMBERS WHO WERE UNABLE TO OBTAIN PRESCRIPTIONS NECESSARY TO MAINTAIN THEIR HEALTH STATUS AND AVOID HOSPITALIZATIONS. TRANSPORTATION WAS ALSO PROVIDED WHEN COMMUNITY MEMBERS WERE UNABLE TO AFFORD BUS OR TAXI SERVICES TO ACCESS HEALTH MAINTENANCE SERVICES. MERCYONE SIOUXLAND PROVIDED ENROLLMENT ASSISTANCE IN GOVERNMENTAL INSURANCE PLANS AND THE HOSPITAL'S CHARITY CARE PROGRAM ALLOWING FOR FREE OR DISCOUNTED CARE. PREVENTATIVE TELEMONITORING WAS PROVIDED FOR THE CONGESTIVE HEART FAILURE POPULATION. THE EMERGENCY ROOM ADOPTED A POLICY TO REFER PATIENTS WITHOUT A PRIMARY CARE PHYSICIAN TO A CARE PROVIDER FOR FOLLOW UP AND PREVENTIVE CARE. MERCYONE SIOUXLAND PROMOTED INFORMATION ON ANNUAL PHYSICALS AND PREVENTIVE SCREENINGS ON SOCIAL MEDIA. MERCYONE SIOUXLAND WORKED WITH THE CHAMBER OF COMMERCE TO EDUCATE LOCAL EMPLOYERS ON THE IMPORTANCE OF GIVING EMPLOYEES TIME OFF FOR PREVENTIVE CARE. MERCYONE SIOUXLAND PARTICIPATED ON THE PREVENTIVE SCREENING COMMITTEE, A COMMUNITY COMMITTEE FOCUSED ON INCREASING AWARENESS OF SCREENING RECOMMENDATIONS. THE COMMITTEE'S PREVENTION 101 CAMPAIGN WILL KICK OFF IN FY24. MERCYONE SIOUXLAND PARTICIPATED ON THE STI COMMITTEE, A COMMUNITY FOCUSED ON DECREASING SEXUALLY TRANSMITTED INFECTION RATES IN THE SIOUXLAND AREA, AND SHARED THE COMMITTEE'S STI TESTING TOOLKIT WITH PROVIDERS.SUBSTANCE MISUSE:MERCYONE SIOUXLAND PARTICIPATED IN COMMUNITY EFFORTS OF THE TOBACCO FREE SIOUXLAND COALITION. PROVIDERS AND HEALTH COACHES CONTINUED TO EDUCATE COMMUNITY MEMBERS ON HEALTHY LIFESTYLE CHOICES, INCLUDING THE CESSATION OF SMOKING AND ELIMINATING SUBSTANCE MISUSE. CARE SITES SCREENED PREGNANT PATIENTS FOR SUBSTANCE USE AS A STANDARD OF CARE AND PROVIDED COUNSELING AND REFERRALS TO SPECIALISTS AS NEEDED. MERCYONE SIOUXLAND, THROUGH MERCYONE SIOUXLAND BUSINESS HEALTH, CONTINUED TO PROVIDE HEALTH COACHING FOR TOBACCO CESSATION. MERCYONE DUBUQUE MEDICAL CENTER PART V, SECTION B, LINE 11: MERCYONE DUBUQUE MEDICAL CENTER ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IN FY23: ACCESS TO HEALTH CARE:THE MOBILE MEDICAL UNIT (MMU) SERVED 3,953 PEOPLE IN FY23 THROUGH VISITS TO FOOD PANTRIES, COMMUNITY RESOURCE CENTERS, AND HOMELESS SHELTERS IN DUBUQUE, DYERSVILLE, CASCADE, AND CLINTON COUNTIES. THESE VISITS INCLUDED FREE HEALTH SCREENINGS, VACCINES, AND CONNECTIONS TO OTHER NEEDED RESOURCES. THE MMU ALSO ATTENDED THE DUBUQUE FARMER'S MARKETS WHERE IT PROVIDED HEALTH EDUCATION AND FREE PREVENTATIVE CARE SERVICES SUCH AS SKIN CANCER SCREENINGS.MERCYONE DUBUQUE SUBSIDIZED THE MATERNAL HEALTH CLINIC, WHICH PROVIDED PRENATAL, POSTPARTUM, AND YEARLY WELL WOMEN VISITS FOR UNDERSERVED WOMEN, AND THE BIRTH CENTER, WHICH WAS THE ONLY LEVEL II REGIONAL PERINATAL CENTER SERVING THE TRI-STATE AREA FOR ABOUT A 70-MILE RADIUS. THESE CRITICAL SERVICES FOR THE DUBUQUE COMMUNITY AND SURROUNDING AREA OPERATED DESPITE FINANCIAL LOSS. ADDITIONALLY, FREE OUTPATIENT LACTATION CONSULTATIONS WERE OFFERED TO BREASTFEEDING/PUMPING FAMILIES IN THE COMMUNITY.FIRST SOURCE WAS CONTRACTED TO ASSIST UNINSURED PATIENTS EXPLORE AND APPLY FOR INSURANCE TO IMPROVE THEIR ACCESS TO HEALTH CARE. FINANCIAL COUNSELORS ALSO ASSISTED PATIENTS WITH ENROLLING IN MEDICAID AND PUBLIC PROGRAMS. IN-KIND OFFICE SPACE WAS ALSO PROVIDED FOR VOLUNTEERS TO OPERATE A SENIOR HEALTH INSURANCE INFORMATION PROGRAM (SHIIP), PROVIDING GUIDANCE TO INDIVIDUALS, FAMILIES, AND CAREGIVERS FOR NAVIGATING THEIR MEDICARE PLANS AND RESOURCES.MERCYONE DUBUQUE HELPED EXPAND ACCESS TO CHILDREN'S FLU VACCINES BY OFFERING THEM FOR FREE. MERCYONE DUBUQUE PROVIDED EDUCATIONAL OPPORTUNITIES TO LOCAL VOLUNTEER EMS AGENCIES IN THE TRI-STATE AREA (IA, IL, WI) ON TOPICS INCLUDING TRAUMA, STROKE, AND CARDIAC CARE. WE HELPED THE AGENCIES DEVELOP POLICIES, AND PERFORMED CASE REVIEWS USING REAL LIFE SITUATIONS TO BETTER PRE-HOSPITAL CARE. THE EMERGENCY DEPARTMENT TRAUMA COORDINATOR ALSO SERVED ON THE DUBUQUE COUNTY EMS ASSOCIATION BOARD AND PARAMOUNT EMS (PEMS) ADVISORY COMMITTEE. THESE GROUPS SOUGHT TO ENHANCE THE KNOWLEDGE AND SKILLS NECESSARY TO SERVE THE PUBLIC WITH COMPETENT AND PROFESSIONAL EMS PROFESSIONALS.MERCYONE DUBUQUE PROVIDED GRANTS TO INCREASE ACCESS TO HEALTH CARE IN OUR COMMUNITY INCLUDING: DUBUQUE FOR REFUGEE CHILDREN, WHICH ASSISTED AND EMPOWERED UNACCOMPANIED IMMIGRANT MINORS WITH THEIR LEGAL, EDUCATIONAL, MEDICAL, AND DENTAL NEEDS; THE PACIFIC ISLANDER HEALTH PROJECT (PIHP), WHICH SERVED COMPACT OF FREE ASSOCIATION (COFA) MIGRANTS LIVING IN THIS AREA, EDUCATED AND EMPOWERED COFA MIGRANTS IN ACHIEVING AND MAINTAINING HEALTH AND WELL-BEING, REMOVED BARRIERS AND ASSISTED THEM IN ACCESSING ESSENTIAL RESOURCES; AND ALMOST HOME, A PROGRAM AND SHELTER FOR HOMELESS FATHERS AND THEIR CHILDREN, TO ASSIST WITH HEALTH-RELATED EXPENSES AND BEHAVIORAL HEALTH CARE SERVICES. MERCYONE DUBUQUE COLLEAGUES DONATED IN-KIND TIME SERVING ON VARIOUS EXTERNAL COMMITTEES AND BOARDS, INCLUDING THE IOWA HEALTHCARE COLLABORATIVE EXEC COMMITTEE, THE IOWA HOSPITAL EDUCATION AND RESEARCH FOUNDATION, AND STONEHILL COMMUNITIES BOARD OF DIRECTORS.MERCYONE DUBUQUE ADVOCATED FOR MULTIPLE VETERAN HEALTH ACCESS POLICIES.MERCYONE DUBUQUE PROVIDED FREE COMPLIANCE PACKAGING FOR PATIENTS' MEDICATIONS FOR THOSE RESIDING IN THEIR HOMES WHO COULD NOT AFFORD IT. MEDICATIONS WERE FILLED IN DAY AND TIME-SPECIFIC PACKAGING TO DECREASE THE BURDEN OF MEDICATION MANAGEMENT FOR PATIENTS WITH A HISTORY OF MISUSE/OVERUSE OF ADDICTIVE MEDICATIONS, POOR VISION, IMPAIRED SHORT-TERM MEMORY OR CONFUSION. BRAIN HEALTH:MERCYONE DUBUQUE PROVIDED GRANTS TO ADDRESS BRAIN HEALTH (INCLUDING SUBSTANCE ABUSE) IN OUR COMMUNITY INCLUDING: LIBERTY RECOVERY COMMUNITY (LRC) PROVIDED AFFORDABLE HOUSING, SUPPLIES AND TRANSPORTATION COSTS FOR LOW-INCOME PERSONS EXITING TREATMENT, JAILS, HOSPITALS, AND OTHER PLACES; ZTM SOBER LIVING, PROVIDED FREE RENT FOR 15 MEN WITH LIMITED FUNDS WHO PARTICIPATED IN THEIR PROGRAM THAT PROVIDES SUPPORT AFTER LEAVING TREATMENT, JAIL, PRISON, AND CORRECTIONAL HALFWAY HOUSES FOR SUBSTANCE ABUSE AND ADDICTION.MERCYONE DUBUQUE CONTINUED TO OPERATE THE INPATIENT AND OUTPATIENT PSYCHIATRIC UNITS AND OUTPATIENT SUBSTANCE USE DISORDER TREATMENT CENTER DESPITE FINANCIAL LOSS. MERCYONE DUBUQUE DEVELOPED A PROGRAM, OPENING IN FY24, THAT WILL PROVIDE A GROUP SETTING FOR TREATMENT OF INDIVIDUALS WHO HAVE DIFFICULTY MAINTAINING THEIR DAILY ROUTINES OR WHO WOULD OTHERWISE REQUIRE INPATIENT PSYCHIATRIC TREATMENT. IN THE COMMUNITY, MERCYONE DUBUQUE PARTICIPATED WITH OTHER STAKEHOLDERS TO ASSIST IN COORDINATING AND LEVERAGING BRAIN HEALTH SPECIFIC RESOURCES. THE OUTPATIENT BEHAVIORAL HEALTH COORDINATOR ALSO SPOKE AT AN OPIOID SUMMIT. ADDITIONALLY, THE MERCYONE DUBUQUE PHARMACY CONTINUED TO STOCK NALOXONE (NARCAN) AND PROVIDED TWO NARCAN TRAININGS TO THE COMMUNITY.THE DIRECTOR OF PSYCHIATRIC SERVICES SERVED ON THE IOWA BOARD OF CERTIFICATION (IBC) BOARD OF DIRECTORS. THE IBC IS A NON-PROFIT PROMOTING STANDARDS FOR PROFESSIONALS IN THE ADDICTION AND BEHAVIORAL HEALTH FIELD. OTHER COLLEAGUES PARTICIPATED IN THE DUBUQUE COUNTY WELLNESS COALITION AND DUBUQUE AREA SUBSTANCE ABUSE COALITION.OBESITY (ACCESS TO NUTRITIONAL FOODS, HEALTHY DIETS):MERCYONE DUBUQUE FUNDED TWO GRANTS TO INCREASE ACCESS TO NUTRITIONAL FOODS: THE SCOUTING FOR FOOD PROJECT, WHICH COLLECTED AND DISTRIBUTED 33,000 POUNDS OF FOOD AND PRODUCTS TO LOCAL FOOD PANTRIES, RECEIVED FUNDING FOR MARKETING AND ADVERTISING; AND THE MISSION SCHOOL OF PRESERVATION OF THE DUBUQUE RESCUE MISSION (DRM) RECEIVED FUNDING FOR THEIR PART-TIME ASSISTANT KITCHEN MANAGER WHO TRAINED MEN IN CULINARY SKILLS, SO THAT THEY COULD FIND EMPLOYMENT AT VARIOUS FOOD SERVICE ESTABLISHMENTS IN DUBUQUE AND THE SURROUNDING AREA. THE MEN IN THIS PROGRAM PREPARED AND PRESERVED 5,000 POUNDS OF FRESH PRODUCE FOR SERVING AT THEIR "FREE MEAL" MINISTRY. DUE TO LIMITED TIME, MONEY, AND OTHER RESOURCES, MERCYONE DUBUQUE COULD NOT REALISTICALLY AND ADEQUATELY ADDRESS, EITHER DIRECTLY OR INDIRECTLY, ALL THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA. THEREFORE, JOBS AND HEALTHY ECONOMY, AGING, AFFORDABLE HEALTH INSURANCE, FAMILY LIFE, AND BULLYING WERE NOT DIRECTLY ADDRESSED IN FY23. DUNES SURGICAL HOSPITAL PART V, SECTION B, LINE 11: THE FOLLOWING NEEDS WERE ADDRESSED BY DUNES SURGICAL HOSPITAL IN FY23:SUBSTANCE MISUSE:THE PROVIDERS AT DUNES CONTINUED TO EDUCATE PATIENTS ON THE HEALTH RISKS OF SMOKING AND USING ALCOHOL. WRITTEN MATERIALS ON SMOKING/VAPING CESSATION WERE DISSEMINATED TO THE COMMUNITY. PHYSICAL HEALTH:DUNES CONTINUED TO PROVIDE PATIENT EDUCATION ON HEALTHY CHOICES, AND THE IMPORTANCE OF MAINTAINING A HEALTHY WEIGHT. THE PROVIDERS AT DUNES CONTINUED TO MEASURE PATIENT'S HEALTH RISK USING BMI FOR HEALTHY WEIGHT MONITORING. POST-SURGICAL EDUCATION WAS PROVIDED TO PATIENTS EMPHASIZING THE IMPORTANCE OF PHYSICAL EXERCISE AND PROPER NUTRITION. A CEREAL DRIVE WAS HELD AT THE HOSPITAL TO SUPPORT THE LOCAL SIOUXLAND FOOD BANK.MENTAL HEALTH:DUNES PROVIDERS CONTINUED TO SCREEN AND EDUCATE COMMUNITY MEMBERS ABOUT MENTAL HEALTH. REFERRALS WERE MADE TO MENTAL HEALTH PROFESSIONALS AS NEEDED. RECRUITMENT CONTINUED FOR ADDITIONAL MENTAL HEALTH PROVIDERS FOR THE SIOUXLAND AREA. PREVENTATIVE CARE:DUNES INCREASED ACCESS TO CARE WITHIN THE COMMUNITY DURING FY23 BY CONTINUING TO OFFER A FINANCIAL ASSISTANCE PROGRAM, WHICH ALLOWED THOSE WHO MET THE FINANCIAL NEED CRITERIA TO RECEIVE ASSISTANCE FOR NECESSARY SERVICES. SUCCESS WAS ACHIEVED IN REDUCING THE PERCENT OF UNINSURED ADULTS IN THE PRIMARY SERVICE AREA (WOODBURY IA, PLYMOUTH IA, UNION SD, DAKOTA NE, DIXON NE, AND THURSTON NE). AT THE TIME OF PATIENTS' DISMISSAL, THE HOSPITAL STAFF MADE FOLLOW UP APPOINTMENTS WITH PRIMARY CARE PHYSICIANS TO AID IN THE MAINTENANCE OR IMPROVEMENT OF OVERALL HEALTH STATUS. MERCYONE NEW HAMPTON MEDICAL CENTER PART V, SECTION B, LINE 11: MERCYONE NEW HAMPTON RESOURCES, AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES WERE TAKEN INTO CONSIDERATION OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENT CHNA PROCESS. MERCYONE NEW HAMPTON DEVELOPED AND/OR SUPPORTED INITIATIVES AND MEASURED THEIR EFFECTIVENESS, TO IMPROVE THE FOLLOWING HEALTH NEEDS:ACCESS TO HEALTH CARE - MERCYONE NEW HAMPTON IDENTIFIED THAT AREA RESIDENTS WOULD DESIRE MORE LOCAL ACCESS TO SPECIALISTS, TREATMENTS/PROCEDURES, AND FAMILY PHYSICIANS. IN FY23, MERCYONE NEW HAMPTON FAMILY MEDICINE WORKED WITH EPION TO PROVIDE ONLINE REGISTRATION FOR APPOINTMENTS, WHICH LAUNCHED IN FALL 2022. TO PROVIDE ONLINE SCHEDULING CAPABILITY, MERCYONE NEW HAMPTON FAMILY MEDICINE HAS BEEN PLANNING TO IMPLEMENT A SELF-SCHEDULING TOOL AS WELL. PAIN SPECIALIST RECRUITMENT TOOK PLACE IN FY23 WITH A START DATE OF OCTOBER 2023. TO EVALUATE THE NEED FOR URGENT CARE AS REQUESTED BY COMMUNITY MEMBERS, THE CLINIC ESTABLISHED A BASELINE ON JANUARY 1, 2023, OF 20% SAME-DAY APPOINTMENT AVAILABILITY. FOR THE REMAINING 6 MONTHS OF THE FISCAL YEAR, THE CLINIC CONSISTENTLY AVERAGED MORE THAN 30% OF SAME-DAY APPOINTMENT AVAILABILITY. IN MAY 2023, FREE SKIN CANCER SCREENINGS WERE HELD. TWENTY-TWO PATIENTS WERE SCREENED WITH ANOTHER EVENT PLANNED FOR LATER THIS YEAR. AGING POPULATION - IN FY23, MERCYONE NEW HAMPTON CREATED A TASKFORCE TO ADDRESS THE NEEDS OF OUR AGING POPULATION WITH CHICKASAW COUNTY PUBLIC HEALTH, SENIOR LIFE SOLUTIONS, NORTHEAST IOWA AREA AGENCY ON AGING, AREA FUNERAL HOMES, CHICKASAW COUNTY AMBULANCE SERVICE AND CHICKASAW COUNTY MINISTERIAL ASSOCIATION. TO BEST CARE FOR THE AGING POPULATION AND TO ENSURE THEIR WISHES ARE KNOWN, EDUCATION AND PLANNING TOOLS FOR LIVING WILLS AND ADVANCED DIRECTIVES WERE PRESENTED AT FOUR EVENTS. MERCYONE NEW HAMPTON HAS DISTRIBUTED OVER 400 COPIES OF THE FIVE WISHES WORKBOOK WITH MAGNETIC CLIPS SO FIRST RESPONDERS COULD LOCATE THE BOOKLET ON THE PATIENT'S REFRIGERATOR. IN FY23, RESIDENTS WERE EDUCATED ABOUT THE IMPORTANCE OF CARDIOVASCULAR HEALTH AND BLOOD PRESSURE TESTING AND THROUGH COORDINATION WITH CHICKASAW COUNTY PUBLIC HEALTH AND AREA INDUSTRIES, 174 PEOPLE HAVE BEEN REACHED. EMERGENCY MEDICAL SERVICES - IN FY23, MERCYONE NEW HAMPTON COLLABORATED WITH CHICKASAW COUNTY BOARD OF SUPERVISORS, CHICKASAW COUNTY AMBULANCE COUNCIL AND CHICKASAW EMS ADVISORY COMMITTEE TO ASSIST WITH THE ESTABLISHMENT OF NEW COUNTY OWNED AND OPERATED EMS, IN RESPONSE TO THE RECENT LOSS OF THE ONLY LOCAL EMS PROVIDER. MERCYONE NEW HAMPTON'S EMERGENCY DEPARTMENT NURSE LEADER SERVED ON THE ADVISORY COMMITTEE. MERCYONE NEW HAMPTON'S CEO AND PUBLIC RELATIONS MANAGER PARTICIPATED AND HELPED WITH DATA COLLECTION, EDUCATING THE PUBLIC, MARKETING, AND RECRUITMENT. MERCYONE NEW HAMPTON DEVELOPED A PARTNERSHIP WITH NORTHEAST IOWA COMMUNITY COLLEGE AND NEW HAMPTON COMMUNITY SCHOOLS TO OFFER EMT EDUCATION TO SENIORS IN HIGH SCHOOL. IN OCTOBER 2022, A CAREER EXPLORATION EVENT WAS HOSTED AT MERCYONE NEW HAMPTON IN PARTNERSHIP WITH NORTHEAST IOWA COMMUNITY COLLEGE THAT FEATURED THE ROLE OF EMT'S AND PARAMEDICS IN ADDITION TO OTHER HEALTH CARE CAREERS. THIRTY HIGH SCHOOL STUDENTS AND TEN STAFF MEMBERS FROM AREA HIGH SCHOOLS AND COLLEGES ATTENDED. TWO RECRUITMENT EVENTS FOR THE NEW EMS PROVIDER WERE SPONSORED BY MERCYONE. THE NEW SERVICE BEGAN ON JANUARY 1, 2023, AND WAS FULLY STAFFED FOR A FULL-TIME 1ST CREW AND A BACK-UP/ON-CALL 2ND CREW. IN JUNE, THE FRIENDS OF CHICKASAW COUNTY EMS WAS FORMED. BOARD MEMBERS ARE REPRESENTATIVES FROM CHICKASAW COUNTY PUBLIC HEALTH, CHICKASAW COUNTY EMS AND MERCYONE NEW HAMPTON. BY-LAWS WERE ESTABLISHED AND AN ATTORNEY IS WORKING ON FILING THE 501(C)(3) PAPERWORK. MERCYONE NEW HAMPTON ACKNOWLEDGES THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE HEALTH NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. FOR THAT REASON, MERCYONE NEW HAMPTON DID NOT ADDRESS THE NEEDS OF 'KNOWLEDGE OF HEALTH CARE RESOURCES/SERVICES AVAILABLE LOCALLY'. WHILE NOT INCLUDED FOR INTERVENTION IN THE IMPLEMENTATION STRATEGY, MERCYONE NEW HAMPTON DID CONTINUE TO PROMOTE AND EDUCATE OUR COMMUNITY ABOUT RESOURCES AVAILABLE THROUGH MERCYONE NEW HAMPTON, COUNTY AND STATE AGENCIES. MERCYONE NEW HAMPTON LAUNCHED AN ONLINE COMMUNITY RESOURCE DIRECTORY WHICH WILL HELP PEOPLE FIND LOCAL PROGRAMS, RESOURCES, AND SUPPORT. ON MAY 23, 2023, MERCYONE NEW HAMPTON ALSO PARTNERED WITH CHICKASAW COUNTY EMS, CHICKASAW COUNTY RESCUE SQUAD AND MERCYONE AIRMED TO HOST A NATIONAL EMS WEEK OPEN HOUSE AT MERCYONE NEW HAMPTON. THE EVENT FEATURED EMERGENCY VEHICLES, INCLUDING MERCYONE AIRMED HELICOPTER, TEDDY BEAR CLINIC, SAFETY DOOR PRIZES, BLOOD PRESSURE CHECKS AND REFRESHMENTS. OVER 100 COMMUNITY MEMBERS WERE IN ATTENDANCE. MERCYONE DYERSVILLE MEDICAL CENTER PART V, SECTION B, LINE 11: MERCYONE DYERSVILLE ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IN FY23: ACCESS TO HEALTH CARE:- ORGANIZED JOB SHADOWING OPPORTUNITIES FOR HIGH SCHOOL AND COLLEGE STUDENTS INTERESTED IN BECOMING A CLINICAL THERAPY ASSISTANT. - HOSTED FOUR BLOOD DRIVES WITH IMPACTLIFE WHERE COLLEAGUES DONATED BLOOD DURING WORKTIME- PROVIDED PRECEPTORSHIP AND MENTORSHIP PROGRAMS FOR RN STUDENTSBRAIN HEALTH (INCLUDING SUBSTANCE MISUSE):- PARTICIPATED IN A MONTHLY BRAIN HEALTH STAKEHOLDERS TEAM TO ASSIST IN COORDINATING AND LEVERAGING BRAIN HEALTH SPECIFIC RESOURCES WITHIN THE COMMUNITY.OBESITY:- SPONSORED THE DYERSVILLE COMMUNITY GAELIC GALLOP 2 MILE/8K FUN WALK/RUN TO ASSIST COMMUNITY MEMBERS IN GETTING OUT AND WALKING AND RUNNING.DUE TO LIMITED TIME, MONEY, AND OTHER RESOURCES, MERCYONE DYERSVILLE COULD NOT REALISTICALLY AND ADEQUATELY ADDRESS, EITHER DIRECTLY OR INDIRECTLY, ALL THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA. THEREFORE, JOBS AND HEALTHY ECONOMY, AGING, AFFORDABLE HEALTH INSURANCE, FAMILY LIFE, AND BULLYING WERE NOT DIRECTLY ADDRESSED IN FY23. MERCYONE NORTH IOWA MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCYONE SIOUXLAND MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCYONE DUBUQUE MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. DUNES SURGICAL HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCYONE NEW HAMPTON MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCYONE DYERSVILLE MEDICAL CENTER PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCYONE NORTH IOWA MEDICAL CENTER - PART V, SECTION B, LINE 7A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE NORTH IOWA MEDICAL CENTER - PART V, SECTION B, LINE 10A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE SIOUXLAND MEDICAL CENTER - PART V, SECTION B, LINE 7A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE SIOUXLAND MEDICAL CENTER - PART V, SECTION B, LINE 10A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE DUBUQUE MEDICAL CENTER - PART V, SECTION B, LINE 7A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE DUBUQUE MEDICAL CENTER - PART V, SECTION B, LINE 10A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ DUNES SURGICAL HOSPITAL - PART V, SECTION B, LINE 7A WWW.DUNESSURGICALHOSPITAL.COM/COMMUNITY-BENEFIT DUNES SURGICAL HOSPITAL - PART V, SECTION B, LINE 10A WWW.DUNESSURGICALHOSPITAL.COM/COMMUNITY-BENEFIT MERCYONE NEW HAMPTON MEDICAL CENTER - PART V, SECTION B, LINE 7A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE NEW HAMPTON MEDICAL CENTER - PART V, SECTION B, LINE 10A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE DYERSVILLE MEDICAL CENTER - PART V, SECTION B, LINE 7A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE DYERSVILLE MEDICAL CENTER - PART V, SECTION B, LINE 10A WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ MERCYONE NEW HAMPTON MEDICAL CENTER - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. MERCYONE NORTH IOWA MEDICAL CENTER - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. MERCYONE SIOUXLAND MEDICAL CENTER - PART V, SECTION B, LINE 7B WWW.DUNESSURGICALHOSPITAL.COM/COMMUNITY-BENEFITWWW.SIOUXLANDDISTRICTHEALTH.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-STATISTICSWWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS DUNES SURGICAL HOSPITAL - PART V, SECTION B, LINE 7B WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/WWW.SIOUXLANDDISTRICTHEALTH.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-STATISTICSWWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS MERCYONE DUBUQUE MEDICAL CENTER - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. MERCYONE DYERSVILLE MEDICAL CENTER - PART V, SECTION B, LINE 9 AS PERMITTED IN THE FINAL SECTION 501(R) REGULATIONS, THE HOSPITAL'S IMPLEMENTATION STRATEGY WAS ADOPTED WITHIN 4 1/2 MONTHS AFTER THE FISCAL YEAR END THAT THE CHNA WAS COMPLETED AND MADE WIDELY AVAILABLE TO THE PUBLIC. MERCYONE NORTH IOWA MEDICAL CENTER, PART V, LINE 16A, FAP WEBSITE: WWW.MERCYONE.ORG/NORTHIOWA/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE DUBUQUE MEDICAL CENTER, PART V, LINE 16A, FAP WEBSITE: WWW.MERCYONE.ORG/DUBUQUE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE DUNES SURGICAL HOSPITAL, PART V, LINE 16A, FAP WEBSITE: WWW.DUNESSURGICALHOSPITAL.COM/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE MERCYONE DYERSVILLE MEDICAL CENTER, PART V, LINE 16A, FAP WEBSITE: WWW.MERCYONE.ORG/DUBUQUE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE MERCYONE NORTH IOWA MEDICAL CTR, PART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.MERCYONE.ORG/NORTHIOWA/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE DUBUQUE MEDICAL CENTER, PART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.MERCYONE.ORG/DUBUQUE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE DUNES SURGICAL HOSPITAL, PART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.DUNESSURGICALHOSPITAL.COM/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE MERCYONE DYERSVILLE, PART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.MERCYONE.ORG/DUBUQUE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE MERCYONE NORTH IOWA MEDICAL CENTER, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.MERCYONE.ORG/NORTHIOWA/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE SIOUXLAND MEDICAL CENTER, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.MERCYONE.ORG/SIOUXLAND/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE DUBUQUE MEDICAL CENTER, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.MERCYONE.ORG/DUBUQUE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE DUNES SURGICAL HOSPITAL, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.DUNESSURGICALHOSPITAL.COM/FINANCIAL-ASSISTANCE-AND-CHARITY-CARE MERCYONE NEW HAMPTON MEDICAL CENTER, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.MERCYONE.ORG/NEWHAMPTON/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE DYERSVILLE MEDICAL CENTER, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.MERCYONE.ORG/DUBUQUE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE MERCYONE NEW HAMPTON MEDICAL CENTER, PART V, LINE 16A, FAP WEBSITE: WWW.MERCYONE.ORG/NEWHAMPTON/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE NEW HAMPTON MEDICAL CTR, PART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.MERCYONE.ORG/NEWHAMPTON/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE SIOUXLAND MEDICAL CENTER, PART V, LINE 16A, FAP WEBSITE: WWW.MERCYONE.ORG/SIOUXLAND/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ MERCYONE SIOUXLAND MEDICAL CTR, PART V, LINE 16B, FAP APPLICATION WEBSITE: WWW.MERCYONE.ORG/SIOUXLAND/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/ 16 1 - MEDICAL ASSOCIATES WEST CAMPUS 1500 ASSOCIATES DRIVE DUBUQUE IA 52001 OCC. HEALTH, PHYS THER, AMBULATORY SURGERY 2 - MEDICAL ASSOCIATES CLINIC 1240 BIG JACK ROAD PLATTEVILLE WI 53818 X-RAY, LAB, EMPLOYED PHYSICIANS 3 - TRI-STATE OCCUPATIONAL HEALTH 1920 ELM STREET DUBUQUE IA 52001 PHYS THERAPY,EMPLOYED PHYSICIANS 4 - MEDICAL ASSOCIATES CLINIC 10988 BARTELL BLVD GALENA IL 61036 HOME CARE,LAB, EMPLOYED PHYSICIANS 5 - MERCYONE DYERSVILLE MEDICAL CENTER 1121 THIRD STREET SW DYERSVILLE IA 52040 CLINIC 6 - MEDICAL ASSOCIATES CLINIC 208 N 12TH STREET BELLEVUE IA 52031 CLINIC 7 - MEDICAL ASSOCIATES CLINIC 911 NW CARTER ELKADER IA 52043 CLINIC 8 - CASCADE FAMILY HEALTH CENTER 805 JOHNSON STREET SW CASCADE IA 52033 EMPLOYED PHYSICIANS, LAB, X-RAY, PT 9 - MEDICAL ASSOCIATES CLINIC 117 SOUTH MADISON CUBA CITY WI 53807 X-RAY, LAB, EMPLOYED PHYSICIANS 10 - MEDICAL ASSOCIATES CLINIC 560 PLEASANT ST ELIZABETH IL 61028 CLINIC 11 - MEDICAL ASSOCIATES CLINIC 107 S PAGE MONONA IA 52159 CLINIC 12 - MEDICAL ASSOCIATES EAST CAMPUS 1000 LANGWORTHY DUBUQUE IA 52001 OCC. HEALTH, PHYSICAL THERAPY 13 - MERCYONE DAKOTA DUNES MEDICAL LAB 101 TOWER RD SUITE 220 DAKOTA DUNES SD 57049 REFERENCE LABORATORY 14 - MASON CITY SURGERY CENTER 990 4TH STREET MASON CITY IA 50401 AMBULATORY SURGERY 15 - MERCY FAMILY CLINIC - BUFFALO CENTER 115 NORTH MAIN BUFFALO CENTER IA 50424 X-RAY, LAB, EMPLOYED PHYSICIANS 16 - TRI-STATE SURGERY CENTER 1500 ASSOCIATES DRIVE DUBUQUE IA 52002 OUTPATIENT CLINIC, OPHTHALMOLOGY, ORTHOPEDICS PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: MERCY HEALTH SERVICES-IOWA (MHS-IA) REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.THE HOSPITAL DIVISIONS OF MHS-IA ALSO INCLUDE A COPY OF THEIR MOST RECENT SCHEDULE H ON THEIR RESPECTIVE WEBSITES. TRINITY HEALTH ALSO INCLUDES MHS-IA'S MOST RECENTLY FILED SCHEDULE H ON ITS WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITALS' COST ACCOUNTING SYSTEMS. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $25,540,717, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: MERCYONE NORTH IOWA MEDICAL CENTER (MERCYONE NORTH IOWA) PARTICIPATED IN THE AGING SERVICES COALITION, COMPOSED OF ORGANIZATIONS DEDICATED TO PROVIDING SERVICES TO THE OLDER RESIDENTS IN THE AREA. MEMBERS WORK TOGETHER TO IDENTIFY AND ADDRESS AREAS OF UNMET NEEDS. MERCYONE DUBUQUE MEDICAL CENTER (MERCYONE DUBUQUE):ENVIRONMENTAL IMPROVEMENTS: MERCYONE DUBUQUE OUTPATIENT PHARMACIES SERVED AS SHARPS COLLECTION LOCATIONS FOR DUBUQUE COUNTY CITIZENS WHO WERE LOOKING TO SAFELY DISPOSE OF NEEDLES AND SYRINGES. PREVIOUSLY, THERE WAS STATE FUNDING TO COVER THE COST OF TAKING THESE CONTAINERS TO THE LANDFILL FOR DESTRUCTION. THIS FUNDING HAD RUN OUT. IN ORDER TO PREVENT A DISRUPTION OF THIS SERVICE, MERCYONE DUBUQUE PHARMACIES PRIVATELY COVERED THESE COSTS.COMMUNITY SUPPORT AND ECONOMIC DEVELOPMENT: MERCYONE DUBUQUE COLLEAGUES DONATED IN-KIND TIME TO PARTICIPATE ON: THE FULL BOARD AND EXECUTIVE COMMITTEE FOR DUBUQUE RACING ASSOCIATION (DRA) WHOSE MISSION IS TO PROVIDE SOCIAL, ECONOMIC AND COMMUNITY BETTERMENT AND TO LESSEN THE BURDEN OF DUBUQUE CITY AND AREA GOVERNMENT; THE LOCAL DUPACO COMMUNITY CREDIT UNION BOARD, A NOT-FOR-PROFIT FINANCIAL COOPERATIVE, TO LEAD EFFORTS TO HELP THOSE IN NEED LEARN MONEY-SAVING SKILLS; AND THE FULL BOARD AND EXECUTIVE COMMITTEE FOR GREATER DUBUQUE DEVELOPMENT CORPORATION, WHOSE PROJECTS INCLUDED DEVELOPING SOLUTIONS TO ADDRESS UNEMPLOYMENT AND TRANSPORTATION NEEDS OF THE COMMUNITY.WORKFORCE DEVELOPMENT: HIGH SCHOOL STUDENTS FROM THE AREA WERE PROVIDED WITH THE OPPORTUNITY TO WORK ALONGSIDE MERCYONE DUBUQUE STAFF; MERCYONE DUBUQUE ATTENDED HIGH SCHOOL CAREER FAIRS TO EXPOSE YOUNG STUDENTS TO ALL THE OPPORTUNITIES THE HEALTH CARE FIELD HAS TO OFFER, INSPIRE INTEREST, AND INFORM THEM OF THE EDUCATIONAL PATHS REQUIRED TO ENTER THE FIELD; AND MERCYONE DUBUQUE COLLEAGUES SERVED ON COLLEGE ADVISORY BOARDS, CONDUCTED MOCK INTERVIEWS, AND GAVE AN IN-DEPTH TOUR OF THE LABORATORY FACILITIES TO INSPIRE INTEREST IN THE FIELD. MERCYONE NEW HAMPTON MEDICAL CENTER (MERCYONE NEW HAMPTON):WORKFORCE DEVELOPMENT: IN FY23, MERCYONE NEW HAMPTON HOSTED A CAREER EXPLORATION EVENT IN PARTNERSHIP WITH NORTHEAST IOWA COMMUNITY COLLEGE (NICC). AREA HIGH SCHOOL STUDENTS LEARNED ABOUT RADIOLOGY, LABORATORY AND EMS/PARAMEDIC CAREERS. THROUGHOUT THE YEAR, MERCYONE NEW HAMPTON WORKS CLOSELY WITH NICC AND THE NEW HAMPTON COMMUNITY SCHOOL DISTRICT ON 8TH GRADE CAREER WEEK, ADULTING 101 DAY FOR SENIORS, AND JOB SHADOWING OPPORTUNITIES AT MERCYONE NEW HAMPTON. IN FY23, MERCYONE NEW HAMPTON ADVOCATED FOR AREA SCHOOLS TO INCREASE THE NUMBER OF COLLEGE HEALTH CARE CAREER CLASSES OFFERED TO HIGH SCHOOL SENIORS. MERCYONE NEW HAMPTON ALSO WORKS WITH THE IOWA INTERMEDIARY NETWORK TO PROMOTE WORK-BASED LEARNING PROGRAMS. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT: THROUGHOUT FY23, THREE MERCYONE NEW HAMPTON COLLEAGUES PARTICIPATED IN A CORE COMMITTEE TO RAISE FUNDS FOR AN INCLUSIVE PLAYGROUND. PLAY IS A VITAL PART OF CHILDREN'S DEVELOPMENT, NOT JUST PHYSICALLY BUT SOCIALLY AND EMOTIONALLY. THE PLAYGROUND WILL HELP THOSE WITH DISABILITIES AND THEIR FAMILIES HAVE FUN PLAYING ALONGSIDE THEIR FRIENDS, FURTHERING THEIR DEVELOPMENT AND SENSE OF BELONGING. FOR OTHER CHILDREN, IT WILL TEACH THEM TO EMBRACE DIVERSITY AND INCLUSION OF CHILDREN DIFFERENT FROM THEM. MERCYONE NEW HAMPTON'S PUBLIC RELATIONS MANAGER IS THE PANTRY COORDINATOR FOR CHICKASAW PRIDE PANTRY LOCATED AT NEW HAMPTON MIDDLE/HIGH SCHOOL. THE PANTRY IS A PROJECT OF THE NEW HAMPTON ROTARY CLUB AND THE NEW HAMPTON HIGH SCHOOL INTERACT CLUB, WHICH MERCYONE NEW HAMPTON'S PUBLIC RELATIONS MANAGER ALSO ADVISES. THE PANTRY DISTRIBUTES FRESH FRUIT AND VEGETABLES, EASY TO OPEN SHELF-STABLE ITEMS, A COMBINATION OF GRAINS, PERSONAL CARE/HYGIENE ITEMS AND PAPER PRODUCTS. THE AGENCY PARTNER IS NORTHEAST IOWA FOOD BANK. IN FY23, 4,963 POUNDS OF FOOD AND PERSONAL CARE ITEMS WERE DISTRIBUTED. MERCYONE NEW HAMPTON COLLEAGUES ALSO HOLD DRIVES TWICE A YEAR TO COLLECT PERSONAL CARE ITEMS FOR THE PANTRY. COMMUNITY SUPPORT: AS NOTED IN PART V SECTION C NARRATIVE, MERCYONE NEW HAMPTON HAS DEDICATED TIME AND RESOURCES TO THE NEWLY FORMED CHICKASAW COUNTY EMS PROGRAM. IN ADDITION TO INVOLVEMENT IN MEETINGS, HOSTING EVENTS AND SERVING ON THE FRIENDS OF CHICKASAW COUNTY EMS BOARD, MERCYONE NEW HAMPTON PROVIDES LINEN SERVICES TO THE AMBULANCE SERVICE. ECONOMIC DEVELOPMENT: AS ONE OF THE LARGEST EMPLOYERS IN THE AREA, MERCYONE NEW HAMPTON TAKES ITS CIVIC RESPONSIBILITY VERY SERIOUSLY. SUPPORT OF, AND CONTRIBUTIONS TO, COMMUNITY ORGANIZATIONS, EVENTS, AND PROGRAMS, SUCH AS THE INDUSTRIAL DEVELOPMENT CORPORATION HELP IMPROVE THE ECONOMY OF MERCYONE NEW HAMPTON'S CATCHMENT COUNTIES. BY PROMOTING ECONOMIC DEVELOPMENT, MERCYONE NEW HAMPTON HELPS CREATE A COMMUNITY THAT CONTINUES TO BUILD ITSELF THROUGH THE LEADERS WHO WORK AND VOLUNTEER AT THE HOSPITAL. ECONOMIC STABILITY IS INTRINSICALLY LINKED TO THE PREVENTION OF HEALTH PROBLEMS ASSOCIATED WITH POVERTY, HOMELESSNESS, AND ENVIRONMENTAL CHALLENGES, AND IS CRUCIAL IF THE COMMUNITY HOPES TO MAINTAIN A VIABLE HOSPITAL COMPLEX WITH A BROAD SPECTRUM OF ESSENTIAL SERVICES. IN FY23, MERCYONE NEW HAMPTON'S CEO AND PUBLIC RELATIONS MANAGER SERVED ON THE INDUSTRIAL DEVELOPMENT CORPORATION BOARD. PROJECTS INCLUDED TWO-DAY CARE EXPANSIONS, GROWTH IN OUR SOUTH INDUSTRIAL PARK AND AVAILABILITY OF AFFORDABLE HOUSING. FOR MERCYONE HAMPTON'S LEADERS, COMMUNITY INVOLVEMENT ISN'T JUST A RESPONSIBILITY; IT'S AN OPPORTUNITY FOR LEADERS TO BE MORE EFFECTIVE AND TO FOSTER A SENSE OF TOGETHERNESS AND PROGRESS WITHIN THE COMMUNITIES THEY SERVE. BEING INVOLVED IN THE COMMUNITY ALLOWS LEADERS TO GAIN A DEEPER UNDERSTANDING OF THE CHALLENGES, NEEDS, AND ASPIRATIONS OF THE PEOPLE THEY SERVE. MERCYONE NEW HAMPTON HAS THREE COLLEAGUES WHO ARE MEMBERS OF NEW HAMPTON ROTARY CLUB, WHOSE AREAS OF FOCUS ALIGN WITH THE MISSION, VISION, AND VALUES OF MERCYONE. THEY FOCUS ON BASIC EDUCATION AND LITERARY; DISEASE PREVENTION AND MANAGEMENT; WATER, SANITATION AND HYGIENE; ECONOMIC EMPOWERMENT AND COMMUNITY DEVELOPMENT ENVIRONMENTAL PROTECTION; MATERNAL AND CHILD HEALTH; PEACE AND CONFLICT PREVENTION. IN FY 2023, OUR COLLEAGUES WITH NEW HAMPTON ROTARY WORKED TO IMPROVE FOOD INSECURITY WITHIN OUR COMMUNITY, YOUTH PROGRAMS, SCHOLARSHIP OPPORTUNITIES, LEADERSHIP TRAINING AND ECONOMIC DEVELOPMENT. ENVIRONMENTAL IMPROVEMENTS: MERCYONE NEW HAMPTON CONTINUES TO PROVIDE MEMBERS OF THE COMMUNITY A PLACE TO SAFELY DISPOSE OF THEIR SHARPS AND CONTAINERS TO REDUCE ENVIRONMENTAL HAZARDS. THE HOSPITAL COLLABORATES WITH PHARMACIES IN NEW HAMPTON TO COLLECT THEIR CONTAINERS AS WELL. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: MHS-IA USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MHS-IA IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MHS-IA IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MHS-IA IS IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: MHS-IA DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - MHS-IA HOSPITALS ASSESS THE HEALTH STATUS OF THEIR COMMUNITIES, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORT TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THEIR COMMUNITIES, OUR HOSPITALS MAY USE PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH AREAS OF UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED.MERCYONE NORTH IOWA AND MERCYONE NEW HAMPTON EACH HAVE A LOCAL BOARD OF GOVERNANCE COMPOSED OF AREA RESIDENTS, EMPLOYERS, AND REPRESENTATIVES OF DEMOGRAPHIC GROUPS. THESE HOSPITALS ALSO COMMUNICATE WITH OTHER AGENCIES ABOUT WHAT SERVICES ARE NEEDED LOCALLY. IN PARTICULAR OUR PRIMARY CARE PHYSICIANS HAVE A STRONG AWARENESS OF PATIENT NEEDS. A COMMITTEE MEETS QUARTERLY THAT IS COMPRISED OF COMMUNITY MEMBERS AND HOSPITAL PERSONNEL THAT WORK DIRECTLY WITH THE UNINSURED, UNDERINSURED AND UNDERSERVED. THE COMMUNITY BENEFIT MINISTRY OFFICER INTERFACES REGULARLY WITH COMMUNITY HUMAN SERVICE AGENCIES AND COALITIONS.THE STAFF OF MERCYONE SIOUXLAND MEDICAL CENTER (MERCYONE SIOUXLAND) ROUTINELY MET WITH VARIOUS COMMUNITY AGENCIES AND SCHOOLS IN SEARCH OF OPPORTUNITIES TO FURTHER COLLABORATE TO ADDRESS PHYSICAL HEALTH, SUBSTANCE MISUSE, MENTAL HEALTH, AND PREVENTATIVE CARE. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MHS-IA HOSPITALS COMMUNICATE EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. THE HOSPITALS OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. NOTIFICATION ABOUT FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITALS. PART VI, LINE 4: COMMUNITY INFORMATION MERCYONE NORTH IOWA:TRINITY HEALTH DATA HUB ESTIMATES POPULATION IN IOWA AT 3.2 MILLION WITH CERRO GORDO COUNTY'S ESTIMATED POPULATION AT 43,185, WHICH IS SLIGHTLY HIGHER THAN THE LAST CHNA REPORTING CYCLE. THE COUNTY HAS A VERY LOW DIVERSITY INDEX, .006 COMPARED TO IOWA AT .40. MOST OF THE RESIDENTS ARE WHITE, MAKING UP 90.74% OF THE POPULATION, WHILE BLACK MAKES UP 2.03%, HISPANIC, 5.38%, AND NON-HISPANIC ASIAN 1.28%. CERRO GORDO'S POPULATION OF UNDER 18-YEAR-OLDS IS 21.04%, 18-64-YEAR-OLDS, 57.58% AND 65 AND OLDER IS 21.38%. CERRO GORDO COUNTY HAS 87 MENTAL HEALTH PROVIDERS LOCATED AT FOUR DIFFERENT FACILITIES AND 201.73 PROVIDERS/100,000 POPULATION. THERE IS A 90.43:100,000 RATIO FOR SUBSTANCE ABUSE PROVIDERS IN THE COUNTY. THERE ARE 22.81% OF THE CERRO GORDO POPULATION WHO CURRENTLY RECEIVE MEDICAID. THIS IS HIGHER THAN BOTH THE STATE (20.47%) AND NATIONALLY (22.19%). FOOD INSECURITY CONTINUES TO BE AN ISSUE IN CERRO GORDO COUNTY WITH 8.30% OF THE POPULATION FOOD INSECURE, WHICH IS HIGHER THAN THE STATE AVERAGE OF 7.30%. STUDENTS ELIGIBLE FOR FREE OR REDUCED LUNCH IS 42.1%. THE MEDIAN HOUSEHOLD INCOME IN CERRO GORDO COUNTY IS $58,271. THE POPULATION UNDER AGE 18 WHO ARE BELOW 200% FEDERAL POVERTY LEVEL IS 36.43%. MOST CERRO GORDO COUNTY RESIDENTS HAVE A HIGH SCHOOL DIPLOMA (93.51%), WITH 23.89% OF THESE INDIVIDUALS HAVING OBTAINED A BACHELOR'S DEGREE OR HIGHER.IN DUBUQUE COUNTY, ONE OTHER HOSPITAL IS PRESENT AND ONE FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER. THE PRIMARY SERVICE AREA OF MERCYONE DUBUQUE AND MERCYONE DYERSVILLE MEDICAL CENTER (MERCYONE DYERSVILLE) IS DUBUQUE COUNTY, IOWA, WHICH IS A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA.THE MAJOR SERVICE AREA FOR MERCYONE DUBUQUE IS DUBUQUE COUNTY, BUT ALSO INCLUDES JACKSON, CLAYTON, LAFAYETTE, AND DELAWARE COUNTIES IN IOWA, GRANT COUNTY, WISCONSIN, AND JO DAVIESS COUNTY, ILLINOIS. THE SERVICE AREA IS RELATIVELY HOMOGENOUS, WITH A WHITE NON-HISPANIC POPULATION OF 92.5% AND VERY LOW OVERALL POPULATION GROWTH. MERCYONE SIOUXLAND AND DUNES SURGICAL HOSPITAL: SIOUX CITY, IOWA SERVES AS THE REGIONAL HUB FOR BUSINESS, EMPLOYMENT, INDUSTRY, RETAIL TRADE, MEDICAL CARE, AND EDUCATIONAL OPPORTUNITIES. SIX COUNTIES IN THE TRI-STATE AREA OF NORTHWESTERN IOWA, NORTHEASTERN NEBRASKA, AND SOUTHWESTERN SOUTH DAKOTA WERE INCLUDED IN THE SIOUXLAND COMMUNITY HEALTH NEEDS ASSESSMENT. INDIVIDUALS RESIDING IN THESE COUNTIES LIVED WITHIN A 40-MILE RADIUS OF SIOUX CITY. THE AREA INCLUDED THE IOWA COUNTIES OF WOODBURY AND PLYMOUTH; THE NEBRASKA COUNTIES OF DAKOTA, DIXON, AND THURSTON; AND THE SOUTH DAKOTA COUNTY OF UNION. THE TOTAL AREA FOR THESE COUNTIES IS 3,355 SQUARE MILES, WITH WOODBURY AND PLYMOUTH REPRESENTING 52% OF THE TOTAL AREA. THE SIOUXLAND REGION HAS A TOTAL CURRENT POPULATION OF 177,000. ABOUT 26% OF THE POPULATION WAS UNDER THE AGE OF 18 YEARS AND 16% OF THE POPULATION WAS OVER THE AGE OF 65 YEARS. THE RACE/ETHNICITY DISTRIBUTION IN THE AREA WAS 84% WHITE, 4% AMERICAN INDIAN, 3% BLACK, 2% ASIAN, 3% TWO OR MORE RACES, AND 4% OTHER. EIGHTY FOUR PERCENT ARE NON-HISPANIC WHILE 16% WERE HISPANIC/LATINO.IN THE AREA, OVERALL POVERTY RATE IS 13%, WITH AMERICAN INDIAN/ALASKA NATIVE AND BLACK OR AFRICAN AMERICAN POPULATIONS HAVING THE HIGHEST POVERTY RATE. THIRTY PERCENT OF HOUSEHOLDS FALL UNDER THE 200% POVERTY RATE AND THE MEDIAN HOUSEHOLD INCOME FOR THE AREA IS $61,393.THE REGIONAL ECONOMY IS BASED ON FOOD MANUFACTURING/PROCESSING, AGRICULTURE, HEALTH CARE AND SOCIAL ASSISTANCE, EDUCATION, AND THE FOOD SERVICE INDUSTRIES. THE JUNE 2021 UNEMPLOYMENT RATE FOR THE LARGEST COUNTIES IN THE REGION WOODBURY, PLYMOUTH, AND DAKOTA WAS 4.9%, 3.5%, AND 3.4%, RESPECTIVELY.WOODBURY COUNTY, IA HAS A POPULATION OF 103,107, WHICH REPRESENTS 58% OF THE SIOUXLAND REGIONAL TOTAL. THE RESIDENTS OF SIOUX CITY AND SERGEANT BLUFF REPRESENT NEARLY 90% OF THE WOODBURY COUNTY POPULATION. PLYMOUTH COUNTY, IA HAS A POPULATION OF 25,177, OR 14% OF THE SIOUXLAND REGIONAL TOTAL. THE LARGEST COMMUNITY IN THE COUNTY IS LE MARS WITH A POPULATION OF 10,081. DAKOTA COUNTY, NE HAS A POPULATION OF 20,026. SOUTH SIOUX CITY AND DAKOTA CITY TOTAL RESIDENTS REPRESENT 73% OF THE COUNTY POPULATION. UNION COUNTY, SD HAS A POPULATION OF 15,932 WHICH REPRESENTS 9% OF THE REGIONAL TOTAL. NORTH SIOUX CITY AND DAKOTA DUNES' TOTAL RESIDENTS REPRESENT 34% OF THE COUNTY POPULATION. THURSTON COUNTY, NE HAS A POPULATION OF 7,224. DIXON COUNTY, NE HAS A POPULATION OF 5,636, REPRESENTING 7% OF THE REGIONAL TOTAL.MERCYONE NEW HAMPTON SERVES THE CHICKASAW AREA AND SURROUNDING COUNTIES WITHIN A 20-MILE RADIUS STRETCHING IN EVERY DIRECTION FROM NEW HAMPTON. THE PRIMARY SERVICE AREA CONSISTS OF THE TOWNS OF NEW HAMPTON, FREDERICKSBURG, ALTA VISTA, IONIA, ELMA, WAUCOMA, LAWLER AND NASHUA. THE ESTIMATED POPULATION OF THIS AREA IS 13,000. ACCORDING TO THE U.S. CENSUS BUREAU, CHICKASAW COUNTY HAD AN ESTIMATED POPULATION OF 12,012 IN 2020. CHICKASAW COUNTY EXPERIENCED AN ESTIMATED 3.5% DECLINE IN POPULATION FROM 2010 TO 2020. THE STRESS THAT THIS TREND PLACES ON THE PROVISION OF SERVICES IS COMPOUNDED BY THE HIGHER-THAN-AVERAGE PROPORTION OF ELDERLY INDIVIDUALS IN THE AREA. OF THE CHICKASAW POPULATION, 21.4% WERE OVER AGE 65 IN 2020, COMPARED TO 17.7% FOR THE STATE AND 16.8% FOR THE NATION. THIS LARGE PERCENTAGE FOR THIS AGE GROUP PRESENTS SPECIAL CHALLENGES TO HEALTH CARE PROVIDERS, BECAUSE THIS AGE GROUP HAS THE HIGHEST INCIDENCE OF DISEASE AND MORTALITY IN MOST CATEGORIES, AND CORRESPONDINGLY, REPRESENTS THE BIGGEST USERS OF HEALTH CARE SERVICES. IN ADDITION, MEDICARE PAYMENT SHORTFALLS PRESENT AN ADDITIONAL BURDEN FOR RURAL HEALTH PROVIDERS. APPROXIMATELY 53% OF MERCYONE NEW HAMPTON'S REVENUES (HOSPITAL INPATIENT AND OUTPATIENT) WERE GENERATED FROM MEDICARE PATIENTS. THE MEDIAN HOUSEHOLD INCOME IN CHICKASAW COUNTY WAS ESTIMATED AT $61,239 IN 2020. PERSONS IN POVERTY COMPRISE 8.3% OF THE POPULATION. THE FISCAL YEAR 2020 PAYER MIX AT POINT OF REGISTRATION INCLUDES 53% COVERED BY MEDICARE, 11.8% COVERED BY MEDICAID AND 1.5% SELF-PAY. PART VI, LINE 5: OTHER INFORMATION - MERCYONE NORTH IOWA HAS PROVIDED MANAGEMENT SERVICES FOR RURAL HOSPITALS SINCE 1978. THESE COMMUNITY HOSPITALS OFFER QUALITY HEALTH CARE AND YET ARE STILL ABLE TO TAKE ADVANTAGE OF ALL THE RESOURCES WE HAVE TO OFFER AS A MAJOR REFERRAL CENTER. WE EXTEND MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED COMMUNITY HEALTH CARE PROVIDERS TO MEET THE NEEDS OF THOSE WHO LIVE IN OUR COMMUNITIES. MERCYONE NORTH IOWA IS INTENTIONAL IN DEVELOPING TRIPLE-AIM ACCOUNTABLE CARE ORGANIZATION RELATIONSHIPS AND WORKS COLLABORATIVELY WITH MANY COMMUNITY HEALTH PROVIDERS, SOCIAL SERVICES, AND AGENCIES IN CREATING A SYSTEM OF CARE COORDINATION PROCESS AND WORK TO IDENTIFY AND REDUCE/ELIMINATE THE SOCIAL DETERMINATES OF HEALTH. AS A TEACHING HOSPITAL, WE HOST A THREE-YEAR FAMILY MEDICINE RESIDENCY PROGRAM, PHARMACY RESIDENCY, INTERNAL MEDICINE RESIDENCY, CARDIOLOGY FELLOWSHIP, NURSE RESIDENCY, AND A SCHOOL OF RADIOLOGIC TECHNOLOGY. MERCYONE NORTH IOWA HAS BEEN AWARDED A PSYCH RESIDENCY GRANT. WE CONTINUE TO ACTIVELY SEARCH TO FILL THE OPEN DIRECTOR POSITION, WHICH IS REQUIRED TO OBTAIN LICENSURE. IN ADDITION, MERCYONE NORTH IOWA OFFERS A 12-MONTH PROGRAM FOR NEWLY LICENSED REGISTERED NURSES AS THEY TRANSITION FROM THEIR STUDENT ROLE INTO A PROFESSIONAL ROLE. THIS OFFERS THEM MORE SUPPORT TO EMPOWER THEM AND BUILD CONFIDENCE IN THEIR NURSING CAREERS. MERCYONE NORTH IOWA OFFERS SPECIALIZED SERVICES INCLUDING HEART AND VASCULAR INSTITUTE, CANCER, DIABETES, STOKE, BARIATRIC, WOUND, REHABILITATION, LEVEL II BIRTH CENTER, AND LEVEL III TRAUMA CENTER. OUR EMERGENCY ROOM HAS PSYCH TRIAGE NURSES WHO ASSIST BEHAVIORAL HEALTH PATIENTS WHO ENTER THE EMERGENCY ROOM WITH REFERRALS AND INFORMATION ON COMMUNITY RESOURCES. MERCYONE NORTH IOWA HAS MATERNAL HEALTH OUTREACH INTO NEW HAMPTON AND HAMPTON, AS WELL AS THE RESIDENCY CLINIC WHERE AN INTERPRETER IS AVAILABLE. PATIENTS ARE ASSISTED IN GETTING TITLE 19 ASSISTANCE.MERCYONE NORTH IOWA CONTINUES TO INVEST IN THE COMMUNITY WE SERVE TO ENHANCE THE HEALTH AND WELL-BEING OF RESIDENTS BY:-SUPPORTING THOSE WHO EXPERIENCE HOMELESSNESS THROUGH RESTRICTED FINANCIAL DONATIONS TO 43 NORTH IOWA AND NORTHER LIGHTS ALLIANCE; GRANT WRITING FOR FREEDOM IN HIS GRACE, A LOW BARRIER SHELTER; PARTICIPATION IN THE NCI COMMUNITY COLLABORATION HOUSING COALITION; AND DONATING MATTRESSES TO A LOCAL SHELTER.-IMPROVING SAFE ACCESS TO MEDICATION BY PROVIDING FREE MEDICATION NAVIGATION ASSISTANCE TO THOSE WHO HAVE NON-COVERED LONG-TERM MEDICATIONS; CONTINUED ADVOCACY FOR, AND PARTICIPATION IN, THE 340B PROGRAM, BY WHICH NORTH IOWA CONTINUED TO SUPPORT MENTAL HEALTH AND SUBSTANCE USE RECOVERY PROGRAMS VIA THE 340B PROGRAM IN THE COMMUNITY PARTNERING WITH THE COMMUNITY HEALTH CENTER OF MASON CITY, BEJE CLARK, SECOND JUDICIAL DISTRICT PROBATION/PAROLE AND PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTH CARE; PARTICIPATION IN THE NORTH IOWA ADDICTION PREVENTION ALLIANCE TO PREVENT UNDERAGE DRINKING, TOBACCO & NICOTINE USE, AND PRESCRIPTION AND OPIOID MISUSE; AND PROVIDING PUBLIC ACCESS TO DRUG DROP OFF BOXES AT MERCYONE NORTH IOWA PHARMACIES.-IMPROVING CONDITIONS FOR SENIOR COMMUNITY MEMBERS THROUGH PARTICIPATION IN THE AGING SERVICES COALITION TO ADVOCATE FOR AND CONNECT ELDERLY TO COMMUNITY RESOURCES, AS WELL AS THE MEALS ON WHEELS PROGRAM.-ADDRESSING SOCIAL NEEDS FOR THOSE IDENTIFIED TO HAVE SOCIAL NEEDS DURING STANDARD SCREENING PROCESSES THROUGH TWO FULL-TIME COMMUNITY HEALTH WORKERS; SPREADING AWARENESS OF FINDHELP, THE ON-LINE COMMUNITY RESOURCE DIRECTORY. -PARTICIPATED IN EVENTS SURROUNDING MENTAL HEALTH AWARENESS AND REDUCING STIGMA, SUCH AS THE MAKE IT OK WALK AND EVENT.-BABY FRIENDLY INITIATIVES INCLUDE, BREAST FEEDING SUPPORT GROUP AND INFANT EDUCATION GROUPS. MERCYONE NORTH IOWA HIRED A NEW LACTATION CONSULTANT THIS YEAR WHO WILL SEE OUTPATIENT AS WELL AS DISCHARGED MOMS PROVIDING FOLLOW UP FOR ADDITIONAL SUPPORT. -MERCYONE NORTH IOWA IS A PARTICIPANT IN THE MISSION LIFELINE STROKE GRANT.-COLLABORATION WITH COMMUNITY ORGANIZATIONS, AGENCIES AND COALITIONS INCLUDING: THE NORTH IOWA AREA COUNCIL OF GOVERNMENTS, THE NORTH IOWA DIVERSITY APPRECIATION TEAM, CERRO GORDO COUNTY'S REGIONAL HUDDLE, EYES/P3C (EMPOWERING YOUTH THROUGH EDUCATION AND SUPPORT) COALITION, NORTH IOWA COALITION LED BY TELLIGEN QI-CONNECT, WORKING ON THE PRODUCE RX PROGRAM WITH HEALTHIEST STATE, AND LEADING A WEEKLY COMMUNITY HUDDLE WHERE ROUGHLY 20 COMMUNITY AGENCIES REGULARLY PARTICIPATE AND SHARE INFORMATION.-MERCYONE NORTH IOWA HAS SPONSORED THE FOLLOWING EVENTS: KCRHC LEGACY BALL; HCHS FOUNDATION GOLF TOURNAMENT; MASON CITY ARENA; MASON CITY CHAMBER MOONLIGHT BIKE RIDE; RECRUITMENT FAIRS; FREEBORN COUNTY FAIR; NORTH IOWA FAIR; AND KIMT HEALTH FAIR.MERCYONE DUBUQUE AND MERCYONE DYERSVILLE ARE ADVISED BY LOCAL BOARDS AND OPERATE EMERGENCY ROOMS, WHICH ARE AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. MERCYONE DUBUQUE ALSO PROVIDED SEVERAL SERVICES THAT WERE UNIQUE TO THE COMMUNITY, INCLUDING OPEN-HEART SURGERY, NEONATAL INTENSIVE CARE, AND INPATIENT COMMUNITY PSYCHIATRIC SERVICES. MERCYONE DUBUQUE AND MERCYONE DYERSVILLE RECOGNIZED THE IMPORTANCE OF SCREENING FOR AND ADDRESSING SOCIAL INFLUENCERS OF HEALTH, SUCH AS AFFORDABLE HOUSING, ACCESS TO EDUCATION, PUBLIC SAFETY, AVAILABILITY OF HEALTHY FOODS, LOCAL EMERGENCY/HEALTH SERVICES, AND ENVIRONMENTS FREE OF LIFE-THREATENING TOXINS. FINDHELP.ORG WAS USED TO CONNECT PATIENTS WITH IDENTIFIED SOCIAL NEEDS. MERCYONE DUBUQUE CONTINUED TO WORK IN PARTNERSHIP WITH RIVERBEND FOOD BANK, ST. STEPHENS FOOD BANKS, AND OUR LADY OF THE MISSISSIPPI ABBEY SISTERS TO MAINTAIN A FOOD PANTRY ONSITE AT MERCYONE DUBUQUE TO HELP ALLEVIATE FOOD INSECURITY FOR 2,503 COLLEAGUES AND PATIENTS. THE FOOD PANTRY STOCKED 36,931 POUNDS OF FOOD IN FY23, THE EQUIVALENT OF 30,776 MEALS. MERCYONE DUBUQUE HELPED BUILD THE HEALTH CARE WORKFORCE AND INCREASE ACCESS TO CARE THROUGH NURSING AND OTHER HEALTH PROFESSIONS EDUCATION BY HOSTING NURSING, IMAGING, THERAPY, LABORATORY, PHARMACY, PARAMEDIC, AND EMERGENCY MEDICAL TECHNICIAN STUDENTS.MERCYONE DUBUQUE'S NORMAL NEWBORN DONOR MILK PROGRAM PROVIDED FREE PASTEURIZED HUMAN DONOR MILK TO ALL INFANTS IN THE NICU AND THE NEWBORN NURSERY WHO NEEDED IT. THE BIRTH CENTER ALSO HOUSED A MILK COLLECTION DEPOT THROUGH A COLLABORATION WITH THE UNIVERSITY OF IOWA HEALTH CARE WHERE NURSING MOTHERS COULD SAFELY DONATE THEIR EXTRA BREAST MILK AND CONTRIBUTE TO THE NETWORK. IN MAY 2023, THIS SERVICE EXPANDED FURTHER TO INCORPORATE A DISPENSARY FOR ANY CAREGIVER WITH A PRESCRIPTION TO PURCHASE DONATED MILK AND AVOID THE $50 SHIPPING FEE THEY WOULD NORMALLY HAVE TO PAY.TWENTY-SEVEN MERCYONE DUBUQUE COLLEAGUES PARTICIPATED IN THE FOUNTAIN OF YOUTH'S COMMUNITY IN CHANGE PROGRAM WITH THE PURPOSE OF CHANGING THE MINDSETS THAT CONTRIBUTE TO GENERATIONAL POVERTY. COLLEAGUES WERE CHALLENGED TO THINK IN NEW WAYS AND UNCOVER WAYS THAT THEY CAN PERSONALLY BECOME A PART OF THE SOLUTION TO MANY SOCIAL PROBLEMS IN OUR COMMUNITY....CONTINUED AFTER PART VI, LINE 6. PART VI, LINE 6: MHS-IA IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE - EMPHASIZING THE NECESSITY TO INTEGRATE SOCIAL AND CLINICAL CARE. WE DO THIS BY: 1. ADDRESSING PATIENT SOCIAL NEEDS, 2. INVESTING IN OUR COMMUNITIES, AND 3. STRENGTHENING THE IMPACT OF OUR COMMUNITY BENEFIT. TRINITY HEALTH CHWB TEAMS LEAD THE DEVELOPMENT AND IMPLEMENTATION OF TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES AND FOCUS INTENTIONALLY ON ENGAGING COMMUNITIES AND RESIDENTS EXPERIENCING POVERTY AND OTHER VULNERABILITIES. WE BELIEVE THAT COMMUNITY MEMBERS AND COMMUNITIES THAT ARE THE MOST IMPACTED BY RACISM AND OTHER FORMS OF DISCRIMINATION EXPERIENCE THE GREATEST DISPARITIES AND INEQUITIES IN HEALTH OUTCOMES AND SHOULD BE INCLUSIVELY ENGAGED IN ALL COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT EFFORTS. THROUGHOUT OUR WORK, WE DISMANTLE OPPRESSIVE SYSTEMS, AND BUILD COMMUNITY CAPACITY AND PARTNERSHIPS.TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2023 (FY23), TRINITY HEALTH CONTRIBUTED $1.47 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. IN ADDITION TO ANNUAL COMMUNITY BENEFIT SPENDING, TRINITY HEALTH IMPLEMENTS A SOCIALLY RESPONSIBLE INVESTING PROGRAM. AS OF THE END OF FY23, $62.7 MILLION (INCLUDING $7.0 MILLION IN NEW LENDING) WAS ALLOCATED IN THE FOLLOWING AREAS:- HOUSING: BUILDING AFFORDABLE HOUSING; IMPROVING ACCESS TO SENIOR HOUSING; AND COMBATTING HOMELESSNESS ($35.5 MILLION)- EDUCATION: SUPPORTING STUDENTS ENTERING THE HEALTH PROFESSIONS ($10.1 MILLION)- FACILITIES: BUILDING COMMUNITY FACILITIES FOR NONPROFITS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS ($9.7 MILLION)- ECONOMIC DEVELOPMENT: ENCOURAGING SMALL BUSINESS DEVELOPMENT, CREATING LOCAL JOBS AND SUPPORTING ACCESS TO HEALTHY FOODS; QUALITY CHILDCARE; AND OTHER COMMUNITY SERVICES ($7.4 MILLION)ACROSS THE SYSTEM, NEARLY 700,000 OF PATIENTS SEEN IN PRIMARY CARE SETTINGS WERE SCREENED FOR SOCIAL NEEDS. FOR ABOUT 30% OF THOSE PATIENTS, AT LEAST ONE SOCIAL NEED WAS IDENTIFIED. TOGETHERCARE - TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, POWERED BY EPIC - HAS MADE IT POSSIBLE FOR TRINITY HEALTH TO STANDARDIZE SCREENING FOR SOCIAL NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES THROUGH THE COMMUNITY RESOURCE DIRECTORY (COMMUNITYRESOURCES.TRINITY-HEALTH.ORG). COMMUNITY HEALTH WORKERS (CHW'S) SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES. TRINITY HEALTH CHW'S PARTNERED WITH POPULATION HEALTH NURSES AND SOCIAL WORK CARE MANAGERS TO SERVE MEDICARE PATIENTS AT RISK FOR PREVENTABLE HOSPITALIZATIONS, RESULTING IN A DECREASE IN PREVENTABLE HOSPITALIZATIONS FOR THE MEDICARE POPULATION OVERALL, AND ALSO FOR LOW-INCOME PATIENTS DUALLY ENROLLED IN MEDICARE AND MEDICAID. CHW'S ADVANCE SOCIAL AND CLINICAL CARE INTEGRATION BY ASSESSING AND ADDRESSING A PATIENT'S SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECTING THE PATIENT (AND THEIR FAMILY) TO SERVICES WITHIN THE COMMUNITY. TRINITY HEALTH PROVIDES A 40+ HOUR FOUNDATIONAL CHW AND CHRONIC DISEASE-SPECIFIC TRAINING TO TRINITY HEALTH-EMPLOYED CHW'S AND ALSO TO COMMUNITY PARTNERS THAT EMPLOY CHW'S. IN 2017, TRINITY HEALTH RECEIVED A SIX-YEAR, $8.5 MILLION GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO INCREASE THE NUMBER OF NATIONAL DIABETES PREVENTION PROGRAM (DPP) DELIVERY SITES, INCREASE PROGRAM ENROLLMENT, MAINTAIN PARTICIPATION RATES, AND INCREASE BENEFIT COVERAGE. IN ADDITION, THE GRANT WAS USED TO STANDARDIZE CLINICAL SCREENING AND DETECTION OF DIABETES. DURING THE GRANT PERIOD, TRINITY HEALTH BUILT THE NATIONAL DPP INTO ITS ELECTRONIC HEALTH RECORD SYSTEM TO MAKE IDENTIFYING PATIENTS AND ENROLLING THEM IN THE PROGRAM EASIER. SINCE SEPTEMBER 2017, OVER 6,000 PARTICIPANTS HAVE ENROLLED IN A TRINITY HEALTH NATIONAL DPP AND HAVE COLLECTIVELY LOST A TOTAL OF OVER 51,000 POUNDS.LASTLY, TRINITY HEALTH'S FY23 SHAREHOLDER ADVOCACY PRIORITIES FOCUSED ON IMPROVING CORPORATE POLICIES AND PRACTICES THAT IMPACT COMMUNITIES, WITH THE AIM OF REDUCING STRUCTURAL RACISM AND HEALTH INEQUITIES. TRINITY HEALTH, IN COLLABORATION WITH ITS PARTNERS THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY AND THE INVESTOR ENVIRONMENTAL HEALTH NETWORK, FILED SHAREHOLDER PROPOSALS AT 20 COMPANIES. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. PART VI, LINE 5 CONTINUED: MERCYONE DUBUQUE PARTICIPATED IN SENIOR CONNECTIONS, A GROUP OF REPRESENTATIVES FROM DIFFERENT FACILITIES AND ORGANIZATIONS THAT MET MONTHLY TO DISCUSS CURRENT LOCAL SERVICES AND PROGRAMS/EVENTS THAT BENEFIT SENIOR CITIZENS. TWO MERCYONE DUBUQUE COLLEAGUES SERVED ON THE MERCYONE IOWA INSTITUTIONAL REVIEW BOARD THAT REVIEWS RESEARCH PROPOSALS TO ENSURE THAT THEY ARE COMPLIANT WITH CURRENT REGULATIONS, MEET ETHICAL STANDARDS, FOLLOW INSTITUTIONAL POLICIES, AND SUFFICIENTLY PROTECT RESEARCH PARTICIPANTS. THESE STUDIES ADDRESSED A VARIETY OF IDENTIFIED HEALTH NEEDS ACROSS THE STATE OF IOWA AND ADVANCED INCREASED GENERAL KNOWLEDGE.MERCYONE DUBUQUE MANAGED A TEAM OF 16 VOLUNTEERS THROUGHOUT FY23 WHO COLLECTIVELY VOLUNTEERED A TOTAL OF 2,127.5 HOURS. THEY HELPED BY GREETING AND WALKING PATIENTS TO THEIR APPOINTMENTS, PUTTING TOGETHER ADMISSION AND SURGERY FOLDERS AND MAILINGS, ROCKING BABIES IN THE CHILDCARE CENTER, ROUNDING WITH THERAPY DOGS, ASSEMBLING AMBULATORY SURGERY CHARTS, AND MANNING THE SENIOR HEALTH INSURANCE INFORMATION PROGRAM (SHIIP) OFFICE. MERCYONE DYERSVILLE IS A 20-BED CRITICAL ACCESS HOSPITAL SERVING 17 RURAL COMMUNITIES IN WESTERN DUBUQUE COUNTY OFFERING THE FOLLOWING SERVICES: EMERGENCY/TRAUMA, ACUTE AND SKILLED CARE, REHABILITATION SERVICES (PT/OT/SPEECH), AMBULATORY SURGERY, HOME CARE, AND A SPECIALTY CLINIC REGARDLESS OF ABILITY TO PAY.MERCYONE DYERSVILLE PARTICIPATED IN TWO FIRE DRILLS WITH DYERSVILLE FIRE DEPARTMENT, INCLUDING ONE FOCUSING ON PEDIATRIC EMERGENCIES.MERCYONE DYERSVILLE DONATED SUPPLIES TO LOCAL COLLEGES TO BE USED FOR NURSING EDUCATION.MERCYONE SIOUXLAND REMAINS FOCUSED ON IMPROVING THE HEALTH OF OUR COMMUNITY. MERCYONE SIOUXLAND IS HOME TO THE ONLY LEVEL II TRAUMA CENTER IN WESTERN IOWA AND PROVIDES A VITAL, LIFESAVING LINK TO RURAL AREAS VIA HELICOPTER AMBULANCE SERVICE. EMERGENCY SERVICES ARE AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. MERCYONE SIOUXLAND OPERATES A PRIMARY CARE CLINIC NETWORK, SPECIALTY CLINICS, AND HOME HEALTH SERVICES. WE ALSO PARTNER WITH OTHER COMMUNITY HEALTH CARE PROVIDERS TO SPONSOR A REGIONAL CANCER CENTER, HOSPICE SERVICES, AND A FREESTANDING SURGERY CENTER TO MEET THE NEEDS OF RESIDENTS IN IOWA, NEBRASKA, AND SOUTH DAKOTA. MERCYONE SIOUXLAND'S CHILD ADVOCACY CENTER IS DEDICATED TO SERVING SUSPECTED VICTIMS OF CHILD ABUSE. THE CENTER IS THE ONLY ONE OF ITS KIND IN NORTHWEST IOWA, PROVIDING MEDICAL EXAMS, FORENSIC INTERVIEWS, ADVOCACY SERVICES, THERAPY SERVICES, PREVENTION AND PROFESSIONAL EDUCATION, AND EXPERT WITNESS TESTIMONY.WE ARE INVOLVED IN SEVERAL COMMUNITY COLLABORATIONS. MERCYONE SIOUXLAND CONTINUES TO HAVE AN OPEN MEDICAL STAFF. MERCYONE SIOUXLAND PARTICIPATES IN REGULAR BLOOD DRIVES THROUGHOUT THE YEAR. IN ADDITION, MERCYONE SIOUXLAND COLLABORATES WITH HEALTH EDUCATION PROGRAMS IN THE AREA INCLUDING ST. LUKE'S COLLEGE OF NURSING, WESTERN IOWA TECH COMMUNITY COLLEGE SCHOOL OF NURSING, NORTHEAST COMMUNITY COLLEGE, NORTHWESTERN COLLEGE, NORTHWEST IOWA COMMUNITY COLLEGE, DORDT UNIVERSITY, MORNINGSIDE UNIVERSITY, AND BRIAR CLIFF UNIVERSITY SCHOOL OF NURSING. MERCYONE SIOUXLAND PARTNERS WITH THE SIOUXLAND MEDICAL EDUCATION FOUNDATION TO ASSIST IN TRAINING MEDICAL STUDENTS DURING THEIR FAMILY MEDICINE RESIDENCY. MERCYONE SIOUXLAND ALSO HAS A VOLUNTEER AMBASSADOR PROGRAM, WHICH HAD NINE VOLUNTEERS IN FY23. THE VOLUNTEERS SUPPORT OUR COMMUNITY MEMBERS BY PROVIDING HOSPITALITY SERVICES AND PET VISITATIONS. EXTRAORDINARY MINISTERS OF HOLY COMMUNION ARE ALSO PART OF THE VOLUNTEER PROGRAM.MERCYONE SIOUXLAND CONTINUES TO SUPPORT THE COMMUNITY BY HAVING LEADERS ACTIVELY PARTICIPATE IN LOCAL COMMUNITY BOARDS. MERCYONE SIOUXLAND CONTRIBUTED TO UNITED WAY OF SIOUXLAND TO SUPPORT THEIR EFFORTS IN IMPROVING THE HEALTH, EDUCATION, AND FINANCIAL STABILITY OF THE COMMUNITY. MERCYONE SIOUXLAND DONATED HOSPITAL BEDS TO THE LOCAL SCHOOL DISTRICT'S CAREER ACADEMY FOR HEALTH CARE CAREER EXPLORATION PROGRAMMING. MERCYONE SIOUXLAND DONATES WINTER GLOVES TO THE WARMING SHELTER AND PROVIDED ADDITIONAL IN-KIND CONTRIBUTIONS TO LOCAL ORGANIZATIONS. DUNES SURGICAL HOSPITAL CONTINUED TO SUPPORT THE HEALTH AND WELL-BEING OF THE COMMUNITY BY SUPPORTING HEALTH EDUCATION IN THE AREAS OF NURSING, SURGICAL TECHNOLOGY, AND RESPIRATORY THERAPY IN COLLABORATION WITH BRIAR CLIFF UNIVERSITY, MORNINGSIDE UNIVERSITY, WESTERN IOWA TECH COMMUNITY COLLEGE SCHOOL OF NURSING, AND UNIVERSITY OF SOUTH DAKOTA. DUNES SURGICAL HOSPITAL ACTIVELY PARTICIPATED IN A CEREAL DRIVE FOR THE LOCAL SIOUXLAND FOOD BANK AS WELL AS A UNITED WAY CAMPAIGN THAT WILL GREATLY BENEFIT THE COMMUNITY. IN ADDITION, EMERGENCY MEDICAL PREPAREDNESS WORK CONTINUED WITH THE SOUTH DAKOTA HEALTH CARE COALITION. MERCYONE NEW HAMPTON:PARENT/CHILD EDUCATION: FAMILY FUN NIGHT OUT IS AN ANNUAL EVENT HELD IN COLLABORATION WITH LEARNING CONNECTIONS AND NEW HAMPTON COMMUNITY SCHOOL DISTRICT. IN OCTOBER 2022, MERCYONE NEW HAMPTON PARTICIPATED IN THIS EVENT BY OFFERING A SAFE AND FUN ACTIVITY FOR FAMILIES WITH CHILDREN BETWEEN THE AGES OF TWO AND FIVE. MERCYONE NEW HAMPTON ALSO PROVIDED EDUCATIONAL MATERIALS TO ASSIST IN HEALTH PROMOTION. COMMUNITY EDUCATION: A MERCYONE NEW HAMPTON FAMILY MEDICINE ARNP SPENT TIME WITH THREE PRESCHOOL CLASSES ON MARCH 21. INFORMATION WAS PRESENTED ON SELF-CARE INCLUDING BRUSHING TEETH, EATING HEALTHY AND HOW TO BE SAFE.COMMUNITY BASED HEALTH EDUCATION: TO ENCOURAGE RESPONSIBILITY IN YOUNG BABYSITTERS, MERCYONE NEW HAMPTON HOSTED BABYSITTING 101 IN JUNE 2023. STUDENTS WERE TAUGHT THE BASICS OF CHILDCARE WITH SPECIAL PRESENTATIONS BY CHICKASAW COUNTY SHERIFF'S DEPARTMENT, NEW HAMPTON FIRE DEPARTMENT, MERCYONE NEW HAMPTON NURSING STAFF AND MERCYONE NEW HAMPTON'S WELLNESS COORDINATOR. THE CLASS IS TO PROMOTE SAFETY, COMPREHEND BASICS OF FIRST AID AND EMPHASIZE THE QUALITY CHARACTERISTICS OF A GOOD BABYSITTER. ENROLLMENT ASSISTANCE: MERCYONE NEW HAMPTON HAS TWO TRAINED COUNSELORS FOR THE SHIIP. SHIIP IS A FREE, CONFIDENTIAL SERVICE THAT HELPS IOWANS MAKE INFORMED DECISIONS ABOUT MEDICARE AND OTHER HEALTH COVERAGE. IN FY23, WE PROVIDED ASSISTANCE TO 170 CLIENTS. HEALTH PROFESSIONALS EDUCATION: MERCYONE NEW HAMPTON OFFERED EDUCATIONAL OPPORTUNITIES THROUGHOUT FY23 TO OUR COLLEAGUES AND AREA HEALTH CARE PROVIDERS. CLASSES INCLUDED: BASIC LIFE SUPPORT, ADVANCED CARDIAC LIFE SUPPORT HEARTCODE, PEDIATRIC ADVANCED LIFE SUPPORT, TRAUMA NURSING CORE COURSE AND AMERICAN HEART ASSOCIATION INSTRUCTOR RENEWAL. MERCYONE NEW HAMPTON ALSO SUPPORTS HEALTH PROFESSIONALS' EDUCATION BY HOSTING PRECEPTORS. IN FY23, TWO STUDENTS STUDYING HEALTH INFORMATION TECHNOLOGY WERE PRECEPTED AS WELL AS AN ARNP STUDENT. SUBSIDIZED HEALTH SERVICES: MERCYONE NEW HAMPTON IS THE SOLE COMMUNITY PROVIDER OFFERING A RANGE OF SPECIALIZED SERVICES, FAMILY HEALTH, DIABETES AND NUTRITION EDUCATION, AND AN EMERGENCY CENTER. EMERGENCY SERVICES ARE AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. EMERGENCY SERVICES ARE PROVIDED AT A FINANCIAL LOSS BUT IS A CRITICALLY NEEDED SERVICE. MERCYONE NEW HAMPTON'S DIABETIC EDUCATION PROGRAM ALSO OPERATES AT A FINANCIAL LOSS. DIABETIC EDUCATION IS CRUCIAL FOR INDIVIDUALS WITH DIABETES AS IT PROVIDES THE KNOWLEDGE, SKILLS, AND SUPPORT NECESSARY TO EFFECTIVELY MANAGE THEIR CONDITION, REDUCE COMPLICATIONS, IMPROVE THEIR QUALITY OF LIFE, AND PROMOTE LONG-TERM HEALTH. IT IS AN INTEGRAL PART OF DIABETES CARE AND CAN HAVE A PROFOUND IMPACT ON THE WELL-BEING OF THOSE LIVING WITH DIABETES, REGARDLESS OF THE PERSON'S ABILITY TO PAY FOR THE SERVICE. 1 AMERICAN CANCER SOCIETY 3380 CHASTAIN MEADOWS PKWY NO 2 KENNESAW IA 30144 131788491 501(C)(3) 10000 0 RELAY FOR LIFE PROGRAM COMMUNITY FOUNDATION GREATER DUBUQUE 700 LOCUST ST SUITE 195 DUBUQUE IA 52001 421526614 501(C)(3) 15000 0 BEN PAKES SCHOLARSHIP AND HARDSHIP FUND CRESCENT COMMUNITY HEALTH CENTER 1789 ELM ST SUITE A DUBUQUE IA 52001 481302204 501(C)(3) 12500 0 PACIFIC ISLANDER HEALTH PROJECT STAFFING DUBUQUE COMMUNITY SCHOOLS 2300 CHANEY ROAD DUBUQUE IA 52001 426001531 PUBLIC SCHOOL 15000 0 SUPPORT OF ATHLETIC TRAINER PROGRAM FOR TWO HIGH SCHOOLS DUBUQUE FOR REFUGEE CHILDREN 1199 MAIN STREET DUBUQUE IA 52004 473092234 501(C)(3) 8000 0 MEDICAL AND DENTAL CARE FOR YOUNG IMMIGRANTS DUBUQUE RESCUE MISSION 398 MAIN ST DUBUQUE IA 52001 420844836 501(C)(3) 7000 0 SUPPORT FOR MISSION SCHOOL OF PRESERVATION GREATER DUBUQUE DEVELOPMENT 900 JACKSON ST SUITE 109 DUBUQUE IA 52001 421263173 501(C)(6) 18000 0 COMMUNITY SUPPORT ST JOHN'S EVANGELICAL LUTHERAN CHURCH 1296 WHITE ST DUBUQUE IA 52001 237421408 501(C)(3) 8736 0 SUPPORT OF THE ALMOST HOME PROGRAM WAHLERT CATHOLIC HIGH SCHOOL 2005 KANE ST DUBUQUE IA 52001 420792429 RELIGIOUS SCHOOL 7500 0 SUPPORT OF ATHLETIC TRAINER PROGRAM AMERICAN HEART ASSOCIATION INC 1716 LOCUST ST DES MOINES IA 50309 135613797 501(C)(3) 15000 0 PARTNERSHIPS AND HEALTH WALK DUBUQUE AREA CHAMBER OF COMMERCE 300 MAIN ST SUITE 200 DUBUQUE IA 52001 420223700 501(C)(6) 17500 0 PLATINUM AND YP PARTNERSHIPS HEALTHY HARVEST OF NORTH IA PO BOX 52 HAMPTON IA 50441 472868649 501(C)(3) 53392 0 COOKING UP A HEALTHIER NORTH IOWA PROGRAM NORTH IOWA COMMUNITY ACTION PO BOX 1627 MASON CITY IA 50401 420921505 501(C)(3) 103000 0 COPA PROGRAM AND TRANSPORTATION SUPPORT NORTHERN LIGHTS ALLIANCE FOR THE HOMELESS 202 1ST ST NW MASON CITY IA 50401 421501295 501(C)(3) 61140 0 COMMUNITY SUPPORT NORTHEAST IOWA COMMUNITY ACTION CORP 305 MONTGOMERY ST DECORAH IA 52101 426092713 501(C)(3) 6000 0 SUPPORT CHICKASAW CO RESIDENTS FACING HOMELESSNESS OR LOSS OF UTILITIES MERCY MEDICAL CENTER - SIOUX CITY FOUNDATION 801 5TH STREET SIOUX CITY IA 51102 141880022 501(C)(3) 525909 0 FUNDING SUPPORT DUBUQUE MERCY HEALTH FOUNDATION 250 MERCY DRIVE DUBUQUE IA 52001 262227941 501(C)(3) 384365 0 FUNDING SUPPORT DYERSVILLE HEALTH FOUNDATION INC 1111 3RD STREET SW DYERSVILLE IA 52040 205383271 501(C)(3) 34634 0 FUNDING SUPPORT 16 2 SCHOLARSHIPS 5 17000 TRANSPORTATION ASSISTANCE 72 16232 HOUSING 3 2250 MEDICAL BILLS AND MEDICATION ASSISTANCE 82 20570 CAR REPAIR AND CAR NOTE ASSISTANCE 1 649 FOOD ASSISTANCE 29 2339 UTILITIES 5 2203 OTHER SERVICES/ITEMS 28 8445 PART I, LINE 2: DONATIONS MADE BY MERCY HEALTH SERVICES - IOWA TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONTRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 LINDA ROSS DIR; CHIEF LEGAL OFFICER TRINITY 0 809865 0 486000 0 266748 0 13725 0 79555 0 1655893 0 0 YEN LIU PHYSICIAN, DERMATOLOGY NORTH IOWA 1234828 0 0 0 87195 0 19561 0 26349 0 1367933 0 0 0 MICHAEL WEGNER TREASURER; PRESIDENT CENTRAL IOWA 0 941059 0 323718 0 22827 0 17925 0 23944 0 1329473 0 0 MIR SUBLA PHYSICIAN, CARDIOLOGIST SIOUX CITY 0 1050047 0 0 0 6100 0 13725 0 4385 0 1074257 0 0 ROBERT RITZ DIRECTOR; REGIONAL PRESIDENT & CEO 0 455638 0 360867 0 10658 0 9150 0 15765 0 852078 0 0 GIOVANNI CIUFFO PHYSICIAN, CARDIOLOGIST SIOUX CITY 0 799276 0 0 0 5331 0 4032 0 24054 0 832693 0 0 ALIREZA YARAHMADI PHYSICIAN, NEUROLOGY NORTH IOWA 700127 0 0 0 53127 0 20761 0 32649 0 806664 0 0 0 RODNEY SCHLADER PRES/CEO MERCYONE N. IOWA THRU 6/23 0 478022 0 110920 0 97751 0 22875 0 44989 0 754557 0 0 KAY TAKES PRESIDENT EASTERN IOWA REGION 0 438893 0 106375 0 88616 0 22875 0 39776 0 696535 0 0 YUVARAJ THANGARAJ PHYSICIAN, NEPHROLOGY NORTH IOWA 604670 0 0 0 45705 0 23766 0 565 0 674706 0 0 0 HEATHER CAMPBELL SEC; CHIEF LEGAL OFFICER MERCYONE 0 420209 0 95071 0 20782 0 16928 0 32513 0 585503 0 0 PAUL MANTERNACH SVP PHYS INTEGRATION/CMO NORTH IOWA 0 405589 0 54204 0 11101 0 22875 0 45199 0 538968 0 0 DOUGLAS STRONG INTERIM PRES MERCYONE SC 8/22-2/23 0 479973 0 0 0 21964 0 13725 0 20813 0 536475 0 0 JODIE ROETTGER INTERIM REGIONAL CFO; VP FINANCE 0 346302 0 52343 0 21938 0 18648 0 13846 0 453077 0 0 BETH HUGHES PRES MERCYONE SIOUXLAND THROUGH 8/22 0 318428 0 0 0 73042 0 4575 0 27040 0 423085 0 61917 JESICA HANSON VP FINANCE MERCYONE SIOUXLAND 288444 0 37523 0 450 0 13667 0 31995 0 372079 0 0 0 MARK TRAMMEL VP FINANCE MERCYONE NORTH IOWA 0 259569 0 19755 0 45541 0 9804 0 15292 0 349961 0 0 KIM DUWE VP FINANCE EASTERN IOWA REGION 0 239180 0 34161 0 5291 0 12838 0 35133 0 326603 0 0 AMY BERENTES EVP COO EASTERN IOWA REGION THR 8/22 0 166231 0 0 0 1154 0 10135 0 10502 0 188022 0 0 PART I, LINE 3 MERCY HEALTH SERVICES - IOWA (MHS-IA) IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MHS-IA HOSPITAL CEO'S ARE PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MHS-IA CEO'S: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2022, AND THEIR NON-VESTED BENEFITS FOR 2022 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2022 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: BETH HUGHES - $63,059 LINDA ROSS - $216,698 RODNEY SCHLADER - $81,147 KAY TAKES - $73,462 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($305,000 FOR 2022). THE FOLLOWING PAYOUTS FOR 2022 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: PAUL MANTERNACH - $5,989 DOUGLAS STRONG - $0 THE FOLLOWING ARE PARTICIPANTS IN A MHS-IA NON-QUALIFIED ELECTIVE DEFERRED COMPENSATION PLAN. THE FOLLOWING DEFERRALS FOR 2022 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: YEN LIU - $76,786 YUVARAJ THANGARAJ - $41,234 ALIREZA YARAHMADI - $47,757 NOAH SCHLADER RELATIVE OF RODNEY SCHLADER, KEY EMPLOYEE 31045 EMPLOYMENT ARRANGEMENT 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCY HEALTH SERVICES - IOWA (MHS-IA) IS TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A TRINITY HEALTH CORPORATION IS THE SOLE MEMBER OF MHS-IA. TRINITY HEALTH CORPORATION HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MHS-IA. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, TRINITY HEALTH CORPORATION MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. TRINITY HEALTH CORPORATION MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MHS-IA IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MHS-IA HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MHS-IA, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MHS-IA AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MHS-IA (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MHS-IA OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MHS-IA (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MHS-IA. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MHS-IA IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND VICE PRESIDENT FINANCE COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE HOSPITAL CEO'S AND VICE PRESIDENTS FINANCE OF MHS-IA ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FOR OTHER EXECUTIVES WHO ARE NOT PART OF THE REBUTTABLE PRESUMPTION PROCESS, TRINITY HEALTH USES A MARKET ANALYSIS TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 MHS-IA IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MHS-IA INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON TRINITY HEALTH'S WEBSITE. MHS-IA'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 44,836. MANAGEMENT AND GENERAL EXPENSES 109,755. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,591. LAUNDRY AND LINEN SERVICES: PROGRAM SERVICE EXPENSES 639,065. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 639,065. BILLING SERVICES: PROGRAM SERVICE EXPENSES 243,999. MANAGEMENT AND GENERAL EXPENSES 271,069. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 515,068. MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 63,627,649. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 63,627,649. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 162,101. MANAGEMENT AND GENERAL EXPENSES 623,970. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 786,071. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 16,221,442. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,221,442. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 40,946,019. MANAGEMENT AND GENERAL EXPENSES 119,064. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,065,083. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,219,573. MANAGEMENT AND GENERAL EXPENSES 1,810,647. FUNDRAISING EXPENSES 137,620. TOTAL EXPENSES 13,167,840. FORM 990, PART XI, LINE 9: NET EQUITY TRANSFERS TO/FROM AFFILIATES -3,233,773. OTHER TRANSACTIONS 465,710. EQUITY GAIN IN UNCONSOLIDATED AFFILIATES 1,390,518. INDIGENT CARE AGREEMENT REVENUE, NET OF CONTRIBUTIONS 19,800. ASSET IMPAIRMENT -41,922,077. FORM 990, PART XII, LINE 2: MHS-IA'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY23 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: DUNES MEDICAL LABORATORIES, FOREST PARK PHARMACY, HEALTHWORKS, MARIAN HEALTH CENTER, MERCY FAMILY PHARMACY, MERCY HEALTH CENTER-DUBUQUE (ST. JOSEPH'S), MERCY HEALTH CENTER-DYERSVILLE (ST. MARY'S),MERCY HEART CENTER & VASCULAR INSTITUTE, MERCY HOME CARE-NORTH IOWA, MERCY HOME HEALTHCARE DUBUQUE, MERCY MEDICAL CENTER-DUBUQUE, MERCY MEDICAL CENTER-DYERSVILLE, MERCY MEDICAL CENTER-NEW HAMPTON, MERCY MEDICAL CENTER-NORTH IOWA, MERCY MEDICAL CENTER-SIOUX CITY, MERCY VASULAR MEDICINE CLINIC, MHC ANESTHESIA SERVICES, NORTH IOWA MERCY CLINICS, NORTH IOWA MERCY HEALTH CENTER, NORTH IOWA MERCY HOME HEALTHCARE, NORTH IOWA TEXTILE SERVICES, SHEFFIELD PHARMACY, SIOUXLAND PATHOLOGY GROUP-SMHC, SIOUXLAND RADIOLOGY-SMHC, ST. JOSEPH COMMUNITY HOSPITAL, MERCY SOFT GOODS, MERCYONE DUBUQUE MEDICAL CENTER, MERCYONE DYERSVILLE MEDICAL CENTER, MERCYONE NEW HAMPTON MEDICAL CENTER, MERCYONE NORTH IOWA CLINICS, MERCYONE NORTH IOWA MEDICAL CENTER, MERCYONE SIOUXLAND MEDICAL CENTER MHN ACO LLC 1449 NW 128TH ST BLDG 5 STE 200 CLIVE IA 50325 421521367 ACCOUNTABLE CARE ORGANIZATION IA 0 0 MERCY HEALTH SERVICES-IOWA CORP ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL 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