2024-05-15T07:50:33-05:00 2023-06-30 990 2022-07-01 420680308 MERCY MEDICAL CENTER - CENTERVILLE MERC 6414374111 1 ST JOSEPHS DRIVE CENTERVILLE IA 52544 TERRI DONOVAN INTERIM VP OF FINANCE 6414374111 2024-05-15 TERRI DONOVAN 999009999 1 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O FOR LIST NICOLE CLAPP 1 ST JOSEPHS DRIVE CENTERVILLE IA 52544 42204709 0 0928 X WWW.MERCYONE.ORG/CENTERVILLE/ X 1965 IA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 11 8 336 18 0 0 2305978 828689 40159416 40962606 2070466 132218 1767115 281196 46302975 42204709 33662 33764 0 0 21781111 3485317 0 0 0 24328336 43695823 46143109 47214904 159866 -5010195 56146885 22517005 9689082 22070282 46457803 446723 X WE, MERCY MEDICAL CENTER - CENTERVILLE AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITITES. MERCY MEDICAL CENTER - CENTERVILLE IS A MEMBER OF TRINITY HEALTH. 0 0 40153296 33764 41126841 MERCY MEDICAL CENTER - CENTERVILLE (MERCYONE CENTERVILLE) IS A CRITICAL ACCESS HOSPITAL LOCATED IN CENTERVILLE, IOWA IN APPANOOSE COUNTY. THE HOSPITAL'S FOCUS IS ON IMPROVING THE HEALTH OF THE COMMUNITY. SERVICES PROVIDED INCLUDE COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES AS WELL AS SPECIALIST PHYSICIAN CLINICS. MERCYONE CENTERVILLE ALSO OPERATES A NURSING HOME UNIT, GERIATRIC MENTAL HEALTH SERVICE AND MEDICAL CLINIC WITH PRIMARY CARE PHYSICIANS AND ADVANCED REGISTERED NURSE PRACTITIONERS, INCLUDING QUICK CARE OPEN SEVEN DAYS A WEEK. EMERGENCY SERVICES ARE AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY.PLEASE SEE SCHEDULE H AND VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES AND SPECIALTIES:WWW.MERCYONE.ORG/LOCATION/MERCYONE-CENTERVILLE-MEDICAL-CENTER 40153296 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1 X 0 0 336 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X TERRI DONOVAN 5156432588 1111 6TH AVENUE DES MOINES IA 50314 X MICHAEL WEGNER DIRECTOR; PRES MERCYONE CENTRAL IA 1.00 54.00 X 0 1287604 41869 RANDALL RUBIN TREAS; SVP, CFO MERCYONE CENTRAL IA 1.00 49.00 X 0 581824 44235 MARLENE BIRKHOLTZ-WIER DO GENERAL SURGEON 50.00 0.00 X 324497 166006 42822 FLORITA HENDERSON MD PHYSICIAN, INTERNAL MED GENERAL 50.00 0.00 X 300341 99274 41347 BRIAN QUINN DO PHYSICIAN, FAMILY MEDICINE 50.00 0.00 X 216392 115873 48427 RYAN ARNEVIK DO DIRECTOR; PHYSICIAN, FAMILY MEDICINE 50.00 0.00 X 197449 113909 50019 JOSHWA TROMBLEE DO PHYSICIAN, FAMILY MEDICINE 50.00 0.00 X 198754 126894 23307 JENNIFER HADEN DO PHYSICIAN, FAMILY MEDICINE 50.00 0.00 X 191994 113321 19760 SHERRI DOGGETT SECRETARY; DIRECTOR PATIENT SERVICES 40.00 0.00 X 89763 61322 27471 CHAD KELLEY FRMR OFFCR; DIR OPERATIONS MERCYONE 0.00 40.00 X 0 158063 17059 NICOLE CLAPP DIRECTOR; PRESIDENT 50.00 0.00 X X 57419 83563 5385 ALISON FRASER DIRECTOR; CHAIR 1.00 1.00 X X 0 0 0 LOTTIE WILSON DIRECTOR; VICE CHAIR 1.00 0.00 X X 0 0 0 VICKY ARNDORFER RSM DIRECTOR 1.00 0.00 X 0 0 0 RAJNI BATRA MD DIRECTOR 1.00 0.00 X 0 0 0 RENATE DEININGER DIRECTOR 1.00 0.00 X 0 0 0 BRADLEY GROTHE DIRECTOR 1.00 0.00 X 0 0 0 JERRY KIRKPATRICK DIRECTOR 1.00 0.00 X 0 0 0 MARGARET WEIGEL RSM DIRECTOR 1.00 0.00 X 0 0 0 1576609 2907653 361701 13 1 1 0 BLOOMFIELD ANESTHETISTS 105 E LOCUST ST BLOOMFIELD IA 52537 PHYSICIAN SERVICES 399060 GLOBAL MEDICAL REIT LP 2 BETHESDA METRO CENTER STE 440 BETHESDA MD 20814 REAL ESTATE INVESTMENT SERVICES 244619 AMN HEALTHCARE 12400 HIGH BLUFF DR STE 100 SAN DIEGO CA 92130 STAFFING SOLUTIONS 242303 HEALTHCARE REALTY SERVICES INC 3310 W END AVE NASHVILLE TN 37203 REAL ESTATE SERVICES 239316 CHRISTNER CONTRACTING INC 17587 HIGHWAY 34 OTTUMWA IA 52501 CONSTRUCTION SERVICES 233709 8 745643 83046 828689 NET PATIENT SERVICE REVENUE 622110 40962606 40962606 40962606 57636 57636 47804 0 47804 47804 47804 74582 0 74582 74582 74582 OTHER OPERATING REVENUE 622110 164235 164235 CAFETERIA REVENUE 722514 69157 69157 233392 42204709 41126841 0 249179 X 33764 33764 686300 539933 146367 2229866 1662525 567341 116153 80622 35531 270979 194393 76586 182019 136514 45505 527796 511996 15800 25027 25027 28868521 23695168 5173353 124281 21777 102504 397673 312201 85472 2601367 2542931 58436 68088 53722 14366 106847 76606 30241 347575 333250 14325 39460 39460 MEDICAL SUPPLIES EXP 7472896 7472896 EQUIPMENT MAINTENANCE 1144585 1054732 89853 I/C PURCHASED SERVICES 841893 822379 19514 BAD DEBT EXPENSE 373976 373976 755838 194451 561387 47214904 40153296 7061608 0 28568 30362 2232576 4812730 6678485 21329 750314 483294 8823 127556 4898831 332301 7706890 4566530 35454009 5131646 10630778 56146885 22517005 1171665 1337966 8517417 20732316 9689082 22070282 X 46457803 446723 46457803 446723 56146885 22517005 X -5010195 -41000885 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4839 0 0 0 4839 0 PART II-B, LINE 1: MERCYONE CENTERVILLE 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 MERCYONE CENTERVILLE WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 890000 890000 1487182 121729 1365453 1328791 210572 1118219 1192858 1192858 4566530 OPERATING LEASE RIGHT-OF-USE ASSETS 3052367 INTERCOMPANY ACCOUNTS RECEIVABLES 7578411 10630778 INTERCOMPANY ACCOUNTS PAYABLES 16999334 OPERATING LEASE LIABILITIES 3091486 OTHER CURRENT LIABILITIES 641496 20732316 1 1 X 1 X 1 X 1 1 0 1 1 123347 123347 0.00260 6132377 6667665 0 0.00000 6255724 6667665 123347 0.00260 13 1374 115808 5710 110098 0.00240 1 35 600 600 0.00000 4 90 25756 25756 0.00050 18 1499 142164 5710 136454 0.00290 18 1499 6397888 6673375 259801 0.00550 1 83 974 974 0.00000 1 83 974 974 0.00000 1 373976 0 12734402 13479908 -745506 X 1 1 1 1 MERCYONE CENTERVILLE MEDICAL CENTER ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 WWW.MERCYONE.ORG/CENTERVILLE/ 040050H X X X MERCYONE CENTERVILLE MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 0 1 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, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 MERCYONE CENTERVILLE MEDICAL CENTER PART V, SECTION B, LINE 3J: N/ALINE 3E:MERCY MEDICAL CENTER - CENTERVILLE (MERCYONE CENTERVILLE) 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 CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: 1. SUBSTANCE ABUSE2. MENTAL HEALTH3. UPDATED/NEW EMERGENCY ROOM4. POVERTY5. WOMEN'S HEALTH6. HEALTH CARE STAFFING7. FAMILY PLANNING8. OBESITY (NUTRITION/EXERCISE)9. AWARENESS OF HEALTH CARE SERVICES10. OWN YOUR HEALTH (APATHY) MERCYONE CENTERVILLE MEDICAL CENTER PART V, SECTION B, LINE 5: TACTICS TO GATHER COMMUNITY INPUT INCLUDED:- A SURVEY TO COMMUNITY STAKEHOLDERS TO INQUIRE ABOUT PAST CHNA UNMET NEEDS AND OBTAIN CURRENT HEALTH CARE DELIVERY TRENDS AND DOCUMENT ON-GOING HEALTH ISSUES - A TOWN HALL MEETING TO REVIEW DATA AND FACILITATE GROUP DISCUSSION TO RANK THE MOST IMPORTANT UNMET COMMUNITY HEALTH NEEDS- THE COMMUNITY SURVEY WAS AVAILABLE ONLINE FROM JANUARY TO MARCH 2022. A TOTAL OF 222 COMMUNITY MEMBERS RESPONDED- A TOWN HALL WAS HELD IN MARCH 2022 WHERE 32 COMMUNITY MEMBERS ATTENDED AND REPRESENTED THE FOLLOWING ORGANIZATIONS: MERCYONE CENTERVILLE, CENTERVILLE FIRE RESCUE, APPANOOSE COUNTY PUBLIC HEALTH, CENTERVILLE COMMUNITY BETTERMENT, CHARITON VALLEY ELECTRIC COOPERATIVE, CITY OF CENTERVILLE, MORGAN E. CLINE FOUNDATION, CHARITON VALLEY PLANNING & DEVELOPMENT, INFINITY HEALTH, AND CAREGIVERS HOME HEALTH. MERCYONE CENTERVILLE MEDICAL CENTER PART V, SECTION B, LINE 6B: MERCYONE CENTERVILLE PARTNERED WITH THE APPANOOSE COUNTY PUBLIC HEALTH DEPARTMENT TO CONDUCT THE FY22 CHNA. MERCYONE CENTERVILLE MEDICAL CENTER PART V, SECTION B, LINE 11: MERCYONE CENTERVILLE ADDRESSED THE FOLLOWING SIGNIFICANT NEEDS IN FY23:MENTAL HEALTH:MENTAL HEALTH SERVICES PROVIDED INCLUDED TELEHEALTH FOR MENTAL HEALTH EVALUATIONS IN THE EMERGENCY ROOM AND SENIOR LIFE SOLUTIONS, AN INTENSIVE OUTPATIENT GROUP THERAPY PROGRAM DESIGNED TO MEET THE UNIQUE NEEDS OF INDIVIDUALS AGES 65 AND OLDER WHO ARE STRUGGLING WITH DEPRESSION AND ANXIETY, OFTEN RELATED TO AGING. MERCYONE CENTERVILLE PARTICIPATED ON THE MENTAL HEALTH & DISABILITY SERVICES ADULT ADVISORY BOARD AND PROVIDED SPACE FOR THE LOCAL NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) ORGANIZATION TO MEET REGULARLY. MERCYONE CENTERVILLE PROMOTED INFORMATION ON MENTAL HEALTH SERVICES AVAILABLE IN THE COUNTY, AND THIS WORK WILL CONTINUE IN FY24. NEW/UPDATED EMERGENCY ROOM:A MASTER FACILITY PLAN OF MERCYONE CENTERVILLE WAS COMPLETED WITH A CONCEPTUAL EMERGENCY DEPARTMENT DESIGN, AND FUNDING OPTIONS WERE INVESTIGATED. FACILITY IMPROVEMENTS MADE IN FY23 INCLUDED REMODELING THE PATIENT RESTROOMS IN THE EMERGENCY ROOM AND UPGRADING SECURITY TO HAVE THE ABILITY TO LOCK DOWN THE EMERGENCY ROOM, AS WELL AS THE ENTIRE HOSPITAL.HEALTH CARE STAFFING:MERCYONE CENTERVILLE PARTICIPATED IN CAREER FAIRS AT THE LOCAL COMMUNITY COLLEGE TO EDUCATE STUDENTS ON HEALTH CARE CAREERS AND OPPORTUNITIES AT THE HOSPITAL. MERCYONE CENTERVILLE CONTINUED TO COLLABORATE WITH COLLEGES IN THE AREA, INCLUDING INDIAN HILLS COMMUNITY COLLEGE AND KIRKWOOD COMMUNITY COLLEGE, TO SERVE AS A CLINICAL ROTATION SITE TO SUPPORT CLINICAL EDUCATION PROGRAMS. MERCYONE CENTERVILLE ALSO PARTNERED WITH LOCAL HIGH SCHOOLS TO PROVIDE JOB SHADOWING OPPORTUNITIES TO INTERESTED STUDENTS. TO IMPROVE ACCESS TO CARE, MERCYONE CENTERVILLE HAS ASSESSED BARRIERS TO OUTPATIENT PHYSICIAN APPOINTMENTS, DEVELOPED A TEAM APPROACH TO CARE UTILIZING AN ADVANCED REGISTERED NURSE PRACTITIONER (ARNP), AND HIRED A NURSE EDUCATOR TO TRAIN NEW NURSES. MERCYONE CENTERVILLE PROVIDED SPACE, SUPPLIES, AND PHARMACY SERVICES FOR A WEEKLY VISITING ONCOLOGY CLINIC TO PROVIDE CANCER CARE LOCALLY. MERCYONE CENTERVILLE CONTINUED TO EVALUATE OPPORTUNITIES TO OFFER ADDITIONAL SPECIALTY SERVICES. OBESITY (NUTRITION/EXERCISE) AND OWN YOUR HEALTH (APATHY):MERCYONE CENTERVILLE PROVIDED WEIGHT MANAGEMENT SERVICES THROUGH THE FAMILY MEDICINE CLINIC. THIS PROGRAM SUPPORTS MEDICALLY SUPERVISED WEIGHT LOSS THROUGH NUTRITION, PHYSICAL ACTIVITY, AND LIFESTYLE COUNSELING WITH MEDICATION ASSISTANCE WHEN APPROPRIATE. THE CLINIC ALSO CONTINUED TO PROVIDE FREE NUTRITIONAL COUNSELING AND INDIVIDUALIZED DIET AND EXERCISE PLANS THROUGH A REGISTERED DIETICIAN. MERCYONE CENTERVILLE ATTENDED THE HEALTHY KIDS FAIR AND BACK TO SCHOOL RESOURCE NIGHT TO PROMOTE HEALTHY NUTRITION AND EXERCISE FOR CHILDREN. THE TRANSITIONAL HEALTH CARE COALITION (THCC) EXPANDED ITS ROLE TO INCLUDE BROAD COMMUNITY HEALTH ISSUES, INCLUDING OBESITY. THCC BRINGS TOGETHER A VARIETY OF COMMUNITY ENTITIES WHO PARTNER FOR A SEAMLESS CARE TRANSITION TO IMPROVE THE QUALITY OF CARE, QUALITY OF LIFE, AND HEALTH OUTCOMES. MERCYONE CENTERVILLE HOSTED THE GROUP'S REGULAR MEETINGS AT THE HOSPITAL. AWARENESS OF HEALTH CARE SERVICES:MERCYONE CENTERVILLE INCREASED AWARENESS OF HEALTH CARE SERVICES BY PROMOTING HOSPITAL AND COMMUNITY RESOURCES THROUGH SOCIAL MEDIA, THE PITCH (RADIO), AND APPANOOSE WEEKLY (NEWSPAPER).MERCYONE CENTERVILLE HELD SUPPORT GROUPS FOR THE FOLLOWING CONDITIONS: ALZHEIMER'S, PARKINSON'S, DIABETES, AND CANCER. THE PURPOSE OF THESE SUPPORT GROUPS WAS TO EDUCATE THE COMMUNITY ON THESE CONDITIONS AND MAKE THEM AWARE OF THE SERVICES AVAILABLE. MERCYONE CENTERVILLE DID NOT DIRECTLY ADDRESS THE NEEDS LISTED BELOW IN THIS CHNA CYCLE DUE TO COMPETING PRIORITIES, LACK OF RESOURCES, AND BECAUSE OTHER AGENCIES ARE ALREADY ADDRESSING THESE ISSUES. THOUGH THEY WERE NOT A DIRECT FOCUS IN FY23, MERCYONE CENTERVILLE CONTINUED TO COLLABORATE WITH OTHER AGENCIES TO ADDRESS THESE NEEDS. ADDITIONAL EFFORTS INCLUDE:SUBSTANCE ABUSE:MERCYONE CENTERVILLE CONTINUED TO REFER PATIENTS TO SUBSTANCE ABUSE RESOURCES AS NEEDED. THE HOSPITAL PROVIDED ANNUAL OPIOID PRESCRIPTION EDUCATION TO CLINICIANS IN THE EMERGENCY ROOM AND CLINIC. POVERTY:MERCYONE CENTERVILLE PROVIDED FUNDING FOR THE 10-15 TRANSIT PUBLIC TRANSPORTATION SYSTEM TO SUPPORT THE SERVICE FROM 1-5 P.M. DAILY, MONDAY THROUGH FRIDAY. THE SERVICE PROVIDES FREE TRANSPORTATION FOR THE GENERAL PUBLIC. MERCYONE CENTERVILLE PROVIDED 444 MEALS IN FY23 TO PATIENTS IN NEED DISCHARGING FROM THE HOSPITAL. MERCYONE CENTERVILLE EMPLOYEES VOLUNTEERED AT THE SCHOOL SUMMER BACKPACK PROGRAM TO PROVIDE MEALS TO CHILDREN OVER THE SUMMER. MERCYONE CENTERVILLE CONTINUED TO PROVIDE PATIENTS WITH A FINANCIAL COUNSELOR TO HELP THEM ACCESS INSURANCE.WOMEN'S HEALTH AND FAMILY PLANNING: MERCYONE CENTERVILLE CONTINUED TO REFER PATIENTS TO WOMEN'S HEALTH RESOURCES AS NEEDED. MERCYONE CENTERVILLE EXPLORED OPPORTUNITIES TO BRING ADDITIONAL OBGYN SERVICES TO THE COMMUNITY AND WILL CONTINUE RECRUITMENT EFFORTS IN FY24. MERCYONE CENTERVILLE 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, AND PATIENTS WHO ARE ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (SUCH AS FOOD STAMPS OR LOW-INCOME/SUBSIDIZED HOUSING).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. PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT: WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY: WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ PART V, SECTION B, LINE 16A-C: FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:WWW.MERCYONE.ORG/CENTERVILLE/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE 1 1 - MERCY CENTERVILLE LT CARE FACILITY ONE ST JOSEPHS DRIVE CENTERVILLE IA 52544 NURSING HOME 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 MEDICAL CENTER - CENTERVILLE (MERCYONE CENTERVILLE) 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.MERCYONE CENTERVILLE ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S 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 HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $373,976, 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: WORKFORCE DEVELOPMENT - MERCYONE CENTERVILLE PROVIDED AWARENESS AND EXPLORATION ACTIVITIES THAT PROVIDED THE COMMUNITY WITH EXPOSURE TO A VARIETY OF HEALTH CARE CAREERS. IN FY23, MERCYONE CENTERVILLE PARTICIPATED IN LOCAL CAREER FAIRS TO EDUCATE COMMUNITY MEMBERS ON HEALTH CARE CAREERS AND OPPORTUNITIES AT THE HOSPITAL. MERCYONE CENTERVILLE HOSTED STUDENTS FROM CENTERVILLE HIGH SCHOOL CAREER ACADEMY AND INDIAN HILLS COMMUNITY COLLEGE TO LEARN MORE ABOUT HEALTH CARE CAREERS. 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: MERCYONE CENTERVILLE 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, MERCYONE CENTERVILLE IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MERCYONE CENTERVILLE IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MERCYONE CENTERVILLE 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 8: MERCYONE CENTERVILLE 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 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION.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 - MERCYONE CENTERVILLE ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS, AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE AND THE HEALTH OF THE OVERALL COMMUNITY. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL USES PATIENT DATA, PUBLIC HEALTH DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES AND INPATIENT CARE, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCYONE CENTERVILLE COMMUNICATES 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. MERCYONE CENTERVILLE OFFERS 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. 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 HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION - APPANOOSE COUNTY IS PREDOMINATELY A RURAL COMMUNITY LOCATED IN SOUTH CENTRAL IOWA ON THE BORDER OF MISSOURI. THE POPULATION WAS 12,609 INDIVIDUALS AS OF JULY 2021, WITH A POPULATION DENSITY OF 25 PERSONS PER SQUARE MILE. THE MAJOR CITIES IN APPANOOSE COUNTY ARE CENTERVILLE, CINCINNATI, EXLINE, MORAVIA, MOULTON, MYSTIC, NUMA, PLANO, RATHBUN, UDELL AND UNIONVILLE. THIRTY-FIVE PERCENT OF THE POPULATION IS AGE 65 OR OLDER, AND 39% IS UNDER AGE 18. OF THE POPULATION, 97% IS WHITE AND LESS THAN 2% IS HISPANIC OR LATINO. THE PER CAPITA INCOME OF $26,012 IS SIGNIFICANTLY LOWER THAN THE STATE'S AVERAGE. NEARLY 16% OF THE POPULATION IS IN POVERTY, AS COMPARED TO THE STATE AVERAGE OF 11.9%. PART VI, LINE 5: COMMUNITY HEALTH PROMOTION - MERCYONE CENTERVILLE REMAINS FOCUSED ON IMPROVING THE HEALTH OF ITS COMMUNITY. MERCYONE CENTERVILLE PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT SERVICES AS WELL AS SPECIALIST PHYSICIAN CLINICS. THE HOSPITAL ALSO OPERATES A NURSING HOME UNIT, GERIATRIC MENTAL HEALTH SERVICE AND MEDICAL CLINIC WITH PRIMARY CARE PHYSICIANS AND ADVANCED REGISTERED NURSE PRACTITIONERS, INCLUDING QUICK CARE OPEN SEVEN DAYS A WEEK. EMERGENCY SERVICES ARE AVAILABLE TO ALL REGARDLESS OF THEIR ABILITY TO PAY. MERCYONE CENTERVILLE HAS AN OPEN MEDICAL STAFF. ITS BOARD OF DIRECTORS IS PRIMARILY COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. MERCYONE CENTERVILLE OFFERS WELLNESS LAB TESTING AND CT CALCIUM SCORING AT DISCOUNTED RATES TO ALL COMMUNITY MEMBERS TO LEARN MORE ABOUT THEIR HEALTH. MERCYONE CENTERVILLE IS INVOLVED IN COMMUNITY COLLABORATIONS AND PARTICIPATES ON LOCAL COMMUNITY BOARDS. THE HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS TO HOST AND SUPPORT COMMUNITY EVENTS. IN ADDITION, MERCYONE CENTERVILLE COLLABORATES WITH HEALTH EDUCATION PROGRAMS IN THE AREA INCLUDING INDIAN HILLS COMMUNITY COLLEGE AND KIRKWOOD COMMUNITY COLLEGE. MERCYONE CENTERVILLE FINANCIALLY CONTRIBUTED TO THE FOLLOWING ORGANIZATIONS AND EVENTS TO PROMOTE COMMUNITY HEALTH:- CENTERVILLE YOUNG PROFESSIONALS TO ENHANCE EDUCATION FOR LOCAL YOUTH THROUGH SCHOLARSHIP OPPORTUNITIES- MOULTON-UDELL COMMUNITY SCHOOL DISTRICT TO PROVIDE A SAFE, DRUG- AND ALCOHOL-FREE EVENT FOR YOUTH AFTER PROM- MORAVIA COMMUNITY SCHOOL DISTRICT TO PROVIDE A SAFE, DRUG- AND ALCOHOL-FREE EVENT FOR YOUTH AFTER PROM- RELAY FOR LIFE SCARE AWAY CANCER EVENT TO SUPPORT IMPROVING THE LIVES OF PEOPLE WITH CANCER AND THEIR FAMILIES THROUGH ADVOCACY, RESEARCH, AND PATIENT SUPPORT PART VI, LINE 6: MERCYONE CENTERVILLE 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. 1 APPANOOSE COMMUNITY CARE SERVICE 19890 ST JOSEPHS DR CENTERVILLE IA 52544 420893264 501(C)(3) 6636 0 COMMUNITY SUPPORT RATHBUN LAKE AREA YMCA 708 S MAIN CENTERVILLE IA 52544 262927214 501(C)(3) 10000 0 COMMUNITY SUPPORT 2 0 PART I, LINE 2: DONATIONS MADE BY MERCYONE CENTERVILLE 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. X X X 0 0 0 0 0 0 0 0 0 MICHAEL WEGNER DIRECTOR; PRES MERCYONE CENTRAL IA 0 941059 0 323718 0 22827 0 17925 0 23944 0 1329473 0 0 RANDALL RUBIN TREAS; SVP, CFO MERCYONE CENTRAL IA 0 490507 0 68574 0 22743 0 17925 0 26310 0 626059 0 0 MARLENE BIRKHOLTZ-WIER DO GENERAL SURGEON 300644 159164 0 0 23853 6842 16556 0 23084 3182 364137 169188 0 0 FLORITA HENDERSON MD PHYSICIAN, INTERNAL MED GENERAL 299803 98974 0 0 538 300 15762 0 22547 3038 338650 102312 0 0 BRIAN QUINN DO PHYSICIAN, FAMILY MEDICINE 215592 115434 0 0 800 439 17900 0 26536 3991 260828 119864 0 0 RYAN ARNEVIK DO DIRECTOR; PHYSICIAN, FAMILY MEDICINE 196985 113648 0 0 464 261 17925 0 27579 4515 242953 118424 0 0 JOSHWA TROMBLEE DO PHYSICIAN, FAMILY MEDICINE 194772 104771 0 20000 3982 2123 6959 0 14411 1937 220124 128831 0 0 JENNIFER HADEN DO PHYSICIAN, FAMILY MEDICINE 191638 113118 0 0 356 203 17221 0 2244 295 211459 113616 0 0 SHERRI DOGGETT SECRETARY; DIRECTOR PATIENT SERVICES 88118 50691 0 9924 1645 707 0 8933 4580 13958 94343 84213 0 0 CHAD KELLEY FRMR OFFCR; DIR OPERATIONS MERCYONE 0 142138 0 15651 0 274 0 8863 0 8196 0 175122 0 0 FORM 990, PART V, LINE 1C: UNTIL SEPTEMBER 1, 2022, MERCYONE CENTERVILLE WAS A SUBSIDIARY IN THE COMMONSPIRIT HEALTH SYSTEM. PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF COMMONSPIRIT HEALTH ARE MADE BY COMMONSPIRIT HEALTH. THEREFORE, NO FORMS 1099 WERE ISSUED BY MERCYONE CENTERVILLE. COMMONSPIRIT HEALTH FILED THE 2022 FORMS 1099 AND COMPLIED WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. THE FORMS 1099 ISSUED ON BEHALF OF MERCYONE CENTERVILLE ARE REPORTED TO THE IRS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCYONE CENTERVILLE IS CATHOLIC HEALTH INITIATIVES - IOWA, OF WHICH MERCY HEALTH NETWORK, INC. IS THE SOLE MEMBER. AS OF SEPTEMBER 1, 2022, MERCY HEALTH NETWORK BECAME A WHOLLY-OWNED SUBSIDIARY OF TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A CATHOLIC HEALTH INITIATIVES - IOWA IS THE SOLE MEMBER OF MERCYONE CENTERVILLE. CATHOLIC HEALTH INITIATIVES - IOWA HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF MERCYONE CENTERVILLE. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, CATHOLIC HEALTH INITIATIVES - IOWA MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. CATHOLIC HEALTH INITIATIVES - IOWA 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 MERCYONE CENTERVILLE 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 MERCYONE CENTERVILLE 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 MERCYONE CENTERVILLE, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DESIGNATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCYONE CENTERVILLE 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 MERCYONE CENTERVILLE (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCYONE CENTERVILLE OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCYONE CENTERVILLE (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 MERCYONE CENTERVILLE. 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 LINE 15A AND B: THE ORGANIZATION USES A THIRD-PARTY CONSULTANT TO SURVEY COMPENSATION TRENDS ANNUALLY AND TO RECOMMEND COMPENSATION RANGES FOR THE PRESIDENT AND CERTAIN OFFICERS. THESE RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR FINAL DETERMINATION AND APPROVAL. THE SALARIES ARE COMPARED TO INDUSTRY STANDARDS AND GUIDELINES FOR APPROPRIATENESS. FORM 990, PART VI, SECTION C, LINE 19 MERCYONE CENTERVILLE 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, MERCYONE CENTERVILLE INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MERCYONE CENTERVILLE'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. PART VII: VICKY ARNDORFER IS A MEMBER OF THE RELIGIOUS SISTERS OF MERCY. HAVING TAKEN A VOW OF POVERTY, SISTER VICKY DID NOT RECEIVE COMPENSATION FOR THE CHAPLAIN SERVICES SHE PROVIDED TO MERCY HEALTH SERVICES - IOWA (MERCYONE NEW HAMPTON), A RELATED ORGANIZATION. INSTEAD, A TOTAL OF $6,000 WAS PAID BY MERCYONE NEW HAMPTON DIRECTLY TO THE RELIGIOUS SISTERS OF MERCY FOR SISTER VICKY'S SERVICES. SISTER VICKY ALSO RECEIVED ROOM AND BOARD FROM MERCYONE NEW HAMPTON. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,136,521. MANAGEMENT AND GENERAL EXPENSES 312. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,136,833. MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 3,040,160. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,040,160. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 26,982. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,982. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,219,103. MANAGEMENT AND GENERAL EXPENSES 79,997. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,299,100. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 9,139. MANAGEMENT AND GENERAL EXPENSES 44,761. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,900. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 34,356. MANAGEMENT AND GENERAL EXPENSES 25,872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,228. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 31,012. MANAGEMENT AND GENERAL EXPENSES 6,409. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,421. OUTSOURCED LABOR - COMMONSPIRIT: PROGRAM SERVICE EXPENSES 14,197,895. MANAGEMENT AND GENERAL EXPENSES 5,016,002. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,213,897. FORM 990, PART XI, LINE 9: OTHER TRANSACTIONS -669,984. EQUITY TRANSFERS FROM AFFILIATES 5,027,733. PURCHASE ACCOUNTING ADJUSTMENT DUE TO ACQUISITION BY TRINITY HEALTH SYSTEM ON SEPT 1, 2022 -45,358,634. FORM 990, PART XII, LINE 2: MERCYONE CENTERVILLE'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: ST. JOSEPH'S MERCY HOSPITAL, CENTERVILLE, IOWA MERCYONE CENTERVILLE MEDICAL CENTER MERCY RURAL ACO LLC 1 ST JOSEPHS DRIVE CENTERVILLE IA 52544 812764927 ACCOUNTABLE CARE ORGANIZATION IA 0 0 MERCY MEDICAL CENTER - CENTERVILLE 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 SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL HEALTH FOUNDATION-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 521025476 FOUNDATION NJ 501(C)(3) LINE 7 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH LIFE INC 7500 K JOHNSON BOULEVARD BORDENTOWN NJ 08505 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH MEDICAL GROUP-EAST TRENTON PA 601 HAMILTON AVENUE TRENTON NJ 08629 832199054 HEALTH CARE SERVICES NJ 501(C)(3) 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