2024-11-14T13:20:16-06:00 2023-12-31 990 2023-01-01 420698265 ALLEN MEMORIAL HOSPITAL CORPORATION ALLE 3192353995 1825 LOGAN AVE WATERLOO IA 507031916 ZACH FRENCH VP FINANCE 3192353544 2024-11-12 0 2023 2024-10-15 13:58:12Z JENNIFER FRIEDLY 1825 LOGAN AVE WATERLOO IA 507031916 397430409 0 X WWW.UNITYPOINT.ORG (SEE SCH O) X 1938 IA IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING. 11 6 2373 306 1924801 13355 8601112 4061357 303046728 363031783 15383074 3457130 1457192 1197726 328488106 371747996 30562864 41054817 0 0 154026368 167948450 0 0 0 155813168 172279310 340402400 381282577 -11914294 -9534581 406846827 391654120 163886013 147584601 242960814 244069519 X THE MISSION OF ALLEN MEMORIAL HOSPITAL CORPORATION IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE THROUGH HEALING, CARING AND TEACHING. 0 0 334481335 29112916 364148164 HEALTH-CARE SERVICES`ALLEN MEMORIAL HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE GREATER CEDAR VALLEY COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH-CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. ALLEN MEMORIAL HOSPTIAL CORPORATION PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PHARMACEUTICAL DRUGS, WOUND CARE, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2023, ALLEN MEMORIAL HOSPITAL CORPORATION ADMITTED 10,329 PATIENTS WITHOUT NEWBORNS AND NICU AND 11,495 PATIENTS WITH NEWBORNS AND NICU; RESULTING IN A TOTAL OF 46,651 PATIENT DAYS WITHOUT NEWBORNS AND NICU, AND 48,993 PATIENT DAYS WITH NEWBORNS AND NICU. OUTPATIENT VISITS TOTALED 215,940 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 4,148. THERE WERE ALSO 37,314 EMERGENCY ROOM VISITS AND 1,300 BABIES DELIVERED. 25792890 11941901 0 CHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: ALLEN MEMORIAL HOSPITAL CORPORATION PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $1,703,926 IN 2023. OFTEN TIMES, ALLEN MEMORIAL HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ALLEN MEMORIAL HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. ALLEN MEMORIAL HOSPITAL CORPORATION'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $921,629 FOR 2023. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $2,625,555.OTHER BENEFITS: ALLEN MEMORIAL HOSPITAL CORPORATION PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. ALLEN MEMORIAL HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. ALLEN MEMORIAL HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $23,167,335. 360274225 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 1 2373 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 6 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X ZACH FRENCH VP FINANCE 3192353932 1825 LOGAN AVE WATERLOO IA 50703 STACEY BENTLEY BOARD MEMBER 1.00 1.00 X 0 0 0 HENRY BEVEL BOARD MEMBER 1.00 1.00 X 0 0 0 MICHAEL BYL BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 KYLE CHRISTIASON MD BOARD CHAIR 1.00 40.00 X X 0 384803 43125 PAMELA DELAGARDELLE TO 823 BOARD MEMBER/PRESIDENT/CEO 40.00 1.00 X X 502003 478658 102337 JENNIFER FRIEDLY-VP COO TO 823 BOARD MEMBER/MARKET PRES (FR 8/23) 40.00 1.00 X X 407057 0 76127 JOAN HEADINGTON BOARD MEMBER 1.00 1.00 X 0 0 0 CAROL HIBBS BOARD MEMBER 1.00 1.00 X 0 0 0 LANCE HORBACH BOARD MEMBER 1.00 1.00 X 0 0 0 PRADEEP RAMESH MD BOARD MEMBER 1.00 40.00 X 0 568543 51789 JOSEPH TRIPP-RIEKS BOARD MEMBER 1.00 1.00 X 0 0 0 MARY WERTZBERGER BOARD MEMBER 1.00 1.00 X 0 0 0 ZACHARY FRENCH VP FINANCE 40.00 1.00 X 226659 0 16492 RUSSELL ADAMS CHIEF MEDICAL OFFICER 40.00 0.00 X 34493 453160 39022 SARAH BROWN TO 723 CHIEF NURSING OFFICER 40.00 0.00 X 204647 253733 46528 JODEE KNOX FR 723 INTERIM CHIEF NURSING OFFICER 40.00 0.00 X 224300 0 11229 RAJEEV ANUGU MD PHYSICIAN- RADIOLOGY 40.00 0.00 X 1156408 0 48406 PAUL MCCAUGHEY DO EMERGENCY MEDICINE 40.00 0.00 X 795699 0 51456 NISHAD NADKARNI MD PHYSICIAN- RADIOLOGY 40.00 0.00 X 919093 0 27242 MARK NEWTON MD PHYSICIAN- UROLOGY 40.00 0.00 X 793733 0 42691 ROBERTO SALAS FRAGOMENI MD PHYSICIAN- RADIOLOGY 40.00 0.00 X 1119108 0 41626 STEVEN PALMERSHEIM TO 1221 FORMER VP FINANCE/CFO UPC & ACO 0.00 40.00 X 0 451102 77246 CHRISTOPHER HILL DO TO 121 PHYSICIAN-ER/PHYSICIAN DYAD LEADER 0.00 40.00 X 0 511104 36658 6383200 3101103 711974 204 1 1 0 AMN HEALTHCARE 2999 OLYMPUS BLVD DALLAS TX 75019 HEALTHCARE STAFFING 7331736 AMERICAN HEALTHCARE STAFFING ASSOCIATION 226 E SIXTEENTH ST SUITE A TRAVERSE CITY MI 49684 HEALTHCARE STAFFING 4335993 HOT SHOTS NM LLC 2017 E KIMERLY ROAD DAVENPORT IA 52807 MEDICAL SERVICES 1732286 WEATHERBY LOCUMS INC 6451 NORTH FEDERAL HIGHWAY SUITE 70 FORT LAUDERDALE FL 33308 HEALTHCARE STAFFING 1456194 CEDAR VALLEY MEDICAL SPECIALIST 4150 KIMBALL AVE WATERLOO IA 50701 MEDICAL SERVICES 229232 67 2941843 1119514 4061357 NET PATIENT REVENUE 900099 325383456 325383456 PHARMACY REVENUE 456110 25453278 23671173 1782105 MGMT & SUPPORT SVCS 561000 5676325 5530325 146000 RENTAL INCOME 531120 4976690 4976690 LABORATORY SERVICES 621500 1561786 1561786 -19752 -16448 -3304 363031783 4001996 4001996 23850283 1094391 24729116 760424 -878833 333967 -544866 -544866 249167 192873 56294 56294 MISCELLANEOUS REVENUE 900099 945514 945514 DEFINED BENEFIT PENSION COST 900099 370296 370296 CAFETERIA/FOOD SVCS 722210 25051 25051 -199429 -199429 1141432 371747996 362223363 1924801 3538475 41054817 41054817 1888269 1888269 517010 517010 137047042 124057936 12989106 4195252 3797633 397619 16500747 14936832 1563915 7800130 7060846 739284 31900646 31900646 389688 5960 383728 816421 290670 525751 22248199 21458115 790084 729615 498757 230858 591558 390596 200962 916367 916367 7841953 7637329 204624 369154 355420 13734 120966 114997 5969 3872075 3872075 11969532 11792051 177481 2401028 2401028 MEDICAL SUPPLIES 88318046 88243624 74422 BAD DEBT EXPENSE 7710 7710 MISCELLANEOUS EXPENSE -213648 -519184 305536 381282577 360274225 21008352 0 4663717 6830322 3765729 4457290 39480519 41095443 41580547 31622058 7686354 8615943 951930 1207886 326529777 213970276 113769860 112559501 167036518 161309497 7928385 7389242 3993978 3452211 15989290 13114727 406846827 391654120 24014404 23218877 2201826 202266 137669783 124163458 163886013 147584601 X 236792621 237500527 6168193 6568992 242960814 244069519 406846827 391654120 X -9534581 10371017 272269 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 166327488 2941843 -8822936 502603 159943792 178627140 1148145 -12931965 515832 166327488 158079615 1682250 19338626 473351 178627140 146329549 1460741 10730349 441024 158079615 144545460 2941849 15378280 16058890 477150 146329549 0.95890 0.02740 0.01370 0 1 1 3812662 3812662 186482423 115864340 70618083 9193834 7398593 1795241 120873135 89818476 31054659 6167723 888867 5278856 112559501 ASBESTOS REMOVAL LIABILITY 8773781 DUE TO AFFILIATES 82901396 LONG-TERM RETENTION INCENTIVES 5366601 SELF-INSURANCE RESERVE 12120098 HEALTH AND WELFARE BENEFITS RESERVE 2011070 MISCELLANEOUS LIABILITY 1436078 OPERATING LEASE LIABILITY 11554434 124163458 X 379285000 10371017 189260 10560277 368724723 525751 2497522 3023273 371747996 338657000 189252 189252 338467748 525751 42289078 42814829 381282577 PART V, LINE 4: THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2020. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 189,252. ROUNDING 8. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN NET ASSETS WITHOUT DONOR RESTRICTION 2,497,522. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 189,252. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN NET ASSETS WITHOUT DONOR RESTRICTION 42,289,019. ROUNDING 59. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 1703926 1703926 0.00450 50407065 49485436 921629 0.00240 52110991 49485436 2625555 0.00690 3818673 2336188 1482485 0.00390 2951658 312723 2638935 0.00690 68552610 61448596 7104014 0.01860 19075863 7133962 11941901 0.03130 94398804 71231469 23167335 0.06070 146509795 120716905 25792890 0.06760 0 1379139 0 19974837 16173105 3801732 X 1 1 1 1 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 WWW.UNITYPOINT.ORG/WATERLOO 070034H X X X ALLEN MEMORIAL HOSPITAL CORPORATION 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, PAGE 8 X 1 22 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 600.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 5: IN 2019, BLACK HAWK COUNTY HEALTHCARE PROVIDERS AND ALLIED SERVICE ORGANIZATIONS CAME TOGETHER AS PARTNERS TO WRITE AND PUBLISH TWO ONLINE SURVEYS TO IDENTIFY THE COMMUNITY HEALTH NEEDS OF CEDAR VALLEY RESIDENTS AND SOCIAL SERVICE AGENCIES. IN 2022, UNITYPOINT HEALTH ALLEN HOSPITAL USED THE ASSESSMENT PREVIOUSLY CREATED WITH THE COMMUNITY PARTNERS AND ADDED FIVE QUESTIONS RELATED TO COVID-19. CONSISTENCY OF THE QUESTIONS FROM 2019 TO 2022 WAS IMPORTANT TO COMPARE THE IMPACT FROM EACH CYCLE. THE ONLINE SURVEY FOR RESIDENTS WAS PUBLISHED FROM SEPTEMBER 5 TO SEPTEMBER 19, 2022, AND DREW 696 UNIQUE RESPONSES. THE PARALLEL SURVEY FOR SOCIAL SERVICE AGENCIES RAN CONCURRENTLY AND DREW 44 RESPONSES. BOTH SURVEYS WERE EXTENDED ONE WEEK TO SEPTEMBER 26, 2022, TO ALLOW FOR ADDITIONAL RETURNS. FOR COMPARISON, IN 2019 THE RESIDENT SURVEY DREW 1,554 UNIQUE RESPONSES WHILE THE SURVEY FOR AGENCIES DREW 41 RESPONSES. SURVEYMONKEY, AN ONLINE SURVEY TOOL, WAS THE ONLY OUTSIDE SERVICE USED IN THIS ASSESSMENT. UNITYPOINT HEALTH ALLEN HOSPITAL REMAINS INVOLVED IN THE COMMUNITY HEALTH IMPROVEMENT STEERING COMMITTEE THROUGH THE BLACK HAWK PUBLIC HEALTH DEPARTMENT AS A COMMUNITY PARTNER. THE SURVEY ASKED BOTH RESIDENTS AND COMMUNITY ORGANIZATIONS FOR THEIR INPUT ON THE HEALTH OF THE COMMUNITY. IN REVIEWING THE DEMOGRAPHICS OF THE SURVEY RESPONDENTS, THOSE THAT RESPONDED DO NOT ACCURATELY REPRESENT THE DIVERSE COMMUNITIES ALLEN HOSPITAL SERVES. THERE COULD BE A VARIETY OF REASONS FOR THE LACK OF DIVERSE RESPONDENTS INCLUDING THE SURVEY DISTRIBUTION METHOD, THE TIMING OF THE SURVEY, THE NATURE OF THE SURVEY, LACK OF TRUST OF THE HEALTHCARE FIELD, AND LANGUAGE BARRIERS. TO REFLECT ACCURATELY THE COMMUNITY DEMOGRAPHIC MAKEUP, AGENCIES AND ORGANIZATIONS WERE INVITED TO PARTICIPATE. AGENCY PARTICIPANTS REPRESENT THE INTERESTS OF AFRICAN AMERICAN, HISPANIC, BOSNIAN, ASIAN, INDIAN, BURMESE, AMERICAN INDIAN AND CONGOLESE POPULATIONS LIVING IN THE CEDAR VALLEY, PREDOMINATELY IN BLACK HAWK COUNTY. THEY ALSO REPRESENT THE INTERESTS OF AND SERVICE RESIDENTS LIVING IN POVERTY; WOMEN AND CHILDREN; WOMEN AND CHILDREN AT-RISK; PRE-SCHOOL CHILDREN; ADULTS 65+; THE DISABLED; THE UNDEREMPLOYED AND UNEMPLOYED; THE MEDICALLY UNDERSERVED; RESIDENTS SUFFERING FROM MENTAL ILLNESS AND/OR ADDICTION; RESIDENTS LIVING WITH FOOD INSECURITY; ENGLISH LANGUAGE LEARNERS AND THE LGBTQ COMMUNITIES. AGENCY PARTICIPANTS WERE RECRUITED SPECIFICALLY FOR THEIR KNOWLEDGE AND RECORD OF SUCCESSFUL SERVICE TO ONE OR MORE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS IN THE CEDAR VALLEY. THE ASSESSMENT PARTNERSHIP ASKED 87 COMMUNITY ORGANIZATIONS TO PARTICIPATE IN THE AGENCY SURVEY. FORTY-FOUR AGENCIES COMPLETED THE SURVEY. ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 6A: MERCYONE WATERLOO MEDICAL CENTER ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 6B: ALLEN HOSPITAL HAS PARTNERED WITH BLACK HAWK COUNTY PUBLIC HEALTH DEPARTMENT ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 11: THE 2020-2022 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING HEALTHNEEDS: ACCESS TO HEALTHCARE; ACCESS TO MENTAL HEALTHCARE; HEALTH EDUCATION; PERSONALEXERCISE; PERSONAL NUTRITION. THE ALLEN HOSPITAL BOARD OF DIRECTORS DISCUSSED FIVE MAJOR HEALTH NEEDS AS WELL AS OTHER ISSUES IDENTIFIED IN THE SURVEY AT THE APRIL 28, 2020 VIRTUAL BOARD MEETING. DIRECTORS THEN CAST INDIVIDUAL VOTES TO DECIDE WHICH THREE NEEDS TO PRIORITIZE IN THE 2020-2022 COMMUNITY HEALTH NEEDS IMPLEMENTATION PLAN. NO HOSPITAL HAS THE RESOURCES TO BEGIN TO ADDRESS ALL THE POSSIBILITIES, SO THE DIRECTORS VOTED TO EMPHASIZE THREE COMMUNITY HEALTH NEEDS: (1) ACCESS TO HEALTHCARE, (2) ACCESS TO MENTAL HEALTHCARE, AND(3) HEALTH EDUCATION.ACCESS TO HEALTHCARE. THESE PROGRAMS AND INITIATIVES HAVE BEEN ADDED OR EXPANDEDIN 2020-2022 TO HELP THE COMMUNITY MEET HEALTHCARE SERVICE'S NEEDS:-ADDED UPC EXPRESS CARE LOCATION IN WAVERLY IN EARLY 2020-OPENED THE WATERLOO SCHOOLS EMPLOYEE HEALTH CENTER IN AUGUST 2020-ESTABLISHED THE UNITYPOINT HEALTH FAMILY MEDICINE RESIDENCY IN THE SUMMER OF 2021-TRANSITIONED THE SURGERY CENTER AT UNITED MEDICAL PARK FROM A HOSPITAL OUTPATIENT DEPARTMENT TO AN AMBULATORY SURGERY CENTER IN FEBRUARY 2020-STARTED ONLINE CHECK-IN FOR OUTPATIENT PROCEDURES TO MAKE IT EASIER TO CHECK IN AT HOME OR ON A MOBILE DEVICE COMPARED TO THE FULL REGISTRATION PROCESS AT THE HOSPITAL-BEGAN SELF-SCHEDULING FOR MAMMOGRAPHY PATIENTS VIA COMPUTER OR MOBILE DEVICE-OPENED NEW UNITYPOINT PEDIATRIC CLINIC IN WATERLOO-THREE PEDIATRIC PROVIDERS ADDED SINCE 2019 WITH ONE ADDITIONAL BEGINNING IN 2023 TO INCREASE PEDIATRIC APPOINTMENT AVAILABILITY-ADDED TWO MIDWIVES TO THE EXISTING PRACTICE TO INCREASE ACCESS FOR MOTHERS DURING PREGNANCY AND DELIVERY-ADDED TELEHEALTH AND VIRTUAL APPOINTMENTS FOR PATIENTS IN RURAL COMMUNITIES FOR ALLEN WOMEN'S HEALTH-CREATED A BLACK DOULA PROGRAM FOR BLACK-IDENTIFYING AND AFRICAN AMERICAN MOTHERS-ARRANGING TRANSPORTATION WITHIN ALLEN HOSPITAL FOR EASE OF SCHEDULING FOR INPATIENTS DISCHARGED-PROVIDING BUS TICKETS FOR PATIENTS TO ASSIST IN ATTENDING FOLLOW UP APPOINTMENTS, FUNDING IS PROVIDED THROUGH THE CARE MANAGEMENT FUND-TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) PROGRAM ADDED TO ALLEN HOSPITAL AS A NEW CARDIAC PROCEDURE-ADDED CARDIOVASCULAR CENTER, NEUROSURGERY, AND CARDIOTHORACIC SURGERY TO UNITYPOINT HEALTH WATERLOO-INTRODUCED PHARMACY DELIVERY SERVICES TO PATIENTS' HOMES-HOSTED COVID-19 VACCINE CLINICS IN MULTIPLE LOCATIONS TO INCREASE VACCINE ACCESS-DRIVE UP FLU AND COVID-19 VACCINE CLINICS DEVELOPED-PARTNERED TO OPEN UPFIT, A 24/7 ACCESS FITNESS CENTER IN THE NORTH CROSSING DEVELOPMENTACCESS TO MENTAL HEALTHCARE. THESE PROGRAMS AND INITIATIVES HAVE BEEN ADDED OR EXPANDED IN 2020-2022 TO HELP THE COMMUNITY MEET MENTAL HEALTH SERVICE NEEDS:-OPENED THE UNITYPOINT MENTAL HEALTH WALK-IN CLINIC TO INCREASE SAME DAY AND CRISIS SERVICES FOR THE COMMUNITY-EXPANDED EMPLOYEE ASSISTANCE PROGRAM (EAP) TO ADDITIONAL COMPANIES-RESTARTED THE INTENSIVE OUTPATIENT PROGRAM, AN EIGHT-WEEK INTENSE GROUP SCHEDULE-INCREASED FUNDRAISING THROUGH THE ALLEN FOUNDATION FOR BLACK HAWK GRUNDY MENTAL HEALTH CENTER THROUGH THE ANNUAL MENTAL HEALTH AWARENESS BREAKFAST-ADDED MENTAL HEALTH TELEHEALTH SERVICES TO THE CHILD PROTECTION CENTER-HIRED TELEHEALTH THERAPIST FOR BLACK HAWK GRUNDY MENTAL HEALTH CENTER-HIRED A CHILD & ADOLESCENT PSYCHOLOGIST IN AUGUST OF 2022-CREATED A CENTRAL WORK QUE FOR TRIAGING BEHAVIORAL HEALTH PATIENTS TO APPROPRIATELY MATCH PATIENT NEEDS TO RECEIVE FASTER SERVICES-ENHANCED RELATIONSHIPS WITH COMMUNITY PARTNERS TO INCREASE ACCESS HEALTH EDUCATION. THE PROGRAMS AND INITIATIVES HAVE BEEN ADDED OR EXPANDED IN2020-2022 TO HELP THE COMMUNITY MEET HEALTH EDUCATION NEEDS:-ADDED HEALTH EDUCATION THROUGH ALLEN WOMEN'S HEALTH TO RURAL COMMUNITIES TO EDUCATE ON REPRODUCTIVE AND SEXUAL HEALTH-ADDED A CHRONIC DISEASE NAVIGATOR TO THE CARE MANAGEMENT TEAM TO EDUCATE INPATIENTS-IMPLEMENTED SEXUAL ORIENTATION AND GENDER IDENTITY (SOGI) DOCUMENTATION TO BETTER SUPPORT PATIENTS, PATIENTS CAN DOCUMENT INFORMATION ABOUT SEXUAL ORIENTATION AND/OR GENDER IDENTITY THROUGH A MYCHART QUESTIONNAIRE-DEVELOPED THE LEGACY PROGRAM IN PARTNERSHIP WITH ALLEN HOSPITAL AND ALLEN COLLEGE TO BE USED AS AN INVENTIVE TO KEEP ALLEN COLLEGE NURSES WORKING AT ALLEN HOSPITAL ALLEN MEMORIAL HOSPITAL CORPORATION PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND, IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. STATE LAW REQUIREMENTS THAT OFFER ADDITIONAL AND/OR MORE STRINGENT ELIGIBILITY REQUIREMENTS WILL BE FOLLOWED FOR THOSE STATES. PART V, LINE 7A, CHNA REPORT: THE CHNA REPORT WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS PART V, LINE 10A, IMPLEMENTATION STRATEGY: THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS PART V, LINE 16A, FAP WEBSITE: THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL): WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART V, LINE 16B, FAP WEBSITE: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART V, LINE 16C, FAP WEBSITE: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE 4 1 - ALLEN CHILD PROTECTION CENTER 212 W DALE ST SUITE 102 WATERLOO IA 50703 OUTPATIENT ONLY - CHILD PROTECTION 2 - ALLEN OCCUPATIONAL HEALTH SERVICES 7024 NORDIC DR CEDAR FALLS IA 50613 OUTPATIENT ONLY - OCCUPATIONAL HEALTH 3 - ALLEN WOMEN'S HEALTH CENTER 233 VOLD STREET WATERLOO IA 50703 OUTPATIENT ONLY - WOMEN'S HEALTH CENTER 4 - ALLEN WOMEN'S HEALTH CENTER 1600 1ST STREET E INDEPENDENCE IA 50644 OUTPATIENT ONLY - WOMEN'S HEALTH CENTER PART I, LINE 6A: ALLEN MEMORIAL HOSPITAL'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7,710. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THE HOSPITAL CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION AND MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. THE HOSPITAL EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, THE HOSPITAL EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COLLABORATE TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH. PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR ALLEN MEMORIAL HOSPITAL. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. PART VI, LINE 2: COMMUNITY HEALTH IS INEXTRICABLY TIED TO SOCIAL HEALTH. ALLEN HOSPITAL REACHES OUT TO IDENTIFY THE SOCIAL DETERMINANTS OF HEALTHCARE AND AFFECT DETERMINANTS IN REAL TIME. WE DO THAT THROUGH ONGOING PARTNERSHIPS, FORMAL AND INFORMAL, WITH OTHER ORGANIZATIONS SERVING THE COMMUNITY. EXAMPLES INCLUDE:THE ALLEN COLLEGE ENGAGEMENT SALVATION ARMY PARTNERSHIP, WHICH PROVIDES A FREE, COMMUNITY CLINIC THROUGHOUT THE YEAR. THE CLINIC PROVIDES CHECKUPS, SCREENINGS, TREATMENT OF MINOR ILLNESS, MEDICATION ASSISTANCE AND REFERRALS TO 1,200 RESIDENTS PER YEAR. IT ALSO PROVIDES ALLEN HOSPITAL WITH REAL-TIME INDICATORS OF CHANGING HEALTHCARE NEEDS OR OUR UNDERSERVED POPULATIONS.THE CEDAR VALLEY ADVERSE CHILDHOOD EXPERIENCES (ACES) COALITION, IN PARTNERSHIP WITH OTHER AREA PROVIDERS, MAJOR PHILANTHROPIC FOUNDATIONS IN OUR AREA, AND THE CEDAR VALLEY UNITED WAY, THE LEAD AGENCY. THE ACES EFFORT IS BOTH BROAD AND DEEP, REACHING ACROSS THE COMMUNITY TO IDENTIFY ROOT CAUSES OF ADULT HEALTH PROBLEMS. THE GOAL OF THE WORK IS TO LESSEN ADULT HEALTH CONCERNS BY REDUCING ACES IN AREA FAMILIES. THE AREA CHNA COALITION INCLUDED ACES QUESTIONS IN ITS 2019 SURVEY TO HELP ADVANCE THE PROJECT.THE BLACK HAWK COUNTY CHILD CARE COALITION, WHICH HAS IDENTIFIED CHILD CARE AS AN ABSOLUTE HEALTH, SOCIAL AND EMPLOYMENT PRIORITY FOR THE ENTIRE REGION. AFFORDABLE CHILD CARE IS PARTICULARLY CRITICAL FOR FAMILIES STRUGGLING TO GET OUT OF POVERTY AND FOR SINGLE-PARENT FAMILIES.THE CEDAR VALLEY MENTAL HEALTH SUMMIT, A BI-ANNUAL CONVOCATION OF AREA AGENCIES, PROVIDERS, AND FUNDERS TO ADDRESS MENTAL HEALTH CARE AS AN ESSENTIAL PART OF COMMUNITY HEALTH. LIKE THE ACES COALITION, IT BRINGS MANY ORGANIZATIONS TOGETHER TO FOCUS COLLECTIVE EFFORT ON A COMMON PROBLEM.PROJECT SEARCH, WHICH TEAMS ALLEN HOSPITAL WITH THE WATERLOO SCHOOLS TO GIVE SPECIAL NEEDS HIGH-SCHOOL SENIORS ON THE JOB TRAINING AND EXPERIENCE. THE PROGRAM IS ENTERING ITS FOURTH RATE WITH A GRADUATION RATE OF ALMOST 100% AND AN EQUALLY HIGH PLACEMENT RATE INTO PERMANENT JOBS FOR GRADUATES. PROJECT SEARCH ADDRESSES AN OFT-OVERLOOKED POPULATION COHORT WHO CAN BE SEMI-INDEPENDENT AND SELF-SUPPORTING WITH THE RIGHT START AND COMMUNITY SUPPORT.THE CEDAR VALLEY EQUITY INITIATIVE WORKSHOP ON RACISM AND HEALTH. THIS IS ANOTHER INITIATIVE THAT FOCUSES ON ROOT CAUSES OF HEALTHCARE OUTCOMES, INCLUDING BOTH RACIAL AND ECONOMIC DISPARITIES IN PRIMARY CARE AND CONSEQUENT HEALTH ISSUES.SUCCESS STREET AND HEALTH EDUCATION IN THE WATERLOO SCHOOLS. ALLEN WOMEN'S HEALTH PROVIDES SEX EDUCATION THROUGHOUT THE WATERLOO SCHOOLS AND OFFERS BOTH THE TOGETHER FOR YOUTH AND YOUNG PARENTS TOGETHER COMMUNITY GROUPS TO HELP TEENS AND YOUNG PARENTS NAVIGATE HEALTHCARE ISSUES FOR THEMSELVES AND THEIR BABIES. ALL THREE PROGRAMS FOSTER FRANK, TWO-WAY DISCUSSION AMONG AREA TEENS AND PROVIDERS AND PROVIDE A CLEAR, CURRENT LOOK AT COMMUNITY HEALTH NEEDS. PART VI, LINE 3: THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ALL PATIENTS AND WITHIN THE COMMUNITY. COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. THE CENTRAL BILLING OFFICE IS AVAILABLE BY PHONE TO ANSWER QUESTIONS ABOUT THE POLICY, OR PATIENTS SHOULD GO TO THE CASHIER'S OFFICE AT THE HOSPITAL TO OBTAIN THIS INFORMATION. THE PLAIN LANGUAGE SUMMARY IS OFFERED AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS AND INCLUDED WHEN A PATIENT IS SENT WRITTEN NOTICE THAT EXTRAORDINARY COLLECTION ACTIONS MAY BE TAKEN AGAINST HIM/HER. THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY, AND ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE IN WHICH LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS CONSTITUTE THE LESSER OF 1,000 PERSONS OR MORE THAN 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE TRANSLATED DOCUMENTS WILL BE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. PART VI, LINE 4: ALLEN MEMORIAL HOSPITAL IS A 201-BED COMMUNITY HOSPITAL SERVING THE CEDAR VALLEY OF IOWA. ALLEN MEMORIAL HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.85% OF ALLEN MEMORIAL HOSPITAL'S MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF BLACK HAWK, BREMER, BUCHANAN, FAYETTE, TAMA AND BUTLER. ALLEN MEMORIAL HOSPITAL ADMITS APPROXIMATELY 11,800 INPATIENTS AND CARES FOR 37,100 EMERGENCY PATIENTS PER YEAR. ALLEN MEMORIAL HOSPITAL CARES FOR MORE INPATIENTS, OUTPATIENTS, EMERGENCY PATIENTS AND CARDIAC PATIENTS THAN ANY OTHER HOSPITAL IN THE CEDAR VALLEY OF IOWA. THERE ARE 5 OTHER HOSPITALS WITHIN THE 6-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $56,043 TO $78,857 AND THE AVERAGE POVERTY RATE IS 11.8%.70.2% OF ALLEN MEMORIAL HOSPITAL INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. BLACK HAWK COUNTY, THE ONLY COUNTY IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATION, IS 83% CAUCASIAN AMERICAN AND BOSNIAN, 10% AFRICAN-AMERICAN, 5% HISPANIC AND 1% ALL OTHER MINORITY POPULATIONS. PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH AN OPEN MEDICAL STAFF AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD APPROVES THE COMMUNITY NEEDS ASSESSMENT AND COMMUNITY BENFEFIT PLAN FOR THE HOSPITAL. THE HOSPITAL IS PART OF AN INTEGRATED HEALTH SYSTEM AND ITS ULTIMATE PARENT UNITYPOINT HEALTH ALONG WITH ITS SUBSIDIARIES THAT INCLUDE THE HOSPITAL HAVE A STANDARD MODEL OF GOVERNANCE THAT ALLOWS THE HOSPITAL TO MAINTAIN A STRONG CLINICAL, FINANCIAL, STRATEGIC AND OPERATIONAL PROFILE THAT INCLUDES SURPLUS FUNDS USED TO FURTHER ITS CHARITABLE PURPOSE. PART VI, LINE 6: THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $4.8B IN OPERATING REVENUE AND 29,000 TEAM MEMBERS. AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 375 CLINICS; 19 COMMUNITY NETWORK HOSPITALS; 12 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THEIR REGIONS. IN 2023, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $232 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. PART VI, LINE 7, REPORTS FILED WITH STATES IA 1 ALLEN COLLEGE 1825 LOGAN AVE WATERLOO IA 50703 421351526 501 C(3) 700000 0 PROGRAM SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501 C(3) 19167 0 PROGRAM SUPPORT BLACK HAWK GRUNDY MENTAL HEALTH CENTER 3251 WEST NINTH ST WATERLOO IA 50702 420733463 501 C(3) 1200000 0 PROGRAM SUPPORT CEDAR VALLEY KIDS CLUB 1955 HEALTH ST WATERLOO IA 50703 850657410 501 C(3) 37339 0 PROGRAM SUPPORT IOWA HEALTH SYSTEM 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421435199 501 C(3) 4286601 0 PROGRAM SUPPORT IOWA PHYSICIANS MEDICAL FOUNDATION 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421411630 501 C(3) 33637461 0 PROGRAM SUPPORT MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVE WATERLOO IA 50703 421201138 501 C(3) 1057910 0 PROGRAM SUPPORT RIVERVIEW CENTER 100 E PARK AVE 250 WATERLOO IA 50703 363920008 501 C(3) 27945 0 PROGRAM SUPPORT ROTARY CLUB OF CEDAR VALLEY 407 MAIN ST CEDAR FALLS IA 50613 455069209 501 C(3) 20000 0 PROGRAM SUPPORT 9 0 PART I, LINE 2: ALLEN MEMORIAL HOSPITAL CORPORATION MONITORS THE USE OF GRANT FUNDS ACCORDING TO THE STANDARD FINANCIAL POLICIES OF THE ORGANIZATION AND AS REQUIRED BY THE GRANT OR GRANTOR. THE POLICIES AND PROTOCOLS OF THE FUNDING SOURCE ARE ENFORCED AND MONITORED BY THE ORGANIZATION AND REPORTED AS REQUIRED. 0 1 0 0 0 0 0 0 0 RAJEEV ANUGU MD PHYSICIAN- RADIOLOGY 1124585 0 27500 0 4323 0 16500 0 31906 0 1204814 0 0 0 ROBERTO SALAS FRAGOMENI MD PHYSICIAN- RADIOLOGY 1115526 0 0 0 3582 0 15435 0 26191 0 1160734 0 0 0 PAMELA DELAGARDELLE TO 823 BOARD MEMBER/PRESIDENT/CEO 305553 240165 168135 221371 28315 17122 86308 0 10441 5588 598752 484246 0 0 NISHAD NADKARNI MD PHYSICIAN- RADIOLOGY 891161 0 27500 0 432 0 16500 0 10742 0 946335 0 0 0 PAUL MCCAUGHEY DO EMERGENCY MEDICINE 787603 0 2000 0 6096 0 16500 0 34956 0 847155 0 0 0 MARK NEWTON MD PHYSICIAN- UROLOGY 757915 0 34838 0 980 0 16500 0 26191 0 836424 0 0 0 PRADEEP RAMESH MD BOARD MEMBER 0 531148 0 36767 0 628 0 16500 0 35289 0 620332 0 0 CHRISTOPHER HILL DO TO 121 PHYSICIAN-ER/PHYSICIAN DYAD LEADER 0 450894 0 59750 0 460 0 16500 0 20158 0 547762 0 0 STEVEN PALMERSHEIM TO 1221 FORMER VP FINANCE/CFO UPC & ACO 0 322310 0 125574 0 3218 0 48926 0 28320 0 528348 0 0 RUSSELL ADAMS CHIEF MEDICAL OFFICER 33486 371713 0 56266 1007 25181 0 16500 1868 20654 36361 490314 0 0 SARAH BROWN TO 723 CHIEF NURSING OFFICER 141671 146759 46536 50000 16440 56974 4785 19631 13576 8536 223008 281900 0 0 JENNIFER FRIEDLY-VP COO TO 823 BOARD MEMBER/MARKET PRES (FR 8/23) 338461 0 63874 0 4722 0 57045 0 19082 0 483184 0 0 0 KYLE CHRISTIASON MD BOARD CHAIR 0 383674 0 0 0 1129 0 16500 0 26625 0 427928 0 0 ZACHARY FRENCH VP FINANCE 188068 0 36818 0 1773 0 6805 0 9687 0 243151 0 0 0 JODEE KNOX FR 723 INTERIM CHIEF NURSING OFFICER 179755 0 15277 0 29268 0 10982 0 247 0 235529 0 0 0 PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: PAMELA DELAGARDELLE $ 69,808, JENNIFER FRIEDLY $ 40,749 & STEVEN PALMERSHEIM $ 32,426. SCHEDULE J, PART I, LINE 3 - ESTABLISHING COMPENSATION THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. ANNALISE BOLT FAMILY MEMBER OF OFFICER PAMELA DELAGARDELLE 102669 EMPLOYMENT 0 BREEANNE FRIEDLY FAMILY MEMBER OF OFFICER JENNIFER FRIEDLY 23773 EMPLOYMENT 0 BRITTANY GROENEVELD FAMILY MEMBER OF BOARD MEMBER STACEY BENTLEY 60396 EMPLOYMENT 0 KATHERINE APPEL FAMILY MEMBER OF OFFICER PAMELA DELAGARDELLE 58673 EMPLOYMENT 0 RONALD ALSTON FAMILY MEMBER OF BOARD MEMBER CAROL HIBBS 167002 EMPLOYMENT 0 FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION IS PART OF A HEALTH SYSTEM UNDER THE ULTIMATE CONTROL OF IOWA HEALTH SYSTEM D/B/A UNITYPOINT HEALTH. UNITYPOINT HEALTH AND ITS SUBSIDIARIES IMPLEMENTED A FULLY-INTEGRATED OPERATING MODEL INCLUDING STANDARD GOVERNANCE ACROSS MARKETS ESTABLISHING RESPECTIVE RESPONSIBILITIES, AUTHORITIES, AND POWERS SET FORTH IN AMENDED GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION A, LINE 6 ALLEN HEALTH SYSTEMS, INC., A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER ALLEN HEALTH SYSTEMS, INC AND THE ORGANIZATION SHARE A COMMON BOARD NOMINATED BY ALLEN HEALTH SYSTEMS, INC. IOWA HEALTH SYSTEM D/B/A UNITYPOINT HEALTH, THE SOLE MEMBER OF ALLEN HEALTH SYSTEMS, INC, APPROVES THE ELECTION OF BOARD MEMBERS AND APPOINTS THE MARKET PRESIDENT WHO SERVES AS AN EX-OFFICIO BOARD MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S SOLE MEMBER ALLEN HEALTH SYSTEMS, INC HAS AUTHORIZED ITS POWERS TO THE ORGANIZATION AND THEY SHARE A COMMON BOARD. POWERS OF THE COMMON BOARD ARE AUTHORIZED TO BE EXERCISED BY IOWA HEALTH SYSTEM D/B/A UNITYPOINT HEALTH. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY UNITYPOINT HEALTH'S CORPORATE SERVICES TAX DEPARTMENT AND GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE DEPARTMENT WITH ULTIMATE APPROVAL BY THE DIRECTOR OF TAX SERVICES. THE DIRECTOR OF TAX SERVICES MEETS WITH THE FINANCE EXECUTIVE AND REVIEWS KEY PARTS OF THE FORM 990 UTILIZING A PRESENTATION SUMMARY. A COPY OF THE FORM 990 IS GIVEN TO EACH MEMBER OF THE BOARD VIA THE BOARD PORTAL ALONG WITH A REVIEW GUIDE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2023 FOR THE FOLLOWING INDIVIDUALS: RUSSELL ADAMS, MD, SARAH BROWN, PAMELA DELAGARDELLE, ZACH FRENCH, JENNIFER FRIEDLY, JODEE KNOX & STEVEN PALMERSHEIM. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST OF MEMORIAL FOUNDATION OF ALLEN HOSPITAL 400,799. CHANGES IN PENSION LIABILITY -128,526. ROUNDING -4. 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IA N/A C 0 DELHI POINT CONDO ASSOCIATION 350 N GRANDVIEW DUBUQUE IA 52001 421467002 REAL ESTATE MANAGEMENT IA N/A C 0 HCP CORPORATION 202 SOUTH PARK STREET MADISON WI 53715 391177562 REAL ESTATE RENTAL WI N/A C 0 HANSEN CHARITABLE REMAINDER ANNUITY TRUST 210 FOURTH AVENUE GRINNELL IA 50112 396770806 INVESTMENT IA N/A T 0 HANSEN CHARITABLE REMAINDER UNITRUST 210 FOURTH AVENUE GRINNELL IA 50112 396770807 INVESTMENT IA N/A T 0 HEALTH ADVANTAGE PLUS INC 210 4TH AVENUE GRINNELL IA 50112 421436490 PHYSICAL THERAPY IA N/A C 0 HNC SERVICES 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 270987243 FIBER OPTIC NETWORK SERVICES IA N/A C 0 MEDIMORE INC 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421414390 MANAGED CARE IA N/A C 0 MERITER HEALTH ENTERPRISES INC 202 SOUTH PARK STREET MADISON WI 53715 391293620 MANAGEMENT SERVICES WI N/A C 0 MERITER MANAGEMENT SERVICES INC 202 SOUTH PARK STREET MADISON WI 53715 391458235 ADMINISTRATIVE SERVICES WI N/A C 0 PRECEDENCE INC 4622 PROGRESS DRIVE STE A DAVENPORT IA 52807 371288604 MANAGED MENTAL CARE IA N/A C 0 PRECEDENCE PLUS INC 4622 PROGRESS DRIVE STE A DAVENPORT IA 52807 364140096 MANAGED MENTAL CARE IA N/A C 0 STL HEALTH RESOURCES CO 1026 A AVE NE CEDAR RAPIDS IA 52402 421193499 PHYSICIAN OFFICE RENTAL IA N/A C 0 TRINITY HEALTH ENTERPRISES INC 2701 17TH ST ROCK ISLAND IL 61201 363320141 RETAIL PHARMACY IL N/A C 0 0 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0 SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $4.8B IN OPERATING REVENUE AND 29,000 TEAM MEMBERS. AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 375 CLINICS; 19 COMMUNITY NETWORK HOSPITALS; 12 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS.