2024-05-15T15:25:57-05:00 2023-06-30 420714325 RSM US LLP 4650 EAST 53RD STREET DAVENPORT IA 528073479 990 2022-07-01 420698295 MERCY MEDICAL CENTER MERC 3193986105 701 10TH ST SE CEDAR RAPIDS IA 52403 NATHAN VAN GENDEREN EXECUTIVE VP/CFO 3193986105 2024-05-14 1 NATHAN VAN GENDEREN 999009999 0 JENIFER L CHASE P01306883 5638884000 2024-05-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z NATHAN VAN GENDEREN 701 10TH ST SE CEDAR RAPIDS IA 52403 572376477 0 0928 X WWW.MERCYCARE.ORG X 1900 IA TO CARE FOR THE SICK AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, GUIDED BY THE SPIRIT OF THE SISTERS OF MERCY. 25 20 3084 634 2244851 974325 11561637 17876568 390702891 408642537 16653110 11446110 -538223 -2259908 418379415 435705307 10528954 15136676 0 0 205610908 227230854 0 0 0 196616824 213667899 412756686 456035429 5622729 -20330122 716000674 714937396 209763154 225373343 506237520 489564053 X TO CARE FOR THE SICK AND ENHANCE THE HEALTH OF THE COMMUNITIES WE SERVE, GUIDED BY THE SPIRIT OF THE SISTERS OF MERCY. 0 0 374886144 15136676 404154755 THE HOSPITAL PROVIDES MEDICAL HEALTH CARE, INCLUDING 24 HOURS A DAY, SEVEN DAYS A WEEK TRAUMA CENTER SERVICE, TO ALL PATIENTS ACCESSING THE SYSTEM, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. A PATIENT IS CLASSIFIED AS A CHARITY PATIENT BY REFERENCE TO CERTAIN ESTABILISHED POLICIES OF THE HOSPITAL. ESSENTIALLY, THESE POLICIES DEFINE CHARITY SERVICES AS THOSE SERVICES FOR WHICH NO OR NOMINAL PAYMENT IS ANTICIPATED. ADDITIONALLY, EACH HOSPITAL DEPARTMENT ACCEPTS ALL PATIENTS WHO ARE COVERED BY GOVERNMENTAL INDIGENT PROGRAMS. SUCH INDIGENT PROGRAMS TYPICALLY REMIT AMOUNTS SUBSTANTIALLY LESS THAN CHARGES. THE FOLLOWING SUMMARIZES THE HOSPITAL'S CARE OF THE UNINSURED AND UNDERINSURED. COSTS IN EXCESS OF MEDICARE REIMBURSEMENT (COSTS OF PROVIDING THE SERVICES LESS THE AMOUNTS RECEIVED FROM MEDICARE) - $38,210,000; OTHER COMMUNITY BENEFITS (INCLUDES SUBSIDIZED HEALTH SERVICES, FINANCIAL CONTRIBUTIONS) - $2,903,000; FREE SERVICE (TO PATIENTS WHO MEET MERCY'S FREE-SERVICE GUIDELINES) - $4,700,000; COSTS IN EXCESS OF MEDICAID REIMBURSEMENT (COSTS OF PROVIDING THE SERVICES LESS THE AMOUNTS RECEIVED FROM MEDICAID) - $12,030,000, PHYSICIAN EDUCATION - $(911,000). IN ADDITION, CHARITY CARE AND COMMUNITY SERVICE ARE PROVIDED THROUGH MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS OFFERED THROUGHOUT THE YEAR. THESE PROGRAMS PROVIDE A BONA FIDE COMMUNITY HEALTH NEED, INCLUDING: A. PUBLIC AND PROFESSIONAL EDUCATIONAL SEMINAR ARE OFFERED ON A VARIETY OF TOPICS INCLUDING JOINT REPLACEMENT SURGERY, PRENATAL EDUCATION, DIABETES, MENTAL HEALTH DISORDERS, AND NUMEROUS OTHER MEDICAL CONDITIONS OF MEDICAL AND PSYCHOSOCIAL NATURE. SPECIALIZED CANCER SEMINARS ARE ALSO OFFERED. B. HOSPITAL MEETING FACILITIES WHICH ARE FREQUENTLY USED WITHOUT CHARGE BY SUCH GROUPS AS THE AMERICAN HEART ASSOCIATION, IOWA BREAST CANCER FOUNDATION, HEALTHY LINN NETWORK ADVISORY COMMITTEE, OVEREATERS ANONYMOUS, CATHOLIC LAYMEN, UNITED WAY, CATHERINE MCAULEY CENTER FOR WOMEN, THE AMERICAN CANCER SOCIETY. M.S. SUPPORT GROUP, EASTERN IOWA ONCOLOGY NURSES SOCIETY, THE IOWA CANCER CONSORTIUM, THE PARENT EDUCATION CONSORTIUM, ARC OF EAST CENTRAL IOWA, AND SEVERAL OTHER GROUPS. C. CONTRIBUTIONS OF APPROXIMATELY 81,050 HOURS TOWARD THE COMMON PURPOSE OF SERVING THE HEALTH CARE OF THE COMMUNITY. THE VALUE OF THESE CONTRIBUTIONS WAS APPROXIMATELY $1,209,400 AND WAS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS. 374886144 1 1 0 1 0 0 0 1 0 1 1 0 1 0 1 1 1 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 118 0 1 3084 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 25 20 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X KIM GRADY 3193986105 701 10TH ST SE CEDAR RAPIDS IA 52403 TIMOTHY L CHARLES FORMER PRESIDENT & CHIEF EXECUTIVE OFFICER 40.00 X X 910163 0 81633 TIMOTHY QUINN MD PRESIDENT & CHIEF EXECUTIVE OFFICER 40.00 X X 718980 0 72934 JOHN-PAUL BESONG MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 LYDIA BROWN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MICHELE BUSSE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BOB CATALDO MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHRIS DEWOLF MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BARRIE ERNST MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 TONY GOLOBIC MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER LUANN HANNASCH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 NANCY KASPAREK MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER SHARON KERRIGAN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 BARB KNAPP MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER TERRY MALTBY MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHERYLE MITVALSKY CHAIRMAN 1.00 X X 0 0 0 DARREL MORF VICE CHAIRMAN/TREASURER 1.00 X X 0 0 0 RUE PATEL MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 FRED PILCHER MD MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MARY QUASS MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JOHN RIFE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 CHARLES ROHDE MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 AL RUFFALO MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 KYLE SKOGMAN MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 JOHN SMITH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 MATT SMITH FORMER MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 SISTER MAURITA SOUKUP SECRETARY 1.00 X X 0 0 0 ANN STROH MEMBER BOARD OF TRUSTEES 1.00 X 0 0 0 NATHAN VAN GENDEREN EXECUTIVE VICE PRESIDENT & CFO/COO 40.00 X 474578 0 65896 NANCY HILL-DAVIS CHIEF TALENT OFFICER 40.00 X 352203 0 37951 JEFFREY CASH CHIEF INFORMATION OFFICER 40.00 X 431218 0 53169 MARY BROBST CHIEF NURSING OFFICER 40.00 X 364872 0 53117 TONY MYERS MD CHIEF MEDICAL OFFICER 40.00 X 386257 0 34007 AMANDEEP DHALIWAL MD PHYSICIAN 40.00 X 1306571 0 22926 SACHIN GOYAL MD PHYSICIAN 40.00 X 1211187 0 14326 CHONG C LEE MD PHYSICIAN 40.00 X 1706403 0 36757 RYAN D HOLLENBECK MD PHYSICIAN 40.00 X 1194761 0 36123 UJJWAL KUMAR MD PHYSICIAN 40.00 X 1206044 0 21634 10263237 0 530473 263 0 1 0 VAYA WORKFORCE SOLUTIONS LLC 5930 CORNERSTONE COURT W STE 300 SAN DIEGO CA 92121 HEALTHCARE PROFESSIONAL SERVICES 16813254 UNIVERSITY OF IOWA HEALTH CARE 200 HAWKINS DRIVE IOWA CITY IA 52242 HEALTHCARE PROFESSIONAL SERVICES 6818335 ONCOLOGY ASSOCIATES OF CEDAR RAPIDS 701 10TH STREET CEDAR RAPIDS IA 52403 HEALTHCARE PROFESSIONAL SERVICES 5215016 SOUND PHYSICIANS PO BOX 942936 LOS ANGELES CA 90074 HEALTHCARE PROFESSIONAL SERVICES 4111634 TRIMEDX 5451 LAKEVIEW PKWY S DRIVE INDIANAPOLIS IN 46268 MAINTAIN AND REPAIR MEDICAL EQUPMENT 3957421 55 16684577 1191991 2531 17876568 PATIENT REVENUES 621110 283063152 283063152 LABORATORY REVENUE 621500 130836246 129766028 1070218 FAMILY COUNSELING REVENUE 624100 178498 178498 LESS: PROVISION FOR BAD DEBT 621110 -5435359 -5435359 408642537 7272407 7272407 2370491 1682097 688394 688394 688394 136378143 9803 132214243 0 4163900 9803 4173703 4173703 2069459 2774830 -705371 -705371 INVESTMENT PARTNERSHIP INCOME(LOS 561000 1768328 593695 1174633 MISCELLANEOUS REVENUE 621110 1349 1349 MRI JOINT VENTURE 621110 -4012608 -4012608 -2242931 435705307 404154755 2244851 11429133 15136676 15136676 3571855 2914136 657719 187432040 152918407 34513633 5965055 4866653 1098402 18751885 15298923 3452962 11510019 9390570 2119449 170988 139502 31486 38086 31073 7013 143 117 26 38825336 31676059 7149277 1458037 1189555 268482 110066032 89798533 20267499 667580 544652 122928 5852119 4774513 1077606 178130 145329 32801 214158 174723 39435 4820286 3932681 887605 21271578 17354641 3916937 1604530 1309073 295457 UNRELATED BUSINESS INCO 204031 204031 CONTRACTED SERVICES 18763133 15308100 3455033 TAXES & LICENSES 2222930 1813601 409329 REPAIRS 2206211 1799961 406250 5104591 4164635 939956 456035429 374886144 81149285 0 17782892 8265576 185218 -321553 50303565 53324654 767990 630112 9318928 10126745 10040012 10020954 604108721 383081851 170436971 221026870 305967083 267154854 151198015 144709184 716000674 714937396 70418461 89435271 2551082 1177423 108015768 111146126 28777843 23614523 209763154 225373343 X 433319726 411276767 72917794 78287286 506237520 489564053 716000674 714937396 X -20330122 -907223 4563878 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 38086 38086 0 PART II-B, LINE 1: THE FOLLOWING PERCENTAGES OF DUES PAID ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES: 21.0% TO THE IOWA HOSPITAL ASSOCIATION, 3.78% TO THE CATHOLIC HEALTH ASSOCIATION, 4.68% TO THE CEDAR RAPIDS METRO ECONOMIC ALLIANCE, 16.45% TO THE AMERICAN ACADEMY OF FAMILY PHYSICIANS, 6% TO THE IOWA STATE BAR ASSOCIATION, 3% TO THE SOCIETY FOR HUMAN RESOURCE MANAGEMENT, AND 1% TO AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES. X 0 81579640 65958 3287666 -129890 14026719 71036435 82365623 5693080 -2715364 716834 3046863 81579642 65433553 6112026 10511350 -812952 504258 82365623 34140867 30594750 1101466 232175 171355 65433553 33874605 146716 389112 140348 129218 34140867 0.53910 0.46090 0.00000 0 1 1 24417371 24417371 329093593 222860378 106233215 247730907 157632354 90098553 2866850 2589119 277731 221026870 INVESTMENT IN MERCY MEDICAL CENTER FOUNDATION 130065604 C INVESTMENT IN CEDAR RAPIDS PHO 1941000 C SLEEP LAB JOINT VENTURE 1229000 C INVESTMENT IN MR ASSOCIATES 425000 C INVESTMENT IN MEDICAL MALL 343008 C INVESTMENT IN UMCSC 300000 C INVESTMENT IN MERCY SENIOR HOUSING 3285430 C INVESTMENT IN US RENAL CARE 4349000 C INVESTMENT IN MERCY SURGERY CENTER 2771142 C 144709184 INTEREST RATE SWAP AGREEMENTS 2147077 PENSION LIABILITY 9148232 SELF INSURANCE RESERVES 9700457 THIRD PARTY SETTLEMENTS 2618757 23614523 X 427817161 -907223 -10419421 -11326644 439143805 -3438498 -3438498 435705307 444490628 2603919 2603919 441886709 14148720 14148720 456035429 PART III, LINE 1A: THE ORGANIZATION HAS A SMALL COLLECTION OF ARTWORK. THE COLLECTION IS ON DISPLAY FOR PUBLIC VIEWING. THE MEDICAL CENTER HAS ELECTED NOT TO CAPITALIZE THEIR COLLECTION AS PERMITTED BY STATEMENT OF FINANCIAL ACCOUNTING STANDARDS (SFAS) NO. 116, ACCOUNTING FOR CONTRIBUTIONS RECEIVED AND CONTRIBUTIONS MADE. THE MEDICAL CENTER'S COLLECTIONS THAT HAVE BEEN DONATED ARE NOT RECOGNIZED AS ASSETS ON THE BALANCE SHEETS. NONE OF THE ARTWORK HAS BEEN SOLD TO RAISE FUNDS. PART V, LINE 4: MERCY HOSPITAL, CEDAR RAPIDS, IA ENDOWMENT FOUNDATION, INC., A RELATED ORGANIZATION, HOLDS THE ENDOWMENT FUNDS. THE FOUNDATION'S ENDOWMENT FUNDS ARE USED FOR THE HALL-PERRINE CANCER CENTER AND CANCER CENTER PROGRAMS, HALL RADIATION CENTER, OLDORF HOSPICE HOUSE, HOSPICE OF MERCY PROGRAMS, HALLMAR, WATTS LIBRARY, CAREGIVERS CENTER, ESPECIALLY FOR YOU RACE AGAINST BREAST CANCER, MERCY MEDICAL CENTER OPERATING AND CAPITAL PROJECTS, AND GENERAL ENDOWMENT FUNDS TO BE USED AT THE BOARD OF DIRECTOR'S DISCRETION. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HOSPITALS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX EXEMPT STATUS OF BONDS ISSUED BY THE OBLIGATED GROUP, THE NATURE, THE CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2023 AND 2022, THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990 AND 990T FILED BY THE HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. PART XI, LINE 2D - OTHER ADJUSTMENTS: GRANT TO MERCYARE SERVICE CORPORATION INCLUDED WITH REVENUES -13,300,000. CHANGE IN INTEREST IN FOUNDATION RECORDED AS REVENUE FOR AUDIT -6,008,614. CONTRIBUTION INCLUDED IN CHANGE IN NET ASSETS -839,749. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 1,700,724. CHANGE IN UNRECOGNIZED FUNDED STATUS OF RETIREMENT PLAN 8,028,218. PART XI, LINE 4B - OTHER ADJUSTMENTS: CAFETERIA COST OF GOODS SOLD NETTED WITH REVENUES -2,603,919. GAIN ON SALE OF ASSETS 9,803. BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME(LOSS) -886,364. AUXILIARY REVENUE NOT INCLUDED IN AUDIT REPORT 42,814. REVENUE INCLUDED WITH EXPENSES ON AUDIT REPORT -832. PART XII, LINE 2D - OTHER ADJUSTMENTS: CAFETERIA COST OF GOODS SOLD NETTED WITH REVENUES 2,603,919. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANT TO MERCYCARE SERVICE CORPORATION INCLUDED WITH REVENUES 13,300,000. GAIN ON SALE OF FIXED ASSETS 9,803. REVENUES INCLUDED WITH EXPENSES ON AUDIT REPORT -832. CONTRIBUTION INCLUDED IN CHANGE IN NET ASSETS 839,749. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 87941112 0 0 0 0 0 0 87941112 0 87941112 1 0 1 1 1 0 PART III ACCOUNTING METHOD: 1 1 X 1 X 1 X 1 1 0 1 1 69422492 47818574 21603918 0.04740 50199567 34015100 16184467 0.03550 119622059 81833674 37788385 0.08290 315926 315926 0.00070 217165 938745 0 0.00000 4247794 7133615 0 0.00000 308358 208886 99472 0.00020 5089243 8281246 415398 0.00090 124711302 90114920 38203783 0.08380 177074 177074 0.00040 36763 36763 0.00010 213837 213837 0.00050 1 5435359 173953438 212162523 -38209085 X 1 1 1 MR ASSOCIATES LLP MRI SERVICES 0.33000 0.00000 0.33000 2 EASTERN IOWA SLEEP CENTER LLC SLEEP STUDIES 0.33000 0.00000 0.33000 3 CEDAR RAPIDS PHYSICIANS-HOSP ORG LC (DBA PARAMOUNT HEALTH OPTIONS) PAYOR CONTRACTING 0.53000 0.00000 0.47000 4 PCI REGIONAL MED MALL LLC MEDICAL SERVICES 0.10000 0.00000 0.80000 5 MERCY SURGERY CENTER AMBULATORY SURGERY CENTER 0.60000 0.00000 0.40000 1 1 MERCY MEDICAL CENTER 701 10TH STREET SE CEDAR RAPIDS IA 52403 WWW.MERCYCARE.ORG 570036H X X X MERCY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE PART V X 1 21 1 SEE PART V 0 1 X 200.000000000000 400.000000000000 X 1 1 X X X 1 X HTTPS://WWW.MERCYCARE.ORG/FINANCIAL-ASSISTANCE-POLICY X HTTPS://WWW.MERCYCARE.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.MERCYCARE.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 MERCY MEDICAL CENTER PART V, SECTION B, LINE 5: THE 2021 ITERATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS FACILITATED BY LINN COUNTY PUBLIC HEALTH WITH OVERSIGHT PROVIDED BY THE TOGETHER! HEALTHY LINN STEERING COMMITTEE. THE CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) INCLUDE PARTNERSHIPS WITH A MULTITUDE OF COMMUNITY STAKEHOLDERS, INCLUDING MERCY MEDICAL CENTER, UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL, AND EASTERN IOWA HEALTH CENTER. THE ALIGNMENT OF THE CHA AND CHIP FOR ALL FOUR ENTITIES IN LINN COUNTY MINIMIZES DUPLICATION AND MAXIMIZES IMPACT, AS ALL AFOREMENTIONED ORGANIZATIONS ARE REQUIRED UNDER LAW, OR BY FUNDERS, TO ASSESS THE HEALTH OF THE COMMUNITY AND DEVELOP AN IMPLEMENTATION PLAN FOR MEETING IDENTIFIED COMMUNITY NEEDS.THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONSISTS OF THE FOLLOWING PARTNERS: ABBEHEALTH, BETHANY LUTHERAN CHURCH, CEDAR RAPIDS CITY COUNCIL, CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT, CITY OF CEDAR RAPIDS, CITY OF MARION POLICE DEPARTMENT, EASTERN IOWA HEALTH CENTER, GREATER CEDAR RAPIDS COMMUNITY FOUNDATION, IOWA STATE UNIVERSITY EXTENSION & OUTREACH, KIRKWOOD COMMUNITY COLLEGE, LINN COUNTY BOARD OF SUPERVISORS, LINN COUNTY PUBLIC HEALTH, MERCY MEDICAL CENTER, STATE OF IOWA REPRESENTATIVE, STATE OF IOWA SENATOR, UNITED WAY OF EAST CENTRAL IOWA, AND UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL.IN ADDITION, MERCY MEDICAL CENTER CONTACTED THE SECONDARY SERVICE AREA PUBLIC HEALTH DEPARTMENTS TO BETTER UNDERSTAND THEIR COUNTY'S NEEDS THROUGH UTILIZING THEIR MOST RECENT CHNA.THE TOGETHER! HEALTHY LINN COLLABORATIVE USES THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) FRAMEWORK TO GUIDE THE CHA AND CHIP PROCESS. MAPP IS A NATIONALLY RECOGNIZED FRAMEWORK FOR CONDUCTING COMMUNITY-WIDE STRATEGIC PLANNING TO IMPROVE COMMUNITY HEALTH. THIS FRAMEWORK BALANCES QUANTITATIVE DATA ABOUT HEALTH TRENDS WITH THE EXPERIENCES OF COMMUNITY MEMBERS AND INSIGHT FROM CONTENT EXPERTS IN THE AGENCIES WITHIN THE LOCAL PUBLIC HEALTH SYSTEM. MAPP CURRENTLY CONSISTS OF SIX PHASES AND EMPHASIZES SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY AS KEY FACTORS THAT INFLUENCE THE OVERALL HEALTH OF THE COMMUNITY.THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) IS A QUANTITATIVE ANALYSIS THAT ANSWERS THE QUESTIONS, "HOW HEALTHY IS OUR COMMUNITY? AND "WHAT DOES THE HEALTH STATUS OF OUR COMMUNITY LOOK LIKE?" RESULTS OF THE CHSA PROVIDE AN UNDERSTANDING OF THE COMMUNITY'S HEALTH STATUS AND ENSURE THAT THE COMMUNITY'S PRIORITIES CONSIDER SPECIFIC HEALTH STATUS ISSUES, SUCH AS RATES OF INCREASING CHRONIC DISEASE, SEXUALLY TRANSMITTED INFECTIONS, AND HEALTH INEQUITIES.LINN COUNTY CONDUCTED THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) BETWEEN MAY AND NOVEMBER OF 2021. THE CTSA IS A QUALITATIVE ANALYSIS OF PERCEPTIONS, THOUGHTS, AND OPINIONS COMMUNITY MEMBERS HAVE REGARDING HEALTH. OF PARTICULAR INTEREST WAS IDENTIFYING NEEDS OF THE COMMUNITY, PERCEIVED QUALITY OF LIFE, AND ASSETS AVAILABLE THAT MAY BE USED TO IMPROVE COMMUNITY HEALTH. THE ASSESSMENT PROCESS WAS GUIDED BY A CTSA SUBCOMMITTEE WITH REPRESENTATION FROM MULTIPLE ENTITIES AND ORGANIZATIONS WITHIN THE LOCAL PUBLIC HEALTH SYSTEM AND IS ASSOCIATED WITH THE LARGER TOGETHER! HEALTHY LINN STEERING COMMITTEE. THE TARGET AUDIENCE FOR THIS ASSESSMENT IS COMMUNITY MEMBERS WHO WORK, RESIDE, WORSHIP, GO TO SCHOOL, OR SEEK ENTERTAINMENT IN LINN COUNTY. AN INITIAL SUBCOMMITTEE MEETING WAS HELD ON OCTOBER 15, 2020, TO PLAN THE ASSESSMENT. OVERALL, IT WAS DECIDED THAT THE ASSESSMENT SHOULD HAVE A GREATER EMPHASIS ON UNDERLYING FACTORS OF POOR HEALTH RATHER THAN A FOCUS ON HEALTH CONDITIONS, AS WELL AS A NEED TO REACH THOSE PREVIOUSLY MISSED THROUGH TRADITIONAL SURVEYING. THE GROUP DECIDED TO MOVE FORWARD WITH DEVELOPING A COMMUNITY HEALTH SURVEY AS THE PRIMARY METHOD FOR COLLECTING COMMUNITY INPUT, STICKER BOARDS FOR QUICKLY ENGAGING COMMUNITY MEMBERS IN COMMON SPACES WHERE SOCIAL DISTANCING COULD STILL OCCUR AND FOCUS GROUPS TO TARGET POPULATIONS NOT CAPTURED THROUGH THE BROADER SURVEY. IN ADDITION, THE ASSESSMENT INCLUDED TARGETED QUESTIONS EVALUATING THE CURRENT HEALTH PRIORITIES THAT WERE SELECTED IN THE 2019-2023 CHIP INCLUDING MENTAL HEALTH, OBESITY, AND COMMUNITY SAFETY. THIS WILL HELP THE TOGETHER! HEALTHY LINN COLLABORATIVE DIG DEEPER INTO THESE ISSUES AS WELL AS IDENTIFY THE NEED FOR CONTINUED PRIORITIZATION.ASSESSMENT ACTIVITIES TOOK PLACE BETWEEN MAY AND DECEMBER OF 2021. AFTER PRELIMINARY ASSESSMENT OF THE SURVEY RESULTS, POPULATIONS THAT WERE UNDERREPRESENTED IN THE SURVEY WERE IDENTIFIED, INCLUDING THOSE 65 YEARS AND OLDER, IMMIGRANT/REFUGEES, COMMUNITIES OF COLOR, LOW TO MIDDLE INCOME, AND RURAL RESIDENTS. THROUGH AN IDENTIFIED NEED TO HOLD FOCUS GROUPS, THE MAPP CORE TEAM COLLABORATED WITH THE COMMUNITY IMPACT ASSESSMENT TEAM FROM UNITED WAY TO HOLD JOINT FOCUS GROUPS. OVERALL, THREE FOCUS GROUPS AND ONE INFORMANT INTERVIEW WAS HELD TO GAIN ADDITIONAL INFORMATION FROM THE UNDERREPRESENTED POPULATIONS. FOCUS GROUPS INCLUDED MEMBERS FROM THE YOUNG PARENTS NETWORK, NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE (NAACP), AND THE AFRICAN AMERICAN MEN'S GROUP. AN ADDITIONAL INFORMANT INTERVIEW WAS CONDUCTED WITH LEADERSHIP FROM UNITED WE MARCH FORWARD, TO CAPTURE THE NEEDS AND PERSPECTIVES OF IMMIGRANT AND REFUGEE RESIDENTS. DATA OBTAINED THROUGH THIS COMPREHENSIVE COMMUNITY ASSESSMENT WERE SYNTHESIZED INTO A SINGLE REPORT AND BROKEN DOWN INTO LOGICAL CATEGORIES TO RELAY ASSESSMENT FINDINGS. THE 2021 COMMUNITY HEALTH ASSESSMENT IDENTIFIED MENTAL HEALTH, LIFESTYLE BARRIERS, INCLUDING ACCESS TO FOOD AND EQUITABLE OPPORTUNITIES TO BE ACTIVE; COMMUNITY SAFETY; SAFE AND AFFORDABLE HOUSING; ACCESS TO HEALTHCARE; CHRONIC DISEASE; SEXUALLY TRANSMITTED INFECTIONS; AND SUBSTANCE USE. SINCE THE DEVELOPMENT OF THE 2019-2021 CHIP, LINN COUNTY HAS EXPERIENCED SIGNIFICANT CHANGES; INCREASED LEVELS OF STRESS, ANXIETY, DEPRESSION, AND SUICIDAL IDEATION WERE DESCRIBED FOLLOWING THE ONSET OF THE COVID-19 PANDEMIC AND THE 2020 DERECHO. LIKEWISE, THESE EVENTS EXACERBATED THE ACCESSIBILITY OF HEALTHY AND AFFORDABLE FOODS, PARTICULARLY FOR MIDDLE TO LOW-INCOME RESIDENTS, AND THE DERECHO PLACED AN EMPHASIS ON AN ALREADY STRUGGLING SYSTEM OF SAFE AND AFFORDABLE HOUSING.DURING THE LAST ROUND OF THE CHA IN 2018, THE TOGETHER! HEALTHY LINN STEERING COMMITTEE USED A SERIES OF PRIORITIZATION TOOLS IN COMBINATION WITH DATA REFLECTION; ASSET AND COMMUNITY MAPPING; SMALL AND LARGE GROUP DISCUSSION; AND AN AGREED UPON SET OF PRIORITIZATION CRITERIA TO DETERMINE WHICH THREE ISSUES NEEDED TO BE ADDRESSED BEFORE THE COMMUNITY VISION COULD BE REALIZED. THE STEERING COMMITTEE WAS LIMITED TO THE TOP THREE ISSUES TO MAINTAIN A REALISTIC, FOCUSED SCOPE OF WORK. THE PRIORITIZATION CRITERIA FOR STRATEGIC ISSUES WERE: -THE ISSUE IS DATA DRIVEN, APPEARING IN TWO OR MORE OF THE ASSESSMENTS -ADDRESSING THE ISSUE REQUIRES A COLLABORATIVE, MULTI-SECTOR APPROACH -ALIGNMENT WITH THE TOGETHER! HEALTHY LINN VISION -ASSETS ARE AVAILABLE WITHIN THE LOCAL PUBLIC HEALTH SYSTEM TO AFFECT THE ISSUE -THE ISSUE REFLECTS A NEED THAT TOGETHER! HEALTHY LINN CAN INFLUENCE THE SIZE AND SIGNIFICANCE OF THE ISSUE HAS SIGNIFICANT IMPACTAT THE END OF THIS PRIORITIZATION SESSION, THREE BROAD ISSUES WERE IDENTIFIED IN RANK ORDER: MENTAL HEALTH, OBESITY, AND SAFETY. USING DATA FROM THE MID-CYCLE ASSESSMENT CONDUCTED IN 2021, THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONVENED ON MARCH 10, 2022, TO REVIEW RESULTS OF THE ASSESSMENT AND EVALUATE WHAT ADJUSTMENTS, IF ANY, SHOULD BE APPLIED TO THE EXTENDED 2019-2023 COMMUNITY HEALTH IMPROVEMENT PLAN. FOLLOWING REVIEW OF THE ASSESSMENT FINDINGS, THE MAPP CORE TEAM PRESENTED SOME RECOMMENDATIONS FOR THE STEERING COMMITTEE TO CONSIDER FOR MODIFICATIONS, INCLUDING EXTENDING THE 2019-2021 PLAN TO 2023; HONE IN ON THE UNDERLYING FACTORS DRIVING THE ISSUES OF OBESITY AND SAFETY; GATHER ADDITIONAL DATA TO TARGET PLANNED STRATEGIES, POPULATIONS IMPACTED AND GEOGRAPHIC LOCATION; AND MAKE MODIFICATIONS TO THE PLAN BASED ON THE ADDITIONAL DATA FINDINGS. RECOMMENDATIONS WERE UNANIMOUSLY ACCEPTED FOR CONTINUATION AND ADJUSTMENT OF THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIZED SIGNIFICANT NEEDS FOR THE 2021 LINN COUNTY CHA ARE MENTAL HEALTH, LIFESTYLE BARRIERS (INCLUDING ACCESS TO FOOD AND OPPORTUNITIES TO BE ACTIVE), COMMUNITY SAFETY, AND SAFE AND AFFORDABLE HOUSING. MERCY MEDICAL CENTER PART V, SECTION B, LINE 6A: LINN COUNTY PUBLIC HEALTH FACILITATED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL AND MERCY MEDICAL CENTER. BOTH HOSPITALS ARE LOCATED IN CEDAR RAPIDS, IA. MERCY MEDICAL CENTER PART V, SECTION B, LINE 6B: THE 2021 ITERATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS FACILITATED BY LINN COUNTY PUBLIC HEALTH WITH OVERSIGHT PROVIDED BY THE TOGETHER! HEALTHY LINN STEERING COMMITTEE. THE CHA AND CHIP INCLUDE PARTNERSHIPS WITH A MULTITUDE OF COMMUNITY STAKEHOLDERS, INCLUDING MERCY MEDICAL CENTER, UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL, AND EASTERN IOWA HEALTH CENTER. THE TOGETHER! HEALTHY LINN STEERING COMMITTEE CONSISTS OF THE FOLLOWING PARTNERS: ABBEHEALTH, BETHANY LUTHERAN CHURCH, CEDAR RAPIDS CITY COUNCIL, CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT, CITY OF CEDAR RAPIDS, CITY OF MARION POLICE DEPARTMENT, EASTERN IOWA HEALTH CENTER, GREATER CEDAR RAPIDS COMMUNITY FOUNDATION, IOWA STATE UNIVERSITY EXTENSION & OUTREACH, KIRKWOOD COMMUNITY COLLEGE, LINN COUNTY BOARD OF SUPERVISORS, LINN COUNTY PUBLIC HEALTH, MERCY MEDICAL CENTER, STATE OF IOWA REPRESENTATIVE, STATE OF IOWA SENATOR, UNITED WAY OF EAST CENTRAL IOWA, AND UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL.ADDITIONALLY, MERCY MEDICAL CENTER REQUESTED INPUT FROM THE PUBLIC HEALTH DEPARTMENTS OF BENTON, BUCHANAN, CEDAR, DELAWARE, IOWA, JOHNSON, JONES, AND TAMA COUNTIES REGARDING HEALTH PRIORITIES IN THEIR AREA. MERCY MEDICAL CENTER PART V, SECTION B, LINE 11: MERCY MEDICAL CENTER IS ADDRESSING THE FOUR PRIORITIZED SIGNIFICANT NEEDS IDENTIFIED IN THE 2021 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN A VARIETY OF WAYS. MERCY MEDICAL CENTER IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF MENTAL HEALTH BY EXPLORING OPTIONS FOR MORE PSYCHIATRIC CONSULTATIVE ROLES WITHIN MERCYCARE CLINICS, PROVIDING AREA SCHOOL DISTRICTS WITH MENTAL HEALTH SERVICES, OFFERING TELEHEALTH MENTAL HEALTH APPOINTMENTS, PARTICIPATING IN THE STEERING COMMITTEE OF THE LINN COUNTY MENTAL HEALTH ACCESS CENTER, INCREASING EARLY INTERVENTION SERVICES FOR SUICIDE THROUGH A SCREENING TOOL AND CREATION OF SAFETY PLAN/INTERVENTIONS AND PROVIDING SCREENING, ONGOING SUPPORT, AND TREATMENT AT SEDLACEK TREATMENT CENTER.MERCY IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF FOOD INSECURITY BY PROVIDING NUTRITION EDUCATION AND COUNSELING, PROVIDING A WELLNESS PROGRAM FOR EMPLOYEES, PURCHASING AND OFFERING LOCAL FRESH PRODUCE FOR PATIENTS, VISITORS AND STAFF, SCREENING PATIENTS FOR FOOD INSECURITY AND PARTNERING WITH HACAP FOOD RESERVOIR TO PROVIDE SHORT AND LONG TERM SUPPORTS, PROVIDING FOOD RESOURCES AT CATHERINE'S CUPBOARD FOR EMPLOYEES AND VOLUNTEERS, AND PROVIDING IN-KIND SPACE TO METRO CATHOLIC OUTREACH, A FOOD PANTRY IN ONE OF MERCY'S BUILDINGS FOR $1 RENT/YEAR. MERCY IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF COMMUNITY SAFETY BY ENHANCING MERCY'S ANTI-HUMAN TRAFFICKING EFFORTS, PARTICIPATING IN COMMUNITY EFFORTS TO REDUCE GUN VIOLENCE, INCLUDING RESTORATIVE JUSTICE PROGRAMMING AT A LOCAL SCHOOL, ASSESSING PATIENTS FOR ABUSE OR ASSAULT AND CONNECTING TO COMMUNITY RESOURCES, IMPLEMENTING PHYSICAL ENVIRONMENT SAFETY IMPROVEMENTS HOSPITAL-WIDE, AND OFFERING TRAINING RELATED TO SAFETY BOTH INTERNALLY AND EXTERNALLY TO MERCY MEDICAL CENTER. MERCY IS ADDRESSING THE SIGNIFICANT HEALTH NEED OF SAFE AND AFFORDABLE HOUSING THROUGH PARTICIPATING IN COMMUNITY INITIATIVES FOCUSED ON AFFORDABLE HOUSING AND EXPLORING OPTIONS TO FURTHER SUPPORT THESE EFFORTS. ADDITIONALLY, MERCY IS SCREENING FOR HOUSING NEEDS AND PARTNERING WITH COMMUNITY-BASED ORGANIZATIONS TO PROVIDE HOUSING ASSISTANCE. WHEN APPROPRIATE, MERCY OCCUPATIONAL THERAPY DEPARTMENTS COMPLETES A SAFETY ASSESSMENT AT HOME FOR PATIENTS. HISTORICALLY, MERCY HAS INCREASED ACCESS TO AND PROVIDED SUPPORT OF AFFORDABLE HOUSING COMMUNITY DEVELOPMENT INITIATIVES, INCLUDING THE PROCUREMENT OF PROPERTY AND/OR PROVIDING FINANCIAL ASSISTANCE IN THE DEVELOPMENT OF LOW-INCOME HOUSING. MERCY MEDICAL CENTER DESCRIBES IN ITS MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY HOW IT IS ADDRESSING OTHER NEEDS IDENTIFIED IN THE CHNA. THESE INCLUDE ACCESS TO HEALTH CARE, A CHRONIC DISEASE, NATURAL ENVIRONMENT, SEXUAL HEALTH, SUBSTANCE USE, AND TRANSPORTATION. MERCY MEDICAL CENTER PART V, SECTION B, LINE 13B: PATIENTS THAT EXCEED 400% OF FPL TABLE ARE ELIGIBLE FOR DISCOUNTS ON ALL BALANCES IN EXCESS OF 10% OF GROSS PERSONAL EARNINGS PER CALENDAR YEAR. SCHEDULE H, PART V, SECTION B, LINE 5, CONTINUED: FOR THE FULL COMMUNITY HEALTH ASSESSMENT REPORTS PREPARED BY LINN COUNTY PUBLIC HEALTH, PLEASE VISIT: HTTP://WWW.LINNCOUNTY.ORG/613/REPORTS-AND-PUBLICATIONS. MERCY MEDICAL CENTER DID NOT RECEIVE ANY WRITTEN COMMENTS ON THE HOSPITAL FACILITY'S MOST RECENTLY CONDUCTED CHNA OR IMPLEMENTATION STRATEGY. HOWEVER, ON THE CHNA AND IMPLEMENTATION STRATEGY WEBPAGE OF THE MERCY WEBSITE, THERE IS A "QUESTIONS?" FORM THAT CAN BE FILLED OUT BY ANY INDIVIDUAL. THE SUBMITTED ONLINE FORM GOES TO MERCY'S MARKETING DEPARTMENT AND WOULD BE FORWARDED TO MERCY'S COMMUNITY BENEFIT OFFICE. ANY MAILED WRITTEN COMMENTS WOULD BE FORWARDED TO THE COMMUNITY BENEFIT OFFICE. SCHEDULE H, PART V, SECTION B, LINE 7A: HTTPS://WWW.MERCYCARE.ORG/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART V, SECTION B, LINE 10A: HTTPS://WWW.MERCYCARE.ORG/ABOUT/COMMUNITY-BENEFIT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART I, LINE 3C: DISCOUNTED CARE IS AVAILABLE TO ALL MERCY MEDICAL CENTER PATIENTS WHO DO NOT HAVE ACTIVE MEDICAL INSURANCE COVERAGE, NOT JUST THOSE WITHIN A FEDERAL POVERTY GUIDELINE FAMILY INCOME LIMIT. IF PATIENTS STILL FIND THEMSELVES UNABLE TO PAY, THEY MAY APPLY FOR ADDITIONAL FINANCIAL ASSISTANCE. PART I, LINE 6A: NOT APPLICABLE PART I, LINE 7: MERCY MEDICAL CENTER UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO, AND THIS RATIO WAS USED IN COMPUTING THE INFORMATION REPORTED IN PART I, LINE 7. PART I, LINE 7G: NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC WERE REPORTED IN SUBSIDIZED HEALTH SERVICES. PART I, LN 7 COL(F): BAD DEBT EXPENSE WAS NOT INCLUDED IN THE DENOMINATOR BECAUSE IT WAS REPORTED ON LINE 2D OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 27.35%. THIS PERCENTAGE INCREASES TO 73.87% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN THE TOTAL COMMUNTY BENEFIT EXPENSE. PART II, COMMUNITY BUILDING ACTIVITIES: MERCY MEDICAL CENTER PARTICIPATED IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTED THE HEALTH OF THE COMMUNITIES MERCY SERVES. THIS INCLUDED MERCY STAFF REPRESENTATION ON COALITIONS, COMMITTEES, AND BOARDS SUCH AS BIG BROTHERS BIG SISTERS OF CEDAR RAPIDS. MERCY MADE CASH CONTRIBUTIONS TO NON-PROFIT ORGANIZATIONS THAT SUPPORT COMMUNITY-BUILDING EFFORTS THROUGH THEIR MENTOR, EDUCATIONAL, OR AFTER SCHOOL PROGRAMMING FOR YOUTH. PART III, LINE 2: THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS REVENUE IN THE AUDITED FINANCIAL STATEMENTS. THEREFORE, NO BAD DEBT EXPENSE IS RECOGNIZED FOR UNCOLLECTED AMOUNTS ON PATIENT ACCOUNTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PART III, LINE 3: NOT APPLICABLE PART III, LINE 4: SEE PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE. PART III, LINE 8: THE COSTS SHOWN FOR THE MEDICARE SHORTFALL ARE BASED ON TOTAL CHARGES OF ALL MEDICARE AND MEDICARE REPLACEMENT (PART C) PATIENTS. THE SHORTFALL IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES BY THE COST TO CHARGE RATIO CALCULATED ON WORKSHEET 2, LESS PAYMENTS WE RECEIVED FOR THESE SERVICES.THE MEDICARE COST REPORT IS NOT AN APPROPRIATE SOURCE TO DETERMINE THE COSTS FOR THESE PATIENTS. MANY ITEMS, INCLUDING ALL OUTPATIENT SERVICES FOR PATIENTS WHO ARE COVERED BY A MEDICARE REPLACEMENT PLAN (PART C) AND MANY SERVICES SUCH AS LABORATORY, PHYSICAL AND OCCUPATIONAL THERAPY, AND OTHERS PAID ON A FEE FOR SERVICE BASIS, ARE NOT INCLUDED ON THE MEDICARE COST REPORT. IN ADDITION, HOSPICE, HOME HEALTH, AND DIALYSIS SERVICES, ALTHOUGH INCLUDED IN MEDICARE COST REPORT, DO NOT SHOW THE COSTS AND PAYMENTS ASSOCIATED WITH THESE SERVICES FOR MEDICARE BENEFICIARIES. FOR MERCY MEDICAL CENTER, THE VAST MAJORITY OF OUR GROSS CHARGES ARE GENERATED BY PATIENTS WITH MEDICARE AND MEDICARE REPLACEMENT (PART C) COVERAGE OR MEDICAID. NEITHER GOVERNMENT PROGRAM HAS HISTORICALLY REIMBURSED ENOUGH TO COVER THE COSTS OF THE SERVICES PROVIDED TO THESE PATIENTS. IF WE DID NOT SERVE THESE PATIENT POPULATIONS, ANOTHER FACILITY WOULD HAVE TO PROVIDE THE SERVICE. PART III, LINE 9B: MERCY MEDICAL CENTER UNDERSTANDS PATIENTS MAY NOT HAVE THE ABILITY TO PAY FOR SERVICES NOR RECOGNIZE THE OPPORTUNITY THEY MAY HAVE TO RECEIVE FINANCIAL ASSISTANCE. TO AID IN THIS PROCESS, MERCY MEDICAL CENTER HAS IMPLEMENTED A PRESUMPTIVE CHARITY ELIGIBILITY PROGRAM (PCEP). PATIENTS WHO QUALIFY FOR THIS PROGRAM DO NOT COMPLETE PAPERWORK. MERCY MEDICAL CENTER UTILIZES AN OUTSIDE VENDOR TO ASSIST IN DETERMINING A PATIENT'S FINANCIAL RISK. MERCY MEDICAL CENTER USES BILLING AND COLLECTION RECOMMENDATIONS FROM THE IOWA HOSPITAL ASSOCIATION. THESE RECOMMENDATIONS INCLUDE: - MERCY MEDICAL CENTER WILL PROVIDE THE SAME INFORMATION CONCERNING SERVICES AND CHARGES TO ALL PATIENTS. - MERCY MEDICAL CENTER WILL NOT KNOWINGLY SEND A PATIENT'S BILL TO A COLLECTION AGENCY BEFORE INITIAL FINANCIAL ELIGIBILITY ASSISTANCE DETERMINATION HAS BEEN MADE. - MERCY MEDICAL CENTER WILL REVIEW THE PATIENT'S RECORD TO DETERMINE IF REASONABLE EFFORTS WERE UNDERTAKEN TO ENSURE THAT FINANCIAL ASSISTANCE WAS OFFERED AND/OR IF FINANCIAL ASSISTANCE IS APPROPRIATE BEFORE ANY COLLECTION AGENCY ASSIGNMENT. PART VI, LINE 2: MERCY MEDICAL CENTER UNDERSTANDS THE NEED FOR ONGOING ASSESSMENT AND USES DATA AND INFORMATION OBTAINED FROM COMPLETED SOCIAL DETERMINANT OF HEALTH SCREENINGS ON PATIENTS, THE COMMUNITY FREE CLINICS, COMMUNITY COALITIONS, COMMUNITY-BASED ORGANIZATIONS, AND THE LOCAL PUBLIC HEALTH DEPARTMENTS TO MODIFY CURRENT ACTIVITIES AND CREATE INNOVATIVE PROGRAMS TO ADDRESS HEALTH NEEDS. ADDITIONALLY, MERCY MEDICAL CENTER RECEIVES REQUESTS FROM LOCAL NON-PROFIT ORGANIZATIONS FOR FINANCIAL AND IN-KIND SUPPORT TO ADDRESS COMMUNITY NEEDS FOR WHICH THEY PROVIDE PROGRAMS AND SERVICES. MERCY MEDICAL CENTER UTILIZES ALL THIS INFORMATION, IN ADDITION TO THE CHNA TO COMPLETE A COMMUNITY BENEFIT PLAN FOR THE HOSPITAL. PART VI, LINE 3: EDUCATION: MERCY MEDICAL CENTER POSTS SIGNAGE AND PROVIDES BROCHURES REGARDING FINANCIAL ASSISTANCE INFORMATION AT ALL POINTS OF ENTRY. THERE IS A NOTIFICATION ON THE BACK OF ALL STATEMENTS INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE TO ASSIST QUALIFYING PATIENTS. TRAINING: MERCY MEDICAL CENTER HAS EDUCATED AND TRAINED STAFF MEMBERS AT ALL REGISTRATION LOCATIONS ABOUT OUR FINANCIAL ASSISTANCE POLICY AND LISTENING TO INDIVIDUALS THAT MAY NEED ASSISTANCE. OUR EMERGENCY DEPARTMENT STAFF IS TRAINED ON MEDICAID APPLICATIONS. MERCY HAS HIRED PATIENT MATTERS TO ASSIST PATIENTS WITH THE MEDICAID APPLICATION PROCESS. PATIENT MATTERS AND OUR FINANCIAL ADVOCATE TEAM KEEP IN COMMUNICATION TO ENSURE PATIENT NEEDS ARE MET. PART VI, LINE 4: MERCY MEDICAL CENTER SERVES A PRIMARY SERVICE AREA (PSA) OF LINN COUNTY AND A SECONDARY SERVICE AREA (SSA) OF EIGHT COUNTIES (BENTON, BUCHANAN, CEDAR, DELAWARE, IOWA, JOHNSON, JONES AND TAMA). THE MAJORITY OF MERCY'S PATIENTS FOR BOTH INPATIENT AND OUTPATIENT SERVICES LIVE IN LINN COUNTY. THE COMMUNITY ADDITIONALLY INCLUDES THOSE COUNTIES ADJACENT TO LINN COUNTY AND WITHIN A REASONABLE DRIVING TIME TO THE HOSPITAL. THE TOTAL POPULATION OF LINN COUNTY IN 2022 WAS 229,033. THE TOTAL POPULATION OF BOTH PRIMARY AND SECONDARY SERVICE AREAS WAS 522,071. DEMOGRAPHICS FOR THE COMBINED SERVICE AREA ARE AS FOLLOWS: 50.6% MALE, 49.4% FEMALE 92.9% CAUCASIAN 2.6% AFRICAN AMERICAN 1.2% NATIVE AMERICAN 1.6% ASIAN/PACIFIC 1.8% TWO OR MORE RACES 4.1% HISPANIC 19.3% OF PERSONS LIVING IN MERCY'S COMBINED SERVICE AREA ARE AGE 65 OR OLDER 94.0% ARE HIGH SCHOOL GRADUATES WHILE 26.2% HOLD A BACHELOR'S DEGREE OR HIGHER THE MEDIAN HOUSEHOLD INCOME IS $73,142 THE PERCENTAGE OF PEOPLE LIVING BELOW POVERTY LEVEL IS 9.9% AS COMPARED TO 11.0% FOR ALL OF IOWA 11.6% OF MERCY'S PATIENTS USE MEDICAID AND THE NUMBER OF UNINSURED INDIVIDUALS UNDER AGE 65 IN IOWA IS 5.4% ACCORDING TO THE US CENSUS BUREAU THE AVERAGE PERSONS PER HOUSEHOLD ARE 2.44 FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS ARE PRESENT IN BENTON, BUCHANAN, DELAWARE, IOWA, JONES, LINN AND TAMA COUNTIES (HTTPS://DATAWAREHOUSE.HRSA.GOV/TOOLS/ANALYZERS/MUAFIND.ASPX)AS OF DECEMBER 2023, THE UNEMPLOYMENT RATE FOR LINN COUNTY IS 3.0%. THE EIGHT CONTIGUOUS UNEMPLOYMENT RATES RANGE FROM 2.0-4.7%. LINN COUNTY FEATURES A DIVERSE EMPLOYER BASE INCLUDING MANUFACTURING, TRADE, EDUCATION, SERVICE, FINANCE, AND AGRICULTURE.UNITYPOINT HEALTH - ST. LUKE'S HOSPITAL IS IN LINN COUNTY AND SERVES A SIMILAR GEOGRAPHIC SERVICE AREA AS MERCY MEDICAL CENTER. ADDITIONALLY, THE UNIVERSITY OF IOWA AND MERCY IOWA CITY ARE IN JOHNSON COUNTY, REGIONAL MEDICAL CENTER IS IN DELAWARE COUNTY, UNITYPOINT HEALTH - JONES REGIONAL MEDICAL CENTER IS IN JONES COUNTY, AND VIRGINIA GAY HOSPITAL IS IN BENTON COUNTY. PART VI, LINE 5: MERCY MEDICAL CENTER'S BOARD OF TRUSTEES IS MADE UP OF VOLUNTEERS, THE MAJORITY OF WHOM ARE RESIDENTS WITHIN THE PRIMARY SERVICE AREA. THE BOARD CONSISTS OF 24 MEMBERS WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. THE CEO OF THE CORPORATION AND THE PRESIDENT OF THE MEDICAL STAFF ADDITIONALLY SERVE AS EX-OFFICIO, VOTING MEMBERS. IN THE EVENT THAT THE PRESIDENT OF THE MEDICAL STAFF IS ALSO AN EMPLOYEE OF THE ORGANIZATION, HE OR SHE WILL SERVE AS AN EX-OFFICIO, NON-VOTING MEMBER. THE GOVERNANCE STRUCTURE ENSURES THAT COMMUNITY INTERESTS ARE REPRESENTED IN DECISION-MAKING FOR THE ORGANIZATION. IN ADDITION, THREE SEATS ARE ALLOCATED TO WOMEN RELIGIOUS WHO ENSURE THE ORGANIZATION REMAINS TRUE TO ITS CHARITABLE MISSION. THERE ARE CURRENTLY FOUR WOMEN RELIGIOUS SERVING ON THE BOARD.MERCY MEDICAL CENTER MAINTAINS AN OPEN MEDICAL STAFF, AS PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS.MERCY MEDICAL CENTER UTILIZES OPERATING INCOME SURPLUSES TO FUND CAPITAL EXPENDITURES. THE PROPOSED CAPITAL ITEMS ARE REVIEWED BY STAFF, MEDICAL STAFF, AND ADMINISTRATION TO ENSURE ITEMS WILL PROVIDE ONGOING HIGH-QUALITY, LOW-COST CARE TO PATIENTS AND ALIGN WITH THE STRATEGIC INITIATIVES FOR THE FACILITY. ANY EXCESS OPERATING FUNDS RETAINED BY THE ORGANIZATION ARE USED FOR FUTURE CAPITAL IMPROVEMENTS OR OPERATING FUNDS AS NEEDED.MERCY'S MISSION COMPELS US TO PROVIDE ACCESS TO HEALTH CARE AND TO ENHANCE THE HEALTH OF THE COMMUNITY. WITH THE CREATION OF THE HOSPITAL IN 1900, THE SISTERS OF MERCY WERE RESPONDING TO THE NEEDS OF THE COMMUNITY AT THE TIME. WE CONTINUE THEIR LEGACY THROUGH OUR COMMITMENT TO ADVANCE HEALTH EQUITY. THIS COMMITMENT INVOLVES BUILDING RELATIONSHIPS OF TRUST, BETTER UNDERSTANDING THE NEEDS OF OUR PATIENTS AND COMMUNITIES, AND PARTNERING WITH THE COMMUNITY TO ADDRESS THESE NEEDS.IN FALL 2022, MERCY CREATED THE POSITION, DIRECTOR OF HEALTH EQUITY AND COMMUNITY PARTNERSHIPS, TO ENSURE FOCUS ON THIS CRITICAL INITIATIVE. MERCY LAUNCHED THE HEALTH EQUITY COUNCIL, A MULTI-DISCIPLINARY TEAM, AS AN ORGANIZING FORCE TO SUPPORT AND OVERSEE PROJECTS AND EFFORTS RELATED TO MERCY'S HEALTH EQUITY STRATEGIC PLANTHE ESPECIALLY FOR YOU (EFY) RACE AGAINST BREAST CANCER SUPPORTS FREE MAMMOGRAMS, AS WELL AS BREAST-CARE AND GYNECOLOGICAL SERVICES, FOR AREA INDIVIDUALS IN NEED THROUGH THE ESPECIALLY FOR YOU FUND. THE EFY RACE MARKED ITS 32ND YEAR WITH A RACE HELD IN OCT. 2022 WITH 15,800 REGISTRANTS FROM 540 CITIES IN 40 STATES, RAISING MORE THAN $499,500. EFY HOSTED AN AWARENESS AND EDUCATION EVENT ON RACIAL DISPARITIES IN BREAST CANCER IN SEPTEMBER 2022 AT COE COLLEGE.MERCY HAS DEDICATED TEAM MEMBERS WHO ASSIST UNINSURED PATIENTS IN ACCESSING INSURANCE. IN CALENDAR YEAR 2022, SENIOR HEALTH INSURANCE INFORMATION PROGRAM (SHIIP) VOLUNTEERS SERVED 1340 CLIENTS AND SAVED MEDICARE BENEFICIARIES $388,504. MERCY PROVIDED ACCESS TO MEDICAL CARE IN RURAL IOWA, MERCYCARE MOUNT VERNON, MERCYCARE CENTER POINT AND MERCYCARE MONTICELLO OFFER PRIMARY CARE SERVICES. CANCER, HEART, SURGERY, AND UROLOGY SPECIALISTS ALSO TRAVEL TO CLINICS OUTSIDE CEDAR RAPIDS TO CREATE EASIER ACCESS FOR PATIENTS IN MANCHESTER, VINTON, ANAMOSA AND TAMA. MERCY INCREASED THE SCREENING RATES FOR BREAST, COLON, AND LUNG CANCERS WITHIN OUR PATIENT POPULATION.MERCY'S SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM, WHICH IS PART OF THE EMERGENCY DEPARTMENT, STARTED MORE THAN 20 YEARS AGO AS A FREE SERVICE TO CARE FOR AND ASSIST VICTIMS OF SEXUAL ASSAULT. MERCY HAS 14 SPECIALLY TRAINED SANE RNS WHO ARE AVAILABLE 24/7. MERCY'S SANE PROGRAM AVERAGES APPROXIMATELY 45 EXAMS OR 250 HOURS OF CARE TO THESE PATIENTS ANNUALLY. THE FAMILY CAREGIVERS CENTER OF MERCY HAS CONNECTED WITH 1,936 CAREGIVERS, INCLUDING 1,521 FEMALE CAREGIVERS AND 424 MALE CAREGIVERS. OF THESE, 1,149 ARE CARING FOR SOMEONE LIVING WITH DEMENTIA AND 265 ARE CARING FOR SOMEONE WITH MULTIPLE CHRONIC CONDITIONS. THE CENTER ALSO SUPPORTS 875 SPOUSAL CAREGIVERS AND 878 ADULT CHILDREN CARING FOR THEIR PARENTS. THE CENTER HAS TWO LOCATIONS ONE ON MERCY'S MAIN CAMPUS, AS WELL AS ONE IN THE CHRIS & SUZY DEWOLF FAMILY INNOVATION CENTER FOR AGING & DEMENTIA.MERCY EXPANDED SCREENING FOR NONMEDICAL NEEDS SUCH AS FOOD, TRANSPORTATION, HOUSING, AND VIOLENCE TO OUR INPATIENT UNITS, MERCY PEDIATRIC CLINIC, HPCC, AND SOME PRIMARY CARE CLINICS. PATIENTS WHO IDENTIFY AS HAVING A NEED ARE CONNECTED TO RESOURCES WITHIN THE COMMUNITYMERCY CONTINUED ITS COLLABORATION WITH HACAP FOOD RESERVOIR. AS PART OF THIS EFFORT, MERCY PROVIDED A FOOD BOX TO PATIENTS IN NEED AND CONNECTS PATIENTS TO OTHER ASSISTANCE AVAILABLE. MERCY'S HEALTH EQUITY FUND PROVIDED SUPPORT TO EIGHT LOCAL NONPROFIT ORGANIZATIONS WITH INITIATIVES FOCUSED ON ADDRESSING ACCESS TO BEHAVIORAL HEALTH SERVICES, FOOD INSECURITY, AND SAFE AND AFFORDABLE HOUSING. MERCY PROVIDED IN-KIND LAB AND RADIOLOGY SERVICES TO BOTH LOCAL FREE CLINICS AS WELL AS PROVIDERS TO THE COMMUNITY HEALTH FREE CLINIC (CHFC). THE NUMBER OF PATIENTS SEEN BY A MERCY PROVIDER AT CHFC FROM JULY 2022 TO JUNE 2023 WAS 3,337. MERCY FAMILY COUNSELING PARTNERED WITH LINN-MAR AND PRAIRIE SCHOOL DISTRICTS TO PLACE STUDENTS ON THE FAST TRACK TO MENTAL HEALTH SUPPORTS. MERCY OFFERED EPIC TO THE CEDAR RAPIDS COMMUNITY SCHOOL DISTRICT'S METRO CARE CONNECTION SCHOOL-BASED HEALTH CENTERS AND THE COMMUNITY HEALTH FREE CLINIC, AND THE EPIC TRAINING ENVIRONMENT TO KIRKWOOD COMMUNITY COLLEGE FOR THEIR NURSING PROGRAMS. MERCY PROVIDED IN-KIND SPACE TO SIX NONPROFITS HOUSED IN MERCY'S SR. MARY LAWRENCE COMMUNITY CENTER. SISTER ORGANIZATIONS MOUNT MERCY UNIVERSITY, THE CATHERINE MCAULEY CENTER AND MERCY CONTINUED THE TRADITION OF SPREADING MERCY IN OUR COMMUNITY WITH CIRCLE THE CITY WITH MERCY - A ONE-DAY COMMUNITY SERVICE PROJECT. IN JULY 2022, MEMBERS OF EACH ORGANIZATION WORKED WITH TAKE AWAY HUNGER TO PUT TOGETHER 16,000 MEAL KITS. THE FOOD WAS GIVEN TO LOCAL FAMILIES IN NEED. TWENTY-SIX MERCY STAFF MEMBERS PARTICIPATED IN UNITED WAY OF EAST CENTRAL IOWA'S DAY OF CARING IN MAY 2023. MERCY VOLUNTEERS HELPED COMMUNITY ORGANIZATIONS WITH FOUR DIFFERENT EFFORTS INCLUDING INSTALLING A RAIN ART PROJECT, PREPARING FOR SUMMER CAMPERS AT CAMP TANAGER, AND PLANTING AND MULCHING AT BEVER PARK AND PRAIRIEWOODS.IN JANUARY 2023, MERCY HOSTED A "HEAD, SHOULDERS, KNEES & TOES" DRIVE IN PARTNERSHIP WITH OLIVET NEIGHBORHOOD MISSION AND THE EASTERN IOWA HEALTH CENTER TO COLLECT ITEMS TO HELP INDIVIDUALS EXPERIENCING HOMELESSNESS IN OUR COMMUNITY GET THROUGH THE WINTER. ALTOGETHER, MERCY STAFF AND VOLUNTEERS DONATED FOUR LINEN CARTS OF WINTER GEAR.EACH YEAR, MERCY CAREGIVERS MAKE DONATIONS TO LOCAL ORGANIZATIONS THROUGH MERCY'S JOYFUL GIVING CAMPAIGN. THIS YEAR, MERCY EMPLOYEES DONATED MORE THAN $131,501 TO THE CATHERINE MCAULEY CENTER, MERCY MEDICAL CENTER FOUNDATION, UNITED WAY OF EAST CENTRAL IOWA, AND VARIETY. DURING MISSION WEEK, MERCY STAFF DONATED FOUR LINEN CARTS AND TEN FLAT BEDS FULL OF SUPPLIES, AS WELL AS $645 IN MONETARY DONATIONS TO ST. JOHN OF THE CROSS CATHOLIC WORKER HOUSE, WAYPOINT, AND WILLIS DADY HOMELESS SERVICES. THIS INCLUDED ITEMS THAT EACH OF THE SHELTERS RELY ON HEAVILY TO HELP THEIR CLIENTS LIVE EACH DAY. ITEMS INCLUDED TOILET PAPER, PAPER TOWELS, CLEANING SUPPLIES, HYGIENE PRODUCTS, LAUNDRY SOAP, AND BEDDING. IN DECEMBER 2022, MERCY STAFF MEMBERS RANG THE BELL FOR THE SALVATION ARMY KETTLE CAMPAIGN. IN AUGUST 2022, HALL-PERRINE CANCER CENTER PROVIDED 58 BACKPACKS FULL OF SCHOOL SUPPLIES TO KIDS TOUCHED BY CANCER AND PROVIDED 160 THANKSGIVING BASKETS IN NOVEMBER 2022 FOR COMMUNITY MEMBERS FIGHTING CANCER.MERCY MEDICAL CENTER PROVIDES REPRESENTATION ON COMMUNITY BOARDS, COALITIONS AND COMMITTEES ADDRESSING HEALTH NEEDS. EXAMPLES INCLUDE: - COMMUNITY HEALTH FREE CLINIC BOARD - FOUR OAKS - HAWKEYE AREA COMMUNITY ACTION PROGRAM - HERITAGE AREA AGENCY ON AGING - LINN COUNTY COMMUNITY SERVICES BOARDMERCY EMPLOYEES HAVE PARTICIPATED IN THE TRAINING OF HEALTH CARE PROFESSIONS STUDENTS, PROVIDING HEALTH EDUCATION TO THE COMMUNITY, OFFERING SUPPORT OF HEALTH PREVENTION AND PROMOTION ACTIVITIES, THROUGH SCREENINGS AND SUPPORT GROUPS, PROVIDING IN-KIND PRINTING TO MULTIPLE NONPROFITS, AND COORDINATING ACTIVITIES TO SUPPORT LOCAL NONPROFITS. MERCY SUPPORTS THE CEDAR RAPIDS MEDICAL SELF-SUPPORTED MUNICIPAL IMPROVEMENT DISTRICT - THE MEDICAL QUARTER REGIONAL MEDICAL DISTRICT (MEDQUARTER) - TO ENHANCE OUR COMMUNITY'S NATIONALLY RECOGNIZED REPUTATION FOR HIGH-QUALITY, LOW-COST CARE WITH A CONCENTRATED AREA OF MEDICAL SERVICES THAT ARE EASILY ACCESSIBLE. PART VI, LINE 7, REPORTS FILED WITH STATES IA 1 MERCY SERVICE CORPORATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 421199429 501(C)(3) 13300000 0 FOR USE IN CONTINUING OPERATIONS MERCY HOSPITAL CEDAR RAPIDS IA ENDOWMENT FOUNDATION 701 10TH STREET SE CEDAR RAPIDS IA 52403 510233180 501(C)(3) 967344 0 FOR USE IN CONTINUING OPERATIONS LINN COUNTY PUBLIC HEALTH 501 13TH STREET NW CEDAR RAPIDS IA 52405 426004338 LINN COUNTY 10000 0 GENERAL SUPPORT CATHERINE MCAULEY CENTER 1220 5TH AVE SE CEDAR RAPIDS IA 52403 421342872 501(C)(3) 15000 0 GENERAL SUPPORT NEWBO CITY MARKET 1100 3RD ST SE CEDAR RAPIDS IA 52401 270600567 501(C)(3) 25000 0 GENERAL SUPPORT UNITED WAY OF EAST CENTRAL IOWA 317 7TH AVENUE SE STE 401 CEDAR RAPIDS IA 52401 420861239 501(C)(3) 7500 0 GENERAL SUPPORT HORIZONS A FAMILY SERVICE ALLIANCE 819 5TH STREET SE PO BOX 667 CEDAR RAPIDS IA 52406 421135083 501(C)(3) 20000 0 GENERAL SUPPORT FOUR OAKS 5400 KIRKWOOD BLVD SW CEDAR RAPIDS IA 52404 420998726 501(C)(3) 10000 0 GENERAL SUPPORT ORCHESTRA IOWA 119 THIRD AVE SE CEDAR RAPIDS IA 52401 420772544 501(C)(3) 15000 0 GENERAL SUPPORT ARC OF EAST CENTRAL IOWA 680 SECOND ST SE CEDAR RAPIDS IA 52401 420805377 501(C)(3) 20000 0 GENERAL SUPPORT ESPECIALLY FOR YOU RACE AGAINST BREAST CANCER 701 10TH ST SE CEDAR RAPIDS IA 52403 420698295 501(C)(3) 20000 0 GENERAL SUPPORT HACAP (FOOD RESERVOIR RURAL SENIOR SERVICES) 1515 HAWKEYE DR HIAWATHA IA 52233 420898405 501(C)(3) 20000 0 GENERAL SUPPORT ZACH JOHNSON FOUNDATION PO BOX 2336 CEDAR RAPIDS IA 52406 272683100 501(C)(3) 6500 0 GENERAL SUPPORT AREA AMBULANCE SERVICE PO BOX 362 CEDAR RAPIDS IA 52406 203693455 501(C)(3) 20000 0 GENERAL SUPPORT CATHOLIC CHARITIES 1229 MT LORETTA AVE DUBUQUE IA 52003 420680493 501(C)(3) 20000 0 GENERAL SUPPORT FEED IOWA FIRST 1506 10TH STREET SE CEDAR RAPIDS IA 52401 454058376 501(C)(3) 20000 0 GENERAL SUPPORT IOWA LEGAL AID 666 WALNUT STREET 25TH FLOOR DES MOINES IA 50309 421079227 501(C)(3) 12500 0 GENERAL SUPPORT WAYPOINT 318 5TH STREET SE CEDAR RAPIDS IA 52401 420680307 501(C)(3) 5160 0 GENERAL SUPPORT 18 0 PART I, LINE 2: ALL CHECKS ARE ISSUED DIRECTLY TO THE ORGANIZATION TO BE USED AT THEIR DISCRETION. 1 X X X X 0 1 0 0 0 0 0 0 0 CHONG C LEE MD PHYSICIAN 1650394 0 40025 0 15984 0 5994 0 30763 0 1743160 0 0 0 AMANDEEP DHALIWAL MD PHYSICIAN 667886 0 638145 0 540 0 7250 0 15676 0 1329497 0 0 0 RYAN D HOLLENBECK MD PHYSICIAN 669198 0 524966 0 597 0 5210 0 30913 0 1230884 0 0 0 UJJWAL KUMAR MD PHYSICIAN 716125 0 468370 0 21549 0 4696 0 16938 0 1227678 0 0 0 SACHIN GOYAL MD PHYSICIAN 721920 0 462881 0 26386 0 5192 0 9134 0 1225513 0 0 0 TIMOTHY L CHARLES FORMER PRESIDENT & CHIEF EXECUTIVE O 788159 0 109006 0 12998 0 63189 0 18444 0 991796 0 0 0 TIMOTHY QUINN MD PRESIDENT & CHIEF EXECUTIVE OFFICER 551922 0 161997 0 5061 0 46778 0 26156 0 791914 0 0 0 NATHAN VAN GENDEREN EXECUTIVE VICE PRESIDENT & CFO/COO 424421 0 47462 0 2695 0 37262 0 28634 0 540474 0 0 0 JEFFREY CASH CHIEF INFORMATION OFFICER 385758 0 38579 0 6881 0 28327 0 24842 0 484387 0 0 0 TONY MYERS MD CHIEF MEDICAL OFFICER 348491 0 32914 0 4852 0 7625 0 26382 0 420264 0 0 0 MARY BROBST CHIEF NURSING OFFICER 319617 0 38270 0 6985 0 30381 0 22736 0 417989 0 0 0 NANCY HILL-DAVIS CHIEF TALENT OFFICER 312571 0 36339 0 3293 0 27835 0 10116 0 390154 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN 2022: MARY BROBST - $22,756, JEFFREY CASH - $21,209, TIMOTHY L CHARLES - $55,564, NANCY HILL-DAVIS - $21,557, TIMOTHY QUINN M.D. - $39,153, AND NATHAN VAN GENDEREN - $29,637. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY THE ORGANIZATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2022. A CITY OF CEDAR RAPIDS IOWA 426004336 150543AA4 2003-04-10 30000000 REIMBURSE HOSPITAL FOR COSTS OF ACQUIRING AND CONSTRUCTING FACILITIES 0 0 0 B CITY OF CEDAR RAPIDS IOWA 426004336 150543AB2 2005-11-17 58405000 ADVANCE REFUND OF 1999 BONDS 0 0 0 C IOWA FINANCE AUTHORITY 521699886 4624466EQ 2012-12-13 45604359 REIMBURSE HOSPITAL FOR CAPITAL 0 0 0 A 8425000 30000000 1288620 28711380 2003 0 0 1 1 B 34480000 58405000 1552500 56852500 2005 0 1 1 1 C 15060000 45604359 604359 45000000 2013 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 1 UBS AG 29.000000000000 0 0 0 0 1 B 0 0 0 1 1 1 UBS AG 24.000000000000 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF CEDAR RAPIDS, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 10/01/2008 ISSUER NAME: CITY OF CEDAR RAPIDS, IOWA DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2009 MERCY CARE MANAGEMENT INC SEE BELOW IN PART V 1433265 MERCY CARE MANAGEMENT, INC. PAID MERCY MEDICAL CENTER RENT. 0 FORM 990, SCHEDULE L, PART IV, COLUMN B TIMOTHY L. CHARLES AND TIMOTHY QUINN, M.D. ARE AN OFFICERS AND BARRIE ERNST, RUE PATEL, FRED PILCHER, M.D. AND KYLE SKOGMAN ARE MEMBERS OF THE BOARD OF TRUSTEES OF MERCY MEDICAL CENTER AND ARE REPORTED ON THE FORM 990, PART VII. DURING THE TAX YEAR, ALL THE AFOREMENTIONED INDIVIDUALS WERE OFFICERS OR MEMBERS OF THE BOARD OF DIRECTORS OF MERCY CARE MANAGEMENT, INC. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MERCY MEDICAL CENTER IS MERCYCARE SERVICE CORPORATION, AN IOWA NONPROFIT CORPORATION. THE SOLE MEMBER HAS THE EXCLUSIVE POWER TO APPOINT, AFTER CONSIDERATION OF ANY RECOMMENDATIONS FROM THE CORPORATION'S BOARD OF TRUSTEES, ANY TRUSTEE TO THE CORPORATION'S BOARD AND TO REMOVE ANY TRUSTEE FROM THE CORPORATION'S BOARD AT ANY TIME FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF MERCY MEDICAL CENTER, MERCYCARE SERVICE CORPORATION HAS THE EXCLUSIVE POWER TO APPOINT, AFTER CONSIDERATION OF ANY RECOMMENDATIONS FROM THE CORPORATION'S BOARD OF TRUSTEES, ANY TRUSTEE TO THE CORPORATION'S BOARD AND TO REMOVE ANY TRUSTEE FROM THE CORPORATION'S BOARD AT ANY TIME FOR ANY REASON. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER OF MERCY MEDICAL CENTER, MERCYCARE SERVICE CORPORATION HAS THE POWER TO APPROVE THE FOLLOWING ACTIONS: 1. AMEND, REPEAL, OR RESTATE THE ARTICLES OF INCORPORATION; 2. ANY MATTER DIRECTLY RELATED TO THE RELIGIOUS PRINCIPLES AND MORAL PHILOSOPHY OF THE SISTERS OF MERCY; 3. ADOPT OR CHANGE THE PHILOSOPHY AND MISSION OF THE CORPORATION; 4. SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, AND MERGER OR CONSOLIDATION OF THE CORPORATION WITH ANOTHER ENTITY; 5. DISSOLUTION OF THE CORPORATION; 6. ADOPTION OR AMENDMENT TO LONG-TERM STRATEGIC PLANS; 7. ADOPTION OR AMENDMENT TO ANNUAL CAPITAL OR OPERATING BUDGETS; AND 8. APPOINTMENT OR REMOVAL OF THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED WITH THE EXECUTIVE COMMITTEE (SUBCOMMITTEE OF THE BOARD OF TRUSTEES) PRIOR TO FILING THE FORM. THE COMMITTEE IS PROVIDED WITH GENERAL BACKGROUND INFORMATION REGARDING THE FORM 990, AND THE FORM ITSELF (INCLUDING ATTACHMENTS) IS REVIEWED. UPON REQUEST, THE TAX RETURN WILL BE AVAILABLE FOR REVIEW BY THE BOARD OF TRUSTEES. MEMBERS OF THE EXECUTIVE COMMITTEE AND MANAGEMENT ARE AVAILABLE TO ANSWER QUESTIONS FROM THE TRUSTEES ON THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL DIRECTORS, OFFICERS, AND KEY EMPLOYEES, AS WELL AS EACH EMPLOYEE TO DISCLOSE ANY INTEREST IN, OBLIGATION OR DUTY TO, OR ACTIVITY FOR ANY CONCERN IN WHICH A DIRECTOR, OFFICER, KEY EMPLOYEE, OR EMPLOYEE OR THEIR FAMILY MEMBER MAY BE INVOLVED THAT: MIGHT CREATE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST OR MIGHT HAVE THE APPEARANCE OF ADVERSELY AFFECTING THE DIRECTOR'S, OFFICER'S, KEY EMPLOYEE'S, OR EMPLOYEE'S JUDGMENT OR ACTIONS IN PERFORMING HIS/HER DUTIES TOWARDS MERCY. ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EMPLOYEES SHALL FILE AN INITIAL CONFLICT OF INTEREST REPORT UPON HIRE AND SHALL BE REQUIRED TO FILE AN UPDATED REPORT IMMEDIATELY IF ANY CHANGES OCCUR WHICH RESULT IN A CONFLICT OF INTEREST OR FINANCIAL INTEREST. ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND EMPLOYEES (SUPERVISOR AND ABOVE), PHYSICIANS, AND ANY EMPLOYEE IN A POSITION TO INFLUENCE A PURCHASE DECISION SHALL RE-SUBMIT A CONFLICT OF INTEREST DISCLOSURE STATEMENT, WITH ANY NECESSARY CHANGES, EACH YEAR AND IMMEDIATELY IF ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISE. ALL BOARD MEMBERS SHALL SUBMIT IN WRITING A CONFLICT OF INTEREST DISCLOSURE STATEMENT LISTING ALL FINANCIAL AND CONFLICTING INTERESTS. THE STATEMENT SHALL BE RESUBMITTED WITH ANY NECESSARY CHANGES EACH YEAR AND AS ANY ADDITIONAL CONFLICTING OR FINANCIAL INTEREST ARISE. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS WITH A MERCY MEDICAL CENTER BOARD MEMBER: -UPON DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, THE BOARD MEMBER, THE CORPORATE OFFICER, OR THE CEO MAKING SUCH DISCLOSURE MAY BE ASKED TO LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. -THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. -IN THE CASE OF DISCLOSURE BY A MEDICAL STAFF MEMBER, PHYSICIAN, EXECUTIVE STAFF MEMBER, DEPARTMENT DIRECTOR, SUPERVISOR, OR OTHER INDIVIDUAL, THE PRESIDENT/CEO OF ENTITY SHALL DETERMINE, BASED ON THE FACTS AND CIRCUMSTANCES DISCLOSED, IF A CONFLICT OF INTEREST EXISTS. -THE PRESIDENT/CEO OF ENTITY SHALL REPORT THE RESULTS OF ALL DETERMINATIONS, WITH REGARD TO CONFLICT OF INTEREST, TO THE CHAIR OF THE BOARD. PENALTIES FOR NON-COMPLIANCE: FAILURE TO COMPLY WITH THIS POLICY SHALL CONSTITUTE GROUNDS FOR REMOVAL FROM OFFICE AND, IN THE CASE OF MERCY MEDICAL CENTER KEY PERSONNEL, EMPLOYEES, OR OTHER AFFECTED PARTIES, TERMINATION OF EMPLOYMENT. RETENTION PERIOD: ALL CERTIFICATES AND DISCLOSURE SUMMARY DOCUMENTS OF CURRENT OR FORMER EMPLOYEES (AND RELATED CORRESPONDENCE) WILL BE RETAINED IN ACCORDANCE WITH MERCY'S RECORD RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS SET BY THE MERCYCARE SERVICE CORPORATION'S HUMAN RESOURCES COMMITTEE. THE COMMITTEE USES MERCER (US) INC. FOR THE REVIEW OF SALARIES AND COMPARES THEM TO COMPARABLE ENTITIES IN THE REGION. THIS PROCESS WAS LAST COMPLETED AND DOCUMENTED ON FEBRUARY 23, 2022. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE IN PARTNERSHIP INCOME(LOSS) 886,364. CHANGE IN ADDITIONAL MINIMUM LIABILITY FOR RETIREMENT BENEFITS 8,028,218. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS 1,700,724. CHANGE IN INTEREST IN NET ASSETS OF AUXILIARY -42,814. CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION -6,008,614. FORM 990, PART XI, LINE 2C THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. 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