2024-05-10T15:40:01-05:00 2023-06-30 990 2022-07-01 420818642 CENTRAL COMMUNITY HOSPITAL CENT 5632457000 901 DAVIDSON ST NW ELKADER IA 520439015 BROOKE KENSINGER CHIEF EXECUTIVE OFFICER 5632457000 2024-05-10 BROOKE KENSINGER 999009999 1 0 AAL1 IAL1 2022 2023-04-26 12:10:37Z SEE SCHEDULE O FOR LIST BROOKE KENSINGER 901 DAVIDSON ST NW ELKADER IA 520439015 13028387 0 X WWW.MERCYONE.ORG/ELKADER X 1958 IA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 8 8 116 14 0 0 279774 276862 9985939 12465349 15621 54222 28469 228486 10309803 13024919 425 5554 0 0 5521673 6680184 0 0 0 4915721 5639711 10437819 12325449 -128016 699470 11649224 13069635 1105352 1599463 10543872 11470172 X CENTRAL COMMUNITY HOSPITAL'S MISSION IS TO SERVE WITH FIDELITY TO THE GOSPEL AS A COMPASSIONATE, HEALING MINISTRY OF JESUS CHRIST TO TRANSFORM THE HEALTH OF OUR COMMUNITIES. 0 0 10172593 5554 12662187 CENTRAL COMMUNITY HOSPITAL (MERCYONE ELKADER) IS A 25-BED CRITICAL ACCESS HOSPITAL WHICH PROVIDES A VITAL LIFESAVING LINK TO RURAL COMMUNITIES IN CLAYTON COUNTY, IOWA AND SURROUNDING AREAS THROUGH AMBULANCE AND EMERGENCY SERVICES. MERCYONE ELKADER IS COMMITTED TO PROVIDING QUALITY, PERSONALIZED AND SAFE HEALTH CARE CLOSE TO HOME.THE EMERGENCY DEPARTMENT IS STAFFED 24 HOURS A DAY, SEVEN DAYS A WEEK WITH BOARD CERTIFIED PHYSICIANS AND ADVANCED LEVEL PRACTITIONERS WHO ARE WELL-TRAINED TO TREAT EMERGENCY NEEDS. MERCYONE ELKADER IS CERTIFIED AS A LEVEL IV TRAUMA CENTER. MERCYONE ELKADER PROVIDES A BROAD RANGE OF SERVICES INCLUDING ACUTE, SKILLED, SAME-DAY SURGERY, OBSERVATION CARE, OUTPATIENT, AND REHABILITATION SERVICES.PLEASE SEE SCHEDULE H AND VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES AND SPECIALTIES:WWW.MERCYONE.ORG/LOCATION/MERCYONE-ELKADER-MEDICAL-CENTER 10172593 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 29 0 1 116 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X BROOKE KENSINGER 5632457085 901 DAVIDSON ST NW ELKADER IA 520439015 DONNA LAWLOR MD PHYSICIAN 40.00 0.00 X 272922 0 34495 BROOKE KENSINGER CHIEF EXECUTIVE OFFICER 50.00 0.00 X 0 234481 17278 LENNA DINAN REGISTERED NURSE 40.00 0.00 X 112723 0 29444 SANDY PHILLIPS REGISTERED NURSE 40.00 0.00 X 119982 0 13084 DONNA DUART REGISTERED NURSE 40.00 0.00 X 103861 0 12012 LAEL ASPENSON REGISTERED NURSE 40.00 0.00 X 102154 0 12295 REBECCA JOHNSON CONTROLLER 40.00 0.00 X 88985 0 20826 JAY MOSER DIRECTOR; CHAIR 0.50 0.00 X X 0 0 0 JENNIFER COWSERT DIRECTOR; VICE CHAIR 0.50 0.00 X X 0 0 0 ROBERT HAUBER DIRECTOR; TREASURER 0.50 0.00 X X 0 0 0 JUSTIN VORWALD DIRECTOR; SECRETARY 0.50 0.00 X X 0 0 0 JACQUELINE BRUNSSEN DIRECTOR 0.50 0.00 X 0 0 0 CHELSEA DREYER DIRECTOR 0.50 0.00 X 0 0 0 GENE GLAWE DIRECTOR 0.50 0.00 X 0 0 0 ROBERT HANKEY DIRECTOR 0.50 0.00 X 0 0 0 800627 234481 139434 7 0 1 0 NORTHERN IOWA THERAPY 217 E BREMER AVE SUITE B WAVERLY IA 50677 CONTRACTED THERAPY STAFF 424474 CERNER PO BOX 959156 ST LOUIS MO 63195 ELECTRONIC HEALTH RECORDS VENDOR 385536 MEDICAL ASSOCIATES CLINIC 1500 ASSOCIATES DR DUBUQUE IA 52002 CONTRACTED ER COVERAGE 260432 WMG RED HAWTHORNE LLC 107 FLYNN DR SUITE 600 MILBANK SD 57252 CONTRACTED ER COVERAGE 200681 AYA HEALTHCARE PO BOX 123519 DALLAS TX 75312 CONTRACTED NURSING STAFF 163767 7 108390 168472 276862 NET PATIENT SERVICE REVENUE 622110 12465349 12465349 12465349 57218 57218 4425 0 4425 4425 4425 472 3468 -2996 -2996 -2996 OTHER REVENUE 622110 196838 196838 CAFETERIA REVENUE 722514 27223 27223 224061 13024919 12662187 0 85870 X 5554 5554 361570 361570 5175238 4662463 512775 113889 112377 1512 652705 569943 82762 376782 319481 57301 3351817 2466055 885762 20988 14528 6460 245769 187555 58214 252349 251698 651 40924 34570 6354 572218 572218 92238 92238 MEDICAL SUPPLIES EXP 557738 557738 EQUIPMENT MAINTENANCE 276848 272398 4450 BAD DEBT EXPENSE 132072 132072 I/C PURCHASED SERVICES 59275 59275 37475 13943 23532 12325449 10172593 2152856 0 5389181 5570365 1372874 2732120 174248 177316 92084 44706 4076470 458089 3537172 3618381 1083665 926747 11649224 13069635 851826 1322374 180483 73043 47905 0 229184 1105352 1599463 X 9629987 10566812 913885 903360 10543872 11470172 11649224 13069635 X 699470 226830 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 391 0 0 0 391 0 PART II-B, LINE 1: CENTRAL COMMUNITY HOSPITAL (MERCYONE ELKADER) HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCYONE ELKADER WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 324816 324816 2084951 117437 1967514 1374142 340652 1033490 292561 292561 3618381 INTEREST IN NET ASSETS OF FOUNDATION 903360 INTERCOMPANY ACCOUNTS RECEIVABLES 11542 MISCELLANEOUS RECEIVABLES 11845 926747 INTERCOMPANY ACCOUNTS PAYABLE 229184 229184 1 1 X 1 X 1 X 1 1 1 0 1 1 63804 63804 0.00520 1130227 1161676 0 0.00000 1194031 1161676 63804 0.00520 7 331 24611 7720 16891 0.00140 1 813 813 0.00010 1 27 62154 62154 0.00510 4 2952 2952 0.00020 13 358 90530 7720 82810 0.00680 13 358 1284561 1169396 146614 0.01200 200 200 0.00000 200 200 0.00000 1 132072 13207 5711426 5778267 -66841 X 1 1 1 1 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 520439015 WWW.MERCYONE.ORG/ELKADER 220051H X X X X CENTRAL COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SCHEDULE H, PART V, SECTION C X 1 23 1 SEE SCHEDULE H, PART V, SECTION C 0 1 X 200.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 3J: N/ALINE 3E:CENTRAL COMMUNITY HOSPITAL (MERCYONE ELKADER) INCLUDED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WRITTEN REPORT A PRIORITIZED LIST AND DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS, WHICH WERE IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA. THE FOLLOWING COMMUNITY HEALTH NEEDS WERE DEEMED SIGNIFICANT AND WERE PRIORITIZED THROUGH A COMMUNITY-INVOLVED SELECTION PROCESS: MENTAL HEALTH, HOME HEALTH/SKILLED CARE, RECRUITING PROVIDERS/ACCESS TO SPECIALISTS, HEALTH CARE TRANSPORTATION, OBESITY (NUTRITION/EXERCISE), DENTAL SERVICES, DRUGS & SUBSTANCE ABUSE CENTRAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: IN NOVEMBER 2021, A MEETING WAS HELD WITH HOSPITAL LEADERS, CLAYTON COUNTY PUBLIC HEALTH/VISITING NURSES ASSOCIATION (VNA) AND VVV CONSULTANTS, LLC TO REVIEW THE CHNA PROCESS AND COLLABORATIVE OPTIONS. THE VNA IN CLAYTON COUNTY PROVIDES NUMEROUS DIRECT SERVICES TO VULNERABLE COMMUNITY MEMBERS TO INCREASE ACCESS TO MEDICAL AND DENTAL CARE AND HOMECARE SERVICES. THEIR WORK WITH MEDICALLY UNDERSERVED AND LOW-INCOME INDIVIDUALS GRANTED THEM THE INSIGHT TO ADVOCATE THEIR NEEDS ON THEIR BEHALF. FROM NOVEMBER 2021 TO FEBRUARY 2022, THE TEAM COLLECTED DATA/RESEARCH AND PREPARED FOR AN ONLINE SURVEY AND TOWN HALL (VIA ZOOM DUE TO THE OMICRON COVID-19 VARIANT). IN FEBRUARY 2022, AN ONLINE SURVEY WAS LAUNCHED (VIA EMAIL AND SENT TO LOCAL MEDIA) TO COLLECT FEEDBACK FROM STAKEHOLDERS. AT THE END OF MARCH 2022, A TOWN HALL TOOK PLACE TO REVIEW THE SURVEY RESULTS AND OTHER DATA/RESEARCH. REPRESENTATIVES FROM NORTHEAST IOWA BEHAVIORAL HEALTH, INC.; CLAYTON COUNTY EMERGENCY MANAGEMENT; CENTRAL COMMUNITY SCHOOL DISTRICT; SUBSTANCE ABUSE SERVICES FOR CLAYTON COUNTY; CENTRAL COMMUNITY HOSPITAL FOUNDATION; CHAMBER OF COMMERCE; CITY OF ELKADER; AND NORTH IOWA COMMUNITY COLLEGE (NICC) PARTICIPATED. AFTER THE TOWN HALL, FEEDBACK WAS GATHERED FROM STAKEHOLDERS UP UNTIL THE END OF APRIL, WHEN THE REPORT WAS FINALIZED. IT WAS APPROVED BY THE MERCYONE ELKADER MEDICAL CENTER BOARD OF DIRECTORS IN MAY OF 2022. CENTRAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: GUTTENBERG MUNICIPAL HOSPITAL AND CLINICS CENTRAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: CLAYTON COUNTY PUBLIC HEALTH/VISITING NURSES ASSOCIATION, NORTHEAST IOWA BEHAVIORAL HEALTH, INC., CLAYTON COUNTY EMERGENCY MANAGEMENT, CENTRAL COMMUNITY SCHOOL DISTRICT, SUBSTANCE ABUSE SERVICES FOR CLAYTON COUNTY, CENTRAL COMMUNITY HOSPITAL FOUNDATION, CHAMBER OF COMMERCE, CITY OF ELKADER, NICC CENTRAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: MENTAL HEALTH: MERCYONE ELKADER CONTRACTED WITH INTEGRATED TELEHEALTH PARTNERS/FLOWSTATE TO PROVIDE CONSULTS TO PATIENTS WHO ARE IN CRISIS. THIS WAS FUNDED BY COUNTY SOCIAL SERVICES AND NOT BILLED TO THE PATIENT. IT WAS A SIGNIFICANT COMMUNITY BENEFIT OFFERED TO THOSE IN CRISIS IN THE EMERGENCY ROOM AND HELPED GET THEM TO THE NEXT LEVEL OF CARE.MERCYONE ELKADER PROVIDED FUNDING TO SEVA HEALTH CENTER FOR WELLBEING, A 501(C)(3) ORGANIZATION PROVIDING AN INNOVATIVE APPROACH TO SUPPORT BRAIN HEALTH. SEVA'S PEACE FOR YOUR MIND PROJECT INCLUDED WORKING WITH INDIVIDUALS TO SUPPORT BRAIN HEALTH THROUGH NUTRITION, EXERCISE, STRESS MANAGEMENT, EDUCATION, COACHING, AND MIND-BODY PRACTICES. THE PROJECT PROVIDED WRAP-AROUND SERVICES THAT TOOK PLACE BEYOND THE WALLS OF THE TRADITIONAL CLINICAL SETTING FOCUSING ON: BRIDGING THE GAP BETWEEN THE PATIENT AND THEIR PROVIDER TO IMPROVE BRAIN HEALTH, EDUCATING AND SUPPORTING INDIVIDUAL BRAIN HEALTH THROUGH HEALTH COACHING, AND PRACTICE OF INTEGRATIVE TECHNIQUES THAT STRENGTHEN AN INDIVIDUAL'S ABILITY TO IMPROVE THEIR BRAIN HEALTH.MERCYONE ELKADER ACQUIRED THE ELKADER AND MONONA CLINICS ON JULY 1, 2022, AND STARTED IMPLEMENTING DEPRESSION SCREENINGS WITH PATIENTS AGE 12+. MERCYONE ELKADER CONTINUED TO PROMOTE 24-HOUR CRISIS HOTLINES AND EXISTING MENTAL HEALTH SERVICES, FACILITIES, AND PROVIDERS. THEY ALSO EDUCATED THE COMMUNITY ON SCREENINGS, BULLYING, MENTAL HEALTH CARE DELIVERY, PLACEMENT PROCESS, AND DEPRESSION.RECRUITING PROVIDERS/ACCESS TO SPECIALISTS: MERCYONE ELKADER CONNECTED INPATIENTS TO SPECIALISTS IN VARIOUS WAYS, WHICH INCLUDED USING: - AVEL E-EMERGENCY AND AVEL E-HOSPITALISTS TELEMEDICINE SERVICES - AVEL E-SANE, WHICH PROVIDED GUIDANCE WHEN SEXUAL ASSAULT VICTIMS PRESENTED TO THE HOSPITAL- INTEGRATED TELEHEALTH PARTNERS/FLOWSTATE FOR BRAIN HEALTH CONSULTS PROVIDERS WERE ENCOURAGED TO UTILIZE THESE TELEHEALTH SERVICES AND MOBILE APPS OPTIONS IN ORDER TO IMPROVE PRODUCTIVITY. MERCYONE ELKADER ALSO CONTRACTED CARDIOLOGISTS FROM MEDICAL ASSOCIATES IN DUBUQUE TO COME TO ELKADER FOR IN-PERSON VISITS AND STARTED THE APPLICATION PROCESS TO BECOME AN APPROVED NATIONAL HEALTH SERVICES CORPS (NHSC) SITE. THIS CERTIFICATION WILL HELP WITH PROVIDER RECRUITMENT AND RETENTION IN ELKADER'S RURAL LOCATION. MERCYONE ELKADER PROMOTED AND ADVERTISED AT SURROUNDING AREA COLLEGE JOB FAIRS TO STUDENTS AND OTHERWISE UNEMPLOYED INDIVIDUALS WITHIN THE COUNTY AND ENCOURAGED AREA PROVIDERS TO COLLECTIVELY HELP RECRUIT AND IDENTIFY AND/OR CONTACT KEY PROVIDERS.MERCYONE ELKADER WORKED ON EXPANDING THEIR RESIDENCY PROGRAMS FOR MEDICAL STUDENTS AND EXPLORED THE OPPORTUNITY TO HAVE A SCHOOL SCHOLARSHIP / INTERNSHIP PROGRAM.DENTAL SERVICES: THE HOSPITAL ASSISTED THE PUBLIC HEALTH DEPARTMENT BY CLEANING AND STERILIZING DENTAL INSTRUMENTS USED BY COUNTY DENTAL CLINIC. MERCYONE ELKADER CONTINUED TO PARTNER WITH A LOCAL DENTIST ON HOSPITAL-RELATED DENTAL NEEDS.DRUGS & SUBSTANCE ABUSE:MERCYONE ELKADER COLLABORATED WITH SCHOOLS AND CHURCHES TO PROVIDE AFTER-SCHOOL PROGRAMS AND ACTIVITY OPTIONS TO KEEP YOUTH FROM DEVELOPING HABITS INVOLVING DRUG / SUBSTANCE USE. MERCYONE ELKADER ALSO CONTINUED TO PROVIDE TOBACCO CESSATION EDUCATION.A CASH DONATION WAS GIVEN TO THE NATIONAL CHILD SAFETY COUNCIL UPON REQUEST FROM THE CLAYTON COUNTY SHERIFF OFFICE, WHICH WAS USED TO PURCHASE AND PROVIDE CHILD SAFETY AND DRUG EDUCATIONAL MATERIALS AND SERVICES FOR CHILDREN AND PARENTS. A CASH DONATION WAS GIVEN TO THE 5C COALITION TO FUND RED RIBBON WEEK, WHICH ENCOURAGES CHILDREN TO CHOOSE A DRUG AND ALCOHOL-FREE LIFESTYLE. MERCYONE ELKADER ESTABLISHED AND PROMOTED DISCARDING OLD PRESCRIPTIONS AT LOCAL POLICE DEPARTMENTS AND PHARMACIES, ESPECIALLY OPIOIDS.MERCYONE ELKADER ACKNOWLEDGES THAT THERE WAS A WIDE RANGE OF PRIORITY HEALTH AND SOCIAL ISSUES THAT EMERGED FROM THE CHNA PROCESS AND DETERMINED THAT IT COULD EFFECTIVELY FOCUS ON ONLY THOSE NEEDS WHICH ARE THE MOST PRESSING, UNDER-ADDRESSED AND WITHIN ITS ABILITY TO INFLUENCE. THEREFORE, MERCYONE ELKADER DID NOT DIRECTLY ADDRESS THE FOLLOWING NEEDS:- HOME HEALTH/SKILLED CARE - HEALTH CARE TRANSPORTATION - OBESITY (NUTRITION/EXERCISE) CENTRAL COMMUNITY HOSPITAL PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, AND PATIENTS WHO ARE ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (SUCH AS FOOD STAMPS, LOW INCOME/SUBSIDIZED HOUSING, AND SUBSIDIZED SCHOOL LUNCHES). PART V, SECTION B, LINE 7A: COMMUNITY HEALTH NEEDS ASSESSMENT: WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ PART V, SECTION B, LINE 10A: IMPLEMENTATION STRATEGY: WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/ PART V, SECTION B, LINE 9: FOLLOWING ADOPTION OF THE FY22 IMPLEMENTATION STRATEGY, MERCYONE ELKADER MADE IMPROVEMENTS TO THEIR IMPLEMENTATION STRATEGY, WHICH WAS READOPTED BY THE BOARD OF DIRECTORS ON NOVEMBER 2, 2023 AND POSTED TO THEIR WEBSITE AT WWW.MERCYONE.ORG/ABOUT-US/COMMUNITY-HEALTH-AND-WELL-BEING/. PART V, SECTION B, LINE 16A-C: FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY:WWW.MERCYONE.ORG/ELKADER/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: CENTRAL COMMUNITY HOSPITAL (MERCYONE ELKADER) REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.MERCYONE ELKADER ALSO INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $132,072, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II: MERCYONE ELKADER MADE A DONATION TO MAIN STREET ELKADER, A NON-PROFIT DEDICATED TO SUPPORTING ECONOMIC DEVELOPMENT IN THE TOWN OF ELKADER FOR THE BENEFIT OF THE ENTIRE COMMUNITY. PART III, LINE 2: MERCYONE ELKADER DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CATEGORY OF PATIENT. PART III, LINE 3: A REASONABLE ESTIMATE OF THE HOSPITAL'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY IS 10% OF IMPLICIT PRICE CONCESSIONS. THIS IS BASED ON THE PERCENTAGE OF INDIVIDUALS BELOW THE POVERTY LEVEL IN THE AREA. PART III, LINE 4: MERCYONE ELKADER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE PATIENT ACCOUNTS RECEIVABLE, ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS FOOTNOTE FROM PAGE 13 OF THOSE STATEMENTS: "AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS FOR RETROACTIVE ADJUSTMENTS, ARE RECEIVABLES IF THE RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTABLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE.THE CORPORATION HAS AGREEMENTS WITH THIRD-PARTY PAYERS THAT PROVIDE FOR PAYMENTS TO THE CORPORATION'S HEALTH MINISTRIES AT AMOUNTS DIFFERENT FROM ESTABLISHED RATES. ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYERS AND OTHER CHANGES IN ESTIMATES ARE INCLUDED IN NET PATIENT SERVICE REVENUE AND ESTIMATED RECEIVABLES FROM AND PAYABLES TO THIRD-PARTY PAYERS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS, AS FINAL SETTLEMENTS ARE DETERMINED." PART III, LINE 8: MERCYONE ELKADER DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - MERCYONE ELKADER CONTINUOUSLY MONITORS THE NEEDS OF THE COMMUNITY BY REVISITING THE COMMUNITY HEALTH IMPROVEMENT PLAN AND UPDATING THE PLAN WITH ACTIONS TAKEN AS WELL AS NEW STRATEGIES THAT NEED TO BE DEPLOYED BASED ON NEW DATA. MERCYONE ELKADER ACTIVELY PARTNERS WITH THE LOCAL SCHOOLS, CITY/TOWNSHIPS, HOSPITALS, PUBLIC HEALTH AGENCIES, EMERGENCY MANAGEMENT AGENCIES, LAW ENFORCEMENT, FIRE AND EMS AND OFTEN IS MADE AWARE OF COMMUNITY NEEDS THROUGH THOSE PARTNERSHIPS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MERCYONE ELKADER COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES, FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS, AND OTHER COMMUNITY-BASED CHARITABLE PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. MERCYONE ELKADER OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. NOTIFICATION ABOUT FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. INFORMATION REGARDING FINANCIAL ASSISTANCE AND GOVERNMENT PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. PART VI, LINE 4: COMMUNITY INFORMATION - MERCYONE ELKADER SERVES THE RESIDENTS OF THE CENTRAL PART OF CLAYTON COUNTY, IOWA INTO THE NORTHEAST SECTION OF THE COUNTY. IT IS A RURAL, AGRICULTURAL AREA. THE GEOGRAPHIC AREA OF CLAYTON COUNTY IS 793 SQUARE MILES. THE NEAREST LARGER CITY IS DUBUQUE, IOWA, WHICH IS 72 MILES FROM ELKADER, THE COUNTY SEAT. CLAYTON COUNTY HAS A POPULATION OF 16,998 AND IS THE FIFTH-LARGEST COUNTY IN IOWA BY AREA. IN 2021, THE MEDIAN HOUSEHOLD INCOME OF CLAYTON COUNTY RESIDENTS WAS $58,148. THE POVERTY RATE OF CLAYTON COUNTY IN 2021 WAS 12%. THE PERCENTAGE OVER AGE 65 IS 25% OF THE TOTAL POPULATION. THE LARGEST CLAYTON COUNTY RACIAL/ETHNIC GROUPS ARE WHITE (95.3%), HISPANIC OR LATINO (2.4%), TWO OR MORE RACES (1.2%), AND BLACK OR AFRICAN AMERICAN (0.9%). CLAYTON COUNTY IS A DESIGNATED MEDICALLY UNDERSERVED AREA (INDEX SCORE OF 55.0). GUTTENBERG MUNICIPAL HOSPITAL ALSO SERVES CLAYTON COUNTY AND IS LOCATED IN GUTTENBERG, IOWA. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH - IN FISCAL YEAR 2023, MERCYONE ELKADER BOARD MEMBERS RESIDED IN THE PRIMARY SERVICE AREA. NO BOARD MEMBERS WERE EMPLOYED OR CONTRACTED BY THE HOSPITAL, AND NO BOARD MEMBERS HAD FAMILY MEMBERS EMPLOYED BY MERCYONE ELKADER.MERCYONE ELKADER EXTENDED HOSPITAL PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS SERVICE AREA EXTENDING TO DUBUQUE, IOWA.WHEN THE HOSPITAL CREATED ITS ANNUAL BUDGET, EFFORTS WERE MADE BY THE ADMINISTRATIVE TEAM TO ALLOCATE FUNDS TO IMPROVE PATIENT CARE BY UPDATING EQUIPMENT, EXPANDING SUPPLIES, AND HIRING STAFF. THE HOSPITAL'S MANAGEMENT TEAM AND BOARD MEMBERS WORKED TO ALIGN CHNA GOALS WITH THE HOSPITAL BUDGET. ONE EXAMPLE IS THE ACQUISITION OF TWO PRIMARY CARE CLINICS (ELKADER AND MONONA). ANY SURPLUS AT THE END OF THE FISCAL YEAR WAS INVESTED BACK INTO THE ORGANIZATION IN THE FORM OF CAPITAL DOLLARS. THESE CAPITAL DOLLARS ARE INVESTED IN EQUIPMENT AND PROJECTS THAT HELP MEET THE NEEDS OF THE COMMUNITY.MERCYONE ELKADER PARTNERED WITH THE CITY OF ELKADER AND LOCAL TOWNSHIPS TO PROVIDE EMS SERVICES. THE HOSPITAL EMPLOYED ALL OF THE STAFF, PROVIDED MEDICAL DIRECTORSHIP, PURCHASED EQUIPMENT, SUPPLIES AND MEDICATIONS, AS WELL AS PAID FOR HALF OF THE GAS AND HANDLED THE BILLING. THE CITY OF ELKADER PURCHASED, MAINTAINED, AND PROVIDED STORAGE FOR THE AMBULANCES, AS WELL AS PAID FOR INSURANCE AND HALF OF THE GAS. THERE ARE TWO CRITICAL ACCESS HOSPITALS IN CLAYTON COUNTY, IOWA: MERCYONE ELKADER IN ELKADER, IOWA AND GUTTENBERG MUNICIPAL HOSPITAL & CLINICS IN GUTTENBERG, IOWA. MERCYONE ELKADER IS 30 MINUTES AWAY FROM GUTTENBERG MUNICIPAL HOSPITAL & CLINICS AS WELL AS THE SAME DISTANCE AWAY FROM THREE OTHER CRITICAL ACCESS HOSPITALS (REGIONAL MEDICAL CENTER, GUNDERSON PALMER LUTHERAN HOSPITAL, AND CROSSING RIVERS HEALTH). THE RESIDENTS OF ELKADER AND SURROUNDING AREAS DEPEND ON THE EMERGENCY ROOM BEING AVAILABLE 24/7/365 WHEN EMERGENCY HEALTH NEEDS ARISE. EMS SERVICE IS ALSO AVAILABLE 24/7/365 FOR ALL 911 CALLS AND TRANSFER CALLS. THE HOSPITAL WORKS RELENTLESSLY TO ENSURE THAT COVERAGE FOR BOTH THE ER AND THE EMS SERVICE IS ALWAYS AVAILABLE FOR THE COMMUNITY, IN AN INCREASINGLY TOUGH RECRUITMENT MARKET. IF THESE SERVICES WERE NOT AVAILABLE, THE COMMUNITY WOULD SUFFER TREMENDOUSLY. IT WAS A HUGE TASK TO ENSURE THAT HEALTH CARE PERSONNEL WERE UP-TO-DATE ON ALL REQUIRED TRAINING. MERCYONE ELKADER OFFERED TRAINING FOR PHYSICIANS, ADVANCED PRACTICE PROVIDERS, NURSES AND EMS PERSONNEL IN BASIC LIFE SUPPORT (CPR-BLS), ADVANCED CARDIOVASCULAR LIFE SUPPORT (CPR-ACLS), PEDIATRIC ADVANCED LIFE SUPPORT (CPR-PALS), NEONATAL RESUSCITATION (CPR-NRP), ADVANCED TRAUMA LIFE SUPPORT (ATLS), AND TRAUMA NURSING CORE COURSE (TNCC).MERCYONE ELKADER WAS INVOLVED IN A REGIONAL COALITION THAT INVOLVED SIX OTHER COUNTIES THAT WORKED TOGETHER ON EMERGENCY PREPAREDNESS STRATEGIES. THE HOSPITAL ALSO PARTICIPATED IN THE HOSPITAL ALLIANCE FOR PREPAREDNESS IN IOWA.MERCYONE ELKADER FAMILY MEDICINE PARTNERED WITH IOWA STATE UNIVERSITY EXTENSION AND OUTREACH TO OFFER A FREE THREE-PART SERIES CALLED "EXPLORING DEMENTIA AND BRAIN HEALTH." THE 15 PARTICIPANTS LEARNED CURRENT INFORMATION ABOUT BRAIN HEALTH AND DIFFERENT TYPES OF DEMENTIA AND RECEIVED A FREE RESOURCE RELATED TO DEMENTIA AND BRAIN HEALTH. MERCYONE ELKADER ALSO HELD A PARKINSON SUPPORT GROUP ONCE A MONTH, WHICH HELPED COMMUNITY MEMBERS CONNECT WITH OTHERS GOING THROUGH THE SAME DIFFICULT JOURNEY. MERCYONE ELKADER'S ACQUISITION OF TWO PRIMARY CARE CLINICS (ELKADER AND MONONA) ALLOWED THE HOSPITAL TO BE INTIMATELY INVOLVED IN CHRONIC DISEASE MANAGEMENT. MERCYONE ELKADER RECEIVED REQUESTS FROM TWO LOCAL HIGH SCHOOLS TO PROVIDE SUBSIDIZED MEDICAL SERVICES FOR THEIR ATHLETIC PROGRAMS TO IMPROVE SAFETY. THESE PROVIDERS PERFORMED CONCUSSION SCREENINGS (BASELINE AND POST-INJURY) AND OTHER PREVENTATIVE AND INJURY TREATMENT MEASURES TO ENSURE THE STUDENTS' SAFETY AT PRACTICES AND GAMES.DEATH INVESTIGATIONS ARE CRITICAL FOR MANY ASPECTS OF PUBLIC HEALTH PRACTICE AND RESEARCH, INCLUDING SURVEILLANCE, EPIDEMIOLOGY, AND PREVENTION PROGRAMS, MOST OFTEN IN INJURY PREVENTION AND CONTROL BUT ALSO IN PREVENTION OF SUICIDE, VIOLENCE, OR SUBSTANCE ABUSE. WHEN IT WAS DECIDED THAT CLAYTON COUNTY'S THEN-CURRENT DEATH INVESTIGATOR WOULD BE TRANSITIONING INTO A CLINIC-BASED ROLE AND WOULD NO LONGER HAVE THE CAPACITY TO SERVE, MERCYONE ELKADER PREEMPTIVELY OFFERED TO PAY FOR THE TRAINING AND CERTIFICATION OF THEIR EMS MANAGER AND CRITICAL CARE PARAMEDIC TO PREVENT A GAP IN THIS SERVICE. MERCYONE ELKADER SUPPORTED BLOOD DRIVES IN THE LOCAL COMMUNITY THROUGH IN-KIND TIME HELPING CHECK PEOPLE IN AND PROVIDING SUPPLIES. MERCYONE ELKADER SUPPORTED ITS COMMUNITY THROUGH SEVERAL CASH AND SUPPLIES DONATIONS. THESE INCLUDED DONATIONS TO: - A LOCAL CHILDCARE CENTER THAT REACHED OUT NEEDING FUNDS IN ORDER TO STAY OPEN - NORTHEAST IOWA COMMUNITY ACTION- MONONA FIRE DEPARTMENT - ELKADER FIRE DEPARTMENT - DEFIBRILLATOR PADS TO A LOCAL CHURCH MERCYONE ELKADER IS DESIGNATED AS A SENIOR HEALTH INSURANCE INFORMATION PROGRAM (SHIIP) SPONSOR ORGANIZATION BY THE IOWA INSURANCE DIVISION. THIS PARTNERSHIP HAS LASTED FOR OVER TEN YEARS AND HAS HELPED MANY RESIDENTS FROM CLAYTON COUNTY AND THE SURROUNDING COUNTIES UNDERSTAND THEIR CHOICES FOR MEDICARE PART D DRUG PLANS. SHIIP SERVICES ARE DELIVERED BY VOLUNTEERS IN A VARIETY OF ROLES THROUGH A STATEWIDE NETWORK OF SPONSOR ORGANIZATIONS. MERCYONE ELKADER HAS TWO CERTIFIED TRAINED SHIIP COUNSELORS AND ALSO EMPLOYS A SHIIP COORDINATOR WHO TAKES PHONE CALLS, SCHEDULES APPOINTMENTS, AND SERVES AS A LIAISON TO THE STATE. PART VI, LINE 6: MERCYONE ELKADER IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH'S COMMUNITY HEALTH AND WELL-BEING (CHWB) STRATEGY PROMOTES OPTIMAL HEALTH FOR PEOPLE EXPERIENCING POVERTY AND OTHER VULNERABILITIES IN THE COMMUNITIES WE SERVE - EMPHASIZING THE NECESSITY TO INTEGRATE SOCIAL AND CLINICAL CARE. WE DO THIS BY: 1. ADDRESSING PATIENT SOCIAL NEEDS, 2. INVESTING IN OUR COMMUNITIES, AND 3. STRENGTHENING THE IMPACT OF OUR COMMUNITY BENEFIT. TRINITY HEALTH CHWB TEAMS LEAD THE DEVELOPMENT AND IMPLEMENTATION OF TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES AND FOCUS INTENTIONALLY ON ENGAGING COMMUNITIES AND RESIDENTS EXPERIENCING POVERTY AND OTHER VULNERABILITIES. WE BELIEVE THAT COMMUNITY MEMBERS AND COMMUNITIES THAT ARE THE MOST IMPACTED BY RACISM AND OTHER FORMS OF DISCRIMINATION EXPERIENCE THE GREATEST DISPARITIES AND INEQUITIES IN HEALTH OUTCOMES AND SHOULD BE INCLUSIVELY ENGAGED IN ALL COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT EFFORTS. THROUGHOUT OUR WORK, WE DISMANTLE OPPRESSIVE SYSTEMS, AND BUILD COMMUNITY CAPACITY AND PARTNERSHIPS.TRINITY HEALTH AND ITS MEMBER HOSPITALS ARE COMMITTED TO THE DELIVERY OF PEOPLE-CENTERED CARE AND SERVING AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN THE COMMUNITIES THEY SERVE. AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO THE COMMUNITIES AND IS COMMITTED TO ADDRESSING THE UNIQUE NEEDS OF EACH COMMUNITY. IN FISCAL YEAR 2023 (FY23), TRINITY HEALTH CONTRIBUTED $1.47 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE VULNERABLE AND LIVING IN POVERTY, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. IN ADDITION TO ANNUAL COMMUNITY BENEFIT SPENDING, TRINITY HEALTH IMPLEMENTS A SOCIALLY RESPONSIBLE INVESTING PROGRAM. AS OF THE END OF FY23, $62.7 MILLION (INCLUDING $7.0 MILLION IN NEW LENDING) WAS ALLOCATED IN THE FOLLOWING AREAS:- HOUSING: BUILDING AFFORDABLE HOUSING; IMPROVING ACCESS TO SENIOR HOUSING; AND COMBATTING HOMELESSNESS ($35.5 MILLION)- EDUCATION: SUPPORTING STUDENTS ENTERING THE HEALTH PROFESSIONS ($10.1 MILLION)- FACILITIES: BUILDING COMMUNITY FACILITIES FOR NONPROFITS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY-BASED ORGANIZATIONS ($9.7 MILLION)- ECONOMIC DEVELOPMENT: ENCOURAGING SMALL BUSINESS DEVELOPMENT, CREATING LOCAL JOBS AND SUPPORTING ACCESS TO HEALTHY FOODS; QUALITY CHILDCARE; AND OTHER COMMUNITY SERVICES ($7.4 MILLION)ACROSS THE SYSTEM, NEARLY 700,000 OF PATIENTS SEEN IN PRIMARY CARE SETTINGS WERE SCREENED FOR SOCIAL NEEDS. FOR ABOUT 30% OF THOSE PATIENTS, AT LEAST ONE SOCIAL NEED WAS IDENTIFIED. TOGETHERCARE - TRINITY HEALTH'S ELECTRONIC HEALTH RECORD, POWERED BY EPIC - HAS MADE IT POSSIBLE FOR TRINITY HEALTH TO STANDARDIZE SCREENING FOR SOCIAL NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES THROUGH THE COMMUNITY RESOURCE DIRECTORY (COMMUNITYRESOURCES.TRINITY-HEALTH.ORG). COMMUNITY HEALTH WORKERS (CHW'S) SERVE AS LIAISONS BETWEEN HEALTH AND SOCIAL SERVICES. TRINITY HEALTH CHW'S PARTNERED WITH POPULATION HEALTH NURSES AND SOCIAL WORK CARE MANAGERS TO SERVE MEDICARE PATIENTS AT RISK FOR PREVENTABLE HOSPITALIZATIONS, RESULTING IN A DECREASE IN PREVENTABLE HOSPITALIZATIONS FOR THE MEDICARE POPULATION OVERALL, AND ALSO FOR LOW-INCOME PATIENTS DUALLY ENROLLED IN MEDICARE AND MEDICAID. CHW'S ADVANCE SOCIAL AND CLINICAL CARE INTEGRATION BY ASSESSING AND ADDRESSING A PATIENT'S SOCIAL NEEDS, HOME ENVIRONMENT AND OTHER SOCIAL RISK FACTORS, AND ULTIMATELY CONNECTING THE PATIENT (AND THEIR FAMILY) TO SERVICES WITHIN THE COMMUNITY. TRINITY HEALTH PROVIDES A 40+ HOUR FOUNDATIONAL CHW AND CHRONIC DISEASE-SPECIFIC TRAINING TO TRINITY HEALTH-EMPLOYED CHW'S AND ALSO TO COMMUNITY PARTNERS THAT EMPLOY CHW'S. IN 2017, TRINITY HEALTH RECEIVED A SIX-YEAR, $8.5 MILLION GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO INCREASE THE NUMBER OF NATIONAL DIABETES PREVENTION PROGRAM (DPP) DELIVERY SITES, INCREASE PROGRAM ENROLLMENT, MAINTAIN PARTICIPATION RATES, AND INCREASE BENEFIT COVERAGE. IN ADDITION, THE GRANT WAS USED TO STANDARDIZE CLINICAL SCREENING AND DETECTION OF DIABETES. DURING THE GRANT PERIOD, TRINITY HEALTH BUILT THE NATIONAL DPP INTO ITS ELECTRONIC HEALTH RECORD SYSTEM TO MAKE IDENTIFYING PATIENTS AND ENROLLING THEM IN THE PROGRAM EASIER. SINCE SEPTEMBER 2017, OVER 6,000 PARTICIPANTS HAVE ENROLLED IN A TRINITY HEALTH NATIONAL DPP AND HAVE COLLECTIVELY LOST A TOTAL OF OVER 51,000 POUNDS.LASTLY, TRINITY HEALTH'S FY23 SHAREHOLDER ADVOCACY PRIORITIES FOCUSED ON IMPROVING CORPORATE POLICIES AND PRACTICES THAT IMPACT COMMUNITIES, WITH THE AIM OF REDUCING STRUCTURAL RACISM AND HEALTH INEQUITIES. TRINITY HEALTH, IN COLLABORATION WITH ITS PARTNERS THE INTERFAITH CENTER ON CORPORATE RESPONSIBILITY AND THE INVESTOR ENVIRONMENTAL HEALTH NETWORK, FILED SHAREHOLDER PROPOSALS AT 20 COMPANIES. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 0 0 0 0 0 0 0 0 0 DONNA LAWLOR MD PHYSICIAN 261672 0 11250 0 0 0 6978 0 27517 0 307417 0 0 0 BROOKE KENSINGER CHIEF EXECUTIVE OFFICER 0 179116 0 26953 0 28412 0 15780 0 1498 0 251759 0 0 PART I, LINE 3 MERCYONE ELKADER'S CEO IS PAID BY A RELATED ORGANIZATION, CATHOLIC HEALTH INITIATIVES - IOWA. CATHOLIC HEALTH INITIATIVES - IOWA USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MERCYONE ELKADER'S CEO: - COMPENSATION SURVEY OR STUDY FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF CENTRAL COMMUNITY HOSPITAL (MERCYONE ELKADER) IS MERCY COMMUNITY HOSPITAL GROUP, LLC, OF WHICH MERCY HEALTH NETWORK, INC. IS THE SOLE MEMBER. AS OF SEPTEMBER 1, 2022, MERCY HEALTH NETWORK BECAME A WHOLLY-OWNED SUBSIDIARY OF TRINITY HEALTH CORPORATION. SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A MERCY COMMUNITY HOSPITAL GROUP, LLC IS THE SOLE MEMBER OF MERCYONE ELKADER. MERCY COMMUNITY HOSPITAL GROUP, LLC HAS THE RIGHT TO APPROVE THE APPOINTMENT OF ALL PERSONS TO THE BOARD OF DIRECTORS OF MERCYONE ELKADER. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, MERCY COMMUNITY HOSPITAL GROUP, LLC MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY COMMUNITY HOSPITAL GROUP, LLC MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION A, LINE 8B LINE 8B IS ANSWERED "NO" BECAUSE MERCYONE ELKADER HAD NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MERCYONE ELKADER IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MERCYONE ELKADER HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MERCYONE ELKADER, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, AND KEY EMPLOYEES. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MERCYONE ELKADER AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MERCYONE ELKADER ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MERCYONE ELKADER OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MERCYONE ELKADER IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MERCYONE ELKADER. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTION 15A IS ANSWERED "NO" BECAUSE THE COMPENSATION FOR THE CEO OF MERCYONE ELKADER IS ESTABLISHED BY CATHOLIC HEALTH INITIATIVES - IOWA, A RELATED ORGANIZATION. IN ESTABLISHING THE CEO'S COMPENSATION, CATHOLIC HEALTH INITIATIVES - IOWA USED A PROCESS BASED ON SALARY ADJUSTMENT RECOMMENDATIONS USING VARIOUS TOOLS, INCLUDING A 360-DEGREE ANNUAL EVALUATION, CEO WAGE SCALES FROM A VARIETY OF SOURCES, AND A REVIEW OF WAGES IN COMPARISON TO COMPARABLE POSITIONS, LOOKING AT FACTORS SUCH AS BED SIZE OF HOSPITAL AND SIZE OF COMMUNITY. HUMAN RESOURCES DOCUMENTS AND PROVIDES SUBSTANTIATION OF THE RECOMMENDED CEO WAGE TO THE BOARD. THIS PROCESS IS DONE ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 MERCYONE ELKADER IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MERCYONE ELKADER INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MERCYONE ELKADER'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,829,589. MANAGEMENT AND GENERAL EXPENSES 275,826. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,105,415. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 636,466. MANAGEMENT AND GENERAL EXPENSES 591,519. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,227,985. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 18,417. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,417. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS FROM AFFLIATES 9,642,987. PURCHASE ACCOUNTING ADJUSTMENT DUE TO ACQUISITION BY TRINITY HEALTH SYSTEM ON SEPT 1, 2022 -9,436,646. OTHER TRANSACTIONS 20,489. FORM 990, PART XII, LINE 2: MERCYONE ELKADER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY23 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCYONE ELKADER MEDICAL CENTER MERCYONE ELKADER FAMILY MEDICINE MERCYONE ELKADER AMBULANCE MERCYONE MONONA FAMILY MEDICINE ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 200 JEFFERSON AVE SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT AVE TROY NY 12180 141651563 TITLE HOLDING COMPANY NY 501(C)(2) N/A LTC (EDDY) INC 1 BETHLEHEM HAVEN OF PITTSBURGH 905 WATSON STREET PITTSBURGH PA 15219 251436685 HOMELESS SHELTER PA 501(C)(3) LINE 7 PITTSBURGH MERCY HEALTH SYSTEM INC 1 BEVERWYCK INC 40 AUTUMN DRIVE SLINGERLANDS NY 12159 141717028 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 BRIGHTSIDE INC 114 WOODLAND STREET HARTFORD CT 06105 042182395 HEALTH CARE SERVICES MA 501(C)(3) LINE 10 THE MERCY HOSPITAL INC 1 CAPITAL HEALTH FOUNDATION-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 521025476 FOUNDATION NJ 501(C)(3) LINE 7 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH LIFE INC 7500 K JOHNSON BOULEVARD BORDENTOWN NJ 08505 222797282 PACE PROGRAM NJ 501(C)(3) LINE 10 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH MEDICAL GROUP-EAST TRENTON PA 601 HAMILTON AVENUE TRENTON NJ 08629 832199054 HEALTH CARE SERVICES NJ 501(C)(3) LINE 3 CAPITAL HEALTH-EAST TRENTON INC 1 CAPITAL HEALTH-EAST TRENTON INC 601 HAMILTON AVENUE TRENTON NJ 08629 223431049 HEALTH CARE AND HOSPITAL SERVICES NJ 501(C)(3) LINE 3 MAXIS HEALTH SYSTEM 1 CAPITAL REGION GERIATRIC CENTER INC 421 WEST COLUMBIA STREET COHOES NY 12047 141701597 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 CATHERINE MCAULEY HEALTH SERVICES CORP 5315 ELLIOTT DR 102 YPSILANTI MI 48197 382507173 HEALTH CARE SERVICES MI 501(C)(3) LINE 3 TRINITY HEALTH-MICHIGAN 1 CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVENUE DES MOINES IA 50314 420680448 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH NETWORK INC 1 CATHOLIC HEALTH MINISTRIES 20555 VICTOR PARKWAY LIVONIA MI 48152 GOVERNANCE AND MANAGEMENT OF TRINITY HEALTH SYSTEM VT 501(C)(3) LINE 1 N/A 0 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 52043 420818642 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY COMMUNITY HOSPITAL GROUP LLC 0 COVENANT FOUNDATION INC 3421 WEST NINTH STREET WATERLOO IA 50702 421295784 FOUNDATION 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