2025-05-08T14:14:12-05:00 2024-06-30 990 2023-07-01 420818642 CENTRAL COMMUNITY HOSPITAL CENT 5632457000 901 DAVIDSON ST NW ELKADER IA 520439015 TERRI DONOVAN INTERIM VP OF FINANCE 5632457000 2025-05-08 1 2023 2025-03-06 01:10:19Z SEE SCHEDULE O FOR LIST ALANA MONSON 901 DAVIDSON ST NW ELKADER IA 520439015 13775973 0 X WWW.MERCYONE.ORG/ELKADER X 1958 IA TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 8 7 111 17 0 0 276862 250542 12465349 13091209 54222 139504 228486 204049 13024919 13685304 5554 1554 0 0 6680184 7228340 0 0 26116 5639711 5877039 12325449 13106933 699470 578371 13069635 13604320 1599463 1607701 11470172 11996619 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 10948015 1554 13263768 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 10948015 1 1 0 1 0 0 0 0 0 0 1 1 0 0 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 23 0 1 111 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 7 0 1 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X SUSAN MCLEAN 5635898037 901 DAVIDSON ST NW ELKADER IA 520439015 DONNA LAWLOR MD PHYSICIAN, FAMILY MEDICINE 40.00 0.00 X 329202 0 28216 JEFFREY MESSERLY DO PHYSICIAN, EMERGENCY CARE 40.00 0.00 X 260806 0 20984 BROOKE KENSINGER DIRECTOR; CHIEF EXECUTIVE OFFICER 50.00 0.00 X X 0 252996 21141 MELISSA SIMON DO PHYSICIAN, EMERGENCY CARE 40.00 0.00 X 231029 0 15898 STACEY EMBRETSON NURSE PRACTITIONER 40.00 0.00 X 135778 0 31075 LENNA DINAN REGISTERED NURSE 40.00 0.00 X 157408 0 5364 REBECCA JOHNSON CONTROLLER THROUGH 2/24 40.00 0.00 X 91349 0 21642 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 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 TERRI DONOVAN PD BY MGMT CO INTERIM VP OF FINANCE MERCYONE 1/24 0.50 49.50 X 0 0 0 1205572 252996 144320 8 0 1 0 NORTHERN IOWA THERAPY 217 E BREMER AVE SUITE B WAVERLY IA 50677 CONTRACTED THERAPY STAFF 444591 WMG RED HAWTHORNE LLC 107 FLYNN DR SUITE 600 MILBANK SD 57252 CONTRACTED ED COVERAGE 274068 WELAND CLINICAL LAB PO BOX 1924 CEDAR RAPIDS IA 52406 LABORATORY SERVICES 127003 DR CLARK WILLIAMS PO BOX 195 DYERSVILLE IA 52040 CONTRACTED ED COVERAGE 106341 4 187184 63358 250542 NET PATIENT SERVICE REVENUE 622110 13091209 13091209 13091209 151780 151780 4025 848 3177 3177 3177 4645 72900 0 89821 4645 -16921 -12276 -12276 OTHER REVENUE 622110 172559 172559 CAFETERIA REVENUE 722514 28313 28313 200872 13685304 13263768 0 170994 X 1554 1554 387128 387128 5644053 5355844 266583 21626 196404 195614 790 597455 552653 42570 2232 403300 178941 223316 1043 1416 1416 2728372 2174225 554147 10909 5967 4942 171514 118718 52692 104 570936 456749 114187 230377 218984 11393 28482 25959 2523 498338 294278 204060 61906 61906 MEDICAL SUPPLIES EXP 655008 655008 EQUIPMENT MAINTENANCE 300363 297523 2840 HOSPITAL PROVIDER TAX 200309 200309 BAD DEBT EXPENSE 169900 169900 249209 45789 203099 321 13106933 10948015 2132802 26116 5570365 1488782 2732120 2629457 177316 173596 44706 18279 4664950 946228 3618381 3718722 4105914 1372522 926747 97048 13069635 13604320 1322374 1396114 47905 0 229184 211587 1599463 1607701 X 10566812 11093259 903360 903360 11470172 11996619 13069635 13604320 X 578371 65055 -116979 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 982 0 0 0 982 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. 304816 304816 2211415 252040 1959375 1986491 694188 1292303 162228 162228 3718722 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 320255 F HEDGE FUNDS 137252 F EQUITY METHOD INVESTMENTS 915015 C 1372522 INTERCOMPANY ACCOUNTS PAYABLE 211587 211587 1 1 X 1 X 1 X 1 1 1 0 1 1 60713 60713 0.00470 1352558 2443228 0 0.00000 1413271 2443228 60713 0.00470 10 419 35576 3500 32076 0.00250 4 7207 4576587 2649748 1926839 0.14890 6 6 11296 11296 0.00090 20 7632 4623459 2653248 1970211 0.15230 20 7632 6036730 5096476 2030924 0.15700 2 218 218 0.00000 2 3245 800 2445 0.00020 1 10 10 0.00000 1 18 18 0.00000 2 175 1416 1416 0.00010 8 175 4907 800 4107 0.00030 1 169900 16990 6092105 6159122 -67017 X 1 1 1 1 MERCYONE ELKADER MEDICAL CENTER 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 400.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 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: MERCYONE ONE ELKADER ADDRESSED THE FOLLOWING NEEDS IN FY24: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 IMPLEMENTED DEPRESSION SCREENINGS WITH PATIENTS AGE 12+. THE HOSPITAL 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; AND INTEGRATED TELEHEALTH PARTNERS/FLOWSTATE FOR BRAIN HEALTH CONSULTS. PROVIDERS WERE ENCOURAGED TO UTILIZE THESE TELEHEALTH SERVICES AND MOBILE APP OPTIONS TO IMPROVE PRODUCTIVITY. MERCYONE ELKADER ALSO CONTRACTED CARDIOLOGISTS FROM MEDICAL ASSOCIATES IN DUBUQUE TO COME TO ELKADER FOR IN-PERSON VISITS AND BECAME AN APPROVED NATIONAL HEALTH SERVICES CORPS (NHSC) SITE. THIS CERTIFICATION HELPS 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.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. SEVERAL CASH DONATIONS WERE MADE TO ORGANIZATIONS TO SUPPORT EFFORTS TO ENCOURAGE 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.ONE RN AND ONE ARNP BECAME TRAINED UNDER THE SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM THIS YEAR. THIS RESULTED IN A TOTAL OF FOUR MEMBERS OF THE NURSING DEPARTMENT NOW BEING TRAINED TO PERFORM SEXUAL ASSAULT EXAMS TO HELP LIMIT THE NEED FOR THESE PATIENTS TO BE TRANSFERRED TO ANOTHER FACILITY. THE MERCYONE ELKADER SANE NURSES WERE ACTIVELY INVOLVED IN THE CLAYTON COUNTY SEXUAL ASSAULT TEAM. 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 INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON LIMITED AVAILABLE INFORMATION. WHEN SUCH APPROVAL IS GRANTED, IT IS CLASSIFIED AS "PRESUMPTIVE SUPPORT." EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, HOMELESS PATIENTS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER. 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/FOR-PATIENTS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE-RHM 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 TRINITY HEALTH'S WEBSITE AT WWW.TRINITY-HEALTH.ORG/OUR-IMPACT/COMMUNITY-HEALTH-AND-WELL-BEING. 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, $169,900, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: ECONOMIC DEVELOPMENT: MERCYONE ELKADER LEADERS SERVED ON BOARDS AND COMMITTEES FOCUSED ON ECONOMIC AND COMMUNITY DEVELOPMENT INITIATIVES.COMMUNITY SUPPORT: MERCYONE ELKADER LEADERS PARTICIPATED IN COMMUNITY SUPPORT ACTIVITIES, INCLUDING SERVING ON LOCAL BOARDS AND PROVIDING MENTORSHIP TO STUDENTS. MERCYONE ELKADER ALSO HOSTED AND LED A SAFE SITTER CLASS FOR THE COMMUNITY.COALITION BUILDING: MERCYONE ELKADER LEADERS PARTICIPATED IN COMMUNITY COALITIONS AND BOARDS FOCUSED ON ADDRESSING HEALTH AND SAFETY ISSUES. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS/SAFETY: MERCYONE ELKADER LEADERS PARTICIPATED IN ADVOCACY EFFORTS BY ATTENDING COMMUNITY MEETINGS FOCUSED ON ENHANCING ADVOCACY STRATEGIES FOR VARIOUS HEALTH AND SOCIAL NEEDS.WORKFORCE DEVELOPMENT: MERCYONE ELKADER LEADERS SPENT TIME ON WORKFORCE DEVELOPMENT INITIATIVES SUCH AS HIGH SCHOOL CAREER EXPLORATION EVENTS, COLLEGE BOARD PARTICIPATION, AND PRESENTATIONS TO AREA SCHOOL GROUPS. 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 14 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. ESTIMATED RECEIVABLES FROM THIRD-PARTY PAYERS ALSO INCLUDES AMOUNTS RECEIVABLE UNDER STATE MEDICAID PROVIDER TAX PROGRAMS."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: THE IRS COMMUNITY BENEFIT OBJECTIVES INCLUDE RELIEVING OR REDUCING THE BURDEN OF GOVERNMENT TO IMPROVE HEALTH. TREATING MEDICARE PATIENTS CREATES SHORTFALLS THAT MUST BE ABSORBED BY HOSPITALS, WHICH PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THEREFORE, THE HOSPITAL BELIEVES ANY MEDICARE SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT. TRINITY HEALTH AND ITS HOSPITALS REPORT AS COMMUNITY IMPACT THE LOSS ON MEDICARE AND A HOST OF MANY OTHER EXPENSES DESIGNED TO SERVE PEOPLE EXPERIENCING POVERTY IN OUR COMMUNITIES. SEE SCHEDULE H, PART VI, LINE 5 FOR MORE INFORMATION.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 26, 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 OFFERED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HEALTH CARE 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 FOR FINANCIAL SUPPORT 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. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R) REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. PART VI, LINE 4: COMMUNITY INFORMATION - 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 2024, 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 PARTNERED WITH THE CITY OF ELKADER AND LOCAL TOWNSHIPS TO PROVIDE EMS SERVICES. THE HOSPITAL EMPLOYED ALL 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 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.MERCYONE ELKADER SUPPORTED BLOOD DRIVES IN THE LOCAL COMMUNITY THROUGH IN-KIND TIME HELPING CHECK PEOPLE IN AND PROVIDING SUPPLIES. 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 HAD CERTIFIED TRAINED SHIIP COUNSELORS AND EMPLOYED A SHIIP COORDINATOR WHO TAKES PHONE CALLS, SCHEDULES APPOINTMENTS, AND SERVES AS A LIAISON TO THE STATE.IN FY24, TRINITY HEALTH ASSESSED THE TOTAL IMPACT ITS HOSPITALS HAVE ON COMMUNITY HEALTH. THIS ASSESSMENT INCLUDES TRADITIONAL COMMUNITY BENEFIT AS REPORTED IN PART I, COMMUNITY BUILDING AS REPORTED IN PART II, THE SHORTFALL ON MEDICARE SERVICES AS REPORTED IN PART III, AS WELL AS EXPENSES THAT ARE EXCLUDED FROM THE PART I COMMUNITY BENEFIT CALCULATION BECAUSE THEY ARE OFFSET BY EXTERNAL FUNDING. ALSO INCLUDED ARE ALL COMMUNITY HEALTH WORKERS, INCLUDING THOSE OPERATING IN OUR CLINICALLY INTEGRATED NETWORKS. OUR GOAL IN SHARING THE COMMUNITY IMPACT IS TO DEMONSTRATE HOW OUR CATHOLIC NOT-FOR-PROFIT HEALTH SYSTEM MAKES A DIFFERENCE IN THE COMMUNITIES WE SERVE - FOCUSING ON IMPACTING PEOPLE EXPERIENCING POVERTY - THROUGH FINANCIAL INVESTMENTS. MERCYONE'S REGIONAL COMMUNITY IMPACT IN FY24 TOTALED $263.9 MILLION. 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 & 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 AIM TO 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 WE 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 2024 (FY24), TRINITY HEALTH CONTRIBUTED NEARLY $1.3 BILLION IN COMMUNITY BENEFIT SPENDING TO AID THOSE WHO ARE EXPERIENCING POVERTY AND OTHER VULNERABILITIES, AND TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES IN WHICH WE SERVE. TRINITY HEALTH FURTHERED ITS COMMITMENT THROUGH AN ADDITIONAL $900 MILLION IN PROGRAMS AND INITIATIVES THAT IMPACT OUR COMMUNITIES - YIELDING A TOTAL COMMUNITY IMPACT OF $2.2 BILLION IN FY24.TRINITY HEALTH'S COMMUNITY INVESTING PROGRAM FINISHED FY24 WITH MORE THAN $68 MILLION COMMITTED TO BUILDING VITAL COMMUNITY RESOURCES. THESE FUNDS, IN PARTNERSHIP WITH 31 PARTNERS, WERE PAIRED WITH OTHER RESOURCES TO GENERATE MORE THAN $931.5 MILLION IN INVESTMENTS, WITH APPROXIMATELY 80% ($749.3 MILLION) OF THESE FUNDS SUPPORTING HIGH PRIORITY ZIP CODES WITHIN TRINITY HEALTH'S SERVICE AREAS (DEFINED AS RACIALLY/ETHNICALLY-DIVERSE COMMUNITIES WITH HIGH LEVELS OF POVERTY). BETWEEN 2018 AND APRIL 2024, THESE INVESTMENTS HAVE BEEN INSTRUMENTAL IN CREATING MUCH-NEEDED COMMUNITY RESOURCES FOR THE PEOPLE THAT WE SERVE, NOTABLY:- CREATING AT LEAST 1,100 CHILDCARE; 7,000 KINDERGARTEN THROUGH HIGH SCHOOL EDUCATION; AND 1,500 EARLY CHILDHOOD EDUCATION SLOTS.- DEVELOPING AT LEAST 7.3 MILLION SQUARE FEET OF GENERAL REAL ESTATE.- PROVIDING 872 STUDENTS NEARLY $2.5 MILLION IN SCHOLARSHIPS TO PURSUE CAREERS IN THE HEALTH PROFESSIONS.- SUPPORTING 10,800 FULL- AND PART-TIME POSITIONS INVOLVED IN THE CREATION OF THESE PROJECTS.- CREATING 12,100 UNITS OF AFFORDABLE HOUSING OVER THE LAST FIVE YEARS (INCLUDING 360 SUPPORTIVE HOUSING BEDS).ACROSS THE TRINITY HEALTH SYSTEM, OVER 875,000 (ABOUT 80%) OF THE PATIENTS SEEN IN PRIMARY CARE SETTINGS WERE SCREENED FOR SOCIAL NEEDS. ABOUT 28% OF THOSE SCREENED IDENTIFIED AT LEAST ONE SOCIAL NEED. THE TOP THREE NEEDS IDENTIFIED INCLUDED FOOD ACCESS, FINANCIAL INSECURITY AND SOCIAL ISOLATION. TRINITY HEALTH'S ELECTRONIC HEALTH RECORD (EPIC) MADE IT POSSIBLE FOR TRINITY HEALTH TO STANDARDIZE SCREENING FOR SOCIAL NEEDS AND CONNECT PATIENTS TO COMMUNITY RESOURCES THROUGH THE COMMUNITY RESOURCE DIRECTORY (CRD), COMMUNITY HEALTH WORKERS (CHW'S) AND OTHER SOCIAL CARE PROFESSIONALS. THE CRD (FINDHELP) YIELDED OVER 88,600 SEARCHES, WITH NEARLY 7,000 REFERRALS MADE AND NEARLY 400 ORGANIZATIONS ENGAGED THROUGH OUTREACH, TRAININGS, ONE-ON-ONE ENGAGEMENTS, AND COLLABORATIVES. CHW'S ARE FRONTLINE HEALTH PROFESSIONALS WHO ARE TRUSTED MEMBERS OF AND/OR HAVE A DEEP UNDERSTANDING OF THE COMMUNITY SERVED. BY COMBINING THEIR LIVED EXPERIENCE AND CONNECTIONS TO THE COMMUNITY WITH EFFECTIVE TRAINING, CHW'S PROVIDE PATIENT-CENTERED AND CULTURALLY RESPONSIVE INTERVENTIONS. CHW'S FULFILL MANY SKILLS AND FUNCTIONS INCLUDING OUTREACH, CONDUCTING ASSESSMENTS LIKE A SOCIAL NEEDS SCREENING OR A HEALTH ASSESSMENT, RESOURCE CONNECTION, SYSTEM NAVIGATION, GOAL-SETTING AND PROBLEM-SOLVING THROUGH ONGOING EDUCATION, ADVOCACY, AND SUPPORT. IN PRACTICE, SOME EXAMPLES ARE A CHW HELPING A PATIENT CONNECT WITH THEIR PRIMARY CARE DOCTOR, ASSISTING WITH A MEDICAID INSURANCE APPLICATION OR UNDERSTANDING THEIR BASIC INSURANCE BENEFITS, OR EMPOWERING A PATIENT TO ASK CLARIFYING QUESTIONS ABOUT THEIR MEDICATIONS OR PLAN OF CARE AT THEIR NEXT DOCTOR'S APPOINTMENT. IN FY24, CHW'S SUCCESSFULLY ADDRESSED NEARLY 16,000 SOCIAL NEEDS. ONE SOCIAL NEED (SUCH AS ADDRESSING HOUSING OR FOOD NEEDS) CAN OFTEN TAKE MONTHS, OR EVEN A YEAR TO SUCCESSFULLY CLOSE, WHICH MEANS THE NEED HAS BEEN FULLY MET AND IS NO LONGER IDENTIFIED AS A NEED. TRINITY HEALTH RECEIVED A NEW CENTER FOR DISEASE CONTROL AND PREVENTION GRANT (5-YEAR, $12.5 MILLION AWARD) IN JUNE 2024. SINCE ITS LAUNCH, WE HAVE CREATED 21 NEW MULTI-SECTOR PARTNERSHIPS ACROSS 16 STATES TO ACCELERATE HEALTH EQUITY IN DIABETES PREVENTION. THIS PAST FISCAL YEAR, OUR HUB ENROLLED NEARLY 700 PARTICIPANTS INTO THE 12-MONTH, EVIDENCE-BASED LIFESTYLE CHANGE PROGRAM (60% REPRESENTING BLACK, LATINX AND/OR 65+ POPULATIONS), REACHED OUT TO NEARLY 20,350 PATIENTS AT RISK FOR TYPE 2 DIABETES, RECEIVED OVER 1,350 POINT OF CARE REFERRALS FROM PHYSICIANS, AND SCREENED NEARLY 1,500 POTENTIAL PARTICIPANTS FOR HEALTH-RELATED SOCIAL NEEDS - PROVIDING CHW INTERVENTIONS WHEN REQUESTED. FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 0 0 0 0 0 0 0 0 0 DONNA LAWLOR MD PHYSICIAN, FAMILY MEDICINE 323702 0 5500 0 0 0 7501 0 20715 0 357418 0 0 0 JEFFREY MESSERLY DO PHYSICIAN, EMERGENCY CARE 260806 0 0 0 0 0 1307 0 19677 0 281790 0 0 0 BROOKE KENSINGER DIRECTOR; CHIEF EXECUTIVE OFFICER 0 207668 0 40513 0 4815 0 19722 0 1419 0 274137 0 0 MELISSA SIMON DO PHYSICIAN, EMERGENCY CARE 216029 0 15000 0 0 0 0 0 15898 0 246927 0 0 0 STACEY EMBRETSON NURSE PRACTITIONER 132037 0 3741 0 0 0 4341 0 26734 0 166853 0 0 0 LENNA DINAN REGISTERED NURSE 157408 0 0 0 0 0 4730 0 634 0 162772 0 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 3 STARTING IN AUGUST 2023, CATHOLIC HEALTH INITIATIVES - IOWA (CHI-IA), A RELATED ORGANIZATION, CONTRACTED WITH HEALTHSOURCE PARTNERS FOR THE PROVISION OF MANAGEMENT SERVICES BY TERRI DONOVAN TO CHI-IA AND RELATED IOWA ORGANIZATIONS. IN CALENDAR YEAR 2023, CHI-IA PAID $172,866 TO HEALTHSOURCE PARTNERS FOR THESE MANAGEMENT SERVICES. MERCYONE ELKADER DOES NOT KNOW HOW MUCH TERRI DONOVAN RECEIVED AS WAGES FROM HEALTHSOURCE PARTNERS IN CALENDAR 2023. EFFECTIVE JANUARY 1, 2024, HEALTHSOURCE PARTNERS CONTINUED TO PROVIDE MANAGEMENT SERVICES WHEN TERRI DONOVAN BECAME THE INTERIM VICE PRESIDENT OF FINANCE OF MERCYONE ELKADER AND OTHER RELATED IOWA ORGANIZATIONS. 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. 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, WHO COLLABORATES WITH INTERNAL LEGAL COUNSEL TO ASSESS THE CONFLICT AND IDENTIFY A CONFLICT MANAGEMENT PLAN WHEN NECESSARY. ADDITIONALLY, THE INTEGRITY AND COMPLIANCE OFFICER ALONG WITH 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 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 1,342,490. MANAGEMENT AND GENERAL EXPENSES 295,670. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,638,160. MISCELLANEOUS PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 485,131. MANAGEMENT AND GENERAL EXPENSES 245,383. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 730,514. RECRUITING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 13,094. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,094. MEDICAL SPECIALIST FEES: PROGRAM SERVICE EXPENSES 266,105. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 266,105. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 80,499. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,499. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO AFFLIATES -116,979. FORM 990, PART XII, LINE 2: MERCYONE ELKADER'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY24 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 801 5TH STREET SIOUX CITY IA 51101 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 801 5TH STREET SIOUX CITY IA 51101 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 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 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