2025-11-13T21:06:13-06:00 2024-12-31 990 2024-01-01 420933383 GRINNELL REGIONAL MEDICAL CENTER GRIN 6412367511 210 FOURTH AVENUE GRINNELL IA 50112 PATRICIA ALLEN MARKET CFO 6412367511 2025-11-10 0 2024 2025-03-06 01:10:19Z DAVID-PAUL CAVAZOS 210 FOURTH AVENUE GRINNELL IA 50112 71535639 0 X WWW.UNITYPOINT.ORG (SEE SCH O) X 1967 IA TO TREAT, HEAL AND CARE FOR THE SICK AND DISABLED. 14 8 426 8 450856 0 1008906 2026260 62233099 67988235 -7028 126184 1168213 1394960 64403190 71535639 442064 504440 0 0 39935154 41450784 0 0 0 23728031 25446585 64105249 67401809 297941 4133830 32982535 36235501 21486925 20605203 11495610 15630298 X GRINNELL REGIONAL MEDICAL CENTER'S MISSION IS DEDICATION TO HEALTH CARE FOR LIFE THROUGH GENUINE CARE AND COMPASSION FOR THE HEALTH AND WELL-BEING OF PATIENTS, FAMILIES AND THE COMMUNITIES GRINNELL REGIONAL MEDICAL CENTER IS PRIVILEGED TO SERVE, RESPONSIVENESS TO BALANCING COMMUNITY NEEDS WITH AVAILABLE RESOURCES, MARVELOUS PEOPLE MAKING A DIFFERENCE THROUGH QUALITY CARE AND SERVICE EXCELLENCE EVERY DAY AND COMMITMENT TO PROMOTING WELLNESS, RESTORING HEALTH AND ENHANCING THE QUALITY OF LIFE WE SERVE. 0 0 60423692 504440 69382273 HEALTH-CARE SERVICESGRINNELL REGIONAL MEDICAL CENTER IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE GRINNELL COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. GRINNELL REGIONAL MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE, CARDIOLOGY, ONCOLOGY, MATERNAL/CHILD CARE, PALLIATIVE CARE, EMERGENCY SERVICES AND OUTPATIENT CLINICS. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2024, GRINNELL REGIONAL MEDICAL CENTER PROVIDED 4,403 DAYS OF ACUTE CARE, 557 DAYS OF SKILLED NURSING CARE AND 411 NURSERY DAYS. 3646817 0 0 CHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: GRINNELL REGIONAL MEDICAL CENTER PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $230,075 IN 2024. OFTENTIMES, GRINNELL REGIONAL MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. GRINNELL REGIONAL MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. OTHER BENEFITS: GRINNELL REGIONAL MEDICAL CENTER PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. GRINNELL REGIONAL MEDICAL CENTER COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. GRINNELL REGIONAL MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL NET OTHER BENEFITS REPORTED VALUE: $3,416,742. 64070509 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 X 0 0 426 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X PATRICIA ALLEN MARKET CFO 6412367511 210 FOURTH AVENUE GRINNELL IA 50112 LISA BISHOP DO BOARD MEMBER 1.00 40.00 X 0 275628 47489 JACOB BOYER PA-C BOARD MEMBER 40.00 0.00 X 222515 0 33741 DARWIN COPEMAN BOARD CHAIR 1.00 1.00 X X 0 0 0 DAVID-PAUL CAVAZOS BOARD MEMBER/RURAL PRESIDENT (FR 06/24) 1.00 40.00 X X 0 208507 26578 RACHAEL KINNICK BOARD CHAIR ELECT 1.00 0.00 X X 0 0 0 SALLY LANG BOARD TREASURER 1.00 0.00 X X 0 0 0 AL MALY BOARD MEMBER 1.00 0.00 X 0 0 0 AMY MILLER BOARD MEMBER 1.00 0.00 X 0 0 0 SID RAMSEY BOARD MEMBERVP MARKETING & BUS DEV-C (TO 06/24) 1.00 40.00 X 0 446539 32342 HENRY MORISADA RIETZ PHD BOARD SECRETARY 1.00 0.00 X X 0 0 0 JON ROZENFELD BOARD MEMBER MARKET PRESIDENT (FR 01/24) 1.00 40.00 X 0 536925 88339 SARAH SMITH BOARD MEMBER 1.00 0.00 X 0 0 0 TRACI SMITH BOARD MEMBER 1.00 0.00 X 0 0 0 DOUGLAS VAN DAELE MD FACS BOARD MEMBER (TO 09/24) 1.00 0.00 X 0 0 0 PROCTOR LUREMAN INTERIM RURAL PRESIDENT (TO 06/24) 1.00 40.00 X 0 218818 16537 KYLE WILCOX VP FINANCE (TO 04/24) 40.00 1.00 X 93624 0 9841 LAURA JUEL VP NURSING & CLINICAL SERV 40.00 0.00 X 198638 0 45897 SCOTT DOYLE CRNA ARNP ANESTHESIOLOGY 40.00 0.00 X 303389 0 38486 STEPHEN ELLESTAD DO PHYSICIAN 40.00 0.00 X 299761 0 15778 KATHRYN OGBURN CRNA RN ARNP ANESTHESIOLOGY 40.00 0.00 X 282446 0 26337 JARROD PHELPS PA-C GENERAL SURGERY 40.00 0.00 X 166033 0 8501 KRISTIN PHELPS PA-C FAMILY MEDICINE 40.00 0.00 X 170328 0 29272 JENNIFER HAVENS FRMR CEO (TO 10/23) 0.00 40.00 X 0 395490 71871 1736734 2081907 491009 46 1 1 0 MAHMOD F EL-TAYASH MD 122 4TH AVE GRINNELL IA 50112 HEALTHCARE SERVICES 828789 AMN HEALTHCARE 2999 OLYMPUS BLVD STE 500 DALLAS TX 75019 STAFFING SERVICES 693152 DES MOINES ORTHOPAEDIC SURGEON 6001 WESTOWN PKWY WEST DES MOINES IA 50266 HEALTHCARE SERVICES 608559 ELIZABETH TIGGES DO FACOG 1326 BROAD ST GRINNELL IA 50112 HEALTHCARE SERVICES 595385 ANNA MENSING MD 1835 MANOR DR GRINNELL IA 50112 HEALTHCARE SERVICES 534967 14 449231 1081747 495282 2026260 NET PATIENT REVENUE 900099 65309030 65309030 LABORATORY SERVICES 621500 1893283 1893283 MISCELLANEOUS REVENUE 900099 461842 461842 RENTAL INCOME 531390 171322 171322 MGMT & SUPPORT SVCS 561000 152758 152758 67988235 96786 10 96776 28898 500 0 0 28898 500 29398 29398 MISCELLANEOUS 900099 727711 276855 450856 SHARED SAVINGS REVENUE 900099 519896 519896 CAFETERIA/FOOD SVCS 722514 147353 146421 932 1394960 71535639 68931417 450856 127106 504440 504440 604256 256256 348000 67894 67894 33729584 31893711 1835873 1013040 957901 55139 4248083 4016863 231220 1787927 1690612 97315 5345588 5345588 130153 101741 28412 136485 58831 77654 5565245 5461891 103354 133171 2118 131053 855027 674363 180664 1680294 1606638 73656 183255 178309 4946 7679 6535 1144 37936 37936 1773497 1709455 64042 568786 568786 MEDICAL SUPPLIES 8922451 8907083 15368 MISCELLANEOUS EXPENSE 107015 91449 15566 SALES & USE TAXES 3 3 67401809 64070509 3331300 0 1518494 3812328 558243 1920610 8092549 8224023 5871081 3565695 1620209 1579145 213869 230505 60826821 48656858 12939237 12169963 2168758 3758787 95 974445 32982535 36235501 4987751 4214233 1310094 228044 146898 67500 1643400 1592921 13398782 14502505 21486925 20605203 X 11449082 15583770 46528 46528 11495610 15630298 32982535 36235501 4133830 858 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 289742 289742 30225400 22768722 7456678 1413656 1356354 57302 27672737 24531782 3140955 1225286 1225286 12169963 LONG-TERM RETENSION INCENTIVES 2052354 DUE TO AFFILIATES 10715984 HEALTH AND WELFARE BENEFITS RESERVE 289326 OPERATING LEASE LIABILITY 974445 SELF INSURANCE RESERVE 470396 14502505 X 70003000 858 858 70002142 -1512 1535009 1533497 71535639 67167000 489 489 67166511 -1512 236810 235298 67401809 PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2021. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 4B - OTHER ADJUSTMENTS: REVENUES IN NET ASSETS WITHOUT DONOR RESTRICTIONS 1,534,941. ROUNDING 68. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 489. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN NET ASSETS WITHOUT DONOR RESTRICTIONS 236,810. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 230075 230075 0.00340 14166901 16234101 0 0.00000 14396976 16234101 230075 0.00340 32925 32925 0.00050 3374843 3374843 0.05010 8974 8974 0.00010 3416742 3416742 0.05070 17813718 16234101 3646817 0.05410 0 809409 0 9996183 11224460 -1228277 X 1 1 1 1 GRINNELL REGIONAL MEDICAL CENTER 210 FOURTH AVENUE GRINNELL IA 50112 WWW.UNITYPOINT.ORG/GRINNELL 790016H X X X GRINNELL REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE PART V, PAGE 8 X 1 22 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 600.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 GRINNELL REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: THIS ASSESSMENT WAS CONDUCTED ON BEHALF OF UNITYPOINT HEALTH - GRINNELL REGIONAL MEDICAL CENTER (UPH-GRMC) BY PRC, A NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS IN HUNDREDS OF COMMUNITIES ACROSS THE UNITED STATES SINCE 1994. THIS ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWS FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY UPH-GRMC AND PRC. A PRECISE AND CAREFULLY EXECUTED METHODOLOGY IS CRITICAL IN ASSERTING THE VALIDITY OF THE RESULTS GATHERED IN THE PRC COMMUNITY HEALTH SURVEY. THUS, TO ENSURE THE BEST REPRESENTATION OF THE POPULATION SURVEYED, A MIXED-MODE METHODOLOGY WAS IMPLEMENTED. THIS INCLUDED TARGETED SURVEYS CONDUCTED BY PRC VIA TELEPHONE (CELL PHONE AND LANDLINE), AS WELL AS A COMMUNITY OUTREACH COMPONENT PROMOTED BY THE STUDY SPONSORS THROUGH SOCIAL MEDIA POSTING AND OTHER COMMUNICATIONS. FOR THE TARGETED ADMINISTRATION, PRC ADMINISTERED 200 SURVEYS AT RANDOM THROUGHOUT THE COUNTY. PRC ALSO CREATED A LINK TO AN ONLINE VERSION OF THE SURVEY, AND UPH-GRMC PROMOTED THIS LINK THROUGHOUT THE VARIOUS COMMUNITIES TO DRIVE ADDITIONAL PARTICIPATION AND BOLSTER OVERALL SAMPLES. THIS YIELDED AN ADDITIONAL 138 SURVEYS TO THE OVERALL SAMPLE. IN ALL, 338 SURVEYS WERE COMPLETED THROUGH THESE MECHANISMS. ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION TO APPROPRIATELY REPRESENT POWESHIEK COUNTY AS A WHOLE. ALL ADMINISTRATION OF THE SURVEYS, DATA COLLECTION, AND DATA ANALYSIS WAS CONDUCTED BY PRC.TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY ALSO WAS IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY UPH-GRMC; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. IN ALL, 65 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY. THROUGH THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW INCOME, MINORITY, OR OTHER MEDICALLY UNDERSERVED POPULATIONS. GRINNELL REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: UPH-GRINNELL CONDUCTED ITS LAST CHNA IN 2022 AND REVIEWED THE HEALTH PRIORITIES IDENTIFIED THROUGH THAT ASSESSMENT. TAKING INTO ACCOUNT THE TOP-IDENTIFIED NEEDS AS WELL AS HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS, AND STRATEGIC PRIORITIES UPH-GRINNELL FOCUSED ON FOUR NEEDS. STRATEGIES FOR ADDRESSING THESE NEEDS WERE OUTLINED IN UPH-GRINNELL'S IMPLEMENTATION STRATEGY, AND THE FOLLOWING PROVIDES AN EVALUATION OF THE IMPACT OF THE ACTIONS TAKEN TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS IN OUR COMMUNITY.1. MENTAL HEALTH AND SUBSTANCE ABUSE UNITYPOINT HEALTH CLINIC (UPC) IMPLEMENTED AN OUTPATIENT TELEHEALTH, BEHAVIORAL HEALTH CLINIC JULY 2024 TO FOCUS ON THERAPY AND MEDICATION MANAGEMENT. THIS CLINIC IS TWO DAYS PER WEEK AND IS STAFFED WITH A APP. THIS CLINIC FURTHER EXPANDED IN AUGUST 2025 TO ADD A THERAPIST 3 DAY/WEEK. MARCH 2024 UPH-GRINNELL INITIATED ADMITTING DETOX PATIENTS THAT PRESENT TO THE ED. UPH-GRINNELL IMPLEMENTED A CONSULT/REFERRAL PROCESS TO POWELL CHEMICAL DEPENDENCY (CDC) FOR INPATIENT SUBSTANCE ABUSE. POST- PARTUM HOME VISITS INCLUDE SCREENING NEW MOMS FOR POSTPARTUM DEPRESSION. LIFE WITH BABY POSTPARTUM SUPPORT AND CONNECTION GROUP IS A FREE SUPPORT GROUP THAT MEETS MONTHLY UPH-GRINNELL. UPH- GRINNELL PUBLIC HEALTH SUB-CONTRACTED THE IOWA TOBACCO GRANT UNDER JOHNSON COUNTY PUBLIC HEALTH UNTIL JULY 1, 2025,WHERE PUBLIC HEALTH TOOK OVER THE GRANT FOR POWESHIEK COUNTY INITIATIVES. UPH- GRINNELL PUBLIC HEALTH CONTINUES TO FOLLOW THE SOCIAL MEDIA PLAN DEVELOPED TO INCREASE AWARENESS OF RESOURCES AND SERVICES, INITIATIVES AND EVENTS THAT ALIGN WITH THE TOP FOUR AREAS OF GREATEST CONCERN FROM THE 2022 CHNA. UPH- GRINNELL POWESHIEK COUNTY PUBLIC HEALTH BEGAN AN ALZHEIMER'S SUPPORT GROUP TO SUPPORT FAMILIES AND FRIENDS WHO ARE NAVIGATING LIFE WITH A FAMILY MEMBER SUFFERING FROM ALZHEIMER'S OR DEMENTIA. UPH- GRINNELL POWESHIEK COUNTY PUBLIC HEALTH UTILIZED OPIOID SETTLEMENT FUNDING THROUGH POWESHIEK COUNTY TO PURCHASE EDUCATIONAL WORKBOOKS FOR SEVENTH GRADE STUDENTS THAT WILL BE UTILIZED THIS FALL, 2025 WITH THE SHERIFF DEPARTMENT AND PUBLIC HEALTH. THE NAME OF PROGRAM IS CALLED "TOO GOOD." UPH- GRINNELL PUBLIC HEALTH WORKED IN COORDINATION WITH BGM HIGH SCHOOL TO HAVE AN I-STEP GROUP FOR STUDENTS TO JOIN IN GRADES 7-12TH. THIS IS A YOUTH-LED SUBSTANCE AND TOBACCO EDUCATION AND PREVENTION PROGRAM THAT EDUCATES AND LEADS STUDENTS TO ADVOCATE FOR HEALTHIER LIFESTYLES AMONG THEIR PEERS. UPH- GRINNELL POWESHIEK COUNTY PUBLIC HEALTH LAUNCHED A DEMENTIA PREVENTION COURSE FOR INDIVIDUALS IN AND AROUND POWESHIEK COUNTY IN 2023. UPH- GRINNELL WELLNESS PROVIDED MULTIPLE FREE EVENTS FOR FAMILIES TO ATTEND INCLUDING YOGA IN THE PARK AND KITTEN YOGA. UPH- GRINNELL PUBLIC HEALTH WORKS WITH AREA BUSINESSES AND SCHOOLS TO EDUCATE ON HEALTHY WAYS TO IMPROVE MENTAL HEALTH. PUBLIC HEALTH PARTNERS TOGETHER WITH UPH-GRINNELL AND THE MENTAL HEALTH CONSORTIUM TO INFORM PARTICIPANTS ON THE AVAILABLE RESOURCES AND EVENTS THROUGHOUT THE COUNTY. UPH- GRINNELL DONATED GRINNELL-AREA MENTAL HEALTH CONSORTIUM $1,200 IN 2024 AND $1,200 IN 2025 TO ASSIST IN EXPANDING SERVICES FOR PATIENTS. UPH- GRINNELL PUBLIC HEALTH CONTINUES TO INCREASE EFFORTS FOR COMMUNITY OUTREACH TO EDUCATE INDIVIDUALS WORKING AND LIVING IN POWESHIEK COUNTY ON MENTAL HEALTH RESOURCES, SUBSTANCE ABUSE RISKS AS WELL AS RESOURCES FOR SUPPORT. PUBLIC HEALTH COLLABORATES WITH IOWA STATE EXTENSION, MONTEZUMA COMMUNITY DEVELOPMENT, BROOKYLN CHAMBER, GRINNELL CHAMBER, SCHOOLS, BROWNELL'S, BAYER, AND GRINNELL MUTUAL TO ATTEND COMMUNITY EVENTS TO PROVIDE EDUCATION AND HIGHLIGHT RESOURCES.2. CANCER UPH- GRINNELL CLINICS PROVIDED BREAST, CERVICAL AND COLORECTAL SCREENINGS ON PATIENTS IN THEIR CARE. TOGETHER WE CARE, RESOURCE AND REFERRAL ARE BEING IMPLEMENTED WITHIN UPH-GRINNELL CLINICS AND THROUGHOUT THE COUNTY TO ALLOW PATIENTS TO ACCESS SERVICES. FROM 2022-2025 UPH-GRINNELL ABSORBED APPROXIMATELY $50,000 IN THE COST OF CHEMO BIOLOGICS VERSUS SENDING PATIENTS TO OUTSIDE FACILITIES.3. PREVENTIVE SERVICES: DIABETES, NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT UPH- GRINNELL OBGYN AND OB DEPARTMENT INCREASED EDUCATION AND EFFORTS TO EDUCATE MOTHERS ON THE COUNT THE KICKS, HEALTHY BIRTH, BREAST-FEEDING AND CAR SEAT SAFETY. UPH- GRINNELL DIABETIC EDUCATOR PROGRAM BEGAN IN 2023. UPH- GRINNELL BARIATRIC IS A LEVEL 1 BARIATRIC SURGICAL CENTER OF EXCELLENCE. IN 2024, THE CLINICAL DIETITIANS AT UPH- GRINNELL BECAME CERTIFIED IN OBESITY FOR PEDIATRIC AND ADULTS. UPH- GRINNELL PUBLIC HEALTH COLLABORATED WITH BGM SCHOOL DISTRICT TO IMPLEMENT A NEW PROGRAM FOR 3RD AND 4TH GRADES CALLED MILEAGE CLUB TO EDUCATE STUDENTS ON HEALTH AND WELLNESS AND ENCOURAGE WALKING/RUNNING DURING LUNCH BREAKS AND EXTRA RECESSES FOR PRIZES. UPH- GRINNELL'S LIFE WITH BABY POSTPARTUM SUPPORT AND CONNECTION GROUP IS A FREE SUPPORT GROUP THAT MEETS MONTHLY UPH-GRINNELL. UPH- GRINNELL PUBLIC HEALTH PROVIDES OUTREACH AND EDUCATION WITHIN THE COMMUNITY COVERING A VARIETY OF PREVENTATIVE TOPICS. UPH- GRINNELL PUBLIC HEALTH ATTENDED AG DAY WITH THE LION'S CLUB IN GRINNELL IN 2023 DRAWING A1C FOR DIABETIC EDUCATION, 2024- CHECKING BLOOD PRESSURES AND DISCUSSING HEART HEALTH, AND IN 2025 DISTRIBUTING EMERGENCY PREPAREDNESS RESOURCES, ATV/ UTV EDUCATIONAL MATERIAL, AND MINI FIRST AID KITS. UPH- GRINNELL PUBLIC HEALTH WORKS IN COLLABORATION WITH CORPORATE BUSINESSES THROUGHOUT THE COUNTY TO PROVIDE WELLNESS BLOOD DRAWS. UPH- GRINNELL PUBLIC HEALTH WORKS TO INCREASE AWARENESS WITH THE COMMUNITY PARTNERSHIPS FOR PROTECTING CHILDREN. UPH- GRINNELL PUBLIC HEALTH ATTENDS GRINNELL FARMER'S MARKETS MONTHLY FROM MAY TO OCTOBER HIGHLIGHTING THE VARIOUS PUBLIC HEALTH PROGRAMS AND RESOURCES AVAILABLE IN THE COUNTY. PWA FITNESS CENTER COLLABORATES WITH THE GRINNELL FOUNDATION, BIKES TO YOU AND OTHER LOCAL BUSINESSES TO PURCHASE, FIT AND DISTRIBUTE FREE BIKE HELMETS TO ALL THIRD-GRADE STUDENTS THROUGHOUT THE COUNTY. UPH- GRINNELL- SUPPORTS ORGANIZATIONS TO PROVIDE FREE SNACKS AND MEALS TO GRINNELL SCHOOL DISTRICT FOR TIGER PACKS PROGRAM. 4. ACCESS TO HEALTH SERVICES UPH- GRINNELL RECEIVED THE CENTER OF EXCELLENCE GRANT IN 2022 AND AGAIN IN 2024 TO INCREASE AND EXPAND MATERNAL HEALTH SERVICES OFFERED AT UPH- GRINNELL. CENTER OF EXCELLENCE (COE) GRANT- EXTENDED MATERNAL HEALTH OUTREACH THROUGH PUBLIC HEALTH SERVICES AS WELL AS OBGYN SUPPORT WITH CLINIC IN MARSHALLTOWN, IOWA. UPH- GRINNELL IS PART OF THE LARGER UNITYPOINT HEALTH SYSTEM, WORKING CLOSELY WITH UNITYPOINT HEALTH DES MOINES TO PROVIDE COORDINATED, SEAMLESS CARE. OUR EMERGENCY DEPARTMENT IS NOW FULLY STAFFED WITH ALL EMERGENCY TRAINED PROVIDERS THROUGH THIS COLLABORATION. TO ENHANCE SERVICES AND ACCESS TO CARE, UPH- GRINNELL HAS HIRED THE FOLLOWING PROVIDERS: OBGYN, NURSE MIDWIFE, FAMILY PRACTICE PROVIDER, GENERAL SURGEON, UPH- GRINNELL LAUNCHED AN APPRENTICESHIP PROGRAM TO INCREASE PATIENT CARE TECHS FOR THE HOSPITAL DEPARTMENTS COLLABORATING WITH MARSHALLTOWN COMMUNITY COLLEGE. SINCE LAUNCHING THE PROGRAM, WE HAVE HAD ONE PARTICIPANT. GRINNELL REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND, IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. STATE LAW REQUIREMENTS THAT OFFER ADDITIONAL AND/OR MORE STRINGENT ELIGIBILITY REQUIREMENTS WILL BE FOLLOWED FOR THOSE STATES. PART V, LINE 7A, CHNA REPORT: THE CHNA REPORT WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS PART V, LINE 10A, IMPLEMENTATION STRATEGY: THE CHNA REPORT WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/ABOUT-UNITYPOINT-HEALTH/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS PART V, LINE 16A, FAP WEBSITE: THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL): WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART V, LINE 16B, FAP WEBSITE: THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE PART V, LINE 16C, FAP WEBSITE: A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE (LIST URL):WWW.UNITYPOINT.ORG/PATIENTS-AND-VISITORS/BILLING-AND-FINANCIAL-INFORMATION/FINANCIAL-ASSISTANCE 14 1 - GRINNELL REGIONAL MEDICAL CENTER 210 FOURTH AVENUE GRINNELL IA 50112 CLINIC 2 - COMMUNITY CARE CLINIC 306 FOURTH AVENUE GRINNELL IA 50112 CLINIC 3 - FAMILY PRACTICERHC 202 4TH AVE SUITE 300 GRINNELL IA 50112 CLINIC 4 - PAIN CLINIC RHC 202 4TH AVE SUITE 200 GRINNELL IA 50112 CLINIC 5 - POSTELS COMMUNITY HEALTH PARK 807 BROAD STREET GRINNELL IA 50112 CLINIC 6 - MONTEZUMARHC 101 WEST WASHINGTON ST SUITE 100 MONTEZUMA IA 50171 CLINIC 7 - VICTOR HEALTH CENTER 709 SECOND STREET VICTOR IA 52347 CLINIC 8 - INTERNAL MEDICINERHC 202 4TH AVE SUITE 200 GRINNELL IA 50112 CLINIC 9 - GRINNELL ORTHOPEDIC CLINIC 202 4TH AVE GRINNELL IA 50112 CLINIC 10 - URGENT CARERHC 202 4TH AVE SUITE 100 GRINNELL IA 50112 CLINIC 11 - OBGYNRHC 202 4TH AVE SUITE 300 GRINNELL IA 50112 CLINIC 12 - ENT 202 4TH AVENUE GRINNELL IA 50112 CLINIC 13 - GENERAL SURGERY 122 4TH AVENUE GRINNELL IA 50112 CLINIC 14 - PAIN CLINIC 210 4TH AVENUE GRINNELL IA 50112 CLINIC PART I, LINE 6A: THE HOSPITAL'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM'S COMMUNITY BENEFIT REPORT (DBA AS UNITYPOINT HEALTH) WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT' LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR CENTRAL IOWA HOSPITAL CORPORATION. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. PART VI, LINE 2: POWESHIEK COUNTY RESIDENTS RECENTLY PARTICIPATED IN AN EXTENSIVE COMMUNITY HEALTH NEEDS ASESSMENT. THIS SURVEY PROVIDED DIRECTION FOR GRINNELL REGIONAL MEDICAL CENTER (GRMC) AND GRINNELL REGIONAL PUBLIC HEALTH TO DEVELOP A HEALTH IMPROVEMENT PLAN OVER THE NEXT FIVE YEARS AND DETERMINE WHAT IS IMPORTANT FOR THE HEALTH OF THE COUNTY. GRMC HAS RECENTLY SURVEYED ITS COMMUNITY HEALTHCARE PROVIDERS TO IDENTIFY WHAT THEY FEEL ARE THE MOST URGENT NEEDS. GRMC ALSO REVIEWS STATEWIDE DATABASES (I.E., TEEN PREGNANCY, CANCER RATES) TO IDENTIFY AREAS IN WHICH TO CONCENTRATE EFFORTS. PART VI, LINE 3: THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ALL PATIENTS AND WITHIN THE COMMUNITY. COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. THE CENTRAL BILLING OFFICE IS AVAILABLE BY PHONE TO ANSWER QUESTIONS ABOUT THE POLICY, OR PATIENTS SHOULD GO TO THE CASHIER'S OFFICE AT THE HOSPITAL TO OBTAIN THIS INFORMATION. THE PLAIN LANGUAGE SUMMARY IS OFFERED AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS AND INCLUDED WHEN A PATIENT IS SENT WRITTEN NOTICE THAT EXTRAORDINARY COLLECTION ACTIONS MAY BE TAKEN AGAINST HIM/HER. THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY, AND ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE IN WHICH LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS CONSTITUTE THE LESSER OF 1,000 PERSONS OR MORE THAN 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE TRANSLATED DOCUMENTS WILL BE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. PART VI, LINE 4: GRINNELL REGIONAL MEDICAL CENTER (GRMC) IS A PRIVATE, NON-PROFIT AND NON-TAX-SUPPORTED MEDICAL CENTER LOCATED ON THE WESTERN EDGE OF POWESHIEK COUNTY, SERVING MORE THAN 49,000 RESIDENTS IN A SIX-COUNTY RURAL AREA OF EAST CENTRAL IOWA. GRINNELL IS 50 MILES EAST OF DES MOINES, IOWA AND 60 MILES WEST OF IOWA CITY, IOWA. DES MOINES AND IOWA CITY ARE THE CLOSEST CITIES WITH TERTIARY HOSPITALS FOR OUR SERVICE AREA. MEDIAN HOUSEHOLD INCOME FOR POWESHIEK IS ESTIMATED AT $64,837 ACCORDING TO U.S. CENSUS BUREAU QUICKFACTS . IN TERMS OF AGE, 29.6% OF RESIDENTS IN POWESHIEK COUNTY ARE 65 YEARS OF AGE OR OLDER WHILE ACROSS THAT STATE 26.8% ARE 65 YEARS OF AGE OR OLDER. PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE PEOPLE AND COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH AN OPEN MEDICAL STAFF AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD APPROVES THE COMMUNITY NEEDS ASSESSMENT AND COMMUNITY BENFEFIT PLAN FOR THE HOSPITAL. THE HOSPITAL IS PART OF AN INTEGRATED HEALTH SYSTEM AND ITS ULTIMATE PARENT UNITYPOINT HEALTH ALONG WITH ITS SUBSIDIARIES THAT INCLUDE THE HOSPITAL HAVE A STANDARD MODEL OF GOVERNANCE THAT ALLOWS THE HOSPITAL TO MAINTAIN A STRONG CLINICAL, FINANCIAL, STRATEGIC AND OPERATIONAL PROFILE THAT INCLUDES SURPLUS FUNDS USED TO FURTHER ITS CHARITABLE PURPOSE. PART VI, LINE 6: THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH), THE NATION'S FIFTH LARGEST NON-DENOMINATIONAL HEALTH SYSTEM WITH $5.3B IN OPERATING REVENUE AND 29,000 TEAM MEMBERS. AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 400 CLINICS; 17 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THEIR REGIONS. IN 2024, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $281 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. PART VI, LINE 7, REPORTS FILED WITH STATES IA 1 ADAIR COUNTY MEMORIAL 609 SE KENT ST GREENFIELD IA 50849 426037639 GOVERNMENT 8474 0 PROGRAM SERVICE AMERICAN HEART ASSOCIATION 1111 9TH STREET STE 280 DES MOINES IA 50314 135613797 501(C)(3) 5931 0 PROGRAM SERVICE BOONE COUNTY HOSPITAL 1015 UNION ST BOONE IA 50036 426037625 GOVERNMENT 11391 0 PROGRAM SERVICE BROADLAWNS MEDICAL CENTER 1801 HICKMAN RD DES MOINES IA 50314 426005830 GOVERNMENT 13060 0 PROGRAM SERVICE CATHOLIC HEALTH INITIATIVES IOWA CORP 1111 6TH AVE DES MOINES IA 50314 420680448 501(C)(3) 33557 0 PROGRAM SERVICE CITY OF BROOKLYN IOWA 138 JACKSON ST BROOKLYN IA 52211 426004302 GOVERNMENT 8000 0 PROGRAM SERVICE DALLAS COUNTY HOSPITAL 610 10TH ST PERRY IA 50220 426037739 501(C)(3) 7695 0 PROGRAM SERVICE GREENE COUNTY MEDICAL CENTER 1000 W LINCOLN WAY JEFFERSON IA 50129 426037888 GOVERNMENT 9960 0 PROGRAM SERVICE GRINNELL REGION MEDICAL CENTER FOUNDATION 210 4TH AVE GRINNELL IA 50112 421454737 501(C)(3) 236810 0 PROGRAM SERVICE GUTHRIE COUNTY HOSPITAL 710 N 12TH ST GUTHRIE CENTER IA 50115 426037888 GOVERNMENT 11122 0 PROGRAM SERVICE MANNING REGIONAL HEALTHCARE CENTER 1550 6TH ST MANNING IA 51455 391902797 501(C)(3) 10971 0 PROGRAM SERVICE MERCY MEDICAL CENTER 701 10TH ST SE CEDAR RAPIDS IA 52403 420698295 501(C)(3) 5866 0 PROGRAM SERVICE ST ANTHONY REGIONAL HOSP 311 CLARK ST CARROLL IA 51401 420733472 501(C)(3) 14264 0 PROGRAM SERVICE STORY COUNTY HOSPITAL 640 S 19TH NEVADA IA 50201 421078827 GOVERNMENT 116443 0 PROGRAM SERVICE 8 7 PART I, LINE 2: GRINNELL REGIONAL MEDICAL CENTER MONITORS THE USE OF GRANT FUNDS ACCORDING TO THE STANDARD FINANCIAL POLICIES OF THE ORGANIZATION AND AS REQUIRED BY THE GRANT OR GRANTOR. THE POLICIES AND PROTOCOLS OF THE FUNDING SOURCE ARE ENFORCED AND MONITORED BY THE ORGANIZATION AND REPORTED AS REQUIRED. 1 1 0 0 0 0 0 0 0 JON ROZENFELD BOARD MEMBER MARKET PRESIDENT (FR 01/24) 0 488775 0 0 0 48150 0 65779 0 22560 0 625264 0 0 SID RAMSEY BOARD MEMBERVP MARKETING & BUS DEV-C (TO 06/24) 0 168652 0 93162 0 184725 0 23672 0 8670 0 478881 0 0 JENNIFER HAVENS FRMR CEO (TO 10/23) 0 292533 0 76106 0 26851 0 45000 0 26871 0 467361 0 0 SCOTT DOYLE CRNA ARNP ANESTHESIOLOGY 301839 0 864 0 686 0 15543 0 22943 0 341875 0 0 0 LISA BISHOP DO BOARD MEMBER 0 260246 0 15000 0 382 0 8583 0 38906 0 323117 0 0 STEPHEN ELLESTAD DO PHYSICIAN 294092 0 0 0 5669 0 14705 0 1073 0 315539 0 0 0 KATHRYN OGBURN CRNA RN ARNP ANESTHESIOLOGY 271576 0 10000 0 870 0 14235 0 12102 0 308783 0 0 0 JACOB BOYER PA-C BOARD MEMBER 222425 0 0 0 90 0 11373 0 22368 0 256256 0 0 0 LAURA JUEL VP NURSING & CLINICAL SERV 164505 0 34073 0 60 0 9380 0 36517 0 244535 0 0 0 PROCTOR LUREMAN INTERIM RURAL PRESIDENT (TO 06/24) 0 142198 0 73619 0 3001 0 10913 0 5624 0 235355 0 0 DAVID-PAUL CAVAZOS BOARD MEMBER/RURAL PRESIDENT (FR 06/24) 0 147403 0 500 0 60604 0 6513 0 20065 0 235085 0 0 KRISTIN PHELPS PA-C FAMILY MEDICINE 170268 0 0 0 60 0 8764 0 20508 0 199600 0 0 0 JARROD PHELPS PA-C GENERAL SURGERY 165873 0 0 0 160 0 8294 0 207 0 174534 0 0 0 PART I, LINES 4A-B SEVERANCE PAYMENTS: THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS DURING THE YEAR THAT WERE INCLUDED IN THEIR TAXABLE INCOME: SIDNEY RAMSEY $169,857. NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: JENNIFER HAVENS $29,840; AND DAVID STARK $48,529. SCHEDULE J, PART I, LINE 3 - ESTABLISHING COMPENSATION THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. LEAH VAN REES FAMILY MEMBER OF BOARD MEMBER RACHAEL KINNICK 67894 EMPLOYMENT 0 FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 CENTRAL IOWA HEALTH SYSTEM, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, CENTRAL IOWA HEALTH SYSTEM, SHALL HAVE THE AUTHORITY TO DIRECTLY APPOINT AND ELECT UP TO THREE DIRECTORS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, CENTRAL IOWA HEALTH SYSTEM, HAS THE FINAL AUTHORITY TO APPROVE MERGERS, CONSOLIDATIONS OR CORPORATE RE-STRUCTURE AND SELECTION OR REMOVAL OF ANY EXISTING CEO AS WELL AS THE ADMINISTRATIVE REPORTING RELATIONSHIP OF THE CEO. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY UNITYPOINT HEALTH'S CORPORATE SERVICES TAX DEPARTMENT AND GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE DEPARTMENT WITH ULTIMATE APPROVAL BY THE DIRECTOR OF TAX SERVICES. THE DIRECTOR OF TAX SERVICES MEETS WITH THE FINANCE EXECUTIVE AND REVIEWS KEY PARTS OF THE FORM 990 UTILIZING A PRESENTATION SUMMARY. A COPY OF THE FORM 990 IS GIVEN TO EACH MEMBER OF THE BOARD VIA THE BOARD PORTAL ALONG WITH A REVIEW GUIDE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR THE TOP EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2024 FOR THE FOLLOWING INDIVIDUALS: DAVID-PAUL CAVAZOS, JENNIFER HAVENS, AND JON ROZENFELD. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. 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AS AN INTEGRATED HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN IN NOT-FOR-PROFIT HOSPITALS, CLINICS AND OTHER HEALTHCARE FACILITIES. UNITYPOINT HEALTH OPERATES: 17 REGIONAL HOSPITALS; OVER 400 CLINICS; 17 COMMUNITY NETWORK HOSPITALS; 13 HOME CARE AREAS OF SERVICE; FIVE AFFILIATED COMMUNITY MENTAL HEALTH CENTERS; THREE ACCREDITED UNITYPOINT HEALTH COLLEGES; AN ACCOUNTABLE CARE ORGANIZATION; AND HAS INSURANCE PRESENCE ACROSS ALL OF ITS MARKETS.