2020-11-13T12:59:04-06:00 2019-12-31 990 2019-01-01 390806367 MERITER HOSPITAL INC MERI 6084176000 202 SOUTH PARK STREET MADISON WI 537151596 BETH ERDMAN CFO 6084176000 2020-11-09 2019 2022-09-23 18:48:47Z SUSAN ERICKSON 202 SOUTH PARK STREET MADISON WI 537151596 582604003 0 X WWW.UNITYPOINT.ORG/MADISON X 1898 WI MERITER HOSPITAL, INC. IS A NOT FOR PROFIT, LOCALLY GOVERNED COMMUNITY HOSPITAL. MERITER HOSPITAL PROVIDES A COMPREHENSIVE ARRAY OF PATIENT-FOCUSED INPATIENT AND OUTPATIENT SERVICES TO MEET THE HEALTH-RELATED NEEDS OF OUR COMMUNITY. 15 14 3578 508 555741 0 575677 450413 447799741 466672167 15686726 13896114 4371880 4575241 468434024 485593935 162812 55705 0 0 229124039 237673080 0 0 1090777 213164086 215957225 442450937 453686010 25983087 31907925 736590555 833005877 268584226 282077028 468006329 550928849 X MERITER HOSPITAL, INC. IS DEDICATED TO IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 378233007 55705 466521456 MERITER HOSPITAL, INC. IS A 448-BED COMMUNITY HOSPITAL FOCUSED ON DELIVERING QUALITY CARE AND PATIENT SAFETY. MERITER PROVIDES SOLUTIONS TO MANY COMMUNITY HEALTH CARE NEEDS, AND PROVIDES THE REGION'S ONLY AVAILABLE CHILD AND ADOLESCENT PSYCHIATRY SERVICES, AND SEXUAL ASSAULT NURSE EXAMINER SERVICES. MERITER IS PROUD TO DELIVER MORE BABIES THAN ANY OTHER HOSPITAL IN WISCONSIN AND RECEIVED NUMEROUS AWARDS.MERITER RECEIVED:-SUCCESSFUL STROKE PROGRAM RE-CERTIFICATION BY THE JOINT COMMISSION. -HEALTHGRADES & LEAPFROG RECOGNITION: UNITYPOINT HEALTH - MERITER RECEIVED NATIONAL RECOGNITION IN SIX SPECIALTY AREAS. HEALTHGRADES HAS RANKED MERITER AMONG THE BEST IN: CARDIAC CARE (TOP 100 NATIONALLY) CRITICAL CARE (TOP 100 NATIONALLY) GASTROINTESTINAL CARE (TOP 100 NATIONALLY) GENERAL SURGERY (TOP 100 NATIONALLY) PULMONARY CARE (TOP 100 NATIONALLY) STROKE CARE EXCELLENCE MERITER HAS BEEN RECOGNIZED AS A GRADE A HOSPITAL IN THE UPCOMING FALL RELEASE OF THE HOSPITAL SAFETY GRADE.-HOSPITALIST RECOGNIZED: MERITER HOSPITALISTS WERE RECOGNIZED AS THE BEST OVERALL PERFORMING HOSPITALIST GROUP AT UNITYPOINT HEALTH BASED ON MANY FACTORS SUCH AS QUALITY, PATIENT SATISFACTION, RESOURCE STEWARDSHIP, ETC. THIS IS THE SECOND YEAR IN A ROW THAT WE HAVE ACHIEVED THIS STATUS; AN AMAZING ACHIEVEMENT GIVEN ALL THE CHANGES WE HAVE NAVIGATED OVER THE PAST TWO YEARS. -DR. SOMMERFELD WAS RECOGNIZED FOR ALL HIS WORK MAKING EPIC FIT THE NEEDS OF PHYSICIANS NOT ONLY IN MADISON, BUT THE ENTIRE UPC SYSTEM. HE JOINS LAST YEAR'S WINNER, JASON YELK IN BEING RECOGNIZED AS GOING ABOVE AND BEYOND THE CALL AND RECEIVING A CHAMPION OF EXCELLENCE AWARD FOR UNITYPOINT HEALTH. -DURING 2019, MERITER STARTED A NEW PROGRAM TO HONOR PATIENTS LOSING THEIR LIVES AND BEING ORGAN DONORS WHILE IN OUR HOSPITAL. THE PROGRAM IS CALLED HONOR WALKS AND BRINGS TOGETHER ALL AVAILABLE CLINICIANS, PROVIDERS AND EMPLOYEES AT THE TIME OF THE PATIENT TRANSITION FROM THE ICU TO THE OR. THIS RESPECTFUL AND DEEPLY MOVING TRIBUTE TO THE PATIENT AND THEIR LOVED ONES OCCURRED 7 TIMES AT MERITER DURING THE COURSE OF 2019.-IN OCTOBER 2019, THE PATIENT CARE DIVISION STARTED A FORMAL NURSE PEER REVIEW COMMITTEE. THIS COMMITTEE WAS DEVELOPED AFTER MEETING WITH EXTERNAL CONSULTANTS AND INTERNAL COLLEAGUES. THE COMMITTEE IS INTERDISCIPLINARY AND IS MODELED AFTER THE PHYSICIAN PEER REVIEW PROCESS THAT CURRENTLY EXISTS AT MERITER. THE KEY AIM OF THE COMMITTEE IS TO IMPROVE NURSING PRACTICE IN A SUPPORTIVE, COLLEGIAL ENVIRONMENT TO ENSURE THAT WE ARE DELIVERING CONSISTENT EVIDENCE-BASED QUALITY CARE. -PATIENT SAFETY EXCELLENCE AWARD RANKED TOP IN THE NATION FOR PROVIDING EXCELLENCE IN PATIENT SAFETY BY PREVENTING INFECTIONS, MEDICAL ERRORS, AND OTHER PREVENTABLE COMPLICATIONS. -OUTSTANDING PATIENT EXPERIENCE AWARD RANKED TOP IN THE NATION FOR OVERALL PATIENT EXPERIENCE BASED ON NINE MEASURES RELATED TO DOCTOR AND NURSE COMMUNICATION, HOSPITAL CLEANLINESS AND NOISE LEVELS, AND MEDICATION AND POST-DISCHARGE CARE INSTRUCTIONS. -UNITYPOINT CLINICS: PATIENT EXPERIENCE METRICS CONTINUE TO PERFORM AT OR ABOVE THE EXCEPTIONAL TARGET FOR THE SECOND QUARTER: RATE THE PROVIDER - 90.6% TOP BOX SCORE RECOMMEND PROVIDER - 94.5% TOP BOX SCORE PHYSICIAN COMMUNICATION QUALITY - 96.3% TOP BOX SCORE OFFICE STAFF QUALITY - 96.2% TOP BOX SCORE ACCESS TO CARE - 88.8% TOP BOX SCORE CARE COORDINATION - 79.7% TOP BOX SCOREMERITER CLINIC'S OFFERS AMBULATORY HEALTH CARE WITH A FOCUSON PROVIDING EDUCATIONAL, OUTREACH AND REFERRAL PROGRAMS THAT INCLUDE WELLNESS AND DISEASE PREVENTION. THIS OCCURS THROUGH ALL SPECIALTIES FOR INDIVIDUALS AND IN GROUP SETTINGS SUCH AS INDIVIDUAL HEALTH EDUCATION SESSIONS WITH A NURSE PRACTITIONER FOR WOMEN MANAGING THEIR HEART DISEASE, OFFERING GROUP SESSIONS ON THE LATEST ADVANCEMENTS FOR TREATMENTS OF OSTEOARTHRITIS, AND EDUCATIONAL PROGRAMS FOR PREGNANT PARENTS ATTENDING CHILDBIRTH EDUCATION PROGRAMS. MERITER CLINIC'S PROVIDERS ALSO OFFER VARIOUS EDUCATIONAL TALKS AND SCREENING OPPORTUNITIES AS PART OF COMMUNITY PROGRAMS/EVENTS EACH YEAR. MERITER'S ADULT PRIMARY CARE CLINICS INCLUDE DIABETES MANAGEMENT SERVICES THROUGH A TEAM CONSISTING OF ENDOCRINOLOGISTS, PROGRAM SERVICE ACCOMPLISHMENTS: CERTIFIED DIABETES EDUCATORS, DIETITIAN AND HEALTH PSYCHOLOGIST. HEALTH PSYCHOLOGY SERVICES ARE AVAILABLE TO PATIENTS WHO NEED EMOTIONAL SUPPORT AND GUIDANCE AS THEY WORK THROUGH PERSONAL HEALTH CHANGES. MERITER CHILD & ADOLESCENT PSYCHIATRY STAFF PROVIDE EDUCATIONAL SESSIONS FOR SCHOOL PERSONNEL. MERITER PRIMARILY SERVES PATIENTS FROM DANE COUNTY. 378233007 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 136 0 1 3578 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X RON SCHROEDER 6084175832 202 SOUTH PARK STREET MADISON WI 537151596 RAY ALLEN TO 1019 BOARD MEMBER 1.00 1.00 X 0 0 0 KATHY BLUMENFELD BOARD MEMBER 1.00 1.00 X 0 0 0 DAVE BOYER BOARD MEMBER 1.00 1.00 X 0 21500 0 JACK COTTON TO 619 VICE CHAIR 1.00 1.00 X X 0 0 0 ALISON CRAIG MD FR 619 BOARD MEMBER 1.00 1.00 X 0 0 0 SUE ERICKSON BOARD MEMBER/CEO/ASST TREAS 35.00 15.00 X X 0 693058 161813 MICHAEL GOLDROSEN MD TO 619 BOARD MEMBER 1.00 1.00 X 0 0 0 VIRGINIA GRAVES BOARD MEMBER 1.00 1.00 X 0 16500 0 RONALD HENSHUE FR 619 BOARD MEMBER 1.00 1.00 X 0 0 0 GEORGE KAMPERSCHROER TO 619 BOARD MEMBER 1.00 1.00 X 0 0 0 BRAD MANNING MD CHAIR TO 619 BOARD MEMBER (FR 7/19) 3.00 3.00 X X 6250 14099 0 MARK MOODY BOARD MEMBER 1.00 1.00 X 0 0 0 MARGARET NOREUIL RN PHD MEMBER (TO 6/19) CHAIR (FR 7/19) 3.00 3.00 X X 6250 13750 0 LISA PEYTON-CAIRE TO 1019 BOARD MEMBER 1.00 1.00 X 0 0 0 AISHA SMITH FR 619 BOARD MEMBER 1.00 1.00 X 0 0 0 MARY STOFFEL MD BOARD MEMBER 1.00 1.00 X 0 0 0 DOUG STRUB BOARD MEMBER TO 619 VICE CHAIR (FR 7/19) 1.00 1.00 X 0 0 0 MARY THOMPSON MD FR 0619 BOARD MEMBER 1.00 1.00 X 0 0 0 CHERYL WITTKE BOARD MEMBER 1.00 1.00 X 0 0 0 BETH ERDMAN CFO/SECRETARY/TREASURER 35.00 15.00 X 0 401791 71637 PAM WETZEL MD CMO/ASSISTANT SECRETARY 5.00 45.00 X 0 550099 101788 JAMES ARNETT CHIEF OPERATING OFFCIER 5.00 45.00 X 0 379318 102308 SHERRY CASALI CHIEF NURSING OFFICER 5.00 45.00 X 0 300084 57207 KRISTINE HOLMES DIR MED/SURG NURSE 40.00 0.00 X 174858 0 26839 KATHERINE KOSTRIVAS EXEC DIRECTOR JOA 40.00 0.00 X 202701 0 28704 JULIE SAMPSON DIR PATIENT EXPERIENCE 40.00 0.00 X 172899 0 17226 CHRISTINA JACKSON DIR PERIOPERATIVE SVCS 40.00 0.00 X 194249 0 35787 JULIE RICE REGISTERED NURSE 40.00 0.00 X 175769 0 26131 GEOFFREY PRIEST MD FORMER CMO/ASST. SEC(TO 3/16) 0.00 0.00 X 0 161389 0 ART NIZZA DSW TO 118 FORMER CEO UPH-MERITER 0.00 49.00 X 0 1064768 278609 932976 3616356 908049 137 1 1 0 JP CULLEN AND SONS INC 330 E DELAVAN DRIVE JANESVILLE WI 53546 CONSTRUCTION 17580340 UNIVERSITY OF WISCONSIN HOSPITAL AND CLI 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS, RESIDENTS, MED-FLIGHT, AND TEAC 14738314 JH FINDORFF AND SON INC 300 SOUTH BEDFORD ST MADISON WI 53703 CONSTRUCTION 9454817 AMN HEALTHCARE ALLIED INC 750 HIGHLAND AVENUE MADISON WI 53792 CONTRACTED REGISTERED NURSES 2430256 UNIVERSITY OF WISCONSIN 750 HIGHLAND AVENUE MADISON WI 53792 MEDICAL SERVICES 1558078 41 450413 450413 NET PATIENT REVENUE 900099 440298178 440298178 SUBS & JOINT VENTURES 900099 5420098 5420098 20953891 20007985 40668 905238 466672167 11296325 11296325 3604732 3040979 563753 563753 704 563049 57214336 39095182 58575378 35134351 -1361042 3960831 2599789 2599789 494782 259360 235422 235422 CAFETERIA/FOOD SVCS 722210 1465978 3932 1462046 CHILDCARE SERVICES 624410 1417879 510437 907442 PARKING REIMBURSEMENT 812930 888177 888177 4032 4032 3776066 485593935 465965715 555741 18622066 24520 24520 31185 31185 12500 12500 185037290 178616496 6420794 6410468 6188025 222443 33667383 32499125 1168258 12545439 12110112 435327 47305640 161457 47144183 23709459 22073506 1635953 2429893 867195 1562698 12920003 12028523 891480 215217 200367 14850 7324296 7324296 1081614 1081614 20068024 18683330 1384694 1102577 1026499 76078 MEDICAL SUPPLIES 69000302 64239281 4761021 MISCELLANEOUS EXPENSES 16729192 15762791 957238 9163 STATE REVENUE ASSESSMEN 8992555 8992555 EQUIPMENT RENTAL & MAIN 5078453 4728040 350413 453686010 378233007 74362226 1090777 32379344 33317813 1823095 2004289 40803530 46791666 4718927 18714336 3199586 3041362 952637 1205132 402878022 117768733 258848094 285109289 318061290 389985420 75804052 52836570 736590555 833005877 59709501 80283265 48179 39152 693883 363484 208132663 201391127 268584226 282077028 X 463142265 545843500 4864064 5085349 468006329 550928849 736590555 833005877 X 31907925 43327237 7687358 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 63380365 63380365 222849354 62678987 160170367 3847783 2294289 1553494 93899806 50885526 43014280 18900714 1909931 16990783 285109289 OTHER LONG-TERM ASSETS 309386 INVESTMENT IN JOINT VENTURES 30701534 DEFERRED COMP 457(B) 584196 OPERATING LEASE RIGHT OF USE ASSETS 11696685 INTEREST IN NET ASSETS FOUNDATION 9544769 52836570 -450 RETIREMENT LIABILITY 19291972 HEALTH & WELFARE INS RESERVES 556000 ASSET RETIREMENT OBLIGATION 666862 DUE TO AFFILIATES 169773711 DEFERRED COMP 457(B) 575340 LT PORTION-WORKERS COMPENSATION & OTHER 506241 OPERATING LEASE-LESS CURRENT PORTION 10021451 201391127 X 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 2016. 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. 1 1 1 X 300.000000000000 1 X 500.000000000000 1 1 0 1 1 2737963 2737963 0.00600 69770432 50745683 19024749 0.04190 12181748 6432282 5749466 0.01270 84690143 57177965 27512178 0.06060 22906 614591 12530 602061 0.00130 5751 11679464 2130 11677334 0.02570 1980837 0 1980837 0.00440 24171 2266334 3 2266331 0.00500 52828 16541226 14663 16526563 0.03640 52828 101231369 57192628 44038741 0.09700 1021 1021 0.00000 26413 26413 0.00010 452067 452067 0.00100 49781 49781 0.00010 3170 3170 0.00000 532452 532452 0.00120 0 3538855 84334217 93026534 -8692317 X 1 1 1 1 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 53715 WWW.UNITYPOINT.ORG/MADISON 316 X X X X X MERITER HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.UNITYPOINT.ORG/MADISON X X 1 18 1 WWW.UNITYPOINT.ORG/MADISON 0 1 X 300.000000000000 500.000000000000 X X X X X X 1 1 X X X X 1 X WWW.UNITYPOINT.ORG/MADISON/FINANCIAL-ASSISTANCE X WWW.UNITYPOINT.ORG/MADISON/FINANCIAL-ASSISTANCE X WWW.UNITYPOINT.ORG/MADISON/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X 1 X 0 0 MERITER HOSPITAL, INC. PART V, SECTION B, LINE 5: UNITYPOINT HEALTH - MERITER, TOGETHER WITH OUR HEALTHY DANE COLLABORATIVE PARTNERS (SSM/ST. MARY'S, STOUGHTON HOSPITAL, UW HEALTH, GHC OF SOUTH-CENTRAL WI AND PUBLIC HEALTH MADISON DANE COUNTY) USED THE COUNTY HEALTH RANKINGS FRAMEWORK FOR OUR ASSESSMENT. WE KNOW THAT ENVIRONMENTAL AND SOCIAL FACTORS GREATLY IMPACT THE HEALTH OF THE COMMUNITY. WE ASSESSED INPUT FROM THE COMMUNITY AND DATA RELATED TO EACH OF THE HEALTH FACTORS IN THE COUNTY HEALTH RANKINGS MODEL TO BETTER UNDERSTAND WHAT IS IMPACTING THE HEALTH OF OUR COMMUNITY: HEALTH BEHAVIORS, CLINICAL CARE, SOCIAL & ECONOMIC FACTORS AND THE PHYSICAL ENVIRONMENT. WE ALSO USED A HEALTH EQUITY LENS IN OUR ASSESSMENT. WE ARE COMMITTED TO ADDRESSING HEALTH INEQUITIES: "TYPES OF UNFAIR HEALTH DIFFERENCES CLOSELY LINKED WITH SOCIAL, ECONOMIC OR ENVIRONMENTAL DISADVANTAGES THAT ADVERSELY AFFECT A GROUP OF PEOPLE."(ATTAINING HEALTH EQUITY. CDC. RETRIEVED FROM: HTTPS://WWW.CDC.GOV/NCCDPHP/DCH/PROGRAMS/HEALTHYCOMMUNITIESPROGRAM/OVERVIEW/HEALTHEQUITY.HTM )WE USED QUALITATIVE AND QUANTITATIVE DATA TO INFORM OUR ASSESSMENT. WE HELD COMMUNITY-BASED FOCUS GROUPS THROUGHOUT THE SUMMER OF 2018 WITH THE FOLLOWING GROUPS: SSM/ST. MARY'S COMMUNITY PARTNER BREAKFAST, HOUSING AND HEALTHCARE (H2) MEETING, SSM DMG PATIENT ADVISORY GROUP, STOUGHTON BUSINESS HEALTH AND WELLNESS ROUNDTABLE, CENTRO HISPANO KEY INFORMANT INTERVIEW, WISCONSIN FAITH VOICES FOR JUSTICE, HARAMBEE VILLAGE DOULAS, SAVING OUR BABIES PUBLIC ENGAGEMENT SESSIONS AND BLACK MEN'S HEALTH TOWN HALL MEETING. THE MEMBERS OF THE HEALTHY DANE COLLABORATIVE FACILITATED THESE MEETINGS WITH THE FOCUS TOPIC AREAS OF MATERNAL AND CHILD HEALTH, MENTAL HEALTH, SUBSTANCE USE AND CHRONIC DISEASE. WE USED THE FOLLOWING QUESTIONS TO GUIDE THE DISCUSSION: "THINKING ABOUT [INSERT FOCUS TOPIC AREA], WHAT WOULD A HEALTHY COMMUNITY LOOK LIKE TO YOU? AND "IN WHAT WAYS CAN HOSPITALS AND HEALTH SYSTEMS PARTNER WITH THE COMMUNITY TO ADDRESS [INSERT FOCUS TOPIC AREA]?" MERITER HOSPITAL, INC. PART V, SECTION B, LINE 6A: SSM/ST. MARY'S, STOUGHTON HOSPITAL AND UW HEALTH MERITER HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE HEALTHY DANE COLLABORATIVE INCLUDES PUBLIC HEALTH MADISON DANE COUNTY AND GHC OF SOUTH-CENTRAL WI AS PRIMARY PARTNERS IN ITS WORK. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 7D: THE COLLABORATIVE'S VENDOR, HEALTHY COMMUNITY INSTITUTE (HCI), DEVELOPS AND MAINTAINS A HIGH-QUALITY DATA AND DECISION-SUPPORT INFORMATION SYSTEM TO AID IN INDICATOR TRACKING, BEST-PRACTICE SHARING AND COMMUNITY DEVELOPMENT. THE SYSTEM PROVIDES ACCESS TO A TEMPLATE, ALONG WITH SUPPORTING SERVICES, TO COMMUNITIES TO HELP IMPROVE QUALITY OF LIFE AND OUTCOMES. IN ADDITION THE CHNA IS POSTED ON THE MERITER HOSPITAL SITE. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 11: WE RECOGNIZE THERE ARE DATA LIMITATIONS: COUNTY AND LOCAL LEVEL DATA BROKEN DOWN BY RACE, ETHNICITY, SOCIOECONOMIC STATUS AND OTHER DEMOGRAPHICS IS NOT ALWAYS AVAILABLE. THESE DATA ARE INCLUDED WHENEVER POSSIBLE. COMMUNITY INPUT SESSIONS REPRESENT VOICES FROM BOTH COMMUNITY LEADERS AND VULNERABLE POPULATIONS. BECAUSE INEQUITIES CONTINUE TO EXIST IN MATERNAL CHILD HEALTH, MENTAL HEALTH, CHRONIC CONDITIONS AND SUBSTANCE ABUSE, WE CHOSE TO FOCUS OUR QUESTIONS IN THOSE SPECIFIC AREAS. IN ADDITION, WE SOUGHT TO BETTER UNDERSTAND HOW HEALTH SYSTEMS AND THE COMMUNITY COULD BETTER PARTNER TOGETHER TO IMPROVE HEALTH OUTCOMES.WE KNOW THAT GENERALLY, DANE COUNTY'S HEALTH OUTCOMES FAIR BETTER THAN MANY STATE AND NATIONAL AVERAGES. HOWEVER, THE STATE AND NATIONAL AVERAGES DO NOT ADEQUATELY CAPTURE THE INEQUITIES BETWEEN POPULATIONS.COMMUNITY MEMBERS VOICED:-- A DESIRE FOR EQUAL OPPORTUNITY, RESOURCES AND RESPECT-- RESILIENCY AND COMMITMENT TO THE COMMUNITY-- A NEED FOR COORDINATED COMMUNITY RESOURCES-- IMPORTANCE OF CONNECTEDNESS AND SOCIAL COHESION-- A NEED FOR CULTURALLY RESPONSIVE CAREBOTH COMMUNITY INPUT AND QUANTITATIVE DATA WERE USED TO ASSESS THE NEEDS AND ASSETS OF DANE COUNTY. AREAS OF HIGH COMMUNITY NEED AND PRIORITY FOCUS WERE IDENTIFIED USING THE FOLLOWING CRITERIA:-- DATA INDICATED AN INEQUITY, DISPARITY OR NOTABLE DIFFERENCES IN OUTCOMES WITHIN THE POPULATION-- COMMUNITY VOICED NEED-- DATA INDICATED THAT DANE COUNTY OUTCOMES ARE WORSE THAN STATE OR NATIONAL OUTCOMES-- ESTABLISHED COLLABORATION AND CONTINUING MOMENTUM OF EXISTING WORK-- AREAS OF IDENTIFIED INEQUITIES WERE WEIGHTED THE MOST HIGHLY WHEN PRIORITIZING HEALTH NEEDS.AFTER CAREFUL AND THOROUGH REVIEW OF AVAILABLE DATA, BOTH QUANTITATIVE AND QUALITATIVE, THE HEALTHY DANE COLLABORATIVE IDENTIFIED FOUR PRIORITY HEALTH OUTCOMES: MATERNAL AND CHILD HEALTH, CHRONIC CONDITIONS, MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERS. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 13H: THE COMPANY MAY RELY ON EXTERNAL SOURCES/AND OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY FOR PATIENT IF: PARTICIPATES IN VARIOUS STATE OR LOCAL ASSISTANCE PROGRAMS; DECEASED WITHOUT ESTATE; FILED BANKRUPTCY; HOMELESS; CREDIT, MEDICAL RECOVERY OR PROPENSITY TO PAY SCORES; AND THIRD PARTY COLLECTION AGENCIES STATEMENTS REGARDING A PATIENT'S LIKELY INCOME LEVEL. 4 1 - CHILD & ADOLESCENT PSYCHIATRY 8001 RAYMOND ROAD MADISON WI 53719 INPATIENT PSYCHIATRY SERVICES 2 - MERITER NEWSTART 1015 GAMMON LANE MADISON WI 53719 SUBSTANCE ABUSE TREATMENT PROGRAM 3 - MERITER WELLNESS CENTER 501 W BELTLINE HWY SUITE 207 MADISON WI 53713 CARDIOVASCULAR & PULMONARY REHAB & NUTRITION 4 - CENTER FOR PERINATAL CARE 202 S PARK ST MADISON WI 53715 PREGNANCY CARE PART I, LINE 6A: A COMMUNITY BENEFIT REPORT IS FILED ON BEHALF OF MERITER HEALTH SERVICES; MERITER HOSPITAL IS A SUBSIDIARY. THE COMMUNITY BENEFIT TEXT IN THIS RETURN REPRESENTS THE HOSPITAL. 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 SEGMENT SPECIFIC 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: MERITER STRIVES TO HELP CREATE A HEALTHY COMMUNITY INCLUDING STRONG SCHOOLS, SAFE NEIGHBORHOODS AND DIVERSE WORKFORCE. THROUGH PARTNERSHIPS WITH LOCAL NON-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS, MERITER IS WORKING TO STRENGTHEN THE COMMUNITY THROUGH CHARITABLE GIVING AND COMMUNITY ENGAGEMENT. WITH THE SUPPORT OF THE FOUNDATION FOR MADISON PUBLIC SCHOOLS, MERITER ADOPTED JAMES MADISON MEMORIAL HIGH SCHOOL AND ENGAGES IN SEVERAL PARTNERSHIP ACTIVITIES TO ENHANCE EDUCATIONAL ATTAINMENT. THE BAYVIEW COMMUNITY, LOCATED ACROSS THE STREET FROM MERITER, IS A CDA HOUSING COMMUNITY, HOME TO A DIVERSE COMMUNITY OF RESIDENTS AND IMMIGRANTS; OVER 80% OF WHOM IDENTIFY AS HMONG. MERITER SUPPORTS BAYVIEW'S GIVING GARDEN, LOCATED ON THE MERITER HOSPITAL GROUNDS. THE GIVING GARDEN INCREASED THE BAYVIEW COMMUNITY'S ACCESS TO HEALTHY AND FRESH, CULTURALLY APPROPRIATE FOOD CHOICES. AS OF SEPTEMBER 2018, YOUTH HARVESTED APPROXIMATELY 450 POUNDS OF ORGANIC PRODUCE! THE HIGHLIGHT OF THE PROGRAM ACCORDING TO THE YOUTH PARTICIPANTS WAS WORK IN THE GARDEN. YOUTH PREPARED THE SOIL, MULCHED, WEEDED, PLANTED, TRIMMED, WATERED, BUILT STRUCTURAL SUPPORT FOR PLANTS, INSTALLED FENCING, LABELED PLANTS, CREATED A GARDEN MAP, PERFORMED SOIL TESTS, REMOVED PESTS, AND HARVESTED PRODUCE. YOUTH WORKED TOGETHER TOWARD A COMMON GOAL: TO PROVIDE FRESH, ORGANIC PRODUCE TO THE BAYVIEW COMMUNITY. THEY SPENT STRUCTURED TIME OUTSIDE AND AWAY FROM DIGITAL DEVICES AND, INSTEAD, WATCHED THE GARDEN CHANGE THROUGHOUT THE SEASON AND TOOK OWNERSHIP OF THE HEALTH OF THE PLANTS. PARTICIPANTS GAINED FAMILIARITY WITH HANDLING VEGETABLES FOR FOOD PREPARATION. YOUTH CHOPPED, TRIMMED, AND PEELED VEGETABLES AND HERBS, AND LEARNED TO FOLLOW RECIPES. YOUTH EXPERIMENTED WITH RECIPES AND TASTE-TESTED A VARIETY OF HEALTHY SNACK ALTERNATIVES. YOUTH LEARNED ABOUT MINDFUL EATING AND HOW TO BETTER UNDERSTAND HUNGER CUES.MERITER IS ALSO WORKING WITH SEVERAL COMMUNITY GROUPS TO FUND TRAINING PROGRAMS, SCHOLARSHIPS AND TUTORING PROGRAMS. EXAMPLES INCLUDE THE URBAN LEAGUE OF GREATER MADISON, AVID/TOPS (PARTNERSHIP WITH MADISON METROPOLITAN SCHOOL DISTRICT AND THE BOYS AND GIRLS CLUB OF DANE COUNTY), OPERATION FRESH START AND MADISON COLLEGE HEALTH PROFESSIONS PROGRAM. PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR ST. LUKE'S HOSPITAL. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL 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. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE AND OFFSETTING REVENUE.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: UNITYPOINT HEALTH - MERITER, TOGETHER WITH OUR HEALTHY DANE COLLABORATIVE PARTNERS (SSM/ST. MARY'S, STOUGHTON HOSPITAL, UW HEALTH, GHC OF SOUTH-CENTRAL WI AND PUBLIC HEALTH MADISON DANE COUNTY) COLLABORATIVE COMPLETED THE HEALTH ASSESSMENT OF DANE COUNTY. WE ENDORSED ONE SINGLE COMMUNITY HEALTH NEEDS ASSESSMENT FOR OUR COMMUNITY, THE FIRST FOR DANE COUNTY. SECONDARY DATA WAS COMPLIED BY THE HEALTHY COMMUNITY INSTITUTE/CONDUENT. THE DATA WAS VALIDATED BY OUR COMMUNITY ENGAGEMENT SESSIONS/FOCUS GROUPS. 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: DANE COUNTY IS IN SOUTH-CENTRAL WISCONSIN AND IS HOME TO MADISON, WISCONSIN'S CAPITAL AND THE COUNTY SEAT. DANE COUNTY IS THE SECOND MOST DENSELY POPULATED COUNTY IN WI, AND MADISON IS THE SECOND LARGEST CITY IN THE STATE. THE POPULATION GREW 3.9% BETWEEN 2013 AND 2018, BRINGING THE TOTAL POPULATION TO 529,843. MADISON HAS 252,086 RESIDENTS, ALMOST HALF OF THE COUNTY'S POPULATION. AND AMONG ITS RESIDENTS ARE MORE THAN 43,000 UW STUDENTS. THE RACIAL DEMOGRAPHICS IN DANE COUNTY ARE CHANGING. IN 2019, BLACK/AFRICAN AMERICANS MADE UP 5.2% OF THE DANE COUNTY POPULATION; ASIANS MADE UP 5.9%; WHITE/CAUCASIANS 82.3%; AND AMERICAN INDIAN OR ALASKA NATIVE 0.3%. IN ADDITION, 6.3% OF DANE COUNTY'S POPULATION ARE OF HISPANIC OR LATINO ETHNICITY. AN OPPORTUNITY GAP EXISTS BETWEEN WHITE STUDENTS AND STUDENTS OF COLOR IN DANE COUNTY EVIDENCED BY DISPARITIES IN EDUCATIONAL OUTCOMES. DANE COUNTY'S 95.6% HIGH SCHOOL GRADUATION RATE HAS IMPROVED SIGNIFICANTLY OVER THE YEARS AND IS NOW ABOVE THE NATIONAL AVERAGE OF 87.7%. THE PERCENT OF THE POPULATION THAT HAS AT LEAST A BACHELOR'S DEGREE IS MUCH HIGHER IN DANE COUNTY COMPARED WITH WISCONSIN AND THE US OVERALL (DANE COUNTY 50.7%, WI 31.3%, US 33.1%). THE MEDIAN HOUSEHOLD INCOME IS ALSO HIGHER IN DANE COUNTY ($70,541) THAN IN WI ($64,168). THERE IS CONSIDERABLE VARIABILITY WHEN YOU DISAGGREGATE MEDIAN HOUSEHOLD INCOME BY RACE AND ETHNICITY; THE MEDIAN INCOME FOR BLACK HOUSEHOLDS IS CLOSER TO $30,000 AND FOR HISPANIC OR LATINO HOUSEHOLDS IS JUST UNDER $40,000.DESPITE DANE COUNTY'S HIGH MEDIAN HOUSEHOLD INCOME AND LOW UNEMPLOYMENT RATE (2.3%), DANE COUNTY IS FACED WITH AN INCREASING NUMBER OF PEOPLE LIVING IN POVERTY. 11.9% OF DANE COUNTY RESIDENTS LIVE IN POVERTY, COMPARABLE TO THE STATE POVERTY RATE BUT TRENDING IN A WORSENING DIRECTION. THE DISPROPORTIONATE IMPACT OF POVERTY ON COMMUNITY'S COLOR IS EVEN MORE PROFOUND WHEN LOOKING AT RATES OF CHILDREN LIVING IN POVERTY. OVERALL, 29.4% OF CHILDREN IN DANE COUNTY ARE ELIGIBLE FOR FREE OR REDUCED-PRICE LUNCH. PART VI, LINE 5: MERITER IS A LOCALLY MANAGED AND A LOCALLY GOVERNED HOSPITAL. THE COMMUNITY-BASED BOARD OF DIRECTORS IS COMMITTED TO PROTECTING THE HEALTH OF THE COMMUNITY THROUGH SUSTAINING SEVERAL OF MERITER'S PROGRAMS AND SERVICES THAT ONLY MERITER PROVIDES. SEVERAL YEARS AGO, THE BOARD MADE A PLEDGE TO CONTINUE TO PROVIDE CHILD AND ADOLESCENT PSYCHIATRIC SERVICES EVEN WHEN OTHER PROVIDERS CHOSE NOT TO PROVIDE SUPPORT. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). AS THE NATION'S 13TH LARGEST NONPROFIT HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES PROGRESSIVE AND HIGH QUALITY SERVICES ACROSS ITS 9 REGIONS WHICH SPAN IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN. THIS REGIONAL CARE MODEL HAS BEEN SUCCESSFUL IN ACHIEVING STANDARDIZED LEVELS OF PERFORMANCE AND KEEPING CARE LOCAL. WITH $4.6B IN TOTAL OPERATING REVENUE, UNITYPOINT HEALTH EMPLOYS APPROXIMATELY 33,000 TEAM MEMBERS AND OPERATES 20 REGIONAL HOSPITALS, 19 COMMUNITY NETWORK HOSPITALS AND OVER 400 CLINICS. AS A KEY COMPONENT OF UNITYPOINT HEALTH, UNITYPOINT CLINIC IS A 1,100 PROVIDER MULTISPECIALTY GROUP THAT IS BUILT ON THE FOUNDATION OF CARE DELIVERY, INNOVATION AND EXPERIENCE. REPRESENTED BY OVER 40 SPECIALTIES, UPC IS A FORWARD-THINKING DELIVERY PROVIDER AND IS ON THE LEADING EDGE OF CARE DELIVERY WITH ITS TELEHEALTH, AMBULATORY AND URGENT CARE PROGRAMS. THE DIVERSIFIED HEALTH SYSTEM ALSO INCLUDES UNITYPOINT ACCOUNTABLE CARE, UNITYPOINT HEALTH COLLEGES, UNITYPOINT AT HOME AND EXTENDS HEALTH COVERAGE THROUGH THE HEALTHPARTNERS UNITYPOINT INSURANCE PLAN. 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 2019, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $575 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 WI 1 MERITER FOUNDATION 202 S PARK STREET MADISON WI 537151596 237098688 501(C)(3) 18270 HOSPITAL PROGRAMS MERITER HEALTH SERVICES INC 202 S PARK STREET MADISON WI 537151596 391412318 501(C)(3) 6250 MERITER HEALTH SERVICES PROGRAMS 2 0 HOSPITAL SCHOLARSHIPS 30 30000 PART I, LINE 2: GRANTS ARE MADE UPON A SPECIFIC PROJECT REQUEST AND ONLY MADE TO ORGANIZATIONS THAT WE HAVE A WORKING RELATIONSHIP WITH AND SHARE A COMMON GOAL OF COMMUNITY BENEFIT. GRANTS ARE ONLY MADE TO 501 (C)(3) ORGANIZATIONS WHICH MUST COMPLETE FORM 990S AND ANNUAL REPORTS. PART III - SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS WHO HAVE SUBMITTED REQUIRED APPLICATION AND SUPPORTING DOCUMENTATION. A SELECTION COMMITTEE REVIEWS THE REQUESTS, EVALUATES EACH APPLICATION BASED UPON FINANCIAL NEED, ACADEMIC RECORD, EXTRA CURRICULAR WORK/VOLUNTEERING, RECOMMENDATION AND ESSAY. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 SUE ERICKSON BOARD MEMBER/CEO/ASST TREAS 0 471009 0 118809 0 103240 0 137614 0 24199 0 854871 0 0 BETH ERDMAN CFO/SECRETARY/TREASURER 0 302481 0 55500 0 43810 0 67472 0 4165 0 473428 0 0 PAM WETZEL MD CMO/ASSISTANT SECRETARY 0 414378 0 76033 0 59688 0 82351 0 19437 0 651887 0 0 JAMES ARNETT CHIEF OPERATING OFFCIER 0 276793 0 50505 0 52020 0 76631 0 25677 0 481626 0 0 SHERRY CASALI CHIEF NURSING OFFICER 0 239106 0 42551 0 18427 0 44292 0 12915 0 357291 0 0 KRISTINE HOLMES DIR MED/SURG NURSE 154395 0 17933 0 2530 0 7161 0 19678 0 201697 0 0 0 KATHERINE KOSTRIVAS EXEC DIRECTOR JOA 179530 0 21950 0 1221 0 8282 0 20422 0 231405 0 0 0 JULIE SAMPSON DIR PATIENT EXPERIENCE 146854 0 19231 0 6814 0 6999 0 10227 0 190125 0 0 0 CHRISTINA JACKSON DIR PERIOPERATIVE SVCS 176314 0 17100 0 835 0 8005 0 27782 0 230036 0 0 0 JULIE RICE REGISTERED NURSE 175059 0 273 0 437 0 7167 0 18964 0 201900 0 0 0 GEOFFREY PRIEST MD FORMER CMO/ASST. SEC(TO 3/16) 0 0 0 0 0 161389 0 0 0 0 0 161389 0 0 ART NIZZA DSW TO 118 FORMER CEO UPH-MERITER 0 796367 0 196165 0 72236 0 252114 0 26495 0 1343377 0 0 PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: BUSINESS CLUB DUES WERE PAID FOR ONE PERSON. THE BUSINESS CLUB IS AN IRS SECTION 501(C)(7). PART I, LINE 4B NONQUALIFIED RETIREMENT PLAN EARNINGS: THE FOLLOWING INDIVIDUAL PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGE TO THEIR ACCOUNT: JAMES ARNETT $65,431; SHERRY CASALI $33,092; BETH ERDMAN $56,272; SUSAN ERICKSON $126,414; ART NIZZA $232,606; AND PAM WETZEL $71,151. FORM 990, PART VI, SECTION A, LINE 6 MERITER HEALTH SERVICES, INC., A TAX-EXEMPT, WISCONSIN NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MERITER HEALTH SERVICES, INC., AS SOLE MEMBER, SHALL APPOINT ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MERITER HEALTH SERVICES, INC., AS SOLE MEMBER, SHALL AUTHORIZE OR APPROVE THE FOLLOWING ACTIONS: (A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; (C) A SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; (D) THE ESTABLISHMENT, FORMATION, ACQUISITION, MERGER, CONSOLIDATION OR DISSOLUTION OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; (E) THE ADOPTION OF THE AGGREGATE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (F) AGGREGATE BORROWING FOR PERIODS OF ONE (1) YEAR OR LESS FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME; AND AGGREGATE BORROWING FOR PERIODS OF MORE THAN ONE (1) YEAR FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME. FOR THE PURPOSE OF THIS SUBPARAGRAPH, THE TERM AGGREGATE BORROWING MEANS BORROWINGS NOT PREVIOUSLY INCLUDED IN THE OPERATING AND/OR CAPITAL BUDGETS, AND INCLUDES BUT IS NOT LIMITED TO LEASE AGREEMENTS AND CONTRACTS FOR SALE; (G) THE PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, AND ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME, NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET; (H) THE APPOINTMENT OF THE INDEPENDENT AUDITOR AND CORPORATE COUNSEL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARDS OF DIRECTORS CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ON A PROACTIVE BASIS, DECLARATIONS OF POTENTIAL CONFLICTS OF INTEREST ARE SIGNED WHEN EACH DIRECTOR JOINS THE BOARD AND ANNUALLY THEREAFTER. THE CEO AND BOARD CHAIR MONITOR THE POTENTIAL CONFLICTS DISCLOSED BY BOARD MEMBERS AND MANAGE ATTENDANCE AT MEETINGS AND PARTICIPATION IN VOTES ACCORDING TO THE ISSUE ON THE AGENDA. INDIVIDUAL DIRECTORS ALSO MONITOR THEIR POTENTIAL CONFLICTS AND RECUSE THEMSELVES FROM BOARD DISCUSSION AND/OR VOTES AS REQUIRED BY THE CIRCUMSTANCES. THE PROCESS OF MANAGING CONFLICTS OF INTEREST IS RECORDED IN THE MEETING MINUTES. 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 2019 FOR THE FOLLOWING INDIVIDUALS: JAMES ARNETT, SHERRY CASALI, BETH ERDMAN, SUSAN ERICKSON, ART NIZZA, PAMELA WETZEL. 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 18 BECAUSE THE ORGANIZATION FILED ITS FORM 1023 BEFORE JULY 1987 AND DID NOT HAVE A COPY OF FORM 1023 ON THAT DATE, IT IS NOT REQUIRED TO MAKE ITS FORM 1023 AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGES IN PENSION LIABILITY 3,420,674. ASSETS RELEASED WITHOUT DONOR RESTRICTION -356,303. ASSETS RELEASED WITH DONOR RESTRICTION FOUNDATION 577,588. UPH TRANSFERS 1,044,164. OTHER 376,456. RELEASED FOR CAPITAL AND OTHER 2,624,779. ABBE CENTER FOR COMMUNITY MENTAL HEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421045257 MENTAL HEALTH CARE IA 501(C)(3) 509(A)(2) ABBEHEALTH INC 0 ABBEHEALTH INC 740 N 15TH AVE NO A HIAWATHA IA 52233 421373123 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III ST LUKE'S HEALTHCARE 0 AGING SERVICES INC 740 N 15TH AVE NO A HIAWATHA IA 52233 237085316 SENIOR SERVICES IA 501(C)(3) 170(B)(1) (A)(VI) ABBEHEALTH INC 0 ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO IA 50703 421351526 EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS IA 501(C)(3) 170(B)(1) (A)(II) ALLEN HEALTH SYSTEMS INC 0 ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO IA 50703 421201924 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 420698265 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ALLEN HEALTH SYSTEMS INC 0 ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA 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SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) THIS ENTITY IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). AS THE NATION'S 13TH LARGEST NONPROFIT HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES PROGRESSIVE AND HIGH QUALITY SERVICES ACROSS ITS 9 REGIONS WHICH SPAN IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN. THIS REGIONAL CARE MODEL HAS BEEN SUCCESSFUL IN ACHIEVING STANDARDIZED LEVELS OF PERFORMANCE AND KEEPING CARE LOCAL. WITH $4.6B IN TOTAL OPERATING REVENUE, UNITYPOINT HEALTH EMPLOYS APPROXIMATELY 33,000 TEAM MEMBERS AND OPERATES 20 REGIONAL HOSPITALS, 19 COMMUNITY NETWORK HOSPITALS AND OVER 400 CLINICS. AS A KEY COMPONENT OF UNITYPOINT HEALTH, UNITYPOINT CLINIC IS A 1,100 PROVIDER MULTISPECIALTY GROUP THAT IS BUILT ON THE FOUNDATION OF CARE DELIVERY, INNOVATION AND EXPERIENCE. REPRESENTED BY OVER 40 SPECIALTIES, UPC IS A FORWARD-THINKING DELIVERY PROVIDER AND IS ON THE LEADING EDGE OF CARE DELIVERY WITH ITS TELEHEALTH, AMBULATORY AND URGENT CARE PROGRAMS. THE DIVERSIFIED HEALTH SYSTEM ALSO INCLUDES UNITYPOINT ACCOUNTABLE CARE, UNITYPOINT HEALTH COLLEGES, UNITYPOINT AT HOME AND EXTENDS HEALTH COVERAGE THROUGH THE HEALTHPARTNERS UNITYPOINT INSURANCE PLAN.