2018-11-14T15:50:51-06:00 2017-12-31 990 2017-01-01 390806367 MERITER HOSPITAL INC MERI 6084176000 202 SOUTH PARK STREET MADISON WI 537151596 BETH ERDMAN CFO 6084176000 2018-11-06 205.167.2.34 2018-11-06 13:40:21 CS P 7BA72CF2FC23A5EB6E597A73BA6EA537B1AB5705 7BA72CF2FC23A5EB6E597A73BA6EA537B1AB5705 2017 2019-02-21 02:37:17Z SUSAN ERICKSON 202 SOUTH PARK STREET MADISON WI 537151596 510467981 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. 16 15 3248 508 627631 0 429495 515034 429756318 413840849 2683368 14597939 15771112 23923876 448640293 452877698 138658 160407 0 0 185362259 189397209 0 0 1039869 244084212 228327691 429585129 417885307 19055164 34992391 705548386 767467522 287781438 288553355 417766948 478914167 X MERITER HOSPITAL, INC. IS DEDICATED TO PROVIDING EXCEPTIONAL HEALTH CARE AND LIVING BY ITS MISSION TO HEAL, TEACH AND SERVE. 0 0 300700025 160407 433483511 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, INCLUDING:1) AWARD OF HOPE AND EXCELLENCE IN TISSUE DONATION FROM THE UNIVERSITY OF WISCONSIN ORGAN AND TISSUE DONATION FOR OUR DONATION PERFORMANCE IN 2016. THE AWARD OF HOPE RECOGNIZES HOSPITALS ACHIEVING OR EXCEEDING A TRUE CONVERSION RATE OF 75 PERCENT AND/OR ORGANS TRANSPLANTED PER DONOR OF 3.25 PERCENT. THE EXCELLENCE IN TISSUE DONATION AWARD RECOGNIZES THE DEDICATION OF HOSPITAL TEAMS TO ACHIEVE OR EXCEED TISSUE CONSENT RATE GOALS.2) THE MADISON REGION OF UNITYPOINT CLINIC WAS RECENTLY RECOGNIZED AMONG TOP PERFORMERS IN THE ORGANIZATION IN THE FOLLOWING AREAS: A. COLORECTAL CANCER SCREENING I. MCKEE PRIMARY CARE AT 76.9% II. DR SANFORD CARIMI (INTERNAL MEDICINE) AT 88.6% B. CLINIC ACCESS I. MCKEE PEDIATRICS AT 100% C. PROVIDER COMMUNICATION I. DR CHRISTINE SHARKEY (RHEUMATOLOGY) AT 100%3) UNITYPOINT HEALTH - MERITER HAS BEEN RECOGNIZED AS THE TOP PERFORMING UNITYPOINT HEALTH SENIOR AFFILIATE HOSPITAL FOR COMMUNICATION WITH NURSES! THIS RECOGNITION IS BASED ON DATA COLLECTED FROM THE COMMUNICATION WITH NURSES DOMAIN ON THE HCAHPS (HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS) SURVEY TOOL. THE AWARD ACKNOWLEDGES CONSISTENTLY HIGH PERFORMANCE IN THE APPLICABLE HCAHPS SURVEY COMMUNICATION DOMAIN FOR EACH ENTITY.4) MERITER EARNED THE 2017 GET WITH THE GUIDELINES HEART FAILURE GOLD ACHIEVEMENT AWARD FOR IMPLEMENTING SPECIFIC QUALITY IMPROVEMENT MEASURES OUTLINED BY THE AMERICAN HEART ASSOCIATION/AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION'S SECONDARY PREVENTION GUIDELINES FOR PATIENTS WITH HEART FAILURE.5) UNITYPOINT HEALTH - MERITER WAS RECOGNIZED WITH AN AWARD FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION (AHA/ASA). MERITER RECEIVED THE MISSION: LIFELINE NSTEMI BRONZE RECOGNITION AWARD. THIS AWARD RECOGNIZES THE SUCCESS BY UNITYPOINT HEALTH - MERITER IN IMPLEMENTING A HIGH QUALITY OF CARE PROGRAM BY ENSURING THAT OUR NSTEMI PROGRAM TREATS PATIENTS ACCORDING TO NATIONALLY ACCEPTED GUIDELINES. UNITYPOINT HEALTH - MERITER ACHIEVED 85% OR HIGHER COMPOSITE ADHERENCE TO ALL MISSION: LIFELINE NSTEMI PERFORMANCE ACHIEVEMENT INDICATORS FOR CONSECUTIVE 90-DAY INTERVALS AND 65% ADHERENCE TO DUAL ANTIPLATELET PRESCRIPTION AT DISCHARGE TO IMPROVE THE QUALITY OF CARE FOR NSTEMI PATIENTS.6) UNITYPOINT HEALTH - MERITER RECEIVES AN "A" FOR PATIENT SAFETY IN FALL 2017 LEAPFROG HOSPITAL SAFETY GRADE -- THE LEAPFROG GROUP, A NATIONAL NONPROFIT HEALTH CARE RATINGS ORGANIZATION, RELEASED NEW LEAPFROG HOSPITAL SAFETY GRADES. THE SAFETY GRADE ASSIGNS LETTER GRADES OF A, B, C, D AND F TO HOSPITALS NATIONWIDE BASED ON THEIR PERFORMANCE IN PREVENTING MEDICAL ERRORS, INFECTIONS AND OTHER HARMS. MERITER WAS ONE OF 832 AWARDED AN "A" FOR ITS COMMITMENT TO KEEPING PATIENTS SAFE AND MEETING THE HIGHEST SAFETY STANDARDS IN THE U.S. MERITER HOSPITAL, INC. OFFERS AMBULATORY HEALTH CARE WITH A FOCUS ON 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 MEDICAL GROUP, INC. PROVIDERS ALSO OFFER VARIOUS EDUCATIONAL TALKS AND SCREENING OPPORTUNITIES AS PART OF COMMUNITY PROGRAMS/EVENTS EACH YEAR. MERITER MEDICAL GROUP, INC.'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. THE MERITER MEDICAL GROUP, INC. PRIMARILY SERVES PATIENTS FROM DANE COUNTY. 300700025 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 1 158 0 1 3248 1 1 1 0 0 0 0 0 0 0 0 0 X 16 15 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 BOARD MEMBER 1.00 1.00 X 0 0 0 KATHY BLUMENFELD BOARD MEMBER 1.00 1.00 X 0 0 0 DAVID BOYER BOARD MEMBER 1.00 1.00 X 0 14008 0 JACK COTTON BOARD MEMBER TO 617 BOARD VICE CHAIR (FR 6/17) 1.00 1.00 X X 0 0 0 MICHAEL GOLDROSEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 VIRGINIA GRAVES BOARD MEMBER 1.00 1.00 X 0 14793 0 PAUL HICK DO BOARD MEMBER 1.00 1.00 X 0 0 0 GEORGE KAMPERSCHROER BOARD CHAIR (TO 6/17) 3.00 3.00 X X 9375 15225 0 BRADLEY MANNING MD BOARD VICE CHAIR (TO 6/17), CHAIR (FR 6/17) 3.00 3.00 X X 6250 11250 0 MARK MOODY BOARD MEMBER 1.00 1.00 X 0 0 0 ARTHUR NIZZA DSW BOARD MEMBER/CEO 5.00 45.00 X X 0 820401 167831 MARGARET NOREUIL RN PHD BOARD MEMBER 1.00 2.00 X 0 0 0 LISA PEYTON-CAIRE BOARD MEMBER 1.00 1.00 X 0 0 0 JULIE SCHURR MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN SIMS BOARD MEMBER (FR 6/17) 1.00 1.00 X 0 0 0 DOUG STRUB BOARD MEMBER 1.00 1.00 X 0 0 0 BETH ERDMAN CFO/SECRETARY/TREASURER 35.00 15.00 X 0 401052 55548 SUE ERICKSON COO/ASST. TREASURER 15.00 35.00 X 0 480606 76612 PAM WETZEL MD CMO 5.00 45.00 X 0 488883 77363 JAMES ARNETT VP HUMAN RESOURCES 5.00 45.00 X 0 348424 72055 TODD BURCHILL VP BUSINESS DEVELOPMENT 5.00 45.00 X 0 374160 68650 PATRICIA GRUNWALD CHIEF NURSING OFFICER 45.00 5.00 X 0 404481 32974 MARY J HANSEN VP-CLINIC OPERATIONS 40.00 0.00 X 300740 0 27715 CHRISTINA JACKSON DIR PERIOPERATIVE SVCS 40.00 0.00 X 198991 0 31315 KATHERINE KOSTRIVAS EXEC DIRECTOR JOA 40.00 0.00 X 213257 0 27224 LANA STECKEL DIR MEDICAL IMAGING 40.00 0.00 X 206418 0 26400 LINDA WONOSKI DIR CARDIOVASCULAR SVCS 40.00 0.00 X 190925 0 17501 GEOFFREY PRIEST MD TO 316 FORMER CMO/ASST. SECRETARY 0.00 0.00 X 0 149723 0 PETER THOREEN TO 215 FORMER BOARD MEMBER/INTERIM CEO 0.00 0.00 X 0 172832 10886 1125956 3695838 692074 104 1 1 0 JP CULLEN AND SONS INC 330 E DELAVAN DRIVE JANESVILLE WI 53546 CONSTRUCTION 7285666 UW MEDICAL FOUNDATION 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS & RESIDENTS 5599526 JH FINDORFF AND SON INC 300 SOUTH BEDFORD STREET MADISON WI 53703 CONSTRUCTION 4697838 UNIVERSITY OF WISCONSIN HOSPITALS AND CL 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS, RESIDENTS, MED-FLIGHT & TEACHIN 4477886 UNIVERSITY OF WISCONSIN 750 HIGHLAND AVENUE MADISON WI 53792 MEDICAL SERVICES 1174800 55 515034 515034 NET PATIENT REVENUE 900099 399038350 399038350 SUBS & JOINT VENTURES 900099 8181869 8181869 6620630 5860876 41264 718490 413840849 10839822 10839822 4452188 3415866 1036322 1036322 738 1035584 57647840 36408 53926082 49 3721758 36359 3758117 3758117 449692 248286 201406 201406 LEGAL SETTLEMENT 900099 19441256 19441256 CHILDCARE SERVICES 624410 1255446 580721 674725 CAFETERIA/FOOD SVCS 722210 1241055 4908 1236147 748391 748391 22686148 452877698 432723757 627631 19011276 127407 127407 33000 33000 15625 15625 144357988 137572859 6785129 1528179 1456355 71824 33243401 31680961 1562440 10252016 9770171 481845 83974799 163034 83811765 4927104 4927104 20531539 18878355 1653184 1305315 876135 429180 13429744 12266728 1163016 201488 184039 17449 8087644 8087644 1006273 1006273 18797968 17170064 1627904 961454 878192 83262 MEDICAL SUPPLIES 46775728 42612688 4163040 MISCELLANEOUS EXPENSES 14857269 13894846 928827 33596 STATE REVENUE ASSESSMEN 9589442 9589442 EQUIPMENT RENTAL & MAIN 3881924 3545749 336175 417885307 300700025 116145413 1039869 2935358 37955238 23149492 1770319 52726698 53523985 2876838 3968039 3334858 2499501 1351624 1302781 335054145 77865143 249999164 257189002 298312055 332522395 70862299 76736262 705548386 767467522 39503463 54638230 22672 45295 3843746 1546546 244411557 232323284 287781438 288553355 X 412257504 473909974 5187917 4683666 321527 320527 417766948 478914167 705548386 767467522 X 34992391 24269113 1885715 X 0 1 X 1 0 X 62414818 62414818 181883542 41653073 140230469 5117707 2241199 2876508 76285941 33312321 42973620 9352137 658550 8693587 257189002 OTHER LONG-TERM ASSETS 309386 INVESTMENT IN JOINT VENTURES 66934993 DEFERRED COMP 457(B) 611530 DUE FROM AFFILIATE 8880353 76736262 25068 RETIREMENT LIABILITY 45577256 HEALTH & WELFARE INS RESERVES 954200 ASSET RETIREMENT OBLIGATION 721519 DUE TO AFFILIATES 184433711 DEFERRED COMP 457(B) 611530 232323284 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 2014. 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. H.R. 1, ORIGINALLY KNOWN AS THE TAX CUTS AND JOBS ACT (THE ACT), WAS SIGNED INTO LAW ON DECEMBER 22, 2017. THE ACT CONTAINS VARIOUS PROVISIONS AFFECTING BOTH TAXABLE AND TAX-EXEMPT ENTITIES. TAX EXEMPT ENTITIES ARE IMPACTED IN PART BY THE INCLUSION OF A NEW EXCISE TAX ON EXCESS COMPENSATION FOR COVERED EMPLOYEES, CHANGES TO UNRELATED BUSINESS INCOME, CHANGES TO TAX RATES, AS WELL AS THEIR ABILITY TO ADVANCE REFUND BONDS. IN ADDITION, TAX-EXEMPT ENTITIES MAY BE IMPACTED THROUGH CERTAIN FOR-PROFIT SUBSIDIARIES AND/OR JOINT VENTURES BASED ON THE ACT'S PROVISIONS FOR TAX RATES, ELIMINATION OF THE CORPORATE ALTERNATIVE MINIMUM TAX, CHANGES TO NET OPERATING LOSS UTILIZATION AND CARRYOVER/CARRYBACK PERIOD, AND MEASUREMENT OF DEFERRED TAXES AS WELL AS OTHER LIMITATIONS ON DEDUCTIONS. THE ACT'S PROVISIONS MAY ALSO IMPACT DONOR TAX INCENTIVES FOR CHARITABLE GIVING. THE SYSTEM IS CURRENTLY ASSESSING THE OVERALL IMPACT OF THE ACT AND ITS IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 1 X 1 X 600.000000000000 1 1 0 1 1 2914376 2914376 0.00700 65713214 41112341 24600873 0.05890 9001994 4810644 4191350 0.01000 77629584 45922985 31706599 0.07590 415283 415283 0.00100 4755 10883040 290 10882750 0.02600 474984 474984 0.00110 24702 817575 817575 0.00200 29457 12590882 290 12590592 0.03010 29457 90220466 45923275 44297191 0.10600 3803 3803 0.00000 1150 18845 18845 0.00000 687181 687181 0.00160 143 31319 31319 0.00010 283 7287 7287 0.00000 1576 748435 748435 0.00170 0 2435559 0 78395729 85199715 -6803986 X 1 1 1 1 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 53715 WWW.MERITER.COM 316 X X X X X MERITER HOSPITAL INC 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X WWW.UNITYPOINT.ORG/MADISON X X 1 15 1 WWW.UNITYPOINT.ORG/MADISON 0 1 X 200.000000000000 600.000000000000 X 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 X 1 X 0 0 MERITER HOSPITAL, INC. PART V, SECTION B, LINE 5: TO PROVIDE AS COMPLETE AN OVERVIEW OF THE HEALTH BEHAVIORS AND PERCEPTIONS OF DANE COUNTY RESIDENTS AS POSSIBLE, MERITER HOSPITAL IS A MEMBER OF THE HEALTHY DANE COLLABORATIVE (HDC) WHICH DEVELOPED A 32 QUESTION COMMUNITY PERCEPTION SURVEY. THE SURVEY ADDRESSED HEALTH AND LIFESTYLE BEHAVIORS, QUALITY OF LIFE, AND ACCESS TO CARE.THE COMMUNITY PERCEPTION SURVEY UTILIZED VALIDATED AND RELIABLE QUESTIONS, WHICH HAD BEEN ON STATE AND NATIONAL NEEDS ASSESSMENTS INCLUDING THE PHQ9 DEPRESSION SCREENER, USDA FOOD SECURITY SCREENER AND THE MEDICAL EXPENDITURE PANEL SURVEY. THE SURVEY PASSED THROUGH A RIGOROUS HEALTH LITERACY REVIEW AND WAS ALSO TRANSLATED INTO SPANISH. A CONVENIENT, SNOWBALL SAMPLE (ASKING PEOPLE TO TAKE IT AND PASS IT ON, THUS CREATING A SNOWBALL EFFECT) WAS USED FOR THE COMMUNITY PERCEPTION SURVEY OVER A SIX WEEK PERIOD. AN INVITATION TO COMPLETE AN ELECTRONIC QUESTIONNAIRE (IN ENGLISH OR SPANISH) WAS SENT TO CONTACTS FROM A RANGE OF PUBLIC AND PRIVATE SOCIAL SERVICE SECTOR ORGANIZATIONS IN THE COMMUNITY. INTENTIONAL AND STRATEGIC OUTREACH WAS KEY TO GETTING A ROBUST RESPONSE RATE. PAPER COPIES OF THE SURVEY WERE MADE AVAILABLE AT COMMUNITY EVENTS AND FOOD PANTRIES. NO INCENTIVES WERE USED TO PROMOTE PARTICIPATION. IN TOTAL, 2,120 PEOPLE COMPLETED THE ENTIRE SURVEY. IN ADDITION TO THE COMMUNITY PERCEPTION SURVEY, FOCUS GROUPS OF KEY STAKEHOLDERS, COMMUNITY PARTNERS AND ADVOCATES WERE CONVENED. THE PRIMARY OBJECTIVE OF THE FOCUS GROUPS WAS TO SOLICIT INPUT FROM CONTENT EXPERTS AND THOSE IN THE COMMUNITY WITH A VESTED INTEREST IN THE HEALTH AND WELL-BEING OF DANE COUNTY RESIDENTS. THE FOCUS GROUPS WERE GUIDED BY A FACILITATOR USING A PARTICIPATORY ANALYSIS MODEL. THERE WERE THREE FOCUS GROUPS CONDUCTED CONSISTING OF BETWEEN 7-11 PARTICIPANTS. THE PARTICIPANTS WERE CHOSEN BASED ON CONTENT EXPERTISE OR COMMUNITY INVOLVEMENT. THE SPECIFIC FOCUS TOPICS DISCUSSED WERE MENTAL HEALTH, OBESITY AND DRUG AND ALCOHOL USE/ABUSE.THE DISCUSSIONS WERE CENTERED ON THREE GENERAL QUESTIONS. A RECORDER WAS USED FOR EACH FOCUS GROUP TO ASSURE PARTICIPANTS RESPONSES WERE ACCURATELY SYNTHESIZED. - WHAT SURPRISES YOU ABOUT THE DATA? - WHAT FACTORS MAY EXPLAIN SOME OF THE TRENDS WE ARE SEEING? - DOES THIS LEAD TO NEW QUESTIONS? FURTHERMORE, THE HDC ALSO USED POPULATION SPECIFIC EVENTS TO GATHER DATA. IN THESE SETTINGS, A SIMPLE PRIORITIZATION TOOL HELPED GAUGE PARTICIPANTS VISION AND PERCEPTION ABOUT THE HEALTH OF DANE COUNTY. IN MANY CASES, THE ASSESSMENT VALIDATED SOME OF WHAT THE HDC ALREADY KNEW ABOUT THE COMMUNITY, AND IN OTHER CASES, THE HDC LEARNED ABOUT UNKNOWN SHORTFALLS IN THE COMMUNITY'S HEALTH. THERE ARE MANY NEEDS IN DANE COUNTY, SOME OF WHICH ARE REFLECTED IN DISPARITIES OF RACE, ETHNICITY, INCOME, GEOGRAPHY AND EDUCATION LEVEL. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 6A: UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS, SSM HEALTH OF WISCONSIN-ST. MARY'S HOSPITAL, STOUGHTON HOSPITAL MERITER HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE HEALTHY DANE COLLABORATIVE INCLUDES PUBLIC HEALTH DEPARTMENTS OF THE CITY OF MADISON AND DANE COUNTY 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: PRIOR TO REVIEW OF THE DATA, A LIST OF CRITERIA WAS DEVELOPED TO AID IN THE SELECTION OF PRIORITY AREAS. DURING THE DATA-REVIEW PROCESS, ATTENTION WAS DIRECTED TO HEALTH ISSUES THAT MET ANY OF THESE CRITERIA: - HEALTH ISSUES THAT IMPACT A LOT OF PEOPLE OR FOR WHICH DISPARITIES EXIST, AND WHICH PUT A GREATER BURDEN ON SOME POPULATION GROUPS - POOR RANKINGS FOR HEALTH ISSUES IN DANE COUNTY AS COMPARED TO WISCONSIN,OTHER COUNTIES OR HEALTHY PEOPLE 2020 NATIONAL HEALTH TARGETS (DANE COUNTY IS THE PRIMARY SERVICE AREA FOR THE COLLABORATING HOSPITALS) - HEALTH ISSUES FOR WHICH TRENDS ARE WORSENING THE HEALTHY DANE COLLABORATIVE ALSO CONSIDERED INDICATORS THAT RELATE TO PROBLEMS THE PUBLIC HEALTH DEPARTMENT HAD ALREADY IDENTIFIED THROUGH ITS FOCUS ON PREVENTION AND THE NATIONAL PREVENTION STRATEGIES. IN ADDITION TO THE 7 AREAS OF FOCUS, PUBLIC HEALTH MADISON AND DANE COUNTY IS ALSO WORKING TO ADDRESS ORAL HEALTH AND ACCESS TO CARE. IN ADDITION, THE COLLABORATIVE EXAMINED "SOCIAL DETERMINANTS OF HEALTH, OR FACTORS IN THE COMMUNITY THAT CAN EITHER CONTRIBUTE TO POOR HEALTH OUTCOMES OR SUPPORT A HEALTHY COMMUNITY. THE COLLABORATIVE SHARES THE OBSERVATION THAT, WHILE SOME HEALTH STATUS INDICATORS FOR DANE COUNTY ARE BETTER THAN AVERAGE, THEY MAY STILL REPRESENT PROBLEMS THAT ARE HIGHLY PREVALENT, PLACE A HEAVY BURDEN ON OUR POPULATION, AND MIGHT BE WORSENING OR FALL SHORT OF BENCHMARKS. IN ADDITION, AGGREGATE HEALTH DATA FOR THE ENTIRE POPULATION OFTEN MASKS THE UNFAIR, HEAVY BURDEN ON SOME POPULATION GROUPS. AFTER REVIEW AND CONSIDERATION OF ALL AVAILABLE DATA INCLUDING FOCUS GROUP AND KEY STAKEHOLDER INPUT, AND GUIDED BY OUR CRITERIA, THE HDC IDENTIFIED TWELVE HEALTH ISSUES THAT SHOWED EVIDENCE OF NEED IN OUR COUNTY LISTED BELOW IN RANK ORDER: 1. MENTAL HEALTH 2. ALCOHOL AND DRUG ABUSE PREVENTION 3. MATERNAL CHILD HEALTH 4. OBESITY PREVENTION/TYPE 2 DIABETES AND HEART DISEASE 5. ORAL HEALTH 6. HEALTHY EATING/FOOD INSECURITY 7. ACCESS TO CARE 8. INFECTIOUS DISEASE 9. RESPIRATORY DISEASE 10. INJURY/VIOLENCE FREE LIVING 11. CANCER 12. TOBACCO FREE LIVING. MERITER HOSPITAL, INC. 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. 6 1 - MAX W POHL DENTAL CLINIC 202 S PARK ST MADISON WI 53715 DENTAL SERVICES 2 - MERITER REHABILITATION MEDICINE 202 S PARK ST MADISON WI 53715 REHABILITATION SERVICES 3 - CHILD & ADOLESCENT PSYCHIATRY 8001 RAYMOND ROAD MADISON WI 53719 INPATIENT PSYCHIATRY SERVICES 4 - MERITER NEWSTART 1015 GAMMON LANE MADISON WI 53719 SUBSTANCE ABUSE TREATMENT PROGRAM 5 - MERITER WELLNESS CENTER 501 W BELTLINE HWY SUITE 207 MADISON WI 53713 CARDIOVASCULAR & PULMONARY REHAB & NUTRITION 6 - 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 A SAFE ENVIRONMENT, INTERCONNECTED NEIGHBORHOODS WITH ADEQUATE AND AFFORDABLE HOUSING, STRONG SCHOOLS AND A PREPARED AND DIVERSE WORKFORCE.THROUGH PARTNERSHIPS WITH AREA NON-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS, MERITER IS WORKING TO STRENGTHEN THE COMMUNITY THROUGH SPONSORSHIPS AND INVOLVEMENT IN BAYVIEW COMMUNITY FOUNDATION, GREENBUSH DAY COMMUNITY CELEBRATION, NEIGHBORHOOD HOUSE, AND HABITAT FOR HUMANITY, AND SUPPORT OF A NEIGHBORHOOD HOUSING INITIATIVE. ALL OF THESE GROUPS, AND OTHERS, CREATE OPPORTUNITIES FOR SAFE AND AFFORDABLE HOUSING, FAMILY-BASED EVENTS, AND STRENGTHENING THE NEIGHBORHOODS THROUGH RAISING AWARENESS OF COMMUNITY RESOURCES AND NEIGHBORHOOD ASSETS. NEIGHBORHOOD HOUSE, IN PARTICULAR, HAS EXPANDED ITS AFTERSCHOOL ACTIVITIES AND SUMMER CAMP PROGRAM. THIS PROGRAM INTRODUCED CHILDREN TO AREAS OF THE COMMUNITY MANY HADN'T EXPERIENCED INCLUDING FIELD TRIPS TO THE UNIVERSITY, ZOO AND TO A LOCAL COMMUNITY GARDEN. BAYVIEW FOUNDATION IS PART OF BAYVIEW TOWNHOMES, A CDA HOUSING COMMUNITY LOCATED NEXT TO MERITER. THE VAST MAJORITY OF BAYVIEW RESIDENTS ARE IMMIGRANTS WITH APPROXIMATELY 80% OF THE TOTAL RESIDENTS IDENTIFYING AS HMONG. THE FOUNDATION'S AFTER-SCHOOL, SCHOOL -AGE AND OTHER PROGRAMS ARE VITALLY IMPORTANT TO ASSISTING THE FAMILIES AND THE CHILDREN WITH ASSIMILATION. THE PROGRAMS PROVIDE AFTER-SCHOOL TUTORING, COMPUTER SKILLS, ENGLISH LANGUAGE COMPETENCY AND SCHOOL READINESS, SUMMER EDUCATIONAL PROGRAMS AND A FREE LENDING LIBRARY. WITHOUT THESE PROGRAMS, THE CHILDREN IN BAYVIEW WOULD FALL DISASTROUSLY BEHIND IN SCHOOL AND LACK THE SOCIAL SKILLS NEEDED FOR ACADEMIC AND EMPLOYMENT SUCCESS. THEY WOULD STRUGGLE WITH BASIC LITERACY, SEVERELY IMPAIRING THEIR ABILITY TO EARN A LIVING OR READ A PHYSICIAN'S INSTRUCTIONS. IT IS WELL DOCUMENTED THAT LITERACY AND EMPLOYMENT STATUS HAVE AN IMPACT ON HEALTH AS A SOCIAL DETERMINANT. MERITER'S EFFORTS IN SUPPORT OF BAYVIEW FOUNDATION, NEIGHBORHOOD HOUSE AND OTHER PROGRAMS ASSOCIATED WITH EMPLOYMENT ARE INVESTMENTS IN THE FUTURE OF THE COMMUNITY. WE HOPE TO CREATE A MORE EDUCATED AND BETTER PREPARED COMMUNITY - WHICH WILL BE HEALTHIER.MERITER LED THE WAY IN ESTABLISHING A WORK-FORCE HOUSING INITIATIVE FOR A RAPIDLY CHANGING NEIGHBORHOOD. THE INITIATIVE, WHICH INCLUDES PARTNERS FROM OTHER AREA EMPLOYERS, HAS GROWN IN TO A SEPARATE ORGANIZATION WHICH PROVIDES HOME-BUYER EDUCATION, BUDGETING, AND OTHER FINANCIAL LITERACY. FINALLY, MERITER IS WORKING WITH COMMUNITY GROUPS SUCH AS THE URBAN LEAGUE TO FUND TRAINING PROGRAMS, SCHOLARSHIPS AND TUTORING PROGRAMS. THROUGH SUPPORT OF EDUCATIONAL PROGRAMS, MERITER IS HELPING INCREASE JOB OPPORTUNITIES FOR AREA RESIDENTS, THEREBY INCREASING JOB SECURITY. 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: WE NOTIFY PATIENTS OF THEIR FINANCIAL RESPONSIBILITY AS WELL AS OUR CHARITY CARE POLICY. OUR COLLECTION AGENCIES ARE EDUCATED ON OUR FAHCP (FINANCIAL ASSISTANCE FOR HEALTH CARE PROGRAM) AND WE FOLLOW WHA (WISCONSIN HOSPITAL ASSOCIATION) GUIDELINES. OUR POLICY STATES "PATIENT ACCOUNTS IN THE PROCESS OF FINANCIAL AID REVIEW WILL NOT KNOWINGLY BE SENT TO COLLECTIONS." PART VI, LINE 2: MERITER JOINED THREE OTHER HOSPITALS IN DANE COUNTY, UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS, STOUGHTON HOSPITAL, AND ST. MARY'S - SSM OF WISCONSIN, ALONG WITH PUBLIC HEALTH MADISON, DANE COUNTY, AND GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN IN THE ASSESSMENT OF THE HEALTH OF DANE COUNTY. SECONDARY DATA WAS COLLECTED AND AGGREGATED BY HEALTHY COMMUNITIES INSTITUTE. THE DATA WAS VERIFIED IN COMMUNITY FOCUS GROUPS AND THE GROUPS PROVIDED INSIGHT AND IDEAS TO ADDRESS IDENTIFIED NEEDS. 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 THE SECOND MOST DENSELY POPULATED COUNTY IN WISCONSIN, AND MADISON IS THE SECOND LARGEST CITY IN THE STATE. THE POPULATION OF DANE COUNTY GREW 9.65% BETWEEN 2010 AND 2016, BRINGING THE TOTAL POPULATION TO 516,818. MADISON HAS 246,034 RESIDENTS, ALMOST HALF OF THE COUNTY'S POPULATION. AMONG ITS RESIDENTS ARE MORE THAN 43,000 UW STUDENTS.THE ETHNIC/RACIAL DEMOGRAPHICS OF DANE COUNTY ARE CHANGING. SINCE 2000, THE PERCENTAGE OF THE POPULATION THAT IS WHITE DECREASED FROM 87.4% TO 82.8%. THE GREATEST GROWTH AMONG MINORITY GROUPS WAS SEEN IN THE HISPANIC POPULATION. COMPARED WITH WISCONSIN AS A WHOLE, DANE COUNTY HAS MORE ETHNIC DIVERSITY, A LARGER PERCENT OF FOREIGN-BORN RESIDENTS (8.3%), AND A LARGER PERCENT THAT SPEAKS A LANGUAGE OTHER THAN ENGLISH IN THE HOME (12% IN DANE COUNTY; 15.6% IN MADISON). MINORITIES ARE MORE CONCENTRATED IN THE CITY OF MADISON. OVER HALF OF ALL STUDENTS IN MADISON PUBLIC SCHOOLS ARE OF RACIAL/ETHNIC MINORITY GROUPS. HMONG ARE ONE OF THE LARGEST ASIAN GROUPS IN DANE COUNTY, AND DANE COUNTY HAS ONE OF THE LARGEST HMONG POPULATIONS IN WISCONSIN. EXAMINATION OF DATA FOR DANE COUNTY REVEALS A LARGE GAP IN EDUCATION AND INCOME BETWEEN AN AFFLUENT MAJORITY POPULATION AND A GROWING LOW-INCOME, LESS EDUCATED POPULATION. THE PERCENT OF THE POPULATION THAT HAS AT LEAST A BACHELOR'S DEGREE IS MUCH HIGHER IN DANE COUNTY THAN IN WISCONSIN AND THE U.S., AND IT IS HIGHER YET IN MADISON (DANE COUNTY 49%, MADISON 53.9%, WISCONSIN 28.4%, U.S. 30.3%). HOWEVER, DANE COUNTY'S CURRENT 86% HIGH SCHOOL GRADUATION RATE IS ONE OF THE LOWEST AMONG WISCONSIN COUNTIES. IN RECENT YEARS, MUCH ATTENTION HAS BEEN PAID TO THE "ACHIEVEMENT GAP AND LOWER GRADUATION RATES FOR SOME RACIAL MINORITY GROUPS IN MADISON, BUT DANE COUNTY'S OTHER 16 PUBLIC SCHOOL DISTRICTS FACE THE SAME CHALLENGE. IN 2014, THE FOUR-YEAR GRADUATION RATE FOR ALL STUDENTS IN THE MADISON METROPOLITAN SCHOOL DISTRICT WAS 89% BUT THERE WAS CONSIDERABLE VARIATION BY RACIAL GROUP. IN THE PAST 3 YEARS, THERE HAVE BEEN IMPROVEMENTS ACROSS THE BOARD IN GRADUATION RATES AND THE GAPS HAVE NARROWED VERY SLIGHTLY.THE MEDIAN HOUSEHOLD INCOME FOR DANE COUNTY IS $64,773 AS COMPARED TO $54,610 IN WISCONSIN. MADISON'S MEDIAN HOUSEHOLD INCOME IS $56,464, WHICH IS LOWER THAN HOUSEHOLD INCOMES IN THE REMAINDER OF DANE COUNTY. HOWEVER, THERE IS CONSIDERABLE VARIABILITY WHEN YOU DISAGGREGATE MEDIAN HOUSEHOLD INCOME BY RACE AND ETHNICITY. DESPITE THE HIGH MEDIAN HOUSEHOLD INCOME AND A RELATIVELY LOW UNEMPLOYMENT RATE (4.4%), DANE COUNTY IS FACED WITH AN INCREASING NUMBER OF PEOPLE LIVING IN POVERTY. 12.7% OF DANE COUNTY RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL (2012-2016), A STATISTIC THAT IS COMPARABLE TO THE STATE POVERTY RATE. IN MADISON, THE POVERTY RATE IS HIGHER AT 18.6%. ACCORDING TO THE CENTER ON WISCONSIN STRATEGY, 35% OF STUDENTS IN DANE COUNTY ARE ELIGIBLE FOR FEDERAL FREE OR REDUCED-PRICE SCHOOL LUNCH IN THE 2012-2013 SCHOOL, AN INCREASE FROM 2000 WHEN ONLY 19% OF STUDENTS WERE ELIGIBLE. POVERTY LEVELS ARE PARTICULARLY STRIKING FOR CHILDREN IN THE COUNTY.TO BE EFFECTIVE, HEALTH PROGRAMS MUST BE MEETING A TANGIBLE NEED OF THE COMMUNITY. TO MEET THE NEED, THEY MUST BE PRESENTED TO AND ACCESSIBLE BY THE VERY PEOPLE WHO NEED THEM MOST. A STUDY OF DEMOGRAPHICS IS NECESSARY TO ENLIGHTEN THE PLANNING AND MARKETING PROCESS AND, ULTIMATELY, TO MOVE THE DIAL TOWARD BETTER COMMUNITY HEALTH. 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. SIMILARLY, MERITER PROVIDES THE ONLY HOSPITAL BASED DENTAL RESIDENCY PROGRAM IN THE AREA. THIS SERVICE OFFERS AN OPTION FOR THOSE WHO CANNOT BE SEEN IN A STANDARD DENTAL OFFICE WHETHER THAT REASON IS FOR AN ILLNESS OR A BEHAVIORAL OR COGNITIVE DISABILITY. FURTHERMORE, THE MERITER'S DENTAL CLINIC IS ONE OF ONLY A HANDFUL OF DENTAL CLINICS INT EH COUNTY THAT ACCEPTS MEDICAL ASSISTANCE. BOTH OF THESE SERVICES OFTEN OPERATE AT A LOSS FOR THE ORGANIZATION. HOWEVER, THE BOARD AND LEADERSHIP ARE COMMITTED TO ENSURING THAT MERITER CONTINUE TO PROVIDE THIS RESOURCE TO THE COMMUNITY. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THROUGH RELATIONSHIPS WITH 36 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 400 OUTPATIENT SITES, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, WESTERN ILLINOIS, AND SOUTHERN WISCONSIN.UNITYPOINT HEALTH ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 30,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 6.2 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $4.2 BILLION, UNITYPOINT HEALTH IS THE FOURTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2017, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $531 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) 52619 HOSPITAL PROGRAMS MERITER HEALTH SERVICES INC 202 S PARK STREET MADISON WI 537151596 391412318 501(C)(3) 29923 MERITER HEALTH SERVICES PROGRAMS 2 0 HOSPITAL SCHOLARSHIPS 33 33000 0 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 ARTHUR NIZZA DSW BOARD MEMBER/CEO 0 622684 0 149727 0 47990 0 152821 0 15010 0 988232 0 0 BETH ERDMAN CFO/SECRETARY/TREASURER 0 286436 0 96736 0 17880 0 50009 0 5539 0 456600 0 0 SUE ERICKSON COO/ASST. TREASURER 0 387889 0 60961 0 31756 0 57182 0 19430 0 557218 0 0 PAM WETZEL MD CMO 0 398479 0 69380 0 21024 0 60581 0 16782 0 566246 0 0 JAMES ARNETT VP HUMAN RESOURCES 0 237387 0 94106 0 16931 0 51310 0 20745 0 420479 0 0 TODD BURCHILL VP BUSINESS DEVELOPMENT 0 256334 0 100605 0 17221 0 43801 0 24849 0 442810 0 0 PATRICIA GRUNWALD CHIEF NURSING OFFICER 0 268376 0 102583 0 33522 0 10800 0 22174 0 437455 0 0 MARY J HANSEN VP-CLINIC OPERATIONS 74254 0 47598 0 178888 0 6711 0 21004 0 328455 0 0 0 CHRISTINA JACKSON DIR PERIOPERATIVE SVCS 168274 0 30073 0 644 0 8166 0 23149 0 230306 0 0 0 KATHERINE KOSTRIVAS EXEC DIRECTOR JOA 170900 0 40812 0 1545 0 8695 0 18529 0 240481 0 0 0 LANA STECKEL DIR MEDICAL IMAGING 164129 0 39959 0 2330 0 8363 0 18037 0 232818 0 0 0 LINDA WONOSKI DIR CARDIOVASCULAR SVCS 161703 0 28343 0 879 0 7720 0 9781 0 208426 0 0 0 GEOFFREY PRIEST MD TO 316 FORMER CMO/ASST. SECRETARY 0 0 0 0 0 149723 0 0 0 0 0 149723 0 0 PETER THOREEN TO 215 FORMER BOARD MEMBER/INTERIM CEO 0 0 0 0 0 172832 0 10886 0 0 0 183718 0 172832 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(S) PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: JAMES ARNETT $40,510; TODD BURCHILL $33,001; BETH ERDMAN $39,209; SUE ERICKSON $46,382; ARTHUR NIZZA $128,442; PETER THOREEN $332; PAM WETZEL $49,781. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: PETER THOREEN $172,832. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS. 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 2017 FOR THE FOLLOWING INDIVIDUALS: JAMES ARNETT, TODD BURCHILL, BETH ERDMAN, SUE ERICKSON, PATRICIA GRUNWALD, 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 -617,177. ASSETS RELEASED FROM RESTRICTION -1,862,363. RELEASED FOR CAPITAL AND OTHER 1,891,153. TEMPORARY & PERMANENTLY RESTRICTED TRANSFER FOUNDATION 1,357,112. UPH TRANSFERS 1,454,659. OTHER -337,669. 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SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 36 HOSPITAL FACILITIES AND OVER 400 OUTPATIENT SITES IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A).