2018-11-12T17:01:46-06:00 2017-12-31 134008324 PricewaterhouseCoopers LLP 600 13th Street NW Ste 1000 Washington DC 20005 990 2017-01-01 310785684 Community Mercy Health Partners COMM 9373287000 100 Medical Center Drive Springfield OH 455031832 William Kusnierz Region CFO 2018-11-12 true Travis Patton P00369623 2124141000 2017 2019-02-21 02:37:17Z Springfield Regional Medical Center MATTHEW CALDWELL PRESIDENT & CEO 100 Medical Center Drive Springfield OH 455031832 316088434 false 0928 X WWW.COMMUNITY-MERCY.ORG X 1983 OH THE MISSION OF COMMUNITY MERCY HEALTH PARTNERS IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. 11 11 2611 1000 0 0 640679 617966 298370080 308511360 2000456 4330037 2513877 2629071 303525092 316088434 16466 4500 0 134612424 141417457 0 0 165936840 162681417 300565730 304103374 2959362 11985060 403949224 377232316 179133887 174019419 224815337 203212897 THE MISSION OF COMMUNITY MERCY HEALTH PARTNERS IS TO CARRY OUT THE MERCY HEALTH MISSION WITHIN OUR COMMUNITY BY PROVIDING SAFE, EFFECTIVE, PATIENT/RESIDENT CENTERED, TIMELY AND COST EFFICIENT CARE AND EDUCATION TO MEET THE HEALTH NEEDS OF ALL PEOPLE, ESPECIALLY THE POOR AND UNDER-SERVED. OUR COMMITMENT TO THIS HEALING MINISTRY WILL BE EVIDENCED BY EXCEPTIONAL CARE, COMPASSION, AND RESPECT FOR THE DIVERSE RELIGIOUS BELIEFS AND FAITH TRADITIONS OF THOSE WE SERVE. false false 266919963 4500 308511360 COMMUNITY MERCY HEALTH PARTNERS IS COMMITTED TO DELIVERING EXCEPTIONAL CARE AND COMPASSION AS IT SEEKS TO MEET THE HEALTH CARE NEEDS OF ALL PEOPLE, ESPECIALLY THE POOR AND UNDER-SERVED. DURING 2017 COMMUNITY MERCY HEALTH PARTNERS PROVIDED $17,202,053 IN NET COMMUNITY BENEFITS REPRESENTING 5.7% OF TOTAL OPERATING EXPENSES. 266919963 true true false true false false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false false false true false false false false true true false false false true 0 0 2611 true false false false false false false true false false false X 11 11 false false false false true true true true true false false true true true true true true true true true true X TRAVIS CRUM 5139525000 1701 Mercy Health Place CINCINNATI OH 45237 JOSEPH R JACKSON CHAIR 1.0 1.5 X X 0 0 0 WENDY H DOOLITTLE VICE CHAIR 1.0 1.5 X X 0 0 0 DEANNA L BROUGHER SECRETARY 1.0 1.5 X X 0 0 0 PIUS KURIAN MD TRUSTEE 1.0 1.5 X 0 0 0 RAVI C KHANNA MD TRUSTEE 1.0 1.5 X 0 0 0 MARK B ROBERTSON TRUSTEE 1.0 1.5 X 0 0 0 REV DARRYL L GRAYSON TRUSTEE 1.0 1.5 X 0 0 0 WILLIAM H RAY TRUSTEE 1.0 2.5 X 0 0 0 SR CHERYL ERB RSM TRUSTEE 1.0 3.0 X 0 0 0 Surender NERAVETLA MD TRUSTEE 1.0 1.5 X 0 0 0 JOSEPH MORMAN MD TRUSTEE 1.0 1.5 X 0 0 0 WILLIAM KUSNIERZ VP, CFO & TREASURER 40.0 1.5 X 0 430959 39073 MATTHEW CALDWELL Pres/CEO Springfield Region, SVP Mercy Health 40.0 4.0 X 613866 0 116749 DONALD B JOHNSON MD CHIEF CLINICAL OFFICER 40.0 0.5 X 394545 0 14644 ADAM GROSHANS VP, COO - VPMA 40.0 0 X 288760 0 34636 ELAINE STORRS VP CHIEF NURSING OFFICER 40.0 0 X 179915 0 26097 JENELLE ZELINSKI ASSISTANT CFO 40.0 0 X 198591 0 39002 PAMELA ALLEN Director, Pharmacy 40.0 0 X 198305 0 19728 ELIZABETH PRICE SUPERVISOR NURSING 40.0 0 X 163668 0 23146 JULIE EBLIN TECHNICAL LEADER LAB SERVICES 40.0 0 X 189095 0 18945 PAMELA TEMPLE TECHNICAL LEADER BLOOD BANK 40.0 0 X 167022 0 31775 KATRINA ENGLISH FORMER VP GENERAL COUNSEL 0.0 56.0 X 0 251849 19672 SHERRY NELSON FORMER VP CHIEF NURSING OFFICER 0.0 0 X 202840 0 14052 PAUL HILTZ FORMER Pres/CEO Springfield Region, SVP Mercy Health 0.0 0.0 X 739759 0 49294 3336366 682808 446813 77 true true false 0 X 617966 617966 NET PATIENT SERVICE REVENUE 621990 306691606 306691606 INCOME FROM JV'S AND PARTNERSHIPS 900099 386363 386363 rental income from affiliates 531120 752219 752219 Intercompany 900099 681172 681172 0 0 0 0 308511360 583579 583579 0 0 3704053 42405 3704053 42405 3746458 3746458 CAFETERIA 722514 1003254 1003254 CMS Care Management Fees 900099 540693 540693 Employee Pharmacy 446110 406548 406548 678576 0 0 678576 2629071 316088434 308511360 0 6959108 X 4500 4500 1669212 1418830 250382 113366831 96361807 17005024 5802925 4932486 870439 12906038 10970132 1935906 7672451 6521583 1150868 61282 61282 17082 17082 75480050 65833145 9646905 0 3628028 3083824 544204 7186929 6108890 1078039 530980 451333 79647 6510522 5533944 976578 17791408 15122697 2668711 1959025 1665171 293854 Medical Supplies 38180652 38180652 State Assessments 4269821 4269821 Membership Dues 476616 405124 71492 Dietary & laboratory supplies 5311138 5311138 1277884 744886 532998 0 304103374 266919963 37183411 0 -47296 -1528280 203240 203040 83956422 56782473 0 0 0 1824975 2098761 6486815 6861960 419469 261441 403126273 181077106 230607441 222049167 78952255 88939632 0 1545903 1564122 403949224 377232316 29982278 29689159 0 146907840 142043304 2243769 2286956 179133887 174019419 X 224307027 202700955 224334 227966 283976 283976 224815337 203212897 403949224 377232316 X 11985060 5717367 -39304867 X false true X true true true X true false false false false true 2078 false false true 2778 4856 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRY OUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING ACTIVITIES PERFORMED INCLUDE BOTH THE USE OF VOLUNTEERS ENCOURAGED TO WRITE LETTERS TO PUBLIC OFFICIALS ON ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE TO PROVIDE HEALTH SERVICES TO THE COMMUNITIES SERVED, AND THE USE OF PAID STAFF MEMBERS AND MANAGEMENT PERSONNEL. PAID MANAGEMENT PERSONNEL REGULARLY ISSUE MAILINGS TO LEGISLATORS ATTEMPTING TO INFLUENCE LEGISLATIVE MATTERS AND REFERENDUM, AND ORGANIZE AND HOST MEETINGS AMONG HOSPITAL EXECUTIVES AND THEIR LEGISLATORS REGARDING ISSUES THAT IMPACT THE ORGANIZATION'S ABILITY TO CONTINUE PROVIDING HEALTHCARE SERVICES TO ITS PATIENTS AND TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. PAID STAFF MEMBERS HAVE, ON LIMITED OCCASIONS, WRITTEN TO LEGISLATORS ON SUCH ISSUES. THE PRIMARY PURPOSE FOR LOBBYING ACTIVITIES IS TO ENHANCE THE ORGANIZATION'S PUBLIC POSITION ON LEGISLATIVE AND REGULATORY ISSUES THAT IMPACT PATIENT CARE THROUGHOUT OUR SYSTEM. THE ORGANIZATION FOCUSES ON PUBLIC POLICY ISSUES THAT EXTEND OUR HEALING MINISTRY TO THOSE WHO ARE POOR AND UNDERSERVED IN THE COMMUNITIES WE SERVE. TO CARRY OUT THESE EFFORTS, THE ORGANIZATION PARTNERS WITH EXPERT CONSULTANTS AND PROFESSIONAL TRADE ASSOCIATIONS TO BUILD AWARENESS AND EXECUTE SPECIFIC STRATEGIES THAT WILL YIELD A FAVORABLE OUTCOME FOR PATIENT CARE IN THE ORGANIZATION'S FACILITIES WHERE THEY ARE TREATED. 23805259 23805259 242534844 78554639 163980205 136658266 102522467 34135799 127904 127904 222049167 MERCY HEALTH INVESTMENT MANAGEMENT PROGRAM 88939632 F 88939632 OTHER 2286956 2286956 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE COMPANY [MERCY HEALTH AND AFFILIATED ENTITIES] COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT DECEMBER 31, 2017 AND 2016, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT DECEMBER 31, 2017 OR 2016. true true X true X true X true true false true true 787860 787860 0 0.0 61973614 46663663 15309951 0.0503 0 0 0 0.0 0 0 62761474 47451523 15309951 0.0503 683445 11976 671469 0.0022 635595 0 635595 0.0021 754602 312841 441761 0.0015 0 0 0 0.0 143467 200 143267 0.0005 0 0 2217109 325017 1892092 0.0062 0 0 64978583 47776540 17202043 0.0566 0 0.0 0 0.0 34751 34751 0.0001 184 184 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 34935 0 34935 0.0001 false 28294112 0 57726674 56531919 1194755 X true true Mercy Medical Office Condominium Association Real Property Management 0.496 0.0 0.504 Northpark Condominium Association Real Property Management 0.55 0.0 0.45 2 1 MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER 100 Medical Center Drive SPRINGFIELD OH 45504 www.mercy.com/locations/hospitals/springfield/springfield-medical-center 1122AHR X X X A 2 MERCY HEALTH - URBANA HOSPITAL 904 SCIOTO STREET URBANA OH 43078 www.mercy.com/springfield 1121AHR X X X X A A false false true X X X X X X X X X 16 true true true true X www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment X true 17 true www.mercy.com/about-us/mission/giving-back/community-health-needs-assessment false true X 200.0 400.0 X X X X X X true true X X X true X https://www.mercy.com/patient-resources/financial-assistance X https://www.mercy.com/patient-resources/financial-assistance X https://www.mercy.com/patient-resources/financial-assistance X X X X X X true X false X X X true X false false Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER. MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER ("SRMC") PARTICIPATED IN A REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS COORDINATED BY THE CLARK COUNTY CHNA STAKEHOLDER GROUP ("STAKEHOLDER GROUP" OR "GROUP"). THE STAKEHOLDER GROUP CONSISTED OF SRMC, CLARK COUNTY COMBINED HEALTH DISTRICT ("CCCHD"), MENTAL HEALTH AND RECOVERY BOARD OF CLARK, GREENE, AND MADISON COUNTIES, AND ROCKING HORSE CENTER. THE GROUP WORKED TOGETHER TO GATHER DATA AND ANALYZE THE CURRENT HEALTH CARE NEEDS IN THE REGION. REGIONAL DATA WAS ACCUMULATED THROUGH RANDOM ADULT TELEPHONE SURVEYS, A YOUTH RISK BEHAVIOR SURVEY WITHIN CLARK COUNTY LOCAL SCHOOLS, AND ORGANIZATIONAL SURVEYS DISTRIBUTED WITHIN THE COMMUNITY. THE SURVEYS TOOK PLACE BETWEEN MAY 2015 TO OCTOBER 2015. THE STAKEHOLDER GROUP USED THE COMMUNITY HEALTH ASSESSMENT AND GROUP EVALUATION (CHANGE) TOOL DEVELOPED BY THE CDC TO EVALUATE THE COMMUNITY-AT-LARGE. THE CHANGE TOOL WAS CONDUCTED AMONG SEVERAL AT-RISK NEIGHBORHOODS WITH THE MOST HEALTH DISPARITIES. CCCHD COMPLETED A "YOUTH RISK SURVEY COMPARISON CLARK 2015 VS. CLARK 2011 VS. OHIO 2011 VS. US 2011" IN OCTOBER 2015. SRMC AND MERCY HEALTH - URBANA HOSPITAL SPONSORED A HEALTH CARE SUMMIT IN OCTOBER 2015. COMMUNITY LEADERS FROM CLARK AND CHAMPAIGN COUNTIES WERE INVITED TO IDENTIFY HEALTHCARE ISSUES WITHIN THE COMMUNITY. DATA WAS PRESENTED AT A LARGE COMMUNITY MEETING IN JANUARY 2016, AND COMMUNITY PARTNERS WERE ASSIGNED A TASK FORCE TO IDENTIFY NEEDS, OBJECTIVES, AND WORK PLANS. MORE THAN 20 LARGE COMMUNITY AND TASK FORCE MEETINGS WERE HELD BETWEEN MARCH 2016 TO JUNE 2016. ATTENDEES INCLUDED THOSE WHO PREDOMINANTLY SERVE THE POOR AND THE MOST AT-RISK POPULATIONS. MEMBERS OF THE FOLLOWING ORGANIZATIONS ATTENDED THE COMMUNITY AND TASK FORCE MEETINGS: ALZHEIMBER'S ASSOCIATION OF MIAMI VALLEY, CARESOURCE, CLARK COUNTY DEPARTMENT OF JOB & FAMILY SERVICES, CLARK COUNTY EMA, CLARK COUNTY JAIL, CLARK COUNTY JUVENILE COURT, CLARK STATE UNIVERSITY, COMMUNITY HEALTH FOUNDATION, FAMILY AND CHILDREN FIRST COUNCIL, MENTAL HEALTH AND RECOVERY BOARD OF CLARK, GREEN, AND MADISON COUNTIES, NATIONAL TRAILS AND PARK DISTRICT, OHIO HOUSE OF REPRESENTATIVES, OHIO STATE UNIVERSITY EXTENSION OFFICE, PARENT ADVOCACY CONNECTION, PLANNED PARENTHOOD AND FAMILIES, ROCKING HORSE CENTER, SPRINGFIELD CITY SCHOOL DISTRICT, SPRINGFIELD FOUNDATION, SPRINGFIELD SOUP KITCHEN, SPRINGFIELD YMCA, UNITED SENIOR SERVICES, UNITED WAY, URBAN LIGHT MINISTRIES, WITTENBERG UNIVERSITY, AND WRIGHT STATE UNIVERSITY. STATISTICS THAT WERE DEEMED TO BE CAUSING THE MOST HEALTH DISPARITIES AND AFFECTING INDIVIDUAL AREAS AND POPULATIONS THE MOST WERE ANALYZED SEPARATELY. THE STATISTICS ("CONCERNING STATISTICS") WERE GROUPED BY TOPIC, FOCUS, AND MEASURE ACCORDING TO THE COUNTY HEALTH RANKINGS SYSTEM, AND SCORED BY AREA, AGE, AND POPULATION. THE OVERALL SCORES WERE CALCULATED, AND THE HEALTH NEEDS WERE PRIORITIZED ACCORDINGLY. THE MOST SERIOUS ISSUES FACING THE COMMUNITY WERE IDENTIFIED TO BE: * SUBSTANCE ABUSE * MENTAL HEALTH * CHRONIC DISEASES * HEALTHY BIRTHS AND SEXUALITY * PHYSICAL ACTIVITY * NUTRITION * SMOKING CESSATION ACCESS TO CARE IS A CRITICAL COMPONENT FOR EACH ISSUE. Schedule H, Part V, Section B, Line 5 Facility A, 2 Facility A, 2 - MERCY HEALTH - URBANA HOSPITAL. MERCY HEALTH - URBANA HOSPITAL, A CRITICAL ACCESS HOSPITAL, PARTICIPATED IN A REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS COORDINATED BY THE CHAMPAIGN COUNTY CHNA STAKEHOLDER GROUP ("STAKEHOLDER GROUP" OR "GROUP"). THE STAKEHOLDER GROUP CONSISTED OF MERCY HEALTH - URBANA HOSPITAL, CHAMPAIGN COUNTY HEALTH DISTRICT, CHAMPAIGN COUNTY YMCA, AND CHAMPAIGN COUNTY DRUG FREE YOUTH COALITION. REGIONAL DATA WAS ACCUMULATED THROUGH RANDOM ADULT TELEPHONE SURVEYS, A YOUTH RISK BEHAVIOR SURVEY PERFORMED IN COLLABORATION WITH CHAMPAIGN COUNTY FAMILY AND CHIDLREN FIRST COUNCIL, AND ORGANIZATIONAL SURVEYS DISTRIBUTED WITHIN THE COMMUNITY. THE SURVEYS TOOK PLACE IN THE SPRING OF 2015. THE STAKEHOLDER GROUP USED THE COMMUNITY HEALTH ASSESSMENT AND GROUP EVALUATION (CHANGE) TOOL DEVELOPED BY THE CDC TO EVALUATE THE COMMUNITY-AT-LARGE. THE CHANGE TOOL WAS CONDUCTED AMONG SEVERAL AT-RISK NEIGHBORHOODS WITH THE MOST HEALTH DISPARITIES. ADDITIONALLY, CHAMPAIGN HEALTH DISTRICT PROVIDED DATA TO IDENTIFY LOCAL HEALTH NEEDS. MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER AND MERCY HEALTH - URBANA HOSPITAL SPONSORED A JOINT HEALTH CARE SUMMIT IN OCTOBER 2015. COMMUNITY LEADERS FROM CLARK AND CHAMPAIGN COUNTIES WERE INVITED TO IDENTIFY HEALTHCARE ISSUES WITHIN THE COMMUNITY. DATA WAS PRESENTED AT A LARGE COMMUNITY MEETING IN JANUARY 2016, AND COMMUNITY PARTNERS WERE ASSIGNED A TASK FORCE TO IDENTIFY NEEDS, OBJECTIVES, AND WORK PLANS. MORE THAN 20 LARGE COMMUNITY AND TASK FORCE MEETINGS WERE HELD BETWEEN MARCH 2016 TO JUNE 2016, AND INCLUDED 31 RESPRESENTATIVES ASSIGNED TO SEVEN TASK FORCES. ATTENDEES INCLUDED THOSE WHO PREDOMINANTLY SERVE THE POOR AND THE MOST AT-RISK POPULATIONS. MEMBERS OF THE FOLLOWING ORGANIZATIONS ATTENDED THE COMMUNITY AND TASK FORCE MEETINGS: CHAMPAIGN COUNTY HEALTH DISTRICT, COMMUNITY HEALTH FOUNDATION, CONSOLIDATED CARE INC., CHAMPAIGN RESIDENTIAL SERVICES, INC., CHAMPAIGN COUNTY FAMILY AND CHILDREN FIRST COUNCIL, MENTAL HEALTH, DRUG & ALCOHOL SERVICES BOARD OF LOGAN AND CHAMPAIGN COUNTIES, MERCY WELL CHILD PEDIATRICS, SUICIDE PREVENTION COALITION OF LOGAN AND CHAMPAIGN COUNTIES, UNITED WAY OF CLARK, CHAMPAIGN, AND MADISON, URBANA CITY SCHOOLS, AND CHAMPAIGN FAMILY YMCA. STATISTICS THAT WERE DEEMED TO BE CAUSING THE MOST HEALTH DISPARITIES AND AFFECTING INDIVIDUAL AREAS AND POPULATIONS THE MOST WERE ANALYZED SEPARATELY. THE STATISTICS ("CONCERNING STATISTICS") WERE GROUPED BY TOPIC, FOCUS, AND MEASURE ACCORDING TO THE COUNTY HEALTH RANKINGS SYSTEM, AND SCORED BY AREA, AGE, AND POPULATION. THE OVERALL SCORES WERE CALCULATED, AND THE HEALTH NEEDS WERE PRIORITIZED ACCORDINGLY. THE MOST SERIOUS ISSUES FACING THE COMMUNITY WERE IDENTIFIED TO BE: * MENTAL HEALTH * HEALTHY LIVING * SUBSTANCE ABUSE * YOUNG CHILD WELLNESS ACCESS TO CARE IS A CRITICAL COMPONENT FOR EACH ISSUE. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER. MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER'S CHNA WAS CONDUCTED, IN PART, WITH MERCY HEALTH - URBANA HOSPITAL. Schedule H, Part V, Section B, Line 6a Facility A, 2 Facility A, 2 - MERCY HEALTH - URBANA HOSPITAL. MERCY HEALTH - URBANA HOSPITAL'S CHNA WAS CONDUCTED, IN PART, WITH MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER. Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER. ALZHEIMBER'S ASSOCIATION OF MIAMI VALLEY CARESOURCE CLARK COUNTY COMBINED HEALTH DISTRICT CLARK COUNTY DEPARTMENT OF JOB & FAMILY SERVICES CLARK COUNTY EMA CLARK COUNTY JAIL CLARK COUNTY JUVENILE COURT CLARK STATE UNIVERSITY COMMUNITY HEALTH FOUNDATION FAMILY AND CHILDREN FIRST COUNCIL MENTAL HEALTH AND RECOVERY BOARD OF CLARK, GREEN, AND MADISON COUNTIES NATIONAL TRAILS AND PARK DISTRICT OHIO HOUSE OF REPRESENTATIVES OHIO STATE UNIVERSITY EXTENSION OFFICE PARENT ADVOCACY CONNECTION PLANNED PARENTHOOD AND FAMILIES ROCKING HORSE CENTER SPRINGFIELD CITY SCHOOL DISTRICT SPRINGFIELD FOUNDATION SPRINGFIELD SOUP KITCHEN SPRINGFIELD YMCA UNITED SENIOR SERVICES UNITED WAY URBAN LIGHT MINISTRIES WITTENBERG UNIVERSITY WRIGHT STATE UNIVERSITY. Schedule H, Part V, Section B, Line 6b Facility A, 2 Facility A, 2 - MERCY HEALTH - URBANA HOSPITAL. CHAMPAIGN COUNTY HEALTH DISTRICT COMMUNITY HEALTH FOUNDATION CONSOLIDATED CARE INC. CHAMPAIGN RESIDENTIAL SERVICES, INC. CHAMPAIGN COUNTY FAMILY AND CHILDREN FIRST COUNCIL MENTAL HEALTH, DRUG & ALCOHOL SERVICES BOARD OF LOGAN AND CHAMPAIGN COUNTIES MERCY WELL CHILD PEDIATRICS NORTH LEWISBURG MAYOR SUICIDE PREVENTION COALITION OF LOGAN AND CHAMPAIGN COUNTIES UNITED WAY OF CLARK, CHAMPAIGN, AND MADISON URBANA CITY SCHOOLS CHAMPAIGN FAMILY YMCA Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - Mercy Health - Springfield Regional Medical Center. Chronic Disease Implementation Activities: Goal: Asthma - By March 2019, the Chronic Disease Task Force will show a decrease in the number of asthma attacks that require emergency room services or treatment. Congestive Heart Failure - By March 2018, the Chronic Disease Task Force will work to decrease the number of readmissions among unaffiliated CHF patients (those without a primary care physician) within 30-90 days of discharge by establishing primary care providers/medical homes for 50% of patients. Diabetes - By March 2018, the Chronic Disease Task Force will increase the number of patients completing diabetes education courses by adding ADA-certified sites in Clark County. Oral health - The Chronic Disease Task Force will campaign for fluoride to be added to the Clark County water supply to decrease the prevalence of tooth decay and tooth extractions. 2017 Strategies and Outcomes: Springfield Regional Medical Center (SRMC) participates in the Chronic Disease Task Force. The following actions were taken by the hospital or the Task Force: *Asthma- Reviewed current practices as well as the physician and hospital procedures and referral of clients to the program in 2017. The data from Springfield Regional Medical Center on emergency department visits and hospital admissions for asthmatics shows that in 2017 the number of emergency department visits declined, but the number of hospital admissions increased. *Asthma - Engaged strategic partners to develop an effective home-based environmental assessment program. In 2017, these partners included PCP, ED physicians, school nurses, Rocking Horse Center (FQHC) and Head Start. *Congestive Heart Failure (CHF) - Collected data on the number of patients discharged with CHF without a primary care physician (PCP). In 2017, a program was established to work with Rocking House Center to identify and follow unaffiliated patients who were accepted by a PCP/medical home and track the following metrics: weight, medication compliance, symptoms and readmissions at 30, 60 and 90 days. *Congestive Heart Failure (CHF)- Identified the admission and discharge criteria at Springfield Regional Medical Center in 2017. *Congestive Heart Failure (CHF)- Established a case manager for congestive heart failure in 2017. *Congestive Heart Failure (CHF)- In partnership with Rocking Horse Center (RHC), notified RHC on day of admission of qualifying CHF patients for initial post-discharge visit and home health referral. In 2017, there was a slow start due to staff changes. *Diabetes - Established an ADA certified site at The Rocking Horse Center in Clark County in 2017. *Diabetes - In 2017, there were 166 referrals by PCP/medical homes to education programs. *Diabetes - The hospital measured attainment of patient-defined goals and patient outcomes using appropriate measurement techniques to evaluate the effectiveness of the educational intervention. In 2017, 82% of patients participated in eye exams, 92% of patients conducted daily foot exams, 91% of patients met their nutrition goals, 62% of patients met their exercise goals, and 93% of patients met their weight loss goals. *Oral Health- In 2017, Clark County Combined Health District staff collected data, developed a presentation and presented to community members. *Oral Health- In 2017, the Health Commissioner reached out to the three local manufacturers regarding the impact of adding fluoride to their business process and all three said it would not affect their process. *Oral Health- In 2017, a focused education and engagement program was presented in the community to improve understanding of scientific support of the addition of fluoride to city water supply to reduce and prevent tooth decay. *Oral health- In 2017, fluoridation ordinance was not placed on the ballot. It is expected to be on the 2018 ballot. Mental Health Implementation Activities: Goal: By March 2019, the Mental Health Task Force will redirect emergency medical service (EMS) frequent users to appropriate care and reduce all EMS overuse as evidenced by the development of pre-hospital treatment protocols and related collaborative multiprovider agreements supporting the implementation of Mobile Integrated Health Care or similar system management concepts. 2017 Strategies and Outcomes: SRMC participates in the Mental Health Task Force. The following actions were taken by the hospital or the Task Force: *Researched and evaluated frequent users of EMS with mental health concerns for trends and conditions, involving EMS, hospital and Mental Health Services for Clark and Madison Counties, Inc., for data and analysis in 2017. Data collection was established in 2017 and continues. A community initiative to gather leaders representing healthcare, fire & rescue, EMS, higher education, government representatives, police, sheriff's office and the health department has established a task force to review the data and look at best practices in other communities to support the needs in the Springfield community. Health Births and Sexuality Implementation Activities: Goal: To promote, implement and support the practice of Kangaroo Care for all mothers and their newborn infants at SRMC; To work collaboratively with community agencies for early recognition of pregnant women using drugs and to promote healthier pregnancies. 2017 Strategies and Outcomes: *Promoted, implemented and supported the practice of Kangaroo Care for all mothers and their newborn infants at the hospital. The hospital's goal is to improve the breastfeeding initiation rate by 1% annually over a three-year period from January 2016 to December 2019. As a result of adopting Kangaroo Care, the breastfeeding initiation rate increased from 68.3% in 2016 to 70.7% in 2017. *Established quiet hours to promote uninterrupted time for mother and baby. *Universal drug screenings were established in 2017 and all pregnant patients were screened upon their first encounter. If the drug screening is positive, the patient is screened on every encounter that follows. *Referrals to McKinley Hall took place in 2017. Nutrition Implementation Activities: Goal: To promote healthy food and education into a regular lifestyle for adults with BMI 25 - 30 (overweight) and BMI 30 and above (obese). 2017 Strategies and Outcomes: *Developed and placed in practice a nutrition education plan at the SRMG Health Resource Center for patients referred by physician practices. The goal to have this in place within the first 12 months of opening the SRMG Health Resource Center was completed in 2017. *Collaborated with Clark County's Healthy Living Task Force to promote community gardens, a food coalition and health and nutrition education in the local schools. In 2017, Second Harvest Food Bank held a produce only mobile market in the SRMC parking lot during the summer months (June, July, and August) and served approximately 120 families in Clark, Logan, and Champaign Counties. Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - CONTINUED: Mercy Health - Springfield Regional Medical Center. Continued description for Mercy Health - Springfield Regional Medical Center: Substance Abuse Implementation Activities: Goal: By March 2019, the Clark County Substance Abuse Prevention Treatment and Support Coalition will assist in the prevention of alcohol and other drug usage in Clark County as evidenced by the implementation of one evidence-based prevention program. 2017 Strategies and Outcomes: *In June 2016, Community Mercy Health Partners began the Mercy REACH program. Clients are assessed at Mercy REACH for referrals to SRMC for detox services. A REACH therapist makes rounds on clients daily while in SRMC to encourage treatment with REACH program. The hospital continues to establish an inpatient detox program at SRMC, and to focus on successfully operationalizing the program. There was an increase in the number of clients assessed for detox services from 83 in 2016 to 197 in 2017. Of the 197 clients assessed for detox services, 151 patients completed the program in 2017. *Mercy REACH opened an Intensive Outpatient Program (IOP) for patients discharged from the inpatient detox program to establish sobriety skills. In 2017, there were 600 encounters in (IOP) as individual clients will attend (IOP) 3 times a week for a period of 30-90 days. REACH offers incentives to reduce barriers to treatment and maintaining sobriety. Under a United Way Grant, the hospital offered $10.00 Gas Cards for clients that attend an IOP for the full week and provided transportation tokens for the bus. REACH also offered Free YMCA Day Passes to clients interested in sober activities. *Mercy REACH established the MAT VIVITROL program to provide injections to help prevent relapse to opioid dependence. Clients may receive the MAT Vivitrol treatment for several months ranging from 2-3 months up to 8-9 months depending on the need of the client. In 2017, 37 clients participated in the MAT program compared to 17 individuals participating in the MAT program in 2016. Significant Needs Not Addressed by the Hospital SMOKING CESSATION - SRMC will not directly address this community need as other organizations in Clark County are specifically designed and better prepared to respond to this need through resources and experience. SRMC will support them as needed. PHYSICAL ACTIVITY (ACTIVE LIVING) - SRMC will not directly address this community need as other organizations in Clark County are specifically designed and better prepared to respond to this need through resources and experience. SRMC will support them as needed. Schedule H, Part V, Section B, Line 11 Facility A, 3 Facility A, 3 - MERCY HEALTH - URBANA HOSPITAL. Nutrition and Wellness (Healthy Living) Implementation Activities: Goal: To promote healthy diet and education about healthy eating into a regular lifestyle for adults with BMI 25-30 (overweight) and BMI 30 and above (obese). By March 2018, the Healthy Living Task Force will increase the number of patients completing diabetes self-management education courses, as documented by increased physician referrals and expansion of programs to include evening hours. 2017 Strategies and Outcomes: *Mercy Health - Urbana Hospital (Urbana Hospital) is working to develop a plan for nutrition education at the Urbana Hospital Chronic Disease Clinic. The Chronic Disease Clinic was relocated and is working to re-establish the nutrition education program. In 2017, the hospital took the following actions: *Within the first 12 months, developed a nutrition-education plan using the American Diabetes Association (ADA) Diabetes Management (DM) Program for patients referred by physician practices at the Urbana Hospital Chronic Disease Clinic. The program was offered through the Department of Health and the local YMCA in 2017. *Collaborated with Springfield Regional Medical Group (SRMG) physician practices to develop a referral process to the Urbana Hospital Dietitian. *The hospital has partnered with the schools to develop and promote healthy-eating education programs to be presented once a year for the middle and high schools in Champaign County. Hospital representatives worked with students and are in process of developing video presentations that will be presented to elementary school students on healthy eating and exercise. In 2017, education programs were presented to 38 students at Graham High School. The hospital also presented to and played educational games under the 5-2-1 Almost None program with 250 parents and kids at a healthy kids day. *Urbana Hospital is developing a plan for diabetic education at the Urbana Hospital Chronic Disease Clinic. In 2017, the hospital took the following actions: *Established extended-hour appointments and offered 6 diabetic educational classes in the evenings. *Tracked the number of referrals by PCP/Medical Homes to education programs and provided SRMG with appropriate educational materials to share with patients during appointments to promote referrals to the classes. 8 patients were referred by their PCP to the diabetic education programs in 2017. Additionally, 2 patients were independent. *Of the patients who participated in the diabetic education programs, 5 patients (or 50%) completed all the components of the program and met their goals as it relates to improve their overall health. Mental Health Implementation Activities: Goal: To investigate precision medicine as a tool for physicians to individualize therapeutic drug choice by using genotype to predict positive clinical outcomes, adverse reactions and levels of drug metabolism for effective support of patients' depression disorders. 2017 Strategies and Outcomes: *In 2017, Pharmacogenics (Precision Medicine) Technology was introduced to 30 Mercy Health physicians and advance practice nurses to track treatment effectiveness and results for patients diagnosed with depression. *The hospital's Chronic Care Clinic utilized the results from a study focused on pharmacogenomics to improve response and remission for major depressive disorder. The study involved 1,167 patients through a randomized controlled trial (RCT). Mercy was not involved in the study, but utilized the results to support the care of patients with depression. *In 2017, insurance providers used by patients were surveyed to determine if mental health testing by GeneSight is covered. It was determined that GeneSight is covered by approximately 50% commercial insurance companies and 100% covered by Medicare, Medicaid, Buckeye, Molina, Care Source and Tri Care. *The hospital continues to investigate grant funding for testing to support patients without insurance coverage. Substance Abuse Implementation Activities: Goal: Patients discharged from Urbana Hospital with an overdose-related diagnoses be referred to Urbana Hospital Chronic Clinic and/or Community Mercy REACH program for substance abuse prevention treatment and support 2017 Strategies and Outcomes: *Urbana Hospital continues to focus on identifying and admitting patients to the inpatient detox treatment program at Springfield Regional Medical Center (SRMC) through Mercy REACH. Clients are scheduled in identified detox appointment times to avoid waiting list. Upon completion of an assessment, a therapist contacts SRMC to refer client for first available bed and SRMC will call client for admission. Mercy REACH had appointment openings identified as detox assessment only to avoid clients waiting to receive services. The hospital's goal is to provide detox services to as many patients as needed. In 2017, 13 clients were referred to the detox treatment program from Champaign County compared to 9 clients in 2016. *Mercy REACH opened an Intensive Outpatient Program (IOP) at SRMC for patients discharged from the inpatient detox program to establish sobriety skills. In 2017, 209 patients were assessed for the IOP program. Of those 209 patients, 190 attended the program and 151 completed the program in 2017. *Worked with Urbana Hospital Chronic Care Clinic to establish a Vivitrol injection program. The program supports client eligible for monthly Vivitrol injections to help prevent relapse to opioid dependence. Clients interested in receiving the Vivitrol injection are reviewed by Medical Director for appropriate referral to Chronic Care Clinic to schedule injection, and the number of injections and length of stay (2-3 months up to 9-10 months) can vary depending on clients' sobriety needs. In 2017, approximately 12 people received Vivitrol injections compared to approximately 8 people receiving the Vivitrol injections in 2016. Significant Needs Not Addressed by the Hospital EARLY CHILDHOOD WELLNESS - Urbana Hospital will not directly address this community need as other organizations in Champaign County are specifically designed and better prepared to respond to this need through resources and experience. Urbana Hospital will support them as needed. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - Mercy Health - Springfield Regional Medical Center, Mercy Health - Urbana Hospital. Mercy Health's financial assistance policy requires a patient or family member to complete an application including gross income for a minimum of 3 months (up to 12 months) prior to the date of application or date of service. Proof of income is required with the exceptions of patients discharged to a skilled nursing facility, patients who are deceased with no estate, and patients who have documented homelessness. Third party income scoring may be used to verify income in situations where income verification is unable to be obtained through other methods. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - Mercy Health - Springfield Regional Medical Center, Mercy Health - Urbana Hospital. Mercy Health's financial assistance policy requires proof that Health Savings Account and/or Medical Savings Account funds be depleted prior to providing healthcare financial assistance. Schedule H, Part V, Section B, Line 13 Facility A, 2 Facility A, 2 - Mercy Health - Springfield Regional Medical Center, Mercy Health - Urbana Hospital. Patients who live in the community served by a Mercy Health hospital will be offered healthcare financial assistance. For those patients living outside of the geographic area, extenuating circumstances must be documented and approved by the PFS Manager. A list of the zip codes of the community served for each Mercy Health hospital is maintained in a separate document and readily available via the contact list at the end of Mercy Health's financial assistance policy. Schedule H, Part V, Section B, Line 13 Facility A, 3 Facility A, 3 - Mercy Health - Springfield Regional Medical Center, Mercy Health - Urbana Hospital. Mercy Health's financial assistance policy requires a patient to apply for health insurance coverage and/or enter the marketplace/exchange before financial assistance may be extended. Exceptions to this policy include patients discharged to a SNF, patients who are deceased with no estate, and patients who have documented homelessness. 40 SPRINGFIELD REGIONAL MEDICAL GROUP - PALLIATIVE MEDICINE 100 MEDICAL CENTER DRIVE SPRINGFIELD OH 45504 SPECIALIST DOCTORS CARDIOLOGISTS OF CLARK AND CHAMPAIGN COUNTIES - SPRINGFIELD 100 W MCCREIGHT AVE FIRST FLOOR SPRINGFIELD OH 45504 SPECIALIST DOCTORS COMMUNITY MERCY FOUNDATION 100 W MCCREIGHT AVE SUITE 200 SPRINGFIELD OH 45504 SPECIALIST DOCTORS MITCHELL THOMAS CENTER - ADMINISTRATION 100 W MCCREIGHT AVE SUITE 4 4TH FLO OR SPRINGFIELD OH 45505 OTHER COMMUNITY MERCY HOME CARE 1111 N PLUM STREET SUITE 4 SPRINGFIELD OH 45504 SPECIALIST DOCTORS SOUTH URBANA FAMILY MEDICINE 1300 US SOUTH 68 URBANA OH 43078 PRIMARY CARE DOCTORS SPRINGFELD REGIONAL IMAGING CENTER 1343 N FOUNTAIN BLVD SPRINGFIELD OH 45504 IMAGING SPRINGFIELD HEALTH RESOURCE CENTER 1343 N FOUNTAIN BLVD SUITE 205 SPRINGFIELD OH 45504 OTHER EXCEL PEDIATRIC REHABILITATION 1345 N FOUNTAIN BLVD SPRINGFIELD OH 45504 SPECIALIST DOCTORS SPRINGFIELD REGIONAL MEDICAL GROUP - WOUND CARE - URBANA 1430 US HIGHWAY 36 EAST SUITE B URBANA OH 43078 SPECIALIST DOCTORS EXCEL SPORTS MEDICINE AND REHABILITATION - URBANA 1450 E US HIGHWAY 36 URBANA OH 43078 SPECIALIST DOCTORS SPRINGFIELD REGIONAL CANCER CENTER 148 W NORTH STREET SPRINGFIELD OH 45504 SPECIALIST DOCTORS OAKWOOD VILLAGE 1500 VILLA ROAD SPRINGFIELD OH 45503 SENIOR LIVING EAST SPRINGFIELD FAMILY MEDICINE 160 SOUTH TUTTLE ROAD SPRINGFIELD OH 45505 PRIMARY CARE DOCTORS COMMUNITY MERCY HOME MEDICAL EQUIPMENT 1702 N LIMESTONE STREET SPRINGFIELD OH 45504 SPECIALIST DOCTORS NORTH FAMILY MEDICINE - WITTENBERG HEALTH CLINIC 200 W WARD STREET ROOM 003 SPRINGFIELD OH 45504 PRIMARY CARE DOCTORS MERCY HEALTH - URBANA FAMILY MEDICINE AND PEDIATRICS 204 PATRICK AVENUE URBANA OH 43078 SPECIALIST DOCTORS MERCY HEALTH - URBANA LAB SERVICES 204 PATRICK AVENUE URBANA OH 43078 OTHER SOUTH SPRINGFIELD FAMILY MEDICINE 2055 S LIMESTONE STREET SPRINGFIELD OH 45504 PRIMARY CARE DOCTORS EAST SPRINGFIELD INTERNAL MEDICINE 2105 E HIGH STREET SPRINGFIELD OH 45505 PRIMARY CARE DOCTORS NORTHPARKE INTERNAL MEDICINE 211 NORTHPARKE DRIVE SPRINGFIELD OH 45503 PRIMARY CARE DOCTORS SPRINGFIELD PHYSICAL MEDICINE - OUTPATIENT 211 NORTHPARKE DRIVE SPRINGFIELD OH 45503 SPECIALIST DOCTORS MERCY HEALTH - SPRINGFIELD LAB SERVICES 2205 N LIMESTONE STREET SPRINGFIELD OH 45503 OTHER ENON PRIMARY CARE 240 ENON ROAD ENON OH 45323 PRIMARY CARE DOCTORS COMMUNITY MERCY OCCUPATIONAL HEALTH - SPRINGFIELD 2501 E HIGH STREET SPRINGFIELD OH 45505 SPECIALIST DOCTORS EXCEL SPORTS MEDICINE AND REHAB - SPRINGFIELD 2600 N LIMESTONE STREET SPRINGFIELD OH 45503 SPECIALIST DOCTORS SPRINGFIELD REGIONAL OUTPATIENT CENTER 2610 N LIMESTONE STREET SPRINGFIELD OH 45503 SPECIALIST DOCTORS SPRINGFIELD REGIONAL SLEEP CENTER 30 W MCCREIGHT AVE SUITE 201 SPRINGFIELD OH 45504 SPECIALIST DOCTORS NORTH FAMILY MEDICINE 30 W MCCREIGHT AVE SUITE 208 SPRINGFIELD OH 45503 PRIMARY CARE DOCTORS SPRINGFIELD WEIGHT MANAGEMENT SOLUTIONS 30 W MCCREIGHT AVE SUITE 209 SPRINGFIELD OH 45504 SPECIALIST DOCTORS CLARK COUNTY GASTROENTEROLGY 30 W MCCREIGHT AVE SUITE 211 SPRINGFIELD OH 45504 SPECIALIST DOCTORS COMMUNITY MERCY REACH DRUG ALCOHOL AND TOBACCO CESSATION 30 W MCCREIGHT AVENUE SPRINGFIELD OH 45504 SPECIALIST DOCTORS COMMUNITY MERCY MED ASSIST 30 W MCCREIGHT SUITE 011 SPRINGFIELD OH 45504 SPECIALIST DOCTORS SPRINGFIELD AND URBANA GENERAL AND LAPAROSCOPIC SURGEONS 30 W MCREIGHT AVE SUITE 106 SPRINGFIELD OH 45504 SPECIALIST DOCTORS SPRINGFIELD REGIONAL MEDICAL GROUP - WOUND CARE - SPRINGFIELD 362 SOUTH BURNETT ROAD SPRINGFIELD OH 45505 SPECIALIST DOCTORS CARDIOLOGISTS OF CLARK AND CHAMPAIGN COUNTIES - URBANA 900 EAST COURT STREET URBANA OH 43078 SPECIALIST DOCTORS URBANA FAMILY AND INTERNAL MEDICINE 900 SCIOTO STREET SUITE 1 URBANA OH 43078 PRIMARY CARE DOCTORS URBANA INTERNAL MEDICINE 900 SCIOTO STREET SUITE 4 URBANA OH 43078 PRIMARY CARE DOCTORS COMMUNTY MERCY OCCUPATIONAL HEALTH - URBANA 904 SCIOTO STREET URBANA OH 43078 SPECIALIST DOCTORS MERCY MCCAULEY CENTER 906 SCIOTO STREET URBANA OH 43078 SENIOR LIVING Schedule H, Part I, Line 6a Community benefit report prepared by related organization Mercy Health Schedule H, Part I, Line 7g Subsidized Health Services COMMUNITY MERCY HEALTH PARTNERS (CMHP) OPERATES THE DPM REACH PROGRAM SUBSTANCE ABUSE AND COPD CLINIC. THE AMOUNT OF SUBSIDIZED HEALTH SERVICES ATTRIBUTABLE TO THE PHYSICIAN CLINIC IS $227,680. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance COST OF CHARITY CARE WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS DETERMINED USING THE HOSPITAL COST ACCOUNTING SYSTEM AND INCLUDED BOTH INPATIENTS AND OUTPATIENTS FOR TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PLANS. FOR SUBSIDIZED SERVICES THE HOSPITAL'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO THE SPECIFIC SERVICE EXCLUDING TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PATIENTS. COSTS FOR CHARITY AND BAD DEBT ACCOUNTS ARE DEDUCTED USING A RATIO OF COST TO CHARGE SPECIFIC TO THAT SUBSIDIZED SERVICE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. Schedule H, Part II Community Building Activities COMMUNITY MERCY HEALTH PARTNERS (CMHP) ENSURES ACCESS TO HEALTH SERVICES BY RECRUITING AND PROVIDING TRANSITIONAL SUPPORT TO PHYSICIANS TO ATTRACT THEM TO THE COMMUNITY FOR SPECIALTIES WHERE THERE IS A DEMONSTRATED NEED. AN APPROPRIATE SUPPLY OF PHYSICIANS IS NECESSARY TO ENSURE THAT RESIDENTS HAVE ACCESS TO ADEQUATE AND TIMELY DIAGNOSIS AND TREATMENT FOR ALL HEALTH CONDITIONS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in health care coverage, and other collection indicators. Net patient accounts are reduced by an allowance for doubtful receivables based upon the hospital's historical collection experience adjusted for current environmental risks and trends for each major payor source. Significant provision is made for self-pay patient accounts in the period of service based on past collection experience. The hospital's concentration of credit risk related to net patient accounts is limited due to the diversity of patients and payors. Net patient accounts consist of amounts due from governmental programs (primarily Medicare and Medicaid), private insurance companies, managed care programs and patients themselves. Net patient service revenue for services provided to patients who have third-party payor coverage is recognized based on contractual rates for services rendered. The hospital recognizes a significant amount of patient service revenue at the time services are rendered even though it does not assess the patient's ability to pay. As a result, the provision for bad debts is presented as a deduction from patient service revenue (net of contractual provisions and discounts). Amounts recognized are subject to adjustment upon review by third-party payors. For uninsured patients that do not qualify for charity care, the hospital recognizes revenue when services are provided. Based on historical experience, a significant portion of the hospital's uninsured patients will be unable or unwilling to pay for services provided. Thus, the hospital records a significant provision for bad debts related to uninsured patients in the period the services are provided. Any discounts applied to self-pay patients would be deemed either Charity or a contractual adjustment. Bad debt would be based on the balance after the charity or contractual adjustment that is deemed uncollectable following a reasonable collection effort. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The hospital's financial assistance policy does not permit the cost of patients who are uncooperative or unable to be located to be reclassified from bad debt to financial assistance. The hospital's financial assistance policy requires an application and supporting documentation. Therefore, zero dollars are being reported on Part III, Line 3 as amounts included in bad debt that could be attributable to patients eligible under the hospital's financial assistance policy. The hospital follows the Catholic Health Association of the United States policy document, Community Benefit Program, A Revised Resource for Social Accountability ("CHA guidelines") for determining community benefit. The CHA guidelines recommend that hospitals not include bad debt expense as community benefit. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The hospital's audited financial statements do not contain a footnote that describes bad debt expense. The hospital elected to early adopt ASU 2011-07. Accordingly, bad debt expense is reflected as a deduction from revenue rather than an operating expense. Notes to Consolidated Financial Statements, B. Significant Accounting Policies, Net Patient accounts and Net Patient Service Revenue (page 13) states net patient accounts are reduced by an allowance for doubtful receivables based upon the historical collection experience of each regional affiliate adjusted for current environmental risks and trends for each major payor source. Significant provision is made for self-pay patient accounts in the period of service based upon past collection experience. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The hospital follows the Catholic Health Association of the United States policy document, Community Benefit Program, A Revised Resource for Social Accountability ("CHA guidelines") for determining community benefit. The CHA guidelines recommend that hospitals not include Medicare losses as community benefit. The hospital's cost accounting system was used to determine the Medicare amounts in Part III. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Patients known to qualify for charity care or financial assistance are not sent to a collection agency. The organization repeatedly offers patients access to financial help during their hospital stays and after, as well as with each billing notice. Bills are sent to a collection agency as a last resort and only: when patients have the ability to pay some portion of their healthcare expenses but refuse to do so; when patients refuse to work with the organization to determine if they qualify for free or discounted care via federal, state, local or hospital assistance programs; when the organization is unable to locate the patient or person responsible for the bill. Schedule H, Part V, Section B, Line 16a FAP website A - MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER: Line 16a URL: https://www.mercy.com/patient-resources/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website A - MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER: Line 16b URL: https://www.mercy.com/patient-resources/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - MERCY HEALTH - SPRINGFIELD REGIONAL MEDICAL CENTER: Line 16c URL: https://www.mercy.com/patient-resources/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment COMMUNITY MERCY HEALTH PARTNERS (CMHP) HOSPITALS ASSESS AND CONTINUALLY RESPOND TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. CMHP HOSPITALS JOIN AN EXISTING COMMUNITY-BASED NEEDS ASSESSMENT EVERY THREE YEARS AND UPDATES ARE PROVIDED BETWEEN ASSESSMENTS. MERCY HEALTH HOSPITALS INCORPORATE PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. CMHP HOSPITALS RECOGNIZE THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS, NOT JUST BY DISEASE AND ILLNESS. OUR COMMUNITY BENEFIT INCLUDES BOTH QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS INCLUDING RACE, AGE, AND ETHNICITY; SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES; PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; AND DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. CMHP HAS A DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT EFFORT. CMHP'S COMMUNITY BENEFITS COMMITTEES MEET TO PROVIDE OVERSIGHT TO THE ORGANIZATION'S COMMUNITY BENEFITS PROGRAM. CMHP HOSPITALS WORK CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES TO AVOID DUPLICATION. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Community Mercy Health Partners (CMHP) posts its charity care policy, or a summary thereof, and financial assistance contact information in admissions areas, emergency departments and other areas of the organization's facilities in which eligible patients are likely to be present. CMHP provides a copy of the policy, or a summary thereof, and financial assistance contact information to patients as part of the intake process and with discharge materials. Additionally, a copy of the policy or a summary along with financial assistance contact information is included in patient bills. CMHP discusses with the patient the availability of various government benefits, such as Medicaid or state programs, and assists the patient with qualification for such programs, where applicable. The Hospital Eligibility Link Program (HELP) is a free referral service provided by CMHP. The purpose of HELP is to assist patients in obtaining medical benefits through federal, state, and hospital programs. HELP representatives will provide the following services at no cost to the patient: * Explore eligibility under public assistance programs * File applications on patient's behalf * Schedule and attend appointments * Provide transportation when necessary * Provide medical documentation to Social Security Administration for disability claims. Through HELP, patients and their counselors look at what options are available. CMHP understands that not everyone can pay for healthcare services. HELP is here to offer options and assistance for those who are uninsured or underinsured. HELP is an extension of CHMP's mission to improve the health of our community with emphasis on the poor and underserved. Meeting the needs of those with limited resources has always been the heart of our mission. CMHP is proud to make our financial assistance information available to the public through our website, which can be found at www.community-mercy.org Other patient education information that is provided for eligibility of assistance is as follows: * A bilingual representative is available in our HELP Program. Two bilingual representatives are available in our customer service department. Each of these representatives are in our regional office in Cincinnati. * Staff training on Hospital Care Assurance Program (HCAP) and Hospital Financial Assistance (HFA) was provided in 2009 by a private auditing company. Training included a manual and in-depth information regarding the preparation of the cost report logs, accurate completion of the HCAP application, as well as an overview of the FAQ's provided by the Ohio Hospital Association. * Financial assistance counselors work with case managers to expedite the transfer of patients to extended care facilities. * Federal poverty guidelines are posted on our website as well as a copy of our charity application. * Consistent review of self pay patients for retroactive Medicaid coverage. * Services provided by vendor to reach out to patients in bad debt to screen for HCAP eligibility. Schedule H, Part VI, Line 4 Community information Community Mercy Health Partners' (CMHP) primary service area includes Clark and Champaign counties, which have a total population of approximately 209,700. According to the most recent Community Health Assessment reports from the two counties, residents of the CMHP primary service area are generally older, poorer and have worse health statistics than state and national averages. Unemployment has also risen in our community during the last several years, and we serve a growing number of uninsured and underinsured patients. CMHP owns two of the three hospitals in this geographic area. The third hospital (not owned by CMHP) is a limited-service for-profit hospital that specializes in outpatient and short-stay surgery, and it does not have an emergency department. Part of the city of Springfield has been federally designated as a medically underserved area. Other demographics of our service area include: * Percentage of adults who have not achieved at least a high school diploma is higher that both the state and national averages * Higher percentage of residents living in poverty than in the state and nationwide * Unemployment rate is higher than both the state and national rates * Median household income is below the state median and US median * The population of the service area consists of 3.3% non-English speaking people. * The population of the service area that is 65 years or older is 17%. * The occupation classification in the community consists of 29% blue collar, 51% white collar and 20% service and farm workers. The major health problems and/or leading causes of death in our service area are Cardiovascular disease, Diabetes, Emphysema and Cancer. Most of these are preventable through proper care and maintaining control of the illness/disease, as well as choosing healthier lifestyles. In our service area 28% of the population are smokers, 40% have high cholesterol, and 30-40% are overweight or at risk for becoming overweight. Schedule H, Part VI, Line 5 Promotion of community health Community Mercy Health Partners (CMHP) operates emergency rooms open to all regardless of ability to pay. In addition to providing emergency services, CMHP also provides minor emergency and urgent care services to all regardless of ability to pay. CMHP participates in Medicaid, Medicare, Champus and/or other government sponsored health programs. CMHP operates skilled nursing units, ICU, newborn nursery, wound care, diabetes management, outpatient pediatrics, substance abuse, prescription assistance and a critical access hospital. CMHP has an open medical staff with privileges available to all qualified physicians in the area. The majority of the governing body consists of independent persons representative of the community served by CMHP. CMHP participates in Medicaid, Medicare, CHAMPUS, and/or other government -sponsored health care programs. CMHP furthers its exempt purpose by providing the following community benefit programs in the communities in which it serves: Community Mercy Med Assist helps area residents who cannot afford their prescription medications. Community Mercy REACH offers outpatient treatment for chemical dependency by licensed professionals who have master's-level education. REACH also offers an innovative and effective smoking cessation program that incorporates exercise and nutrition/weight control to promote an overall healthy lifestyle. Mercy Well Child Pediatrics is a pediatric clinic that identifies and addresses potential health and developmental concerns in children. The clinic promotes quality pediatric care with a holistic approach to meet the health, social and emotional needs of children and families. Mercy Well Child Pediatrics serves children from infants to age 21, regardless of the families' income or insurance status. CMHP's emergency department treats an increasing number of patients who use the facility for primary care needs. Patient demographics reflect the changing community. As in other communities, some area physicians place limits on their acceptance of Medicaid patients. In addition, some primary care physicians refer patients with after-hours needs directly to area emergency rooms. Community groups and individuals are very supportive of CMHP. For the past decade, the Rocking Horse Center has been a key partner with CMHP in making basic healthcare more accessible, especially for the poor and underserved. Early in 2009, Rocking Horse was granted status as a Federally Qualified Health Center, which will provide higher levels of Medicaid reimbursement. In addition, CMHP and Rocking Horse collaborated to develop an ER referral process, to identify patients who did not have a medical home and to provide follow-up care. Schedule H, Part VI, Line 6 Affiliated health care system Community Mercy Health Partners (CMHP) is a member of Community Mercy Health Systems. CMHP is sponsored by the Sisters of Mercy and has been an integral part of the community since 1950. CMHP includes an acute care hospital and a critical care access hospital with approximately 641 licensed beds combined. Community Mercy Health System community benefit for 2016 per the audit footnote is as follows: Total 2017 Community Benefit: $17.8 Million Benefits to the Broader Community: $1.4 million Unreimbursed Care for Those Who Are Poor and Qualify for Medicaid: $15.8 million Support for Other Programs for Those Who are Poor: $0.6 million Community Benefit as Percent of Total Expense: 5.9 percent CMHP is a member of Mercy Health, which is the largest health system in Ohio, the state's fourth largest employer and one of the largest Catholic health systems in the United States. Mercy Health is sponsored by Partners in Catholic Health Ministries (PCHM). PCHM is a public juridic person of the Roman Catholic Church. Mercy Health continues the healthcare ministries begun by its founders in urban and rural areas across Ohio and Kentucky more than 150 years ago. Mercy Health provides integrated health services via acute care hospitals, physician practices, long-term care residences, housing sites for the elderly, home health agencies, hospice programs, outreach services and wellness centers. Mercy Health hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Mercy Health's mission calls it to extend the healing ministry of Jesus by improving the health of the communities it serves with special emphasis on people who are poor and under-served. In addition to providing programs and services designed to enhance the health of entire communities, Mercy Health cares for everyone who comes to its facilities, regardless of their ability to pay. Mercy Health's home office in Cincinnati, Ohio provides services and support to the entire system. Its governance practices have been nationally recognized for quality. System leadership provides strategic vision and management oversight in support of the ministry by directing resources, providing access to lower cost debt financing, improving clinical outcomes and reducing operating costs. System-wide community benefit for 2017 per the audit footnote is as follows: Total 2017 Community Benefit: $384.2 Million Benefits to the Broader Community: $83.6 million Unreimbursed Care for Those Who Are Poor and Qualify for Medicaid: $279.6 million Cost of Care for Those Who Could Not Afford to Pay: $3.1 million Support for Other Programs for Those Who are Poor: $17.9 million Community Benefit as Percent of Total Expense: 8.4 percent X true true X X X X X true true false false false false false true false PAUL HILTZ FORMER Pres/CEO Springfield Region, SVP Mercy Health 198218 0 77000 0 464541 0 21359 0 27935 0 789053 0 220898 0 WILLIAM KUSNIERZ VP, CFO & TREASURER 0 280800 0 67756 0 82403 0 27547 0 11526 0 470032 0 13013 MATTHEW CALDWELL Pres/CEO Springfield Region, SVP Mercy Health 442313 0 0 0 171553 0 90433 0 26316 0 730615 0 0 0 KATRINA ENGLISH FORMER VP GENERAL COUNSEL 0 146352 0 70084 0 35413 0 6160 0 13512 0 271521 0 29936 SHERRY NELSON FORMER VP CHIEF NURSING OFFICER 5102 0 0 0 197738 0 298 0 13754 0 216892 0 0 0 DONALD B JOHNSON MD CHIEF CLINICAL OFFICER 314788 0 40154 0 39603 0 11989 0 2655 0 409189 0 0 0 ADAM GROSHANS VP, COO - VPMA 160024 0 40000 0 88736 0 16558 0 18078 0 323396 0 0 0 ELAINE STORRS VP CHIEF NURSING OFFICER 159362 0 18307 0 2246 0 15021 0 11076 0 206012 0 0 0 JENELLE ZELINSKI ASSISTANT CFO 191021 0 6648 0 922 0 37521 0 1481 0 237593 0 0 0 PAMELA ALLEN Director, Pharmacy 180119 0 6324 0 11862 0 10197 0 9531 0 218033 0 0 0 ELIZABETH PRICE SUPERVISOR NURSING 158037 0 1758 0 3873 0 13543 0 9603 0 186814 0 0 0 JULIE EBLIN TECHNICAL LEADER LAB SERVICES 179352 0 1663 0 8080 0 11361 0 7584 0 208040 0 0 0 PAMELA TEMPLE TECHNICAL LEADER BLOOD BANK 161475 0 4301 0 1246 0 8832 0 22943 0 198797 0 0 0 Schedule J, Part I, Line 4b Terms and conditions of the Cincinnati Market SERP The Cincinnati Market SERP is a deferred compensation plan which provides employment continuation incentives to all executive council members. The plan is no longer accepting new participants and the cessation of contributions has occurred. Participants must complete a two tiered vesting provision. Participants must be vested under the base qualified plan and must count 24 months after termination during which they do not compete with Mercy Health Cincinnati LLC. Amounts includible as taxable compensation for listed individuals due to executive benefit plan participation in the reporting year were as follows: Paul Hiltz $0. Schedule J, Part I, Line 4b Terms and conditions of the Mercy Health System SERP The Mercy Health System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Paul Hiltz $281,103; Matthew Caldwell $0; Donald B. Johnson MD $31,479; Sherry Nelson $1,292; William Kusnierz $14,624; Katrina English $34,151; Elaine Storrs $0; Adam Groshans $0. Schedule J, Part II, Column (C) Reporting negative deferred compensation Annual actuarially-determined contributions to defined benefit plans, which are based on prior plan contributions, changes in interest rates, the present value of accrued benefits, and other data and assumptions about the future, may, for some plan participants and for some plan years, result in negative contribution amounts. Schedule J, Part I, Line 1a Tax indemnification and gross-up payments A tax indemnification benefit to cover the income tax incurred on moving expenses was paid to two officers and a key employee. The entire benefit was treated as taxable compensation. Schedule J, Part I, Line 4a Severance or change-of-control payment Severance Benefits consisting of continuation of base salary and insurance benefits were provided to a listed individual for a specified period. The listed individual executed a release and waiver of claims in exchange for the severance benefits. The salary continuation amount provided during the reporting year to the listed individual were as follows: Paul Hiltz $177,686; Sherry Nelson $193,827. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The Community Mercy Health Partners SERP plan is a deferred compensation plan which provides supplemental retirement benefits to persons selected by the CMHP Committee. The plan is no longer accepting new participants and cessation of contributions has occurred. Participants vest the later of five years of active service or the second anniversary of his or her separation from service with the employer. Vesting occurs earlier for death or total disability. Payments during employment are made for required tax withholding. Payment of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Katrina English $0; Donald B. Johnson, MD $0. Schedule J, Part I, Line 7 Non-fixed payments The organization provides annual incentive compensation for listed individuals. The organization's Board of Trustees establishes objective thresholds for quality, community benefit, and financial performance which must be achieved for incentives to be awarded. The Board also establishes threshold, target and maximum levels for incentive awards. Within these established parameters, the Board determines the CEO's incentive award and incentive awards for other listed individuals are determined by the listed individual's supervisor and disclosed to the Board. The Board may authorize modified incentive awards when appropriate in its judgment. SPRINGFIELD HEART SURGEONS SURENDER NERAVETLA, M.D. (BOARD MEMBER) HAS A REPORTABLE OWNERSHIP INTEREST 1091878 INDEPENDENT CONTRACTOR false Form 990, Part IV, Line 14a Consolidated audited financial statements The filing organization does not have separate, independent audited financial statements. The organization is included in Mercy Health's consolidated audited financial statements, which are prepared in accordance with Generally Accepted Accounting Principles. Mercy Health's Audit and Corporate Responsibility Committee has responsibility for oversight of the audit and the selection of an independent accountant. Form 990, Part VI, Line 6 Classes of members or stockholders COMMUNITY MERCY HEALTH SYSTEM IS THE SOLE SHAREHOLDER OF COMMUNITY MERCY HEALTH PARTNERS. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Mercy Health elects all board members who have full voting rights. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Certain matters require approval of the Mercy Health Corporate Member, Mercy Health Governing body, or Mercy Health CEO. The regulations of the organization describe the level of approval required for various decisions. Form 990, Part VI, Line 11b Review of form 990 by governing body The Form 990 is prepared by Mercy Health's Tax Department and reviewed by an independent accounting firm. A copy of the Form 990 is then reviewed by management. Once the Form 990 is reviewed by all applicable parties a copy of the final version is provided to all members of the governing body prior to filing. Form 990, Part VI, Line 12c Conflict of interest policy ALL BOARD MEMBERS ARE COVERED BY THE Mercy Health CONFLICT OF INTEREST POLICY WHICH REQUIRES DISCLOSURE ON AN ANNUAL BASIS. ALL POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY Mercy Health CORPORATE COMPLIANCE OFFICER. AT THE BEGINNING OF EACH BOARD MEETING ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. BOARD MEMBERS DETERMINED TO HAVE A CONFLICT OF INTEREST ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISION-MAKING FOR THE TRANSACTION IN WHICH THE CONFLICT EXISTS. Form 990, Part VI, Line 15a Process to establish compensation of top management official The organization's formal process for determining total compensation for the CEO and other officers and key employees is intended to provide reasonable compensation for accomplishing the organization's mission, to recognize performance, and to operate in keeping with the organization's obligations as a tax-exempt charitable organization. The Compensation & Evaluation Committee of the organization's Board of Trustees conducts an annual review of the compensation and performance of the CEO and other officers and key employees. In doing so, the Committee retains a qualified independent compensation consultant to conduct a competitive market analysis annually of the market ranges of base, incentive, and total cash compensation. The Committee utilizes that analysis and other appropriate information in connection with its annual review and adjustment of compensation ranges. It also reviews and recommends to the full board the threshold, target, and maximum incentive awards for which the listed individuals may be eligible, based upon the organization's performance results for community benefit, quality, and financial performance. The committee's recommendations concerning salary range adjustments and incentive awards go to the full board for approval. The committee, with full board approval, determines the adjustment to the ceo's base compensation and incentive award, within such established parameters. For the coo, cao, evp, and svp positions, adjustments and incentive awards are approved by the organization's ceo within such parameters. Adjustments and awards for other listed individuals are recommended by the supervising executive. Base salary adjustments and incentive awards are disclosed to the committee. A formal performance appraisal process is incorporated in the compensation adjustment and award process. It utilizes a multi-perspective approach and performance measures which are linked to the organization's long-term strategic plan, achievement of annual system objectives, and personal objectives. Form 990, Part VI, Line 15b Process to establish compensation of other employees Compensation-related determinations are conducted in accordance with applicable requirements of the Internal Revenue Code and regulations to qualify for the presumption that the compensation is reasonable, including but not limited to approval by an authorized body composed of individuals who do not have a conflict of interest, obtaining and relying on appropriate data as to comparability, and concurrent documentation of the basis for the compensation determinations. Form 990, Part VI, Line 19 Required documents available to the public THE CONFLICT OF INTEREST POLICY and financial statements are POSTED ON THE Mercy Health WEBSITE. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other Revenues - Total Revenue: 678576, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 678576; Form 990, Part IX, Line 11g Other Fees Medical Professional fees - Total Expense: 11167353, Program Service Expense: 11167353, Management and General Expenses: , Fundraising Expenses: ; Consulting - Total Expense: 585128, Program Service Expense: 497359, Management and General Expenses: 87769, Fundraising Expenses: ; Affiliate Purchased services - Total Expense: 42612717, Program Service Expense: 36220809, Management and General Expenses: 6391908, Fundraising Expenses: ; Other purchased services - Total Expense: 21114852, Program Service Expense: 17947624, Management and General Expenses: 3167228, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Intercompany Eliminations - -467595; Write-off I/C Balance with CarePath - 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