2018-05-10T08:00:08-05:00 2017-06-30 990 2016-07-01 421336618 MERCY MEDICAL CENTER - CLINTON INC MERC 5632445555 1410 NORTH 4TH STREET CLINTON IA 527322940 RODNEY SCHLADER TREASURER AND REGIONAL CFO 5632445555 2018-05-10 2016 2022-09-23 18:48:47Z SEE SCHEDULE O FOR LIST SEAN WILLIAMS 1410 NORTH 4TH STREET CLINTON IA 527322940 95244168 0 X WWW.MERCYCLINTON.COM X 1989 DE TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES 5 4 1154 231 68606 29527 387400 111303 99653512 91725821 80550 2135354 1060630 1115172 101182092 95087650 90620 30030 0 0 50744341 48478941 0 0 0 48322351 49557665 99157312 98066636 2024780 -2978986 141544695 141995652 30915164 29804570 110629531 112191082 X WE, MERCY HEALTH SERVICES - IOWA AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. MERCY MEDICAL CENTER - CLINTON IS A MEMBER OF MERCY HEALTH SERVICES - IOWA AND TRINITY HEALTH. 0 0 88257963 30030 90802581 MERCY MEDICAL CENTER - CLINTON (MMC-CLINTON) IS LOCATED IN CLINTON, IOWA. MMC-CLINTON IS A FULL-SERVICE COMMUNITY HEALTH SYSTEM SERVING RESIDENTS IN CLINTON, IOWA AND SURROUNDING COMMUNITIES IN EASTERN IOWA AND NORTHWESTERN ILLINOIS. WITH A HISTORY DATING BACK MORE THAN 120 YEARS, MMC-CLINTON IS PROUD TO OFFER THE LATEST IN HEALTH AND MEDICAL SERVICES WITH A CARING, COMPASSIONATE AND PERSONAL TOUCH.MMC-CLINTON PROVIDES A BROAD RANGE OF SERVICES TO MEET THE HEALTH CARE NEEDS OF RESIDENTS IN THE BI-STATE AREA. WITH TWO MAIN CAMPUSES, MMC-CLINTON OPERATES 346 LICENSED BEDS, INCLUDING 183 LONG-TERM CARE BEDS AND A 23 BED DEMENTIA CARE UNIT. SERVICES INCLUDE A RADIATION ONCOLOGY CENTER IN AFFILIATION WITH THE UNIVERSITY OF IOWA HOSPITALS AND CLINICS, TWO CARDIAC CATHETERIZATION LABS, RENAL DIALYSIS AND A TRAUMA CENTER. RESIDENTS ALSO HAVE ACCESS TO THE SKILL OF MMC-CLINTON'S HOME HEALTH AND HOSPICE CARE, AS WELL AS QUALITY EQUIPMENT AND SUPPLIES THROUGH MERCY HOME MEDICAL EQUIPMENT. IN FY17 THE HOSPITAL PROVIDED OVER 62,000 PATIENT DAYS OF HEALTHCARE SERVICES TO THE COMMUNITY.RECOGNIZING THE IMPORTANCE OF MAINTAINING HEALTH, MMC-CLINTON CREATES OPPORTUNITIES TO PROMOTE WELLNESS AND ASSIST PEOPLE TO TAKE RESPONSIBILITY FOR THEIR OWN HEALTH AND WELL-BEING. IN ADDITION, MMC-CLINTON SUPPORTS COMMUNITY PROGRAMS AND ACTIVITIES THAT ENHANCE THE CULTURAL AND ECONOMIC PROSPERITY OF ITS ASSOCIATES AND THE COMMUNITY AT LARGE.PLEASE VISIT SCHEDULE H AND OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT OUR SERVICES, RECOGNITIONS AND AWARDS: WWW.MERCYCLINTON.COM 88257963 1 1 0 1 0 0 0 0 1 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 235 0 1 1154 1 1 1 0 0 0 0 0 0 0 0 0 X 5 4 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X WILLIAM MURDOCK 5632445555 1410 NORTH 4TH STREET CLINTON IA 527322940 DAVID VELLINGA DIRECTOR; REGIONAL PRESIDENT & CEO 1.00 1.00 X X 0 0 0 MILTON AVERY DIRECTOR; CHAIR 1.00 1.00 X X 0 0 0 MARY CORITA HEID RSM DIRECTOR; VICE CHAIR 1.00 1.00 X X 0 0 0 MAURITA SOUKUP RSM DIRECTOR 1.00 1.00 X 0 0 0 JAMES CODDINGTON MD DIRECTOR THROUGH 7/16 1.00 1.00 X 0 0 0 LAMETTA WYNN DIRECTOR THROUGH 7/16 1.00 1.00 X 0 0 0 MARK NIEMER MD DIRECTOR THROUGH 7/16 1.00 1.00 X 0 0 0 MARTI RODAMAKER DIRECTOR THROUGH 7/16 1.00 1.00 X 0 0 0 RALPH REEDER MD DIRECTOR 1.00 1.00 X 0 0 0 CLAYTON FITZHUGH DIR & TRINITY EVP CHRO THROUGH 7/16 1.00 54.00 X 0 1005114 32084 SEAN WILLIAMS PRESIDENT & CEO 54.00 1.00 X 0 452989 32680 RODNEY SCHLADER TREASURER; REGIONAL CFO 1.00 49.00 X 0 363443 49503 MARCIA SMITH SECRETARY; ASSOCIATE COUNSEL 1.00 44.00 X 0 281518 38595 WILLIAM MURDOCK VP FINANCE 49.00 1.00 X 0 153411 26591 MOHAMMED IRSHAD MD PHYSICIAN, GASTROENTEROLOGY 50.00 0.00 X 592708 0 13277 MARK LEDING DO PHYSICIAN, ANESTHESIOLOGY 50.00 0.00 X 444063 0 44022 DOUGLAS CODY MD PHYSICIAN, ENT 50.00 0.00 X 412246 0 49446 AMY BERENTES VP PATIENT CARE/CNO 50.00 0.00 X 0 192321 19049 LINDA DUNNAM CRNA 50.00 0.00 X 188887 0 28060 RODNEY TOKHEIM FORMER KE; VP BUS DEV THR 3/17 50.00 0.00 X 0 171689 38111 RICHARD O'CONNELL FORMER KE; TRINITY EVP THROUGH 11/16 0.00 55.00 X 0 1545409 47362 1637904 4165894 418780 19 1 1 0 HEALTH CAROUSEL LLC 1700 MADISON RD CINCINNATI OH 45209 STAFFING SERVICES 1076888 MEDICAL ASSOCIATES OF CLINTON 849 13TH AVE N CLINTON IA 52732 PHYSICIAN ON-CALL AND MEDICAL DIRECTOR C 1046734 APOGEE MEDICAL MANAGEMENT 2525 E CAMELBACK RD PHOENIX AZ 85016 HOSPITALISTS 1011879 STRATEGIC STAFFING SOLUTIONS 5550 WILD ROSE LANE 400 WEST DES MOINES IA 50266 STAFFING SERVICES 824951 TRANE 4801 GRAND AVENUE DAVENPORT IA 52807 HEATING & COOLING SERVICES 535067 24 97598 13705 111303 NET PATIENT SERVICE REVENUE 622110 90586431 90586431 PHARMACY REVENUE 446110 1070784 1070784 LABORATORY UBI 621500 68606 68606 91725821 1038758 1038758 199487 149405 50082 50082 50082 1098995 4714 0 7113 1098995 -2399 1096596 1096596 CAFETERIA REVENUE 722514 450951 450951 CHILDCARE REVENUE 624410 397989 397989 MANAGEMENT REVENUE 541618 24901 24901 191249 191249 1065090 95087650 90802581 68606 4105160 30030 30030 665671 665671 338307 128507 209800 39358995 37762439 1596556 1567498 1501425 66073 3749856 3591789 158067 2798614 2633433 165181 381707 359178 22529 17049 17049 131769 131769 8672216 8160360 511856 220865 220865 1116717 1050806 65911 4948259 4948259 2486434 2339678 146756 165055 155313 9742 67879 63873 4006 698778 698778 8549016 8044432 504584 612902 612902 UBI TAXES 8400 8400 MEDICAL SUPPLIES 10958042 10958042 INTERCO. PURCHASED SVCS 3687679 3470024 217655 BAD DEBT 3603584 3603584 3231314 3093370 137944 98066636 88257963 9808673 0 351671 1955326 14382177 11135060 200978 276656 2238161 2317554 124636 150460 126136972 92465153 34270042 33671819 42368477 45036847 40279990 39481606 1431667 887658 5896896 7082666 141544695 141995652 8072604 7161315 20151 19821 549704 451213 22272705 22172221 30915164 29804570 X 110629531 112190915 167 110629531 112191082 141544695 141995652 X -2978986 7763737 -3223200 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 17009 1 2787 0 0 19796 0 PART II-B, LINE 1: MERCY MEDICAL CENTER - CLINTON HAS MADE GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES. THESE GRANTS HAVE BEEN IN THE FORM OF MEMBERSHIP DUES PAID TO REGIONAL AND NATIONAL HEALTH CARE ORGANIZATIONS, WHERE THE ORGANIZATIONS HAVE PROVIDED MERCY MEDICAL CENTER - CLINTON WITH AN ESTIMATED PERCENTAGE OF DUES PAYMENTS WHICH ARE USED FOR LOBBYING ACTIVITIES. 0 1 X 843689 843689 83735793 63068816 20666977 39821910 29396337 10425573 1735580 1735580 33671819 COMMINGLED FUNDS DIRECTLY HOLDING SECURITIES 17640717 F HEDGE FUNDS 8400342 F EQUITY METHOD INVESTMENTS 13440547 C 39481606 OTHER LONG-TERM LIABILITIES 333896 INTERCOMPANY NOTES PAYABLE 17235209 INTERCOMPANY PAYABLES 2455454 OTHER CURRENT LIABILITIES 758848 ASSET RETIREMENT OBLIGATION (FIN 47) 873778 DEFERRED COMPENSATION LIABILITY 515036 22172221 PART IV, LINE 2B: MERCY LIVING CENTER, A LONG TERM CARE FACILITY, HAS TWO CUSTODIAL ACCOUNTS THAT WERE FOR LONG TERM CARE RESIDENTS' PERSONAL USE. PART V, LINE 4: ENDOWMENTS HELD BY MERCY HEALTHCARE FOUNDATION - CLINTON FOR THE BENEFIT OF MERCY MEDICAL CENTER - CLINTON ARE REPORTED ON THE FORM 990 OF MERCY HEALTHCARE FOUNDATION - CLINTON. 1 1 X 1 X 1 X 1 1 1 0 1 1 1 590 1086746 1086746 0.01150 1 13089 18438609 15922824 2515785 0.02660 2 13679 19525355 15922824 3602531 0.03810 18 2925 151734 760 150974 0.00160 8 8751 2442884 1320164 1122720 0.01190 1 2 1818 1818 0.00000 17 5790 48670 48670 0.00050 44 17468 2645106 1320924 1324182 0.01400 46 31147 22170461 17243748 4926713 0.05210 1 11 1703 1703 0.00000 2 248 8829 8829 0.00010 1 3 3423 3423 0.00000 1 10 20986 20986 0.00020 5 272 34941 34941 0.00030 1 3603584 0 32264541 33867999 -1603458 X 1 1 1 CLINTON IMAGING SERVICES LLC MRI SERVICES 0.65000 0.35000 1 1 MERCY MEDICAL CENTER - CLINTON 1410 N 4TH STREET CLINTON IA 52732 WWW.MERCYCLINTON.COM 230056H X X X LAB, RADIOLOGY MERCY MEDICAL CENTER - CLINTON 1 0 0 1 X X X X X X X X X 14 1 1 1 1 X WWW.MERCYCLINTON.COM/COMMUNITY-BENEFIT X X 1 14 1 WWW.MERCYCLINTON.COM/COMMUNITY-BENEFIT 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X X X 1 X WWW.MERCYCLINTON.COM/FINANCIAL-SERVICES X WWW.MERCYCLINTON.COM/FINANCIAL-SERVICES X WWW.MERCYCLINTON.COM/FINANCIAL-SERVICES X X X X X 1 X 0 X X X X X 1 X 0 0 MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 5: MERCY MEDICAL CENTER - CLINTON (MMC-CLINTON), WORKING IN CONJUNCTION WITH THE GENESIS VISITING NURSES ASSOCIATION (VNA) AND GENESIS MEDICAL CENTER-DEWITT, HELD A SERIES OF MEETINGS WITH VARIOUS COMMUNITY AGENCIES AND ELECTED OFFICIALS TO REVIEW DATA AND PRIORITIZE LOCAL HEALTH ISSUES. THE VNA IS THE AGENCY THAT CLINTON COUNTY IOWA CONTRACTS WITH TO HANDLE MOST OF ITS PUBLIC HEALTH FUNCTIONS. AS A RESULT, THE HEALTH ISSUES IDENTIFIED AS A PART OF THIS PROCESS WILL ALSO BECOME THE PRIORITIES FOR CLINTON COUNTY, THE GEOGRAPHIC AREA WHERE MOST OF THE POPULATION THAT MMC-CLINTON SERVES RESIDE. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS WAS CONDUCTED DURING THREE MEETINGS WHICH OCCURRED ON SEPTEMBER 17, 2014, NOVEMBER 5, 2014 AND MARCH 4, 2015. INPUT FROM THE SURROUNDING COUNTIES OF JACKSON, CARROLL AND WHITESIDE WAS INCORPORATED BY REVIEWING COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT MATERIAL, WHICH WAS ACCESSED IN DECEMBER OF 2014.MMC-CLINTON RETAINED THE SERVICES OF VERNON RESEARCH TO CONDUCT FOCUS GROUP RESEARCH AND TELEPHONE INTERVIEWS WITH THOSE WHO ARE POOR, TO ENSURE THEIR VOICES WERE HEARD IN THIS PROCESS. ACTUAL SURVEYING OCCURRED DURING THE MONTH OF OCTOBER 2014 WITH THE FINAL REPORT BEING RECEIVED ON NOVEMBER 14, 2014. MMC-CLINTON ALSO CONDUCTED FOCUS GROUPS WITH HISPANIC AND AFRICAN AMERICAN REPRESENTATIVES WITHIN THE COMMUNITY. A LOCAL CATHOLIC PARISH HELPED TO IDENTIFY POTENTIAL HISPANIC INDIVIDUALS TO ATTEND THE FOCUS GROUP HELD ON DECEMBER 17, 2014. REPRESENTATIVES OF THE MARTIN LUTHER KING CELEBRATION COMMITTEE, ASSOCIATED WITH CLINTON COMMUNITY COLLEGE, HELPED IDENTIFY INDIVIDUALS TO ATTEND THE AFRICAN AMERICAN FOCUS GROUP HELD ON FEBRUARY 23, 2015. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 6A: THE EXECUTIVE DIRECTOR OF THE VISITING NURSES ASSOCIATION (VNA) SAT ON THE STEERING COMMITTEE. THE VNA IS OWNED BY GENESIS HEALTH SYSTEM. THIS INDIVIDUAL IS ALSO THE PERSON RESPONSIBLE FOR DEVELOPING THE CHNA FOR THE GENESIS HOSPITAL IN DEWITT, IOWA AND THE GENESIS MANAGED HOSPITAL IN JACKSON COUNTY. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 6B: CLINTON COUNTY COMMUNITY FOCUS GROUP: AS A WAY TO GAIN INSIGHT INTO UNDERSERVED POPULATIONS, GENESIS VNA AND MMC-CLINTON CONVENED A SERIES OF MEETINGS WITH REPRESENTATIVES FROM VARIOUS ORGANIZATIONS WITHIN THE SERVICE AREA INCLUDING: BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER, CLINTON COUNTY BOARD OF HEALTH, CLINTON COUNTY BOARD OF SUPERVISORS, CLINTON COUNTY EARLY CHILDHOOD OF IOWA PROGRAM, CLINTON COUNTY MEDICAL SOCIETY, EASTERN IOWA COMMUNITY COLLEGE - CLINTON, GATEWAY IMPACT (SUBSTANCE ABUSE) COUNCIL, GENESIS VNA, GENESIS MEDICAL CENTER-DEWITT, HYVEE GROCERY STORE, IOWA STATE EXTENSION SERVICE, IOWA STATE SENATE OFFICE, LUTHERAN SOCIAL SERVICES, UNITED WAY OF CLINTON COUNTY, VISITING NURSES OF IOWA (I-SMILE) DENTAL PROGRAM, AND THE YWCA. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 7D: THE FOLLOWING ARE ADDITIONAL WAYS MMC-CLINTON COMMUNICATED ITS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO THE BROADER COMMUNITY: 1.) DISTRIBUTION OF COPIES TO INDIVIDUALS WHO SERVED ON OUR CHNA STEERING COMMITTEE 2.) INDIVIDUALS WHO PARTICIPATED IN THE SOCIAL SERVICES FOCUS GROUP 3.) THROUGH ARTICLES IN THE HOSPITAL'S NEWSLETTERS. THE CHNA AND THE CHNA IMPLEMENTATION PLANS ARE BOTH POSTED ON THE HOSPITAL'S WEB SITE. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 11: MAJOR PRIORITIES (IN ORDER OF PRIORITY):ACCESS TO CARE: THERE ARE TWO MAJOR WAYS THAT MMC-CLINTON SUPPORTED IMPROVED ACCESS TO CARE. FIRST, MMC-CLINTON OPERATES MERCY SPECIALTY CLINIC, A COMMUNITY BASED MEDICAL CLINIC, WHICH PROVIDES ENT AND GASTROENTEROLOGY SERVICES. IN CONJUNCTION WITH THE CLINIC, CHARITY CARE AND FREE HEALTH SCREENINGS ARE PROVIDED. THE HOSPITAL IS ACTIVELY WORKING TO EXPAND SPECIALTY SERVICES. THE HOSPITAL CONTINUES TO HELP PATIENTS WHO HAVE FINANCIAL NEEDS RECEIVE TRANSPORTATION TO AND FROM THE HOSPITAL OR TO OTHER MEDICAL PROVIDERS. MEDIC AMBULANCE SERVICE, CAB OR BUS VOUCHERS ARE AVAILABLE FOR PATIENTS WITHOUT MEANS OF TRANSPORTATION WHO HAVE NO OTHER METHOD TO PAY. MENTAL HEALTH SERVICE: THE HOSPITAL PLANS TO CONTINUE ITS SUPPORT FOR BRIDGEVIEW COMMUNITY MENTAL HEALTH CENTER'S OUTPATIENT BEHAVIORAL HEALTH SERVICES AND ITS OWN INPATIENT MENTAL HEALTH UNIT. MAINTAINING AN INPATIENT UNIT WAS SEEN AS CRITICAL SINCE THE NEXT NEAREST UNIT IS OVER 35 MILES AWAY AND MANY OF THE CHRONICALLY MENTALLY ILL HAVE TRANSPORTATION ISSUES. THE ANNUAL RENT SUBSIDY THAT MMC-CLINTON PROVIDES BRIDGEVIEW IS $169,501 BASED ON THE MOST RECENT MEDICARE COST REPORT. THE ESTIMATED ANNUAL SUBSIDY TO THE MENTAL HEALTH UNIT WOULD BE REFLECTED IN OTHER PARTS OF THE HOSPITAL'S 990 REPORT. HOWEVER, WHAT WOULD NOT BE INCLUDED IN THAT NUMBER IS THE SUBSIDY THE HOSPITAL PROVIDES ON THE PROFESSIONAL SIDE OF CARE. DUE TO A SHORTAGE OF PSYCHIATRISTS IN THE COMMUNITY, THE HOSPITAL'S INPATIENT BEHAVIORAL HEALTH UNIT IS STAFFED BY A TELE-PSYCHIATRIST SERVICE. THE SUBSIDY TO MAINTAIN THAT SERVICE DURING THE PAST YEAR WAS $235,827.PRESCRIPTION ASSISTANCE: DURING FISCAL YEAR 2017, MMC-CLINTON PROVIDED $8,929 IN FREE PRESCRIPTIONS TO LOW INCOME INDIVIDUALS BEING DISCHARGED FROM THE HOSPITAL. WHILE THE INITIAL FOCUS OF THIS PROGRAM WAS ON CONGESTIVE HEART FAILURE PATIENTS, WHICH STARTED IN FISCAL YEAR 2016, MMC-CLINTON EXPANDED THE PROGRAM IN FISCAL YEAR 2017 TO A BROADER RANGE OF INPATIENTS. DIABETES: DIABETES IS CLEARLY A SIGNIFICANT ISSUE FOR OUR SERVICE AREA RESIDENTS. THERE ARE SEVERAL WAYS THAT MMC-CLINTON ADDRESSED THIS ISSUE IN FISCAL YEAR 2017. FIRST, THE HOSPITAL PARTICIPATED IN AN ACCOUNTABLE CARE ORGANIZATION/CLINICALLY INTEGRATE NETWORK (ACO/CIN) IN CONJUNCTION WITH MEDICAL ASSOCIATES, THE MAJOR MULTISPECIALTY MEDICAL PROVIDER IN THE REGION, AND OTHER AREA PRIMARY CARE PROVIDERS. ONE OF THE FIRST CLINICAL AREAS OF FOCUS FOR THIS ORGANIZATION WAS THE USE OF HEALTH COACHES TO BETTER MANAGE THE HEALTH OF THESE PATIENTS. HEALTH COACHES ARE LOOKING AT SEVERAL QUALITY MEASURES TO WORK TO IMPROVE OUTCOMES. TWO OF THE INDICATORS TARGET INDIVIDUALS WITH DIABETES AND A HBA1C GREATER THAN 9 AND DIABETICS WITH BLOOD PRESSURE ABOVE 140/90. IN ADDITION, TWO OF MMC-CLINTON'S COMMUNITY EDUCATORS ARE BEING TRAINED AS LIFESTYLE COACHES TO FACILITATE A CENTERS FOR DISEASE CONTROL RECOGNIZED DIABETES PREVENTION PROGRAM (DPP). THE CERTIFIED DIABETES EDUCATOR AND COMMUNITY WELLNESS COORDINATOR ARE WORKING WITH THE LOCAL COMMUNITY CLINIC AND PRIMARY CARE PHYSICIANS TO INITIATE A REFERRAL PROCESS FOR THE DPP. MMC-CLINTON'S COMMUNITY HEALTH AND WELLNESS DEPARTMENT CONTINUES TO FOCUS A MAJOR PORTION OF COMMUNITY EDUCATION TARGETED AT THE PRE-DIABETIC POPULATION. WEIGHT LOSS AND PHYSICAL ACTIVITY: BASED ON THE RWJ FOUNDATION COUNTY HEALTH RANKINGS, CLINTON COUNTY HAS INCREASED IN ADULT OBESITY FROM 31% IN 2016 TO 33% IN 2017. CLINTON COUNTY WENT FROM A RANKING OF 86 OUT OF 99 COUNTIES IN HEALTH BEHAVIORS TO 91 IN 2017.THE HOSPITAL IS ADDRESSING WEIGHT LOSS AND PHYSICAL ACTIVITY THROUGH ITS EFFORTS IN THE LOCAL HEALTHY LIFESTYLE COALITION/LET'S LIVE HEALTHY CLINTON, WORKING IN AREA SCHOOLS ON NUTRITION AND PHYSICAL ACTIVITY PROGRAMS, AND PATIENT DIABETES EDUCATION. THE CLINTON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT HAS INCLUDED A GOAL TO "DECREASE OR MAINTAIN THE PERCENTAGE OF ADULTS OVER THE AGE OF 18 IN CLINTON COUNTY WHO REPORT NO PHYSICAL ACTIVITY ON THE COUNTY HEALTH RANKINGS". IN CONJUNCTION WITH THIS COUNTY HEALTH GOAL, THE HEALTHY LIFESTYLE COALITION DEVELOPED A MASTER STRATEGIC PLAN. THE MASTER PLAN WILL TARGET THREE AREAS - EAT WELL, MOVE MORE AND FEEL BETTER. THE EAT WELL, MOVE MORE AND FEEL BETTER THEME IS A PARTNERSHIP WITH THE HEALTHY HOMETOWN SPONSORED BY WELLMARK. THE MASTER PLAN HAS BEEN SUBDIVIDED WITH A COLLABORATION OF KEY STAKEHOLDERS WORKING ON THESE INITIATIVES. PARTNERSHIPS IN THE COUNTY INCLUDE, BUT NOT LIMITED TO, MERCY MEDICAL CENTER, YWCA, PUBLIC HEALTH, CITY MANAGER, ASSISTANT ENGINEER, LOCAL AREA SUPERINTENDENTS, IOWA STATE EXTENSION OFFICE, COUNTY BOARD OF HEALTH, CHAMBER OF COMMERCE, CLINTON COMMUNITY COLLEGE, CLINTON HERALD, AND MEDICAL ASSOCIATES.SECONDARY PRIORITIES: WHILE NOT THE TOP AREAS OF FOCUS FOR MMC-CLINTON'S COMMUNITY BENEFIT PROGRAM, THE HOSPITAL ALSO WORKED ON A VARIETY OF OTHER HEALTH ISSUES INCLUDING: TOBACCO USE, LOW FOOD ACCESS, MINORITY HEALTH INSURANCE ENROLLMENT, EXERCISE, HEART DISEASE/HIGH BLOOD PRESSURE, SENIOR SERVICES, CANCER AWARENESS/PREVENTION AND LOW BIRTH WEIGHT BABIES. ISSUES NOT TO BE ADDRESSED BY MMC-CLINTON: MMC-CLINTON CANNOT REALISTICALLY DIRECTLY IMPACT ALL OF THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA. THE REMAINING NEEDS ARE THOUGHT TO BE BETTER ADDRESSED THROUGH OTHER ORGANIZATIONS IN THE COMMUNITY. LISTED BELOW ARE THE REMAINING ISSUES AND THE CORRESPONDING ALTERNATIVE PROVIDER. ALCOHOL/SUBSTANCE ABUSE: SINCE MMC-CLINTON DOES NOT CURRENTLY OFFER TREATMENT IN THESE AREAS, GATEWAY IMPACT COALITION AND THE CLINTON SUBSTANCE ABUSE AND PREVENTION COUNCIL HAVE MORE EXPERIENCE AND CAPACITY TO ADDRESS THIS NEED. MMC-CLINTON DOES PROVIDE THE GATEWAY IMPACT COALITION WITH FINANCIAL ASSISTANCE. AIR QUALITY AND ASTHMA: SINCE MMC-CLINTON DOES NOT EMPLOY PRIMARY CARE PHYSICIANS, IT WAS FELT BEST TO LEAVE THIS ISSUE TO BE HANDLED BY LOCAL CLINICIANS. THE ADDITION OF A NEW FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER IN TOWN SHOULD ALSO REDUCE ANY ACCESS ISSUES LOW INCOME INDIVIDUALS MIGHT HAVE SEEKING TREATMENT.DENTAL: ALTHOUGH NOT DIRECTLY ADDRESSING DENTAL CARE, THE OPENING OF THE NEW FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER, WHICH INCLUDES DENTAL FACILITIES, WILL GO A LONG WAY TO ADDRESS THIS ISSUE.DOMESTIC VIOLENCE: MMC-CLINTON IS AN ACTIVE REPORTER OF DOMESTIC VIOLENCE PARTICULARLY OF VICTIMS SEEN IN THE HOSPITAL'S EMERGENCY DEPARTMENT. THE YMCA HAS BEEN THE MAJOR PROVIDER OF HOUSING FOR DOMESTIC VIOLENCE VICTIMS IN MMC-CLINTON'S SERVICE AREA FOR A LONG TIME. IMMUNIZATION: THIS WAS FELT TO BE AN EDUCATIONAL EFFORT BEST HANDLED BY PUBLIC HEALTH AND LOCAL PROVIDERS.LANGUAGE: THE LANGUAGE NEEDS IDENTIFIED WERE PRIMARILY RELATED TO PHYSICIAN OFFICES. SINCE MMC-CLINTON OWNS FEW PHYSICIAN PRACTICES, LANGUAGE NEEDS WOULD NOT REALISTICALLY BE IMPACTED. THE PHYSICIAN PRACTICES THAT THE HOSPITAL DOES OWN ARE LOCATED IN THE HOSPITAL AND TAKE ADVANTAGE OF THE HOSPITAL'S LANGUAGE SUPPORT SYSTEMS.LEAD POISONING: THIS IS VIEWED AS A PUBLIC HEALTH ISSUE, WHICH THE VNA/COUNTY HEALTH IS PREPARED TO ADDRESS. RADON: THIS WAS ALSO VIEWED AS A PUBLIC HEALTH ISSUE THAT IS BEST ADDRESSED BY THE VNA/COUNTY HEALTH.SEXUALLY TRANSMITTED DISEASES: WOMEN'S HEALTH SERVICES PROVIDES SIGNIFICANT EDUCATION IN THE HIGH SCHOOL ON THIS NEED. BOTH WOMEN'S HEALTH AND VNA/COUNTY HEALTH ALSO OFFER TESTING.TEEN BIRTHS: WHILE IT IS OUT OF MMC-CLINTON'S SCOPE TO PREVENT TEEN BIRTHS, MMC-CLINTON HAS ACTIVELY WORKED TO SUPPORT YOUNG WOMEN AFTER THEY BECOME PREGNANT. EFFORTS HERE INCLUDE THE PROVISION OF AFFORDABLE PRENATAL EDUCATION, PARTICIPATION IN A STATE OF IOWA PILOT PROGRAM TO REDUCE INFANT DEATHS THROUGH THE PROVISION OF FREE CRIBS, AND FINANCIALLY SUPPORTING THE LOCAL CRISIS PREGNANCY CENTER WHICH PROVIDES COUNSELING, RESOURCES AND MENTORING TO TEEN MOMS. WATER QUALITY: THIS ISSUE WAS IDENTIFIED THROUGH THE LOW-INCOME RESIDENT SURVEYS. UPON CHECKING PUBLIC HEALTH DATA, THE WATER QUALITY APPEARED NORMAL, THEREFORE MMC-CLINTON DOES NOT PLAN TO ADDRESS THIS ISSUE FURTHER. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 13H: THE HOSPITAL RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL AND/OR SOCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON AVAILABLE INFORMATION. EXAMPLES OF PRESUMPTIVE CASES INCLUDE: DECEASED PATIENTS WITH NO KNOWN ESTATE, THE HOMELESS, UNEMPLOYED PATIENTS, NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS, PATIENT BANKRUPTCIES, AND MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD PARTY IS UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. THIS REVIEW UTILIZES A HEALTH CARE INDUSTRY-RECOGNIZED, PREDICTIVE MODEL THAT IS BASED ON PUBLIC RECORD DATABASES. THESE PUBLIC RECORDS ENABLE THE HOSPITAL TO ASSESS WHETHER THE PATIENT IS CHARACTERISTIC OF OTHER PATIENTS WHO HAVE HISTORICALLY QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. IN CASES WHERE THERE IS AN ABSENCE OF INFORMATION PROVIDED DIRECTLY BY THE PATIENT, AND AFTER EFFORTS TO CONFIRM COVERAGE AVAILABILITY, THE PREDICTIVE MODEL PROVIDES A SYSTEMATIC METHOD TO GRANT PRESUMPTIVE ELIGIBILITY TO FINANCIALLY NEEDY PATIENTS. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 15E: THE HOSPITAL PROVIDES ASSISTANCE WITH SIGNING UP FOR MEDICARE OR MEDICAID. MERCY MEDICAL CENTER - CLINTON PART V, SECTION B, LINE 20E: IF INDIVIDUAL REGISTERS AS SELF-PAY HE/SHE MEETS WITH A FINANCIAL COUNSELOR. 1 1 - MERCY LIVING CENTER - NORTH 600 14TH AVE NORTH CLINTON IA 52732 LONG TERM CARE PART I, LINE 3C: IN ADDITION TO LOOKING AT A MULTIPLE OF THE FEDERAL POVERTY GUIDELINES, OTHER FACTORS ARE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. PART I, LINE 6A: MERCY MEDICAL CENTER - CLINTON (MMC-CLINTON) REPORTS ITS COMMUNITY BENEFIT INFORMATION AS PART OF THE CONSOLIDATED COMMUNITY BENEFIT INFORMATION REPORTED BY TRINITY HEALTH (EIN 35-1443425) IN ITS AUDITED FINANCIAL STATEMENTS, AVAILABLE AT WWW.TRINITY-HEALTH.ORG.IN ADDITION, MMC-CLINTON INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY TOTAL CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, SPECIFIC COST-TO-CHARGE RATIOS WERE CALCULATED AND APPLIED TO THOSE CATEGORIES. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. PART I, LN 7 COL(F): THE FOLLOWING NUMBER, $3,603,584, REPRESENTS THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN TOTAL FUNCTIONAL EXPENSES IN FORM 990, PART IX, LINE 25. PER IRS INSTRUCTIONS, THIS AMOUNT WAS EXCLUDED FROM THE DENOMINATOR WHEN CALCULATING THE PERCENT OF TOTAL EXPENSE FOR SCHEDULE H, PART I, LINE 7, COLUMN (F). PART II, COMMUNITY BUILDING ACTIVITIES: THE COMMUNITY BUILDING PROGRAMS SUPPORTED BY MMC-CLINTON ARE INTENDED TO PROMOTE THE OVERALL HEALTH OF OUR COMMUNITY. MANY ARE AIMED AT IMPROVING THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, CHALLENGING FAMILY SITUATIONS, FINANCIAL CHALLENGES, AND ENVIRONMENTAL PROBLEMS. MMC-CLINTON SUPPORTS THE CHAMBER OF COMMERCE, CLINTON REGIONAL DEVELOPMENT CORPORATION, COMMUNITY RESOURCES UNITED TO STOP HEROIN (CRUSH), UNITED WAY, BRIDGEVIEW COMMUNITY HEALTH CENTER AND THE YWCA. MMC-CLINTON ALSO PROVIDES LEADERSHIP SUPPORT AND PARTICIPATION IN COMMUNITY DEVELOPMENT ACTIVITIES, AND PROVIDES IN-KIND AND FINANCIAL SUPPORT TO UNITED WAY, CRUSH, AND BRIDGEVIEW COMMUNITY HEALTH CENTER IN ORDER TO SUPPORT THEIR EFFORTS TO ADDRESS THE CHALLENGES IN OUR COMMUNITY AT THE ROOT OF MANY HEALTH PROBLEMS. OTHER COMMUNITY BUILDING ACTIVITIES ARE LISTED BELOW:CLINTON SCHOOLS: PROVIDES SUPPORT AS REQUESTED FOR CAREER DEVELOPMENT PROGRAMS. DURING FISCAL YEAR 2017, MMC-CLINTON PROVIDED FINANCIAL AND IN-KIND SUPPORT TO PROJECT SEARCH, A PROGRAM TO ASSIST WITH JOB SKILLS FOR STUDENTS WITH LEARNING DISABILITIES. FIVE STUDENTS PARTICIPATED IN THE INITIAL PROGRAM WITH EACH SERVING IN THREE DIFFERENT ROTATIONS THROUGHOUT THE SCHOOL YEAR.ADVOCACY - BROADER COMMUNITY: LEADERSHIP AND ASSOCIATES ARE ACTIVELY ENGAGED IN ADVOCACY EFFORTS TO IMPROVE MEDICAL ACCESS AND COVERAGE FOR ALL. ADVOCACY EFFORTS ARE TARGETED AT IMPROVING CARE FOR THE UNINSURED AND UNDERINSURED IN OUR COMMUNITY.IN-KIND BOARD MEMBER: OFFERS IN-KIND TIME SPENT AS A BOARD MEMBER ON THE CHAMBER OF COMMERCE BOARD OF DIRECTORS, THE FINANCE COMMITTEE OF THE CHAMBER OF COMMERCE, THE CHAMBER FOUNDATION AND GOVERNMENT RELATIONS COMMITTEE, CLINTON REGIONAL DEVELOPMENT CORPORATION, THE PAUL B. SHARAR FOUNDATION OF CLINTON COMMUNITY COLLEGE AND THE YWCA. PART III, LINE 2: METHODOLOGY USED FOR LINE 2 - ANY DISCOUNTS PROVIDED OR PAYMENTS MADE TO A PARTICULAR PATIENT ACCOUNT ARE APPLIED TO THAT PATIENT ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFF AND ARE THUS NOT INCLUDED IN BAD DEBT EXPENSE. AS A RESULT OF THE PAYMENT AND ADJUSTMENT ACTIVITY BEING POSTED TO BAD DEBT ACCOUNTS, WE ARE ABLE TO REPORT BAD DEBT EXPENSE NET OF THESE TRANSACTIONS. PART III, LINE 3: MMC-CLINTON USES A PREDICTIVE MODEL THAT INCORPORATES THREE DISTINCT VARIABLES IN COMBINATION TO PREDICT WHETHER A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE: (1) SOCIO-ECONOMIC SCORE, (2) ESTIMATED FEDERAL POVERTY LEVEL (FPL), AND (3) HOMEOWNERSHIP. BASED ON THE MODEL, CHARITY CARE CAN STILL BE EXTENDED TO PATIENTS EVEN IF THEY HAVE NOT RESPONDED TO FINANCIAL COUNSELING EFFORTS AND ALL OTHER FUNDING SOURCES HAVE BEEN EXHAUSTED. FOR FINANCIAL STATEMENT PURPOSES, MMC-CLINTON IS RECORDING AMOUNTS AS CHARITY CARE (INSTEAD OF BAD DEBT EXPENSE) BASED ON THE RESULTS OF THE PREDICTIVE MODEL. THEREFORE, MMC-CLINTON IS REPORTING ZERO ON LINE 3, SINCE THEORETICALLY ANY POTENTIAL CHARITY CARE SHOULD HAVE BEEN IDENTIFIED THROUGH THE PREDICTIVE MODEL. PART III, LINE 4: MMC-CLINTON IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH. THE FOLLOWING IS THE TEXT OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOOTNOTE FROM PAGE 14 OF THOSE STATEMENTS: "THE CORPORATION RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH THE CORPORATION DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY AT THAT TIME. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE CORPORATION ESTABLISHES AN ALLOWANCE TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THIS ALLOWANCE IS ESTABLISHED BASED ON THE AGING OF ACCOUNTS RECEIVABLE AND THE HISTORICAL COLLECTION EXPERIENCE BY THE HEALTH MINISTRIES AND FOR EACH TYPE OF PAYOR. A SIGNIFICANT PORTION OF THE CORPORATION'S PROVISION FOR DOUBTFUL ACCOUNTS RELATES TO SELF-PAY PATIENTS, AS WELL AS CO-PAYMENTS AND DEDUCTIBLES OWED TO THE CORPORATION BY PATIENTS WITH INSURANCE."PART III, LINE 5:TOTAL MEDICARE REVENUE REPORTED IN PART III, LINE 5 HAS BEEN REDUCED BY THE TWO PERCENT SEQUESTRATION REDUCTION. PART III, LINE 8: MMC-CLINTON DOES NOT BELIEVE ANY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS IS SIMILAR TO CATHOLIC HEALTH ASSOCIATION RECOMMENDATIONS, WHICH STATE THAT SERVING MEDICARE PATIENTS IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS AND THAT THE EXISTING COMMUNITY BENEFIT FRAMEWORK ALLOWS COMMUNITY BENEFIT PROGRAMS THAT SERVE THE MEDICARE POPULATION TO BE COUNTED IN OTHER COMMUNITY BENEFIT CATEGORIES.PART III, LINE 8: COSTING METHODOLOGY FOR LINE 6 - MEDICARE COSTS WERE OBTAINED FROM THE FILED MEDICARE COST REPORT. THE COSTS ARE BASED ON MEDICARE ALLOWABLE COSTS AS REPORTED ON WORKSHEET B, COLUMN 27, WHICH EXCLUDE DIRECT MEDICAL EDUCATION COSTS. INPATIENT MEDICARE COSTS ARE CALCULATED BASED ON A COMBINATION OF ALLOWABLE COST PER DAY TIMES MEDICARE DAYS FOR ROUTINE SERVICES AND COST TO CHARGE RATIO TIMES MEDICARE CHARGES FOR ANCILLARY SERVICES. OUTPATIENT MEDICARE COSTS ARE CALCULATED BASED ON COST TO CHARGE RATIO TIMES MEDICARE CHARGES BY ANCILLARY DEPARTMENT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CHARITY DISCOUNTS ARE APPLIED TO THE AMOUNTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. COLLECTION PRACTICES FOR THE REMAINING BALANCES ARE CLEARLY OUTLINED IN THE ORGANIZATION'S COLLECTION POLICY. THE HOSPITAL HAS IMPLEMENTED BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. PART VI, LINE 2: NEEDS ASSESSMENT - MMC-CLINTON ASSESSES THE HEALTH STATUS OF ITS COMMUNITY, IN PARTNERSHIP WITH COMMUNITY COALITIONS, AS PART OF THE NORMAL COURSE OF OPERATIONS AND IN THE CONTINUOUS EFFORTS TO IMPROVE PATIENT CARE. TO ASSESS THE HEALTH OF THE COMMUNITY, THE HOSPITAL MAY USE PATIENT DATA, ANNUAL COUNTY HEALTH RANKINGS, MARKET STUDIES AND GEOGRAPHICAL MAPS SHOWING AREAS OF HIGH UTILIZATION FOR EMERGENCY SERVICES, WHICH MAY INDICATE POPULATIONS OF INDIVIDUALS WHO DO NOT HAVE ACCESS TO PREVENTATIVE SERVICES OR ARE UNINSURED. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - MMC-CLINTON IS COMMITTED TO:- PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE, PARTICULARLY THE POOR AND THE UNDERSERVED IN OUR COMMUNITIES- CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES- ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THEY RECEIVE - BALANCING NEEDED FINANCIAL ASSISTANCE FOR SOME PATIENTS WITH BROADER FISCAL RESPONSIBILITIES IN ORDER TO SUSTAIN VIABILITY AND PROVIDE THE QUALITY AND QUANTITY OF SERVICES FOR ALL WHO MAY NEED CARE IN A COMMUNITYIN ACCORDANCE WITH AMERICAN HOSPITAL ASSOCIATION RECOMMENDATIONS, MMC-CLINTON HAS ADOPTED THE FOLLOWING GUIDING PRINCIPLES WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: - PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS- MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS- OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS- IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER- IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PATIENT PAYMENT OBLIGATIONSMMC-CLINTON COMMUNICATES EFFECTIVELY WITH PATIENTS REGARDING PATIENT PAYMENT OBLIGATIONS. FINANCIAL COUNSELING IS PROVIDED TO PATIENTS ABOUT THEIR PAYMENT OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL-BASED FINANCIAL SUPPORT POLICIES AND EXTERNAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES ARE MADE AVAILABLE TO PATIENTS DURING THE PRE-REGISTRATION AND REGISTRATION PROCESSES AND/OR THROUGH COMMUNICATIONS WITH PATIENTS SEEKING FINANCIAL ASSISTANCE. FINANCIAL COUNSELORS MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UNTIL ONE YEAR AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. MMC-CLINTON OFFERS FINANCIAL SUPPORT TO PATIENTS WITH LIMITED MEANS. THIS SUPPORT IS AVAILABLE TO UNINSURED AND UNDERINSURED PATIENTS WHO DO NOT QUALIFY FOR PUBLIC PROGRAMS OR OTHER ASSISTANCE. NOTIFICATION ABOUT FINANCIAL ASSISTANCE, INCLUDING CONTACT INFORMATION, IS AVAILABLE THROUGH PATIENT BROCHURES, MESSAGES ON PATIENT BILLS, POSTED NOTICES IN PUBLIC REGISTRATION AREAS INCLUDING EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, AND OTHER PATIENT FINANCIAL SERVICES OFFICES. SUMMARIES OF HOSPITAL PROGRAMS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS ALSO AVAILABLE ON HOSPITAL WEBSITES. IN ADDITION TO ENGLISH, THIS INFORMATION IS ALSO AVAILABLE IN OTHER LANGUAGES AS REQUIRED BY INTERNAL REVENUE CODE SECTION 501(R), REFLECTING OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICED BY OUR HOSPITAL. MMC-CLINTON HAS ESTABLISHED A WRITTEN POLICY FOR THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS. MMC-CLINTON MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS WITH LIMITED MEANS IN A PROFESSIONAL, CONSISTENT MANNER. PART VI, LINE 4: COMMUNITY INFORMATION - MMC-CLINTON SERVES A 16 ZIP CODE AREA ALONG THE MISSISSIPPI RIVER IN EASTERN IOWA AND WESTERN ILLINOIS. ITS PRIMARY AND SECONDARY SERVICE AREAS HAVE A TOTAL POPULATION OF APPROXIMATELY 72,500, WHICH IS PROJECTED TO DECLINE SLIGHTLY BY 1.9% BETWEEN 2014 AND 2019. WHILE THE OVERALL POPULATION IS DECLINING, THE NUMBER OF RESIDENTS 65 YEARS OF AGE AND OLDER WILL INCREASE. THE ETHNICITY OF MMC-CLINTON'S SERVICE AREA IS PRIMARILY WHITE (94.7%), WITH SMALL BLACK AND HISPANIC COMMUNITIES (1.8% EACH). THE AVERAGE HOUSEHOLD INCOME FOR THE SERVICE AREA IS $53,450 WITH THE STATE AVERAGE BEING $61,960 AND US AVERAGE OF $71,071.THE MEDICAL CENTER CONSISTS OF AN ACUTE CARE HOSPITAL AND A STRONG CONTINUUM OF SERVICES FOR SENIORS (TWO NURSING HOMES, A DEMENTIA UNIT, TRANSITIONAL CARE BEDS, HOME CARE AND HOSPICE). PART VI, LINE 5: OTHER INFORMATION - MMC-CLINTON HAS AN OPEN MEDICAL STAFF. AS A SOLE COMMUNITY PROVIDER, WE OFFER MANY SERVICES TO THE COMMUNITY THAT WOULD OTHERWISE BE UNAVAILABLE. IN ADDITION TO TRADITIONAL ACUTE CARE SERVICES, WE OFFER EMERGENCY SERVICES REGARDLESS OF ABILITY TO PAY, RADIATION ONCOLOGY, RENAL DIALYSIS, HOME CARE, HOSPICE CARE, WOUND CARE AND INPATIENT BEHAVIORAL HEALTH. WE ALSO HAVE A COMMUNITY INSTITUTIONAL REVIEW BOARD, WHICH APPROVES ANY MEDICAL-RELATED RESEARCH REQUESTS.MMC-CLINTON OFFERS MANY OPPORTUNITIES FOR STUDENTS PURSUING MEDICAL-RELATED CAREERS TO GAIN CLINICAL EXPERIENCE. THIS INCLUDES, BUT IS NOT LIMITED TO, PHYSICIANS, NURSES, LAB TECHNICIANS, EEG, RADIOLOGY, PHARMACY AND RESPIRATORY THERAPY.WE PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE IN MANY WAYS. TO CREATE GREATER ACCESS TO CARE FOR THE UNDERSERVED MMC-CLINTON IN CONJUNCTION WITH THE SISTERS OF ST. FRANCIS ARE HELPING TO SUBSIDIZE THE OPENING OF A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER SATELLITE CLINIC IN CLINTON. MMC-CLINTON ALSO HAS A VERY ACTIVE AND EXPANSIVE VOLUNTEER PROGRAM, WHICH OFFERS OPPORTUNITIES ACROSS THE CONTINUUM, FROM ACUTE CARE TO LONG-TERM CARE AND HOSPICE. MAJOR COMMUNITY BENEFIT PROGRAMS ARE LISTED BELOW ALONG WITH THE DESCRIPTION OF THEIR IMPACT ON IMPROVING HEALTH IN THE COMMUNITY.PRENATAL EDUCATION: PROVIDES EDUCATION TO LOW INCOME FAMILIES TO PROMOTE HEALTHY OUTCOMES FOR MOTHER AND BABY. THE MAJORITY OF DELIVERIES AT OUR HOSPITAL ARE WITH MOTHERS WHO ARE AT OR BELOW THE POVERTY LEVEL. EVIDENCE HAS DOCUMENTED THAT EDUCATION HAS AN IMPACT ON HEALTHY PREGNANCIES AND HEALTHY BABIES. IN ADDITION MMC-CLINTON IS ACTIVELY MOVING TO BECOME A CERTIFIED BABY FRIENDLY SITE. BABY FRIENDLY HOSPITALS ARE HOSPITALS THAT ARE RECOGNIZED FOR ENCOURAGING BREASTFEEDING AND MOTHER/BABY BONDING, WHICH IS KNOWN TO PROVIDE HEALTH BENEFITS FOR INFANTS, CHILDREN, AND MOTHERS.AMBULANCE AND CAB SERVICE: PROVIDES TRANSPORTATION FOR ADDITIONAL MEDICAL CARE OR TRANSPORTATION HOME. ACCESS TO CARE CONTINUES TO BE A GAP IN OUR COMMUNITY. MANY PATIENTS ARRIVE IN OUR ER AND DO NOT HAVE TRANSPORTATION AVAILABLE TO RETURN HOME. DRUG ENDANGERED CHILD TASK FORCE: WORKS ON REDUCING THE RISK FOR DRUG-ENDANGERED CHILDREN BORN IN OUR FACILITY. THIS WAS IDENTIFIED AS PART OF THE GOALS/STRATEGIES FOR THE CLINTON COUNTY HEALTH IMPROVEMENT PLAN FOR 2011-2015.SUBSIDIZED PROGRAMS: BRIDGEVIEW MENTAL HEALTH: PROVIDES FINANCIAL SUBSIDY TO THE PROGRAM, WHICH PROVIDES MENTAL HEALTH SERVICES TO COUNTY FUNDED AND OTHER LOW INCOME AND/OR UNINSURED PATIENTS IN OUR COMMUNITY. SPECIALTY CLINIC SUBSIDY: PROVIDES GI AND ENT SERVICES TO PATIENTS IN THE COMMUNITY, OPERATING AT A LOSS, DUE IN PART TO ACCEPTANCE OF MEDICAID AND CHARITY CARE PATIENTS. THE PREGNANCY CENTER: ASSISTS WITH SUPPORT FOR MOTHERS WITH UNPLANNED PREGNANCIES. ALSO PROMOTES AND PROVIDES EDUCATION ON HEALTHY RELATIONSHIPS. REDUCING THE NUMBER OF SUBSEQUENT PREGNANCIES IN YOUNG WOMEN UNDER 20 IS ONE OF THE GOALS/STRATEGIES FOR THE CLINTON COUNTY HEALTH IMPROVEMENT PLAN.CERTIFIED DIABETES CENTER: PROVIDES EDUCATION AND MEDICAL MANAGEMENT FOR DIABETIC PATIENTS IN OUR COMMUNITY.COMMUNITY COLLABORATION AND ADVOCACY:MMC-CLINTON ACTIVELY PARTICIPATES IN A VARIETY OF LOCAL COALITIONS INCLUDING THE BREATH EASY COALITION (ANTI-TOBACCO), HEALTHY LIFE STYLES (OBESITY AND PHYSICAL ACTIVITY) AND CRUSH (DRUG ADDICTION). PART VI, LINE 6: MMC-CLINTON IS A MEMBER OF TRINITY HEALTH, ONE OF THE LARGEST CATHOLIC HEALTH CARE DELIVERY SYSTEMS IN THE COUNTRY. TRINITY HEALTH ANNUALLY REQUIRES THAT ALL MEMBER ORGANIZATIONS DEFINE - AND ACHIEVE - SPECIFIC COMMUNITY HEALTH AND WELL-BEING GOALS. IN FISCAL YEAR 2017, GOALS INCLUDED 1) PARTICIPATING IN LOCAL COALITION AND ADVOCACY EFFORTS AIMED AT CURBING TOBACCO USE AND PREVENTING OBESITY, 2) ASSESSING CAPACITY TO IDENTIFY AND SUPPORT INDIVIDUALS THAT ARE HOUSING INSECURE AND ACKNOWLEDGING OTHER BARRIERS INDIVIDUALS HAVE ACCESSING HEALTH CARE AND 3) EXPANDING ACCESS AND DELIVERY OF DIABETES PREVENTION PROGRAMS. TRINITY HEALTH ACKNOWLEDGES THE IMPACT SOCIAL DETERMINANTS SUCH AS ADEQUATE HOUSING, SAFETY, ACCESS TO FOOD, EDUCATION, INCOME, AND HEALTH COVERAGE HAVE ON THE HEALTH OF THE COMMUNITY. IN FISCAL YEAR 2016, TRINITY HEALTH LAUNCHED THE TRANSFORMING COMMUNITIES INITIATIVE (TCI), AWARDING EIGHT COMMUNITIES FUNDING TO IMPROVE THE HEALTH AND WELL-BEING OF THEIR COMMUNITIES IN PARTNERSHIP WITH THE LOCAL TRINITY HEALTH MEMBER HOSPITAL. THE AWARDED COMMUNITIES FOCUS ON POLICY, SYSTEM, AND ENVIRONMENTAL CHANGES THAT SPECIFICALLY IMPACT COMMUNITY IDENTIFIED NEEDS AND THAT WILL REDUCE CHILDHOOD OBESITY AND YOUTH TOBACCO USE. IN FISCAL YEAR 2017, TRINITY HEALTH INVESTED $2.7 MILLION IN TCI.AS A NOT-FOR-PROFIT HEALTH SYSTEM, TRINITY HEALTH REINVESTS ITS PROFITS BACK INTO OUR COMMUNITIES THROUGH PROGRAMS SERVING THOSE WHO ARE POOR AND VULNERABLE, HELPING MANAGE CHRONIC CONDITIONS LIKE DIABETES, PROVIDING HEALTH EDUCATION, PROMOTING WELLNESS AND DEVELOPING PROGRAMS AND POLICIES TO SPECIFICALLY SUPPORT VULNERABLE POPULATIONS. ANNUALLY, THE ORGANIZATION INVESTS OVER $1.1 BILLION IN SUCH COMMUNITY BENEFITS AND WORKS TO ENSURE THAT ITS MEMBER HOSPITALS AND OTHER ENTITIES/AFFILIATES ENHANCE THE OVERALL HEALTH OF THE COMMUNITIES THEY SERVE BY ADDRESSING THE SPECIFIC NEEDS OF EACH COMMUNITY.FOR MORE INFORMATION ABOUT TRINITY HEALTH, VISIT WWW.TRINITY-HEALTH.ORG. 1 CLINTON REGIONAL DEVELOPMENT CORPORATION 144 8TH AVENUE SOUTH CLINTON IA 52732 420738495 501(C)(4) 20000 COMMUNITY SUPPORT 0 1 PART I, LINE 2: DONATIONS MADE BY MERCY MEDICAL CENTER - CLINTON TO CHARITABLE ORGANIZATIONS ARE MADE IN FURTHERANCE OF THE RECIPIENT ORGANIZATION'S EXEMPT PURPOSE. DONATIONS ARE INCLUDED IN COMMUNITY BENEFITS IN SCHEDULE H IF THE CONRIBUTION HAS BEEN FORMALLY RESTRICTED TO A COMMUNITY BENEFIT ACTIVITY THAT MEETS THE CRITERIA TO BE REPORTED ON SCHEDULE H. 0 1 0 0 0 0 0 0 0 CLAYTON FITZHUGH DIR & TRINITY EVP CHRO THROUGH 7/16 0 511710 0 216184 0 277220 0 15900 0 16184 0 1037198 0 0 SEAN WILLIAMS PRESIDENT & CEO 0 295319 0 70662 0 87008 0 7950 0 24730 0 485669 0 0 RODNEY SCHLADER TREASURER; REGIONAL CFO 0 305424 0 56637 0 1382 0 19875 0 29628 0 412946 0 0 MARCIA SMITH SECRETARY; ASSOCIATE COUNSEL 0 252029 0 28408 0 1081 0 12294 0 26301 0 320113 0 0 WILLIAM MURDOCK VP FINANCE 0 130878 0 14051 0 8482 0 6900 0 19691 0 180002 0 0 MOHAMMED IRSHAD MD PHYSICIAN, GASTROENTEROLOGY 589923 0 0 0 2785 0 11925 0 1352 0 605985 0 0 0 MARK LEDING DO PHYSICIAN, ANESTHESIOLOGY 442093 0 0 0 1970 0 11925 0 32097 0 488085 0 0 0 DOUGLAS CODY MD PHYSICIAN, ENT 388030 0 23244 0 972 0 11925 0 37521 0 461692 0 0 0 AMY BERENTES VP PATIENT CARE/CNO 0 169049 0 23051 0 221 0 12132 0 6917 0 211370 0 0 LINDA DUNNAM CRNA 169246 0 0 0 19641 0 7827 0 20233 0 216947 0 0 0 RODNEY TOKHEIM FORMER KE; VP BUS DEV THR 3/17 0 149446 0 21366 0 877 0 13636 0 24475 0 209800 0 0 RICHARD O'CONNELL FORMER KE; TRINITY EVP THROUGH 11/16 0 878773 0 258051 0 408585 0 11925 0 35437 0 1592771 0 112018 PART I, LINE 3 MERCY MEDICAL CENTER - CLINTON IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. MERCY MEDICAL CENTER - CLINTON'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MERCY MEDICAL CENTER - CLINTON'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2016. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. BENEFITS FOR PARTICIPANTS VESTED IN A PLAN WERE PAID OUT IN 2016, AND BENEFITS FOR PARTICIPANTS NOT YET VESTED IN A PLAN WERE ACCRUED IN 2016. THE FOLLOWING PAYOUTS FOR 2016 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: CLAYTON FITZHUGH - $262,095 RICHARD O'CONNELL - $221,949 SEAN WILLIAMS - $73,184 THE FOLLOWING IS A PARTICIPANT IN A TRINITY HEALTH RESTORATION OR RETENTION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($265,000 FOR 2016). THE FOLLOWING PAYOUT FOR 2016 FOR THIS PLAN IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: RICHARD O'CONNELL - $121,018 COLUMN (F) OF SCHEDULE J, PART II INCLUDES THE PORTION OF THIS AMOUNT THAT WAS REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. BRANDEN TOKHEIM FAMILY MEMBER OF RODNEY TOKHEIM, FORMER KEY EMPLOYEE 128507 EMPLOYMENT ARRANGEMENT 0 FORM 990, PART VI, SECTION A, LINE 2 RODNEY SCHLADER, OFFICER, AND MARTI RODAMAKER, BOARD DIRECTOR, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERS OF MERCY MEDICAL CENTER - CLINTON (MMC-CLINTON) ARE MERCY HEALTHCARE FOUNDATION - CLINTON (THE CLASS A MEMBER) AND MERCY HEALTH SERVICES-IOWA CORP. (THE CLASS B MEMBER). SEE LINE 7 FOR ADDITIONAL INFORMATION. FORM 990, PART VI, SECTION A, LINE 7A THE SYSTEM PARENT, TRINITY HEALTH CORPORATION, APPOINTS THE DIRECTORS OF MMC-CLINTON. THE BOARD OF DIRECTORS ELECTS THE BOARD OFFICERS. FORM 990, PART VI, SECTION A, LINE 7B MERCY HEALTH SERVICES-IOWA, CLASS B MEMBER, AND TRINITY HEALTH CORPORATION, SYSTEM PARENT, MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. MERCY HEALTH SERVICES-IOWA MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. AS CLASS A MEMBER, MERCY HEALTHCARE FOUNDATION - CLINTON MUST APPROVE THE SALE OF SUBSTANTIALLY ALL ASSETS TO, OR MERGER OF MMC-CLINTON WITH, AN ENTITY NOT AFFILIATED WITH TRINITY HEALTH CORPORATION. MERCY HEALTHCARE FOUNDATION - CLINTON MUST ALSO APPROVE ANY MODIFICATIONS TO GOVERNING DOCUMENTS THAT WOULD CHANGE THE VOTING OR APPROVAL RIGHTS OF THE CLASS A MEMBER. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR MMC-CLINTON IS REVIEWED BY SENIOR MANAGEMENT. IN ADDITION, CERTAIN KEY SECTIONS OF THE FORM ARE REVIEWED BY THE BOARD OF DIRECTORS. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MMC-CLINTON HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF MMC-CLINTON, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF MMC-CLINTON AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO INTERNAL LEGAL COUNSEL AND THE INTEGRITY AND COMPLIANCE OFFICER, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF MMC-CLINTON (OR A DELEGATED COMMITTEE OF THE BOARD) ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO MMC-CLINTON OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF MMC-CLINTON (OR A DELEGATED COMMITTEE OF THE BOARD) IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD (OR A DELEGATED COMMITTEE OF THE BOARD) WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF MMC-CLINTON. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF MMC-CLINTON IS ESTABLISHED AND PAID BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO AND CFO OF MMC-CLINTON ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 MMC-CLINTON IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. IN ADDITION, MMC-CLINTON INCLUDES A COPY OF ITS MOST RECENTLY FILED SCHEDULE H ON BOTH ITS OWN WEBSITE AND TRINITY HEALTH'S WEBSITE. MMC-CLINTON'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY TRANSFERS TO/FROM AFFILIATES -3,223,200. FORM 990, PART XII, LINE 2: MMC-CLINTON'S FINANCIAL STATEMENTS WERE INCLUDED IN THE FY17 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM. FORM 990, PAGE 1, DOING BUSINESS AS NAMES: MERCY MEDICAL CENTER - CLINTON, MERCY HOME CARE & HOSPICE - CLINTON, MERCY LIVING CENTER - NORTH, MERCY LIVING CENTER - SOUTH, MERCY SPECIALTY CLINIC - CLINTON AND MERCY HOME MEDICAL EQUIPMENT. MERCY-CLINTON ANESTHESIA GROUP LLC 1410 NORTH 4TH STREET CLINTON IA 52732 461906752 ANESTHESIOLOGISTS IA 0 0 MERCY MEDICAL CENTER - CLINTON INC ADVANTAGE HEALTHSAINT MARY'S MEDICAL GROUP 245 STATE ST SE GRAND RAPIDS MI 49503 272491974 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 TRINITY HEALTH-MICHIGAN 1 ALLEGANY FRANCISCAN MINISTRIES INC 33920 US HIGHWAY 19 NORTH SUITE 269 PALM HARBOR FL 34684 581492325 GRANT MAKING FL 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 ASYLUM HILL FAMILY MEDICINE CENTER INC 114 WOODLAND STREET HARTFORD CT 06105 061450170 HEALTH CARE SERVICES CT 501(C)(3) LINE 3 TRINITY HEALTH OF NEW ENGLAND CORP INC 1 BAUM HARMON MERCY HOSPITAL 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 421500277 HEALTH CARE AND HOSPITAL SERVICES IA 501(C)(3) LINE 3 MERCY HEALTH SERVICES-IOWA CORP 1 BAUM HARMON MERCY HOSPITAL AND CLINICS FOUNDATION 255 NORTH WELCH AVENUE PRIMGHAR IA 51245 262973307 FOUNDATION IA 501(C)(3) LINE 12A, I BAUM HARMON MERCY HOSPITAL 1 BEECHWOOD INC 2212 BURDETT 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LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 GLOBAL HEALTH MINISTRY 20555 VICTOR PARKWAY LIVONIA MI 48152 421253527 HEALTH CARE SERVICES MI 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 GOOD SAMARITAN HOSPITAL INC 5401 LAKE OCONEE PARKWAY GREENSBORO GA 30642 261720984 HEALTH CARE AND HOSPITAL SERVICES GA 501(C)(3) LINE 3 ST MARY'S HEALTH CARE SYSTEM INC 1 GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION 701 W NORTH AVE MELROSE PARK IL 60160 363332852 COMMUNITY OUTREACH IL 501(C)(3) LINE 10 GOTTLIEB MEMORIAL HOSPITAL 1 GOTTLIEB MEMORIAL FOUNDATION 701 W NORTH AVE MELROSE PARK IL 60160 743260011 FOUNDATION IL 501(C)(3) LINE 12C, III-FI N/A 0 GOTTLIEB MEMORIAL HOSPITAL 701 W NORTH AVE MELROSE PARK IL 60160 362379649 HEALTH CARE AND HOSPITAL SERVICES IL 501(C)(3) LINE 3 LOYOLA UNIVERSITY HEALTH SYSTEM 1 GRAND RAPIDS MEDICAL EDUCATION PARTNERS INC 945 OTTAWA AVE NW GRAND RAPIDS MI 49503 237270669 MEDICAL EDUCATION TRAINING PROGRAMS MI 501(C)(3) LINE 12A, I TRINITY HEALTH-MICHIGAN 1 HACKLEY LIFE COUNSELING 125 E SOUTHERN AVENUE MUSKEGON MI 49442 381386362 HEALTH CARE SERVICES MI 501(C)(3) LINE 10 MERCY HEALTH PARTNERS 1 HAWTHORNE RIDGE INC 30 COMMUNITY WAY EAST GREENBUSH NY 12061 800102840 SENIOR LIVING COMMUNITY NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HEART CENTER OF GREATER WATERBURY INC PO BOX 2153 WATERBURY CT 06722 830416893 MANAGEMENT CT 501(C)(3) LINE 12A, I N/A 0 HERITAGE HOUSE NURSING CENTER INC 2920 TIBBITS AVE TROY NY 12180 141725101 LONG TERM CARE NY 501(C)(3) LINE 10 LTC (EDDY) INC 1 HOLY CROSS CARENET INC PO BOX 9184 FARMINGTON HILLS MI 48152 521945054 LONG TERM CARE MD 501(C)(3) LINE 10 TRINITY CONTINUING CARE SERVICES 1 HOLY CROSS HEALTH FOUNDATION INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 208428450 FOUNDATION MD 501(C)(3) LINE 7 HOLY CROSS HEALTH INC 1 HOLY CROSS HEALTH INC 1500 FOREST GLEN RD SILVER SPRING MD 20910 520738041 HEALTH CARE AND HOSPITAL SERVICES MD 501(C)(3) LINE 3 TRINITY HEALTH CORPORATION 1 HOLY CROSS HOSPITAL 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NY 12180 222564710 MANAGEMENT SERVICES FOR LONG TERM CARE NY 501(C)(3) LINE 12B, II ST PETER'S HEALTH PARTNERS 1 MARIAN COMMUNITY HOSPITAL 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE PA 19073 240711230 HEALTH CARE SERVICES (INACTIVE) PA 501(C)(3) LINE 10 MAXIS HEALTH SYSTEM 1 MARIAN HOME HEALTHCARE 801 5TH STREET SIOUX CITY IA 51101 383320705 HOME HEALTH SERVICES (INACTIVE) IA 501(C)(3) LINE 12A, I MERCY HEALTH SERVICES-IOWA CORP 1 MAXIS HEALTH SYSTEM 3805 WEST CHESTER PIKE STE 100 NEWTOWN SQUARE PA 19073 911940902 HEALTH CARE SYSTEM MANAGEMENT AND SUPPORT (INACTIVE) PA 501(C)(3) LINE 12A, I TRINITY HEALTH CORPORATION 1 MCAULEY CENTER INC 275 STEELE ROAD WEST HARTFORD CT 06117 061058086 SENIOR LIVING COMMUNITY CT 501(C)(3) LINE 10 MERCY COMMUNITY HEALTH INC 1 MCAULEY CLINIC CORPORATION PO BOX 992 ANN ARBOR MI 48106 382561013 HEALTH CARE SERVICES (INACTIVE) MI 501(C)(3) LINE 3 CATHERINE MCAULEY HEALTH SERVICES CORP 1 MCAULEY MINISTRIES 3333 FIFTH AVENUE PITTSBURGH PA 15213 943436142 GRANT MAKING PA 501(C)(3) LINE 12B, II PITTSBURGH MERCY HEALTH SYSTEM INC 1 MEMORIAL HOSPITAL ALBANY NY 600 NORTHERN BLVD ALBANY NY 12204 141338457 HEALTH CARE AND HOSPITAL SERVICES NY 501(C)(3) LINE 3 ST PETER'S HEALTH PARTNERS 1 MERCY AMICARE HOME HEALTHCARE OAKLAND 1111 W LONG LAKE RD STE 102 TROY MI 48098 383320698 HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 MERCY AMICARE HOME HEALTHCARE PORT HURON 17410 COLLEGE PARKWAY STE 150 LIVONIA MI 48152 383320701 HOME HEALTH SERVICES MI 501(C)(3) LINE 10 TRINITY HOME HEALTH SERVICES 1 MERCY CARE FOUNDATION 424 DECATUR STREET ATLANTA GA 30312 581448522 FOUNDATION GA 501(C)(3) LINE 7 SAINT JOSEPH'S HEALTH SYSTEM INC 1 MERCY CATHOLIC MEDICAL CENTER OF SOUTHEASTERN PENNSYLVANIA ONE WEST ELM STREET SUITE 100 CONSHOHOCKEN PA 19428 231352191 HEALTH CARE AND HOSPITAL SERVICES PA 501(C)(3) LINE 3 MERCY HEALTH SYSTEM OF SOUTHEASTERN PENNSYLVANIA 1 MERCY COMMUNITY HEALTH INC 2021 ALBANY AVENUE WEST HARTFORD CT 06117 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