2016-11-14T11:14:53-06:00 2015-12-31 990 2015-01-01 362739299 TRINITY MEDICAL CENTER TRIN 3097795000 2701 17TH ST ROCK ISLAND IL 61201 KATHERINE MARCHIK SR VP FINANCE/CFO 3097795700 2016-11-08 2015 2017-02-10 21:41:12Z RICHARD SEIDLER 2701 17TH ST ROCK ISLAND IL 61201 400732799 0 X WWW.UNITYPOINT.ORG/QUADCITIES X 1969 IL IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 18 13 3511 492 21627 0 5801972 1379709 352183015 373566545 8595480 8041396 4224930 3858840 370805397 386846490 15188018 21164810 0 0 141835209 172827051 0 0 0 191609627 186948904 348632854 380940765 22172543 5905725 437088535 437245218 214589093 213962719 222499442 223282499 X THE MISSION OF TRINITY MEDICAL CENTER IS TO IMPROVE THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 0 0 298080232 12381225 375380806 HEALTH-CARE SERVICESTRINITY MEDICAL CENTER IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE QUAD CITY COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. TRINITY MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, SKILLED NURSING, MATERNAL/CHILD CARE, LABORATORY, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2015, TRINITY MEDICAL CENTER ADMITTED 18,831 PATIENTS RESULTING IN A TOTAL OF 82,916 PATIENT DAYS. OUTPATIENT VISITS TOTALED 201,279 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 9,782. THERE WERE ALSO 90,510 EMERGENCY ROOM VISITS AND 2,414 BABIES DELIVERED. 44347460 8783585 COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: TRINITY MEDICAL CENTER PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $3,519,927 IN 2015. OFTENTIMES, TRINITY MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. TRINITY MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. TRINITY MEDICAL CENTER'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $27,404,252 FOR 2015. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $30,924,179.OTHER BENEFITS: TRINITY MEDICAL CENTER PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; SUBSIDIZED HEALTH SERVICES; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. TRINITY MEDICAL CENTER COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. TRINITY MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. APPROXIMATELY 70,544 PERSONS WERE SERVED THROUGH THESE PROGRAMS. TOTAL OTHER BENEFITS REPORTED VALUE: $13,423,281. 342427692 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 1 3511 1 1 1 0 0 0 0 0 0 0 0 0 X 18 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X X JAY QUICK EXECUTIVE DIRECTOR OF REGIONAL ACCOUNTING 5152247160 4949 WESTOWN PKWY STE 255 WEST DES MOINES IA 50266 MARY ANN ANDERSON BOARD MEMBER 1.00 1.00 X 1009 0 0 JOHN BECKEY BOARD MEMBER 1.00 1.00 X 0 0 0 ROBERT CHESSER MD BOARD MEMBER 1.00 1.00 X 0 296013 28917 COSTAS CONSTANTINOU MD BOARD MEMBER 1.00 1.00 X 0 0 0 PATRICK EIKENBERRY BOARD MEMBER 1.00 1.00 X 964 0 0 PASTOR STACIE FIDLAR BOARD MEMBER 1.00 1.00 X 76 0 0 FARAZ MANAZIR MD BOARD MEMBER 1.00 1.00 X 182 0 0 PETER MCLAUGHLIN BOARD MEMBER 1.00 1.00 X 226 15006 0 MSGR MARK MERDIAN BOARD MEMBER 1.00 1.00 X 0 0 0 CHRIS MOEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 TODD NICHOLSON BOARD CHAIR 1.00 1.00 X X 1069 10667 0 AHMED OKBA MD BOARD MEMBER 1.00 1.00 X 0 0 0 COLLEEN RAFFERTY BOARD MEMBER 1.00 1.00 X 0 0 0 MARK SCHWIEBERT BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 RICHARD SEIDLER BOARD MEMBER/PRESIDENT/CEO 1.00 40.00 X X 726825 0 182435 JANET SICHTERMAN BOARD MEMBER 1.00 1.00 X 0 0 0 KARLA STEELE BOARD MEMBER 1.00 1.00 X 0 0 0 MARIE ZIEGLER BOARD MEMBER 1.00 1.00 X 0 0 0 TAMARA BYRAM MAHL VP LEGAL & COMPLIANCE 40.00 1.00 X 217440 0 40406 PAUL MCLOONE MD CMO/CQO 40.00 1.00 X 430927 0 40812 GREG PAGLIUZZA JR VP FINANCE/CFO 40.00 1.00 X 432655 0 89663 JAY WILLSHER EXEC VP/COO 40.00 1.00 X 423782 0 113514 SUSAN BESWICK DIR EMERGENCY SERVICES 40.00 0.00 X 150806 0 24751 DAVID DEOPERE PRESIDENT RYC (TO 9/15) & VICE PRESIDENT (TMC) 1.00 40.00 X 504901 0 39650 DENNIS DUKE FR 515 PRESIDENT RYC 1.00 40.00 X 193139 0 32201 CARA FULLER VP HUMAN RESOURCES 40.00 1.00 X 300917 0 31994 TAMMY PAUWELS EXEC DIR OUTPATIENT SVCS 40.00 1.00 X 174280 0 18222 KATHERINE PEARSON CHIEF STRATEGY OFFICER 40.00 1.00 X 399508 0 68453 MARY PETERSEN DIR BEHAV HLTH SVC 40.00 0.00 X 163140 0 10674 TRACY POELVOORDE CHANCELLOR 40.00 0.00 X 193622 0 24660 ROCHELLE TINMAN DIR NURSING EXCELLENCE 40.00 0.00 X 159458 0 17352 DOUG GAITHER MD PHYSICIAN-ER/TRAUMA 40.00 0.00 X 615740 0 23644 KEVIN KURTH MD MEDICAL DIRECTOR-ER/TRAUMA 40.00 0.00 X 600450 0 45074 TOYOSI OLUTADE MD PHYSICIAN HOSPITALIST 40.00 0.00 X 624889 1260 46859 AAMIR PASHA MD PHYSICIAN HOSPITALIST 40.00 1.00 X 511447 0 45023 WILLIAM ROGERS III MD PHYSICIAN-ER/TRAUMA 40.00 0.00 X 579858 0 41571 TOM TIBBITTS TO 610 FORMER INTERIM PRESIDENT/CEO 0.00 40.00 X 0 159620 1559 CINDA BATES TO 212 FORMER UTILIZATION MGMT SPECIALIST 40.00 0.00 X 160953 0 32251 KATHLEEN CUNNINGHAM TO 511 FORMER VP QUALITY 0.00 40.00 X 0 290570 19936 RICHARD MURPHY FORMER CFO RYC 0.00 40.00 X 101306 0 14450 BOBETTE PATTERSON FORMER DIR OPERATIONS/DIR CARDIOVASCULAR 40.00 0.00 X 148697 0 30294 7818266 773136 1064365 156 1 1 0 METROPOLITAN MEDICAL LAB P L C 1520 7TH STREET MOLINE IL 61265 LAB SERVICES 9908418 RUSSELLPEPPER CONSTRUCTION LLC 643 N ORLEANS ST CHICAGO IL 60654 CONSTRUCTION SERVICES 7053364 OWENS & MINOR DISTRIBUTION 12199 COLLECTION CENTER DR CHICAGO IA 60693 MEDICAL EQUIPMENT 7023460 SIEMENS MEDICAL SOLUTIONS DEPT CH 14195 PALATINE IL 60055 MEDICAL EQUIPMENT 6896096 ARAMARK MANAGEMENT SERVICES 24863 NETWORK PLACE CHICAGO IL 60673 MANAGEMENT SERVICES 2257312 159 7200 1268913 12000 91596 10500 1379709 NET PATIENT REVENUE 900099 296048768 296048768 LABORATORY SERVICES 621500 68358613 68358613 EDUCATION & RESEARCH 900099 4428654 4428654 RENTAL INCOME 531100 2131407 2131407 MISCELLANEOUS REVENUE 900099 1119254 1119254 1479849 1458222 21627 373566545 4244488 126112 4118376 17038974 13140 13165360 89846 3873614 -76706 3796908 3796908 73106 7200 20953 52153 52153 535676 610150 -74474 -74474 CAFETERIA/FOOD SVCS 722210 2066900 2066900 MISCELLANEOUS REVENUE 900099 1814261 1814261 3881161 386846490 375485291 21627 9959863 21163465 21163465 1345 1345 3717613 3717613 531980 531980 140671128 125064066 15607062 5394349 4796871 597478 14773767 13131698 1642069 7738214 6879202 859012 2180663 1993246 187417 618793 618793 905 905 12500 12500 987966 376292 611674 37913484 35432882 2480602 679764 554765 124999 4716981 4611463 105518 -1990030 -1990030 8686081 8291122 394959 198623 112447 86176 96110 37008 59102 9086078 879790 8206288 17767671 17363839 403832 1953685 775820 1177865 MEDICAL SUPPLIES 70168114 69687221 480893 MISCELLANEOUS EXPENSE 33782481 33206139 576342 BAD DEBT EXPENSE 80899 50000 30899 INCOME TAXES 8136 8136 380940765 342427692 38513073 0 9915203 3476259 2739318 676942 49608495 44354081 31284872 33044346 7549687 8140571 1086029 1150580 386077444 214881730 170192231 171195714 152447158 143135045 11493542 31444430 772000 627250 437088535 437245218 32464823 25918608 -33768 177340 3174676 8969634 3095846 2744720 175887516 176152417 214589093 213962719 X 216161889 215864770 4869914 5580157 1467639 1837572 222499442 223282499 437088535 437245218 X 5905725 -6484889 1362221 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 12500 0 0 12500 0 PART II-B, LINE 1: DENNY JACOBS AND ASSOCIATES ACTS ON TMC'S BEHALF TO PROMOTE AND EDUCATE LEGISLATORS AND STATE GOVERNMENT ABOUT TMC'S POSITION RELATING TO LAWS, BILLS, POLICIES, PROCEDURES AND ETC. 128132004 2548567 84797 506039 1229165 129030164 129639131 2477695 342790 3349680 977932 128132004 134069152 5661086 11021876 362296 20000000 750687 129639131 103720828 20260989 13910998 510972 3312691 134069152 111608387 342481 -7619436 610604 103720828 0.94300 0.01420 0.04280 0 1 1 6916648 6916648 265276522 137325196 127951326 103342099 71483253 31858846 10542175 6073281 4468894 171195714 BENEFICIAL INTEREST IN TRINITY HEALTH FOUNDATION 7241870 F PRECEDENCE, INC 191872 F QUAD CITY AMBULATORY SURGERY CENTER 3354790 F ADVANCED IMAGING CENTER 939631 F PRECEDENCE CCE 1094497 F TRINITY ONCOLOGY SERVICES CO-MANAGEMENT COMPANY, LLC 50000 F MISSISSIPPI VALLEY SLEEP DISORDER CENTER, L.C. 549270 F UPHT-SCA HOLDINGS, LLC 17977500 F UNITYPOINT AT WORK 45000 F 31444430 DUE TO AFFILIATES 2997989 ASBESTOS REMOVAL LIABILITY 1360261 MISCELLANEOUS LIABILITY 235000 SELF-INSURANCE RESERVE 11010705 LONG-TERM RETENTION INCENTIVES 3645401 HEALTH AND WELFARE BENEFITS RESERVE 1465024 IOWA HEALTH SYSTEM NOTE PAYABLE 155438037 176152417 X 416362000 -6484889 38392884 31907995 384454005 342791 2049694 2392485 386846490 393326000 34215983 34215983 359110017 342791 21487957 21830748 380940765 PART V, LINE 4: THE ORGANIZATION RETAINS FUNDS FOR INTENDED FUTURE USES, INCLUDING PURCHASE OF EQUIPMENT, INDIGENT CARE, FUNDING OF MISSION RELATED OPERATIONS, AND HEALTH EDUCATION. IN ADDITION, SOME FUNDS ARE HELD FOR INVESTMENT IN PERPETUITY. PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2012. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY ELIMINATING ENTRIES (MISSISSIPPI VALLEY SLEEP DISORDER CENTER) 566,774. SUBSIDIARY ELIMINATING ENTRIES (PRECEDENCE, INC.) 573,135. SUBSIDIARY ELIMINATING ENTRIES (PRECEDENCE CARE COORDINATION ENTITY, LLC) 992,744. SUBSIDIARY ELIMINATING ENTRIES (THE ROBERT YOUNG CTR FOR COMM MENTAL HEALTH) 19,969,200. SUBSIDIARY ELIMINATING ENTRIES (TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD) 183,442. SUBSIDIARY ELIMINATING ENTRIES (UPHT-SCA HOLDINGS) 15,497,068. COST OF GOODS SOLD 610,150. REVENUES NETTED IN EXPENSES 371. PART XI, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES 707,699. REVENUES IN UNRESTRICTED FUND BALANCE 813,333. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 423,651. SPECIAL EVENT EXPENSES 59,353. EXPENSES NETTED IN REVENUES 45,541. ROUNDING 117. PART XII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY ELIMINATING ENTRIES (MISSISSIPPI VALLEY SLEEP DISORDER CENTER) 455,380. SUBSIDIARY ELIMINATING ENTRIES (PRECEDENCE, INC.) 582,619. SUBSIDIARY ELIMINATING ENTRIES (PRECEDENCE CARE COORDINATION ENTITY, LLC) 268,217. SUBSIDIARY ELIMINATING ENTRIES (THE ROBERT YOUNG CTR FOR COMM MENTAL HEALTH) 19,969,200. SUBSIDIARY ELIMINATING ENTRIES (TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD) 117,078. SUBSIDIARY ELIMINATING ENTRIES (UPHT-SCA HOLDINGS) 12,212,606. COST OF GOODS SOLD 610,150. REVENUES NETTED IN EXPENSES 371. ROUNDING 362. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES IN UNRESTRICTED FUND BALANCE 20,959,412. IOWA HEALTH SYSTEM CONTRACTING SERVICES, LC PURCHASE REBATES 423,651. SPECIAL EVENT EXPENSES 59,353. EXPENSES NETTED IN REVENUES 45,541. STYLE SHOW GARDEN PARTY 1 1 X 1 X 1 X 1 1 1 0 1 1 3519927 3519927 0.00920 75207226 47802974 27404252 0.07200 78727153 47802974 30924179 0.08120 5068513 1105860 3962653 0.01040 427704 10032 417672 0.00110 516584 257213 259371 0.00070 15555172 6771587 8783585 0.02310 21567973 8144692 13423281 0.03530 100295126 55947666 44347460 0.11650 69257 69257 0.00020 69257 69257 0.00020 0 4437442 0 116973985 121078203 -4104218 X 1 1 1 QUAD CITY AMBULATORY SURGERY CENTER LLC AMBULATORY SURGERY CENTER 0.50000 0.50000 2 TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC ADMINISTRATION OF ORTHOPEDIC SERVICE LINES 0.50000 0.50000 3 TRINITY ONCOLOGY SERVICES CO-MANAGEMENT COMPANY LLC ADMINISTRATION OF ONCOLOGY SERVICE LINES 0.50000 0.50000 4 MISSISSIPPI VALLEY SLEEP DISORDER CENTER SLEEP STUDY CLINIC 0.51000 0.49000 3 1 TRINITY MEDICAL CENTER - ROCK ISLAND 2701 17TH ST ROCK ISLAND IL 61201 WWW.UNITYPOINT.ORG/QUADCITIES/TRINITY- 2132866 X X X A 2 TRINITY MEDICAL CENTER - MOLINE 500 JOHN DEERE RD MOLINE IL 61265 WWW.UNITYPOINT.ORG/QUADCITIES/TRINITY- 2150794 X X X A 3 TRINITY MEDICAL CENTER - BETTENDORF 4500 UTICA RIDGE RD BETTENDORF IA 52722 WWW.UNITYPOINT.ORG/QUADCITIES/TRINITY- 820042H X X X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 15 1 1 1 1 X HTTPS://WWW.UNITYPOINT.ORG/QUADCITIES/COMMUNITY-HEALTH-ASSESSMENT.ASPX X 1 15 1 HTTPS://WWW.UNITYPOINT.ORG/QUADCITIES/COMMUNITY-HEALTH-ASSESSMENT.ASPX 0 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X HTTP://WWW.UNITYPOINT.ORG/QUADCITIES/FINANCIAL-ASSISTANCE.ASPX X HTTP://WWW.UNITYPOINT.ORG/QUADCITIES/FINANCIAL-ASSISTANCE.ASPX X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: TRINITY MEDICAL CENTER - ROCK ISLAND, - FACILITY 2: TRINITY MEDICAL CENTER - MOLINE, - FACILITY 3: TRINITY MEDICAL CENTER - BETTENDORF GROUP A-FACILITY 1 -- TRINITY MEDICAL CENTER - ROCK ISLAND PART V, SECTION B, LINE 5: FOLLOWING STEERING COMMITTEE MEMBERS:BROOKE BARNES, SCOTT COUNTY HEALTH DEPARTMENTTOM BOWMAN, COMMUNITY HEALTH CAREDENISE BULAT, BI-STATE REGIONAL COMMISSIONANDY BURMAN, GENESIS HEALTH SYSTEMNICOLE CARKNER, QUAD CITY HEALTH INITIATIVE KEN CROKEN, GENESIS HEALTH SYSTEMRACHEL EVANS, QUAD CITY HEALTH SYSTEMDANIEL JOINER, UNITYPOINT HEALTH - TRINITY NITA LUDWIG, ROCK ISLAND COUNTY HEALTH DEPARTMENT ED RIVERS, SCOTT COUNTY HEALTH DEPARTMENT CHRISTY A. ROBY WILLIAMS, UNITYPOINT HEALTH - TRINITY PAT SHOUSE, UNITYPOINT HEALTH - TRINITY TIFFANY TJEPKES, SCOTT COUNTY HEALTH DEPARTMENT GROUP A-FACILITY 1 -- TRINITY MEDICAL CENTER - ROCK ISLAND PART V, SECTION B, LINE 6A: GENESIS HEALTH SYSTEM GROUP A-FACILITY 1 -- TRINITY MEDICAL CENTER - ROCK ISLAND PART V, SECTION B, LINE 6B: COMMUNITY HEALTH CARE, QUAD CITY HEALTH INITIATIVE, ROCK ISLAND COUNTY PUBLIC HEALTH DEPARTMENT, AND SCOTT COUNTY PUBLIC HEALTH DEPARTMENT. GROUP A-FACILITY 1 -- TRINITY MEDICAL CENTER - ROCK ISLAND PART V, SECTION B, LINE 11: UNITYPOINT HEALTH - TRINITY IS IN THE MIDST OF ITS THREE YEAR PLAN THAT ADDRESSES THE TOP HEALTH ISSUES FOUND IN OUR CHNA REPORT COMPLETED IN 2015. WE HAVE CREATED A STRONG WORKING GROUPS CONSISTING OF MULTIPLE DEPARTMENTS AND COMMUNITY COLLABORATIONS THAT HAVE IDENTIFIED WAYS TO ADDRESS MAJOR HEALTH CHALLENGES IN OUR COMMUNITY. WE ARE WORKING IN COLLABORATION WITH A NUMBER OF COMMUNITY PARTNERS SUCH AS HABITAT FOR HUMANITY, RIVER BEND FOODBANK, AND GLOBAL COMMUNITIES, TO NAME A FEW. DURING COMMUNITY EVENTS WE ARE ADDRESSING THE NEEDS OF THE UNDERSERVED POPULATIONS BY DOING FREE BLOOD PRESSURE CHECKS, FREE BLOOD SUGAR SCREENINGS, ADDRESSING HEALTH INSURANCE NEEDS, PROVIDING EDUCATION ON HEALTHY EATING, TOBACCO CESSATIONS INFORMATION, AND PROVIDING ACCESS TO HEALTH BY LINKING COMMUNITY MEMBERS TO PRIMARY CARE AND SPECIALTY SERVICES. WHEN WE SCREEN AN INDIVIDUAL IN THE COMMUNITY AND THEIR RESULTS ARE ABNORMAL, IF THEY DON'T HAVE A PRIMARY CARE PHYSICIAN, AND/OR THEY DON'T HAVE HEALTH INSURANCE, WE ARE CONNECTING THEM TO THE PROPER RESOURCES IN ORDER TO GET THEM THE CARE THAT THEY NEED TO PREVENT THEIR SITUATION FROM LEADING TO AN ER VISIT OR ADMISSION. REGULAR MEETINGS ARE HELD WITH A NUMBER OF MENTAL HEALTH ORGANIZATIONS THAT HAVE COME TOGETHER TO LOOK AT HOW WE CAN ADDRESS MENTAL/BEHAVIORAL HEALTH ISSUES AS A COMMUNITY. THE QUAD CITIES MENTAL HEALTH COALITION HAS BEGUN WORK TO LOOK AT HOW WE CAN MAKE PROGRESS TOWARDS IMPROVING THE CHALLENGES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. WE HAVE REPRESENTATIVES FROM ALL OF THE MAJOR MENTAL HEALTH ORGANIZATIONS IN THE QUAD CITIES COMMUNITY TO LOOK AT TOPICS LIKE ACCESS TO SERVICES, EDUCATION, AND SUICIDE PREVENTION. A CHARTER HAS BEEN CREATED AND AN ACTION PLAN IS CURRENTLY BEING DEVELOPED. UNITYPOINT HEALTH - TRINITY IS ALSO SPONSORING COMMUNITY EVENTS TO PROMOTE MENTAL HEALTH AWARENESS AND HOW TO ACCESS MENTAL HEALTH SERVICES IN OUR COMMUNITY. UNITYPOINT HEALTH - TRINITY IS A PART OF THE QUAD CITY HEALTH INITIATIVE THAT CONSIST OF BOTH HEALTH SYSTEMS, BOTH ROCK ISLAND AND SCOTT COUNTY HEALTH DEPARTMENTS, COMMUNITY HEALTH CARE, BUSINESS LEADERS IN OUR COMMUNITY, REPRESENTATION FROM LOCAL SCHOOL DISTRICTS, AS WELL AS MEMBERS FROM OUR LOCAL GOVERNMENTS. THERE ARE MULTIPLE PROJECTS UNDERWAY TO PROMOTE HEALTHY LIVING AND EXERCISE. SOME OF THESE PROJECTS INCLUDE COMMUNITY GARDENS, SAFE ROUTES TO SCHOOLS FOR CHILDREN, PUBLICIZING AND MAPPING LOCAL HIKE AND BIKE TRAILS, AND ADVERTISING TO PROMOTE THE BENEFITS OF MAKING HEALTHIER FOOD CHOICES. A CREATIVE MARKETING PLAN HAS BEEN DEVELOPED, AND HAS BEEN RECOGNIZES BY THE CDC FOR ITS CREATIVITY, TO REACH KIDS TO SHARE WITH THEM HOW TO EAT HEALTHIER AND EXERCISE MORE. A PARTNERSHIP HAS ALSO BEEN ESTABLISHED WITH GLOBAL COMMUNITIES. THROUGH THE EFFORTS OF GLOBAL COMMUNITIES, WE HAVE PARTNERED WITH OTHER ORGANIZATIONS HELP MEETING THE NEEDS OF MINORITY POPULATIONS WITHIN OUR COMMUNITY. SOME OF THESE PARTNERS INCLUDE HABITAT FOR HUMANITY, THE ESPERANZA CENTER, PALOMARES CRIMINAL JUSTICE CENTER, THE BOYS & GIRLS CLUB, AND A NUMBER OF OTHER SMALL BUSINESSES AND NON-PROFIT ORGANIZATIONS. WE ARE WORKING WITH THESE GROUPS TO ADDRESS WORKFORCES AND EDUCATION CHALLENGES, HEALTH, AND ECONOMIC DEVELOPMENT WITHIN THE COMMUNITY. THE THREE YEAR COMMITMENT TO THIS ORGANIZATION IS TO HELP THIS COMMUNITY GAIN ACCESS TO THE RESOURCES ITS NEEDS TO THRIVE IN THE QUAD CITIES. WE ARE ALSO UTILIZING A COMMITTEE TO EVALUATE AND SCORE ALL SPONSORSHIP OPPORTUNITIES AND THE IMPACT ON AWARENESS AND EDUCATION IN OUR KEY FOCUS AREAS, WITH A KEEN FOCUS ON HEART, DIABETES, MENTAL HEALTH. WE ARE RELYING ON OUR ESTABLISHED PARTNERSHIPS WITHIN TO COMMUNITY TO COORDINATE WITH US IN PROMOTING HEALTH AND WELLNESS THROUGHOUT THE QUAD CITIES. WE ARE TARGETING AREAS AND POPULATIONS WE FEEL ARE IN THE NEED OF EDUCATION AND SERVICES THE MOST TO MAKE THE BIGGEST IMPACT POSSIBLE WITH OUR STAFFING AND EQUIPMENT. OUR GOAL IS TO CONTINUE TO LIVE OUT OUR MISSION DAILY BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. ON AN ANNUAL BASIS WE WILL PROVIDE AN UPDATED REPORT TO THE MISSION EFFECTIVENESS COMMITTEE, THIS IS A STANDING COMMITTEE OF TRINITY'S BOARD OF DIRECTORS. WE ARE WORKING TO SHOW RESULTS IMPACTING EACH OF OUR TARGETED AREAS. THIS COMMITTEE PROVIDES OVERSIGHT AND DIRECTION FOR THE WORK THAT WE ARE DOING IN THE COMMUNITY TO MEET OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. AN ANNUAL REPORT WILL ALSO GO TO THE TRINITY MEDICAL CENTER BOARD OF TRUSTEES AND TRINITY'S SENIOR LEADERSHIP TEAM. GROUP A-FACILITY 1 -- TRINITY MEDICAL CENTER - ROCK ISLAND PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND . IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. GROUP A-FACILITY 2 -- TRINITY MEDICAL CENTER - MOLINE PART V, SECTION B, LINE 5: FOLLOWING STEERING COMMITTEE MEMBERS:BROOKE BARNES, SCOTT COUNTY HEALTH DEPARTMENTTOM BOWMAN, COMMUNITY HEALTH CAREDENISE BULAT, BI-STATE REGIONAL COMMISSIONANDY BURMAN, GENESIS HEALTH SYSTEMNICOLE CARKNER, QUAD CITY HEALTH INITIATIVE KEN CROKEN, GENESIS HEALTH SYSTEMRACHEL EVANS, QUAD CITY HEALTH SYSTEMDANIEL JOINER, UNITYPOINT HEALTH - TRINITY NITA LUDWIG, ROCK ISLAND COUNTY HEALTH DEPARTMENT ED RIVERS, SCOTT COUNTY HEALTH DEPARTMENT CHRISTY A. ROBY WILLIAMS, UNITYPOINT HEALTH - TRINITY PAT SHOUSE, UNITYPOINT HEALTH - TRINITY TIFFANY TJEPKES, SCOTT COUNTY HEALTH DEPARTMENT GROUP A-FACILITY 2 -- TRINITY MEDICAL CENTER - MOLINE PART V, SECTION B, LINE 6A: GENESIS HEALTH SYSTEM GROUP A-FACILITY 2 -- TRINITY MEDICAL CENTER - MOLINE PART V, SECTION B, LINE 6B: COMMUNITY HEALTH CARE, QUAD CITY HEALTH INITIATIVE, ROCK ISLAND COUNTY PUBLIC HEALTH DEPARTMENT, AND SCOTT COUNTY PUBLIC HEALTH DEPARTMENT. GROUP A-FACILITY 2 -- TRINITY MEDICAL CENTER - MOLINE PART V, SECTION B, LINE 11: UNITYPOINT HEALTH - TRINITY IS IN THE MIDST OF ITS THREE YEAR PLAN THAT ADDRESSES THE TOP HEALTH ISSUES FOUND IN OUR CHNA REPORT COMPLETED IN 2015. WE HAVE CREATED A STRONG WORKING GROUPS CONSISTING OF MULTIPLE DEPARTMENTS AND COMMUNITY COLLABORATIONS THAT HAVE IDENTIFIED WAYS TO ADDRESS MAJOR HEALTH CHALLENGES IN OUR COMMUNITY. WE ARE WORKING IN COLLABORATION WITH A NUMBER OF COMMUNITY PARTNERS SUCH AS HABITAT FOR HUMANITY, RIVER BEND FOODBANK, AND GLOBAL COMMUNITIES, TO NAME A FEW. DURING COMMUNITY EVENTS WE ARE ADDRESSING THE NEEDS OF THE UNDERSERVED POPULATIONS BY DOING FREE BLOOD PRESSURE CHECKS, FREE BLOOD SUGAR SCREENINGS, ADDRESSING HEALTH INSURANCE NEEDS, PROVIDING EDUCATION ON HEALTHY EATING, TOBACCO CESSATIONS INFORMATION, AND PROVIDING ACCESS TO HEALTH BY LINKING COMMUNITY MEMBERS TO PRIMARY CARE AND SPECIALTY SERVICES. WHEN WE SCREEN AN INDIVIDUAL IN THE COMMUNITY AND THEIR RESULTS ARE ABNORMAL, IF THEY DON'T HAVE A PRIMARY CARE PHYSICIAN, AND/OR THEY DON'T HAVE HEALTH INSURANCE, WE ARE CONNECTING THEM TO THE PROPER RESOURCES IN ORDER TO GET THEM THE CARE THAT THEY NEED TO PREVENT THEIR SITUATION FROM LEADING TO AN ER VISIT OR ADMISSION. REGULAR MEETINGS ARE HELD WITH A NUMBER OF MENTAL HEALTH ORGANIZATIONS THAT HAVE COME TOGETHER TO LOOK AT HOW WE CAN ADDRESS MENTAL/BEHAVIORAL HEALTH ISSUES AS A COMMUNITY. THE QUAD CITIES MENTAL HEALTH COALITION HAS BEGUN WORK TO LOOK AT HOW WE CAN MAKE PROGRESS TOWARDS IMPROVING THE CHALLENGES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. WE HAVE REPRESENTATIVES FROM ALL OF THE MAJOR MENTAL HEALTH ORGANIZATIONS IN THE QUAD CITIES COMMUNITY TO LOOK AT TOPICS LIKE ACCESS TO SERVICES, EDUCATION, AND SUICIDE PREVENTION. A CHARTER HAS BEEN CREATED AND AN ACTION PLAN IS CURRENTLY BEING DEVELOPED. UNITYPOINT HEALTH - TRINITY IS ALSO SPONSORING COMMUNITY EVENTS TO PROMOTE MENTAL HEALTH AWARENESS AND HOW TO ACCESS MENTAL HEALTH SERVICES IN OUR COMMUNITY. UNITYPOINT HEALTH - TRINITY IS A PART OF THE QUAD CITY HEALTH INITIATIVE THAT CONSIST OF BOTH HEALTH SYSTEMS, BOTH ROCK ISLAND AND SCOTT COUNTY HEALTH DEPARTMENTS, COMMUNITY HEALTH CARE, BUSINESS LEADERS IN OUR COMMUNITY, REPRESENTATION FROM LOCAL SCHOOL DISTRICTS, AS WELL AS MEMBERS FROM OUR LOCAL GOVERNMENTS. THERE ARE MULTIPLE PROJECTS UNDERWAY TO PROMOTE HEALTHY LIVING AND EXERCISE. SOME OF THESE PROJECTS INCLUDE COMMUNITY GARDENS, SAFE ROUTES TO SCHOOLS FOR CHILDREN, PUBLICIZING AND MAPPING LOCAL HIKE AND BIKE TRAILS, AND ADVERTISING TO PROMOTE THE BENEFITS OF MAKING HEALTHIER FOOD CHOICES. A CREATIVE MARKETING PLAN HAS BEEN DEVELOPED, AND HAS BEEN RECOGNIZES BY THE CDC FOR ITS CREATIVITY, TO REACH KIDS TO SHARE WITH THEM HOW TO EAT HEALTHIER AND EXERCISE MORE. A PARTNERSHIP HAS ALSO BEEN ESTABLISHED WITH GLOBAL COMMUNITIES. THROUGH THE EFFORTS OF GLOBAL COMMUNITIES, WE HAVE PARTNERED WITH OTHER ORGANIZATIONS HELP MEETING THE NEEDS OF MINORITY POPULATIONS WITHIN OUR COMMUNITY. SOME OF THESE PARTNERS INCLUDE HABITAT FOR HUMANITY, THE ESPERANZA CENTER, PALOMARES CRIMINAL JUSTICE CENTER, THE BOYS & GIRLS CLUB, AND A NUMBER OF OTHER SMALL BUSINESSES AND NON-PROFIT ORGANIZATIONS. WE ARE WORKING WITH THESE GROUPS TO ADDRESS WORKFORCES AND EDUCATION CHALLENGES, HEALTH, AND ECONOMIC DEVELOPMENT WITHIN THE COMMUNITY. THE THREE YEAR COMMITMENT TO THIS ORGANIZATION IS TO HELP THIS COMMUNITY GAIN ACCESS TO THE RESOURCES ITS NEEDS TO THRIVE IN THE QUAD CITIES. WE ARE ALSO UTILIZING A COMMITTEE TO EVALUATE AND SCORE ALL SPONSORSHIP OPPORTUNITIES AND THE IMPACT ON AWARENESS AND EDUCATION IN OUR KEY FOCUS AREAS, WITH A KEEN FOCUS ON HEART, DIABETES, MENTAL HEALTH. WE ARE RELYING ON OUR ESTABLISHED PARTNERSHIPS WITHIN TO COMMUNITY TO COORDINATE WITH US IN PROMOTING HEALTH AND WELLNESS THROUGHOUT THE QUAD CITIES. WE ARE TARGETING AREAS AND POPULATIONS WE FEEL ARE IN THE NEED OF EDUCATION AND SERVICES THE MOST TO MAKE THE BIGGEST IMPACT POSSIBLE WITH OUR STAFFING AND EQUIPMENT. OUR GOAL IS TO CONTINUE TO LIVE OUT OUR MISSION DAILY BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. ON AN ANNUAL BASIS WE WILL PROVIDE AN UPDATED REPORT TO THE MISSION EFFECTIVENESS COMMITTEE, THIS IS A STANDING COMMITTEE OF TRINITY'S BOARD OF DIRECTORS. WE ARE WORKING TO SHOW RESULTS IMPACTING EACH OF OUR TARGETED AREAS. THIS COMMITTEE PROVIDES OVERSIGHT AND DIRECTION FOR THE WORK THAT WE ARE DOING IN THE COMMUNITY TO MEET OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. AN ANNUAL REPORT WILL ALSO GO TO THE TRINITY MEDICAL CENTER BOARD OF TRUSTEES AND TRINITY'S SENIOR LEADERSHIP TEAM. GROUP A-FACILITY 2 -- TRINITY MEDICAL CENTER - MOLINE PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND . IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. GROUP A-FACILITY 3 -- TRINITY MEDICAL CENTER - BETTENDORF PART V, SECTION B, LINE 5: FOLLOWING STEERING COMMITTEE MEMBERS:BROOKE BARNES, SCOTT COUNTY HEALTH DEPARTMENTTOM BOWMAN, COMMUNITY HEALTH CAREDENISE BULAT, BI-STATE REGIONAL COMMISSIONANDY BURMAN, GENESIS HEALTH SYSTEMNICOLE CARKNER, QUAD CITY HEALTH INITIATIVE KEN CROKEN, GENESIS HEALTH SYSTEMRACHEL EVANS, QUAD CITY HEALTH SYSTEMDANIEL JOINER, UNITYPOINT HEALTH - TRINITY NITA LUDWIG, ROCK ISLAND COUNTY HEALTH DEPARTMENT ED RIVERS, SCOTT COUNTY HEALTH DEPARTMENT CHRISTY A. ROBY WILLIAMS, UNITYPOINT HEALTH - TRINITY PAT SHOUSE, UNITYPOINT HEALTH - TRINITY TIFFANY TJEPKES, SCOTT COUNTY HEALTH DEPARTMENT GROUP A-FACILITY 3 -- TRINITY MEDICAL CENTER - BETTENDORF PART V, SECTION B, LINE 6A: GENESIS HEALTH SYSTEM GROUP A-FACILITY 3 -- TRINITY MEDICAL CENTER - BETTENDORF PART V, SECTION B, LINE 6B: COMMUNITY HEALTH CARE, QUAD CITY HEALTH INITIATIVE, ROCK ISLAND COUNTY PUBLIC HEALTH DEPARTMENT, AND SCOTT COUNTY PUBLIC HEALTH DEPARTMENT. GROUP A-FACILITY 3 -- TRINITY MEDICAL CENTER - BETTENDORF PART V, SECTION B, LINE 11: UNITYPOINT HEALTH - TRINITY IS IN THE MIDST OF ITS THREE YEAR PLAN THAT ADDRESSES THE TOP HEALTH ISSUES FOUND IN OUR CHNA REPORT COMPLETED IN 2015. WE HAVE CREATED A STRONG WORKING GROUPS CONSISTING OF MULTIPLE DEPARTMENTS AND COMMUNITY COLLABORATIONS THAT HAVE IDENTIFIED WAYS TO ADDRESS MAJOR HEALTH CHALLENGES IN OUR COMMUNITY. WE ARE WORKING IN COLLABORATION WITH A NUMBER OF COMMUNITY PARTNERS SUCH AS HABITAT FOR HUMANITY, RIVER BEND FOODBANK, AND GLOBAL COMMUNITIES, TO NAME A FEW. DURING COMMUNITY EVENTS WE ARE ADDRESSING THE NEEDS OF THE UNDERSERVED POPULATIONS BY DOING FREE BLOOD PRESSURE CHECKS, FREE BLOOD SUGAR SCREENINGS, ADDRESSING HEALTH INSURANCE NEEDS, PROVIDING EDUCATION ON HEALTHY EATING, TOBACCO CESSATIONS INFORMATION, AND PROVIDING ACCESS TO HEALTH BY LINKING COMMUNITY MEMBERS TO PRIMARY CARE AND SPECIALTY SERVICES. WHEN WE SCREEN AN INDIVIDUAL IN THE COMMUNITY AND THEIR RESULTS ARE ABNORMAL, IF THEY DON'T HAVE A PRIMARY CARE PHYSICIAN, AND/OR THEY DON'T HAVE HEALTH INSURANCE, WE ARE CONNECTING THEM TO THE PROPER RESOURCES IN ORDER TO GET THEM THE CARE THAT THEY NEED TO PREVENT THEIR SITUATION FROM LEADING TO AN ER VISIT OR ADMISSION. REGULAR MEETINGS ARE HELD WITH A NUMBER OF MENTAL HEALTH ORGANIZATIONS THAT HAVE COME TOGETHER TO LOOK AT HOW WE CAN ADDRESS MENTAL/BEHAVIORAL HEALTH ISSUES AS A COMMUNITY. THE QUAD CITIES MENTAL HEALTH COALITION HAS BEGUN WORK TO LOOK AT HOW WE CAN MAKE PROGRESS TOWARDS IMPROVING THE CHALLENGES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. WE HAVE REPRESENTATIVES FROM ALL OF THE MAJOR MENTAL HEALTH ORGANIZATIONS IN THE QUAD CITIES COMMUNITY TO LOOK AT TOPICS LIKE ACCESS TO SERVICES, EDUCATION, AND SUICIDE PREVENTION. A CHARTER HAS BEEN CREATED AND AN ACTION PLAN IS CURRENTLY BEING DEVELOPED. UNITYPOINT HEALTH - TRINITY IS ALSO SPONSORING COMMUNITY EVENTS TO PROMOTE MENTAL HEALTH AWARENESS AND HOW TO ACCESS MENTAL HEALTH SERVICES IN OUR COMMUNITY. UNITYPOINT HEALTH - TRINITY IS A PART OF THE QUAD CITY HEALTH INITIATIVE THAT CONSIST OF BOTH HEALTH SYSTEMS, BOTH ROCK ISLAND AND SCOTT COUNTY HEALTH DEPARTMENTS, COMMUNITY HEALTH CARE, BUSINESS LEADERS IN OUR COMMUNITY, REPRESENTATION FROM LOCAL SCHOOL DISTRICTS, AS WELL AS MEMBERS FROM OUR LOCAL GOVERNMENTS. THERE ARE MULTIPLE PROJECTS UNDERWAY TO PROMOTE HEALTHY LIVING AND EXERCISE. SOME OF THESE PROJECTS INCLUDE COMMUNITY GARDENS, SAFE ROUTES TO SCHOOLS FOR CHILDREN, PUBLICIZING AND MAPPING LOCAL HIKE AND BIKE TRAILS, AND ADVERTISING TO PROMOTE THE BENEFITS OF MAKING HEALTHIER FOOD CHOICES. A CREATIVE MARKETING PLAN HAS BEEN DEVELOPED, AND HAS BEEN RECOGNIZES BY THE CDC FOR ITS CREATIVITY, TO REACH KIDS TO SHARE WITH THEM HOW TO EAT HEALTHIER AND EXERCISE MORE. A PARTNERSHIP HAS ALSO BEEN ESTABLISHED WITH GLOBAL COMMUNITIES. THROUGH THE EFFORTS OF GLOBAL COMMUNITIES, WE HAVE PARTNERED WITH OTHER ORGANIZATIONS HELP MEETING THE NEEDS OF MINORITY POPULATIONS WITHIN OUR COMMUNITY. SOME OF THESE PARTNERS INCLUDE HABITAT FOR HUMANITY, THE ESPERANZA CENTER, PALOMARES CRIMINAL JUSTICE CENTER, THE BOYS & GIRLS CLUB, AND A NUMBER OF OTHER SMALL BUSINESSES AND NON-PROFIT ORGANIZATIONS. WE ARE WORKING WITH THESE GROUPS TO ADDRESS WORKFORCES AND EDUCATION CHALLENGES, HEALTH, AND ECONOMIC DEVELOPMENT WITHIN THE COMMUNITY. THE THREE YEAR COMMITMENT TO THIS ORGANIZATION IS TO HELP THIS COMMUNITY GAIN ACCESS TO THE RESOURCES ITS NEEDS TO THRIVE IN THE QUAD CITIES. WE ARE ALSO UTILIZING A COMMITTEE TO EVALUATE AND SCORE ALL SPONSORSHIP OPPORTUNITIES AND THE IMPACT ON AWARENESS AND EDUCATION IN OUR KEY FOCUS AREAS, WITH A KEEN FOCUS ON HEART, DIABETES, MENTAL HEALTH. WE ARE RELYING ON OUR ESTABLISHED PARTNERSHIPS WITHIN TO COMMUNITY TO COORDINATE WITH US IN PROMOTING HEALTH AND WELLNESS THROUGHOUT THE QUAD CITIES. WE ARE TARGETING AREAS AND POPULATIONS WE FEEL ARE IN THE NEED OF EDUCATION AND SERVICES THE MOST TO MAKE THE BIGGEST IMPACT POSSIBLE WITH OUR STAFFING AND EQUIPMENT. OUR GOAL IS TO CONTINUE TO LIVE OUT OUR MISSION DAILY BY IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. ON AN ANNUAL BASIS WE WILL PROVIDE AN UPDATED REPORT TO THE MISSION EFFECTIVENESS COMMITTEE, THIS IS A STANDING COMMITTEE OF TRINITY'S BOARD OF DIRECTORS. WE ARE WORKING TO SHOW RESULTS IMPACTING EACH OF OUR TARGETED AREAS. THIS COMMITTEE PROVIDES OVERSIGHT AND DIRECTION FOR THE WORK THAT WE ARE DOING IN THE COMMUNITY TO MEET OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE. AN ANNUAL REPORT WILL ALSO GO TO THE TRINITY MEDICAL CENTER BOARD OF TRUSTEES AND TRINITY'S SENIOR LEADERSHIP TEAM. GROUP A-FACILITY 3 -- TRINITY MEDICAL CENTER - BETTENDORF PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND . IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. FACILITY REPORTING GROUP - A, PART V, SECTION B, LINE 16 A AND B HTTP://WWW.UNITYPOINT.ORG/QUADCITIES/FINANCIAL-ASSISTANCE.ASPX 3 1 - TRINITY CENTER FOR WOUND CARE 4480 UTICA RIDGE ROAD SUITE 110 BETTENDORF IA 52722 OUTPATIENT ONLY 2 - TRINITY OUTPATIENT REHABILITATION SERVIC 4480 UTICA RIDGE ROAD SUITE 102 BETTENDORF IA 52722 OUTPATIENT ONLY 3 - QUAD CITY AMBULATORY SURGERY CENTER 520 VALLEY VIEW DRIVE SUITE 300 MOLINE IL 61265 AMBULATORY SURGERY CENTER PART I, LINE 6A: TRINITY MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM CONSOLIDATED COMMUNITY BENEFIT REPORT WHICH IS POSTED ON ITS WEBSITE AT WWW.UNITYPOINT.ORG.IN ADDITION, THE HOSPITAL AND ITS REGIONAL AFFILIATES PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS POSTED ON ITS WEBSITE AT WWW.UNITYPOINT/QUADCITIES/DEFAULT.ASPX. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 80,899. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES ARE ESSENTIAL ROLES FOR HEALTH-CARE ORGANIZATIONS IN THAT THEY ADDRESS MANY OF THE UNDERLYING DETERMINANTS OF HEALTH. RESEARCH HAS CONTINUALLY SHOWN THAT WHEN THE FACTORS INFLUENCING HEALTH ARE EXPLORED, HEALTH CARE ACTUALLY PLAYS THE SMALLEST ROLE PROPORTIONATELY. A REPORT IN THE JOURNAL OF AMERICAN MEDICAL ASSOCIATION AND THE CENTER FOR DISEASE CONTROL (MCGINNIS, 1996) SUGGESTS THAT THE FACTORS IMPACTING HEALTH ARE AS FOLLOWS: LIFESTYLE AND BEHAVIORS, 50%, ENVIRONMENT (HUMAN AND NATURAL), 20%, GENETICS AND HUMAN BIOLOGY, 20%, AND HEALTH CARE, 10%. COMMUNITY BUILDING ACTIVITIES HELP TO ADDRESS THE OTHER INDICATORS OUTSIDE OF THE ROLE TRADITIONALLY PLAYED BY HEALTH-CARE ORGANIZATIONS. THESE ACTIVITIES ARE ALMOST EXCLUSIVELY DONE IN SOME FORM OF PARTNERSHIP IN WHICH THE COMMUNITY OR OTHER ORGANIZATIONS ARE BETTER SUITED TO ADDRESS. HEALTH-CARE ORGANIZATIONS GENERALLY PROVIDE TIMELY AND SPECIFIC RESOURCES TO HELP THESE ISSUES. HEALTH-CARE ORGANIZATIONS CAN BE A RICH AND VALUABLE COMMUNITY RESOURCE IN WAYS NOT TYPICALLY CONSIDERED. OFTEN THE MOST EFFECTIVE WAY TO HELP IMPACT AND IMPROVE THE COMMUNITY HEALTH STATUS IS TO SUPPORT OTHER AGENCIES AND ORGANIZATIONS IN A VARIETY OF WAYS OUTSIDE OF HEALTH SERVICES. THIS IS OFTEN DONE THROUGH CASH OR IN-KIND SERVICES TO SUPPORT OTHER NON-PROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO CERTAIN AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. TRINITY MEDICAL CENTER CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THESE DONATIONS ALLOW OTHER NON-PROFIT ORGANIZATIONS TO FULFILL THEIR MISSIONS TO IMPROVE THE WELL BEING OF THE COMMUNITY AND CONTRIBUTE TO ITS OVERALL HEALTH STATUS IN WAYS THAT MAY DIFFER FROM THE DIRECT SERVICES OF THE HOSPITAL ORGANIZATION AND MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. TRINITY MEDICAL CENTER EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, TRINITY MEDICAL CENTER EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COLLABORATE TO ADDRESS COMPLEX HEALTH ISSUES. THESE TYPES OF ACTIVITIES SPEAK TO THE BREADTH AND CAPACITY THAT THE HOSPITAL HAS IN IMPACTING THE HEALTH STATUS OF THE COMMUNITY IN A COMPREHENSIVE AND INTENTIONAL APPROACH. PART III, LINE 4: THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT.THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING IRS WORKSHEET 2 'RATIO OF PATIENT CARE COST TO CHARGES' TO CALCULATE THE COST TO CHARGE RATIO FOR TRINITY MEDICAL CENTER. THIS RATIO WAS THEN APPLIED AGAINST THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS USING IRS WORKSHEET A TO ARRIVE AT THE BAD DEBT EXPENSE AT COST REPORTED ON LINE 2. PART III, LINE 8: AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B 'TOTAL MEDICARE ALLOWABLE COSTS.' THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE.THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE ORGANIZATION'S COST ACCOUNTING SYSTEM CALCULATES A MEDICARE SHORTFALL OF $13,868,978. IN ADDITION TO THESE ITEMS THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM DO NOT INCLUDE MEDICARE PHYSICIAN FEE SCHEDULE EXPENSE AND REVENUE.THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. PART VI, LINE 2: TRINITY MEDICAL CENTER CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN THE QUAD CITY AREA OF IOWA AND ILLINOIS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. IT'S PRIMARY "COMMUNITY HEALTH ASSESSMENT" PARTNERS ARE THE SCOTT COUNTY PUBLIC HEALTH DEPARTMENT, THE ROCK ISLAND COUNTY HEALTH DEPARTMENT, THE COMMUNITY HEALTH CARE CENTER (AN FAQC), GENESIS MEDICAL CENTER AND THE QUAD CITY HEALTH INIITIATIVE. (THE QUAD CITY HEALTH INITIATIVE IS JOINTLY SPONSORED BY TRINITY MEDICAL CENTER AND GENESIS MEDICAL CENTER). THIS COLLABORATION CONTINUES AND EXISTS TO FACILITATE COORDINATION AND NON-DUPLICATION OF EFFORT AMONG THE PARTNERS AS WE ALL DEVELOP PROGRAMS AND SERVICES DESIGNED TO RESPOND TO THE NEEDS IDENTIFIED IN THE ASSESSMENT. AS NOTED EARLIER, TRINITY MEDICAL CENTER AND GENESIS HEALTH SYSTEM ARE THE SPONSORING PARTNERS OF THE QUAD CITY HEALTH INITIATIVE (QCHI). QCHI IS A COMMUNITY PARTNERSHIP WORKING TO CREATE A HEALTHY COMMUNITY. IT CONSISTS OF OVER 200 VOLUNTEERS FROM ALL WALKS OF LIFE, AS WELL AS A BOARD OF DIRECTORS WHOSE MEMBERS ARE REPRESENTATIVE OF THE COMMUNITY IN TERMS OF SOCIO-ECONOMIC VARIABLES AND COMMUNITY LEADERSHIP. THE BOARD MEETS QUARTERLY. QCHI IS ONE OF THE RESOURCES THAT TRINITY UTILIZES WHEN ADDRESSING THE COMMUNIITY'S HEALTH NEEDS. TRINITY'S MISSION EFFECTIVENESS COMMITTEE WHICH CONSISTS OF AREA CLERGY, PHYSICIANS, REPRESENTATIVES OF THE BUSINESS AND SOCIAL SERVICE COMMUNITIES AND TRINITY SENIOR LEADERSHIP IS ANOTHER INVALUABLE RESOURCE UTILIZED TO DEVELOP AND MONITOR TRINITY'S COMMUNITY BENEFITS PLAN. THE PLAN IDENTIFIES SPECIFIC HEALTH PRIORITIES, STRATEGIES AND PLANS OF ACTION TO ADDRESS THOSE NEEDS WHICH ARE CONSISTENT WITH ITS MISSION AND CAPACITY. TRINITY'S EFFORTS TO "IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE" ARE MONITORED IN PART BY THE OTHER PARTNER AGENCIES CITED EARLIER I.E. SCOTT COUNTY PUBLIC HEALTH DEPARTMENT, COMMUNITY HEALTH CARE CENTER, ROCK ISLAND COUNTY PUBLIC HEALTH DEPARTMENT AND GENESIS MEDICAL CENTER AS WELL AS BY THE MISSION EFFECTIVENESS COMMITTEE. THE LATTER IS A STANDING COMMITTEE OF TRINITY REGIONAL HEALTH SYSTEM'S BOARD AND MEETS A MINIMUM OF FOUR TIMES A YEAR. ADDITIONALLY, THE QUAD CITY HEALTH INITIATIVE MONITORS AND REPORTS SPECIFIC INDICATORS TO AID IN THE DEVELOPMENT OF NEW PLANS OR REFINING EXISTING ONES. TRINITY MEDICAL CENTER ALSO PARTICIPATES AS PART OF THE UNITED WAY COMMUNITY IMPACT COMMITTEE. THIS GROUP ACTIVELY ADDRESSES NEED AND STRATEGIES ASSOCIATED WITH HEALTH. MORE SPECIFICALLY, THIS GROUP OFTEN FOCUSES ON THE SOCIAL DETERMINANTS OF HEALTH AND HOW TO IMPACT THEM IN THE EFFORT TO RAISE THE COMMUNITY HEALTH STATUS. THIS WIDE BASED COLLABORATIVE PROVIDES OPPORTUNITIES FOR TRINITY MEDICAL CENTER TO ENGAGE IN VARIOUS AREAS OF SERVICE TO THE COMMUNITY THAT MAY BE OUTSIDE OF ITS TYPICAL EXPERTISE BUT WITHIN ITS EXISTING RESOURCES. IN ADDITION TO THESE ORGANIZED COMMUNITY EFFORTS, TRINITY MEDICAL CENTER CONTINUALLY MONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS OFTEN WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT. PART VI, LINE 3: THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ALL PATIENTS AND WITHIN THE COMMUNITY. COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. THE CENTRAL BILLING OFFICE IS AVAILABLE BY PHONE TO ANSWER QUESTIONS ABOUT THE POLICY, OR PATIENTS SHOULD GO TO THE CASHIER'S OFFICE AT THE HOSPITAL TO OBTAIN THIS INFORMATION. THE PLAIN LANGUAGE SUMMARY IS OFFERED AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS AND INCLUDED WHEN A PATIENT IS SENT WRITTEN NOTICE THAT EXTRAORDINARY COLLECTION ACTIONS MAY BE TAKEN AGAINST HIM/HER. THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY, AND ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE IN WHICH LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS CONSTITUTE THE LESSER OF 1,000 PERSONS OR MORE THAN 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE TRANSLATED DOCUMENTS WILL BE AVAILABLE BY MAIL, ON EACH HOSPITAL'S WEBSITE, AND IN PERSON AT EACH HOSPITAL. PART VI, LINE 4: UNITYPOINT HEALTH - TRINITY IS A 515-BED COMMUNITY HOSPITAL SERVING EASTERN IOWA AND WESTERN ILLINOIS. UNITYPOINT HEALTH - TRINITY IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF UNITYPOINT HEALTH - TRINITY'S MARKET RESIDENTS LIVE WITHIN THE ILLINOIS AND IOWA COUNTIES OF ROCK ISLAND AND SCOTT, RESPECTIVELY.UNITYPOINT HEALTH - TRINITY ADMITS APPROXIMATELY 19,000 INPATIENTS AND CARES FOR 90,500 EMERGENCY PATIENTS PER YEAR. MEDIAN HOUSEHOLD INCOMES RANGE FROM $48,226 TO $53,704 AND THE AVERAGE POVERTY RATE IS 10%. 62% OF UNITYPOINT HEALTH - TRINITY INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. ROCK ISLAND COUNTY IS 82% CAUCASION, 12% HISPANIC, AND 10% AFRICAN AMERICAN. SCOTT COUNTY IS 86% CAUCASION, 8% AFRICAN AMERICAN, AND 6% HISPANIC. PART VI, LINE 5: THE HOSPITAL IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE HOSPITAL SUPPORTS THIS MISSION WITH A COMMUNITY BOARD, OPEN MEDICAL STAFF, AND AN EMERGENCY ROOM AVAILABLE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE BOARD OF DIRECTORS OF THE HOSPITAL IS COMPOSED OF CIVIC LEADERS WHO RESIDE IN THE SERVICE AREA OF THE HOSPITAL. THE BOARD ACTIVELY DEBATES AND SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL BUT DOES NOT GET INVOLVED IN ISSUES RELATED TO THE DIRECT OPERATIONS OF THE HOSPITAL. THE BOARD TAKES A BALANCED APPROACH WHEN ADDRESSING COMMUNITY AND BUSINESS/FINANCIAL CONCERNS. THE BOARD IS ALSO THE PRIMARY GROUP FOR DETERMINING THE USE OF HOSPITAL SURPLUS FUNDS, WHICH ARE ALL USED TO FURTHER OUR CHARITABLE PURPOSE. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). INITIALLY FORMED IN 1994, UNITYPOINT HEALTH IS THE STATE'S FIRST AND LARGEST INTEGRATED HEALTH SYSTEM, SERVING NEARLY ONE OF EVERY THREE PATIENTS IN IOWA. THROUGH RELATIONSHIPS WITH 32 HOSPITALS IN METROPOLITAN AND RURAL COMMUNITIES AND MORE THAN 280 PHYSICIAN CLINICS, UNITYPOINT HEALTH PROVIDES CARE THROUGHOUT IOWA, ILLINOIS, AND SOUTHERN WISCONSIN.UNITYPOINT HEALTH ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 30,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, THROUGH MORE THAN 4.5 MILLION PATIENT VISITS, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. WITH ANNUAL REVENUES OF $3.9 BILLION, UNITYPOINT HEALTH IS THE FOURTH LARGEST NONDENOMINATIONAL HEALTH SYSTEM IN AMERICA AND PROVIDES COMMUNITY BENEFIT PROGRAMS AND SERVICES TO IMPROVE THE HEALTH OF PEOPLE IN ITS COMMUNITIES. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES THROUGHOUT IOWA, AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THE STATE. IN 2015, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $507 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. PART VI, LINE 7, REPORTS FILED WITH STATES IL,IA 1 IOWA HEALTH SYSTEM 1776 WEST LAKES PARKWAY WEST DES MOINES IA 50266 421435199 501(C)(3) 19882569 PROGRAM SUPPORT FRIENDS OF TRINITY (AUXILIARY) 2701 17TH ST ROCK ISLAND IL 61202 362739299 501(C)(3) 59165 PROGRAM SUPPORT THE ROBERT YOUNG CENTER FOR COMMUNITY MENTAL HEALTH 2701 17TH ST ROCK ISLAND IL 61202 363678909 501(C)(3) 417828 PROGRAM SUPPORT TRINITY HEALTH FOUNDATION 2701 17TH ST ROCK ISLAND IL 61202 363321751 501(C)(3) 803678 PROGRAM SUPPORT 4 0 PART I, LINE 2: TRINITY MEDICAL CENTER REQUIRES EACH RECIPIENT OF THE GRANTS MENTIONED IN PART II & III (OTHER THAN ASSISTANCE TO RELATED ORGANIZATIONS IN THE FORM OF WORKING CAPITAL) TO APPLY FOR THE GRANT AND OUTLINES A SERIES OF ELIGIBLITY STANDARDS THAT ARE REQUIRED TO BE MET. THE ORGANIZATION THEN REVIEWS THESE APPLICATIONS, AND BASED ON NEED AND ELIGIBILITY, A COMMITTEE MAKES THE FINAL DECISION ON ALL GRANT RECIPIENTS. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 ROBERT CHESSER MD BOARD MEMBER 0 277892 0 12627 0 5494 0 14170 0 14747 0 324930 0 0 RICHARD SEIDLER BOARD MEMBER/PRESIDENT/CEO 554851 0 114259 0 57715 0 167543 0 14892 0 909260 0 0 0 TAMARA BYRAM MAHL VP LEGAL & COMPLIANCE 160369 0 33946 0 23125 0 15221 0 25185 0 257846 0 0 0 PAUL MCLOONE MD CMO/CQO 342257 0 69739 0 18931 0 20295 0 20517 0 471739 0 0 0 GREG PAGLIUZZA JR VP FINANCE/CFO 331843 0 65114 0 35698 0 70567 0 19096 0 522318 0 0 0 JAY WILLSHER EXEC VP/COO 333715 0 65093 0 24974 0 92871 0 20643 0 537296 0 0 0 SUSAN BESWICK DIR EMERGENCY SERVICES 142473 0 7725 0 608 0 10501 0 14250 0 175557 0 0 0 DAVID DEOPERE PRESIDENT RYC (TO 9/15) & VICE PRESI 404913 0 45815 0 54173 0 26998 0 12652 0 544551 0 0 0 DENNIS DUKE FR 515 PRESIDENT RYC 172497 0 11028 0 9614 0 13482 0 18719 0 225340 0 0 0 CARA FULLER VP HUMAN RESOURCES 235595 0 43593 0 21729 0 20822 0 11172 0 332911 0 0 0 TAMMY PAUWELS EXEC DIR OUTPATIENT SVCS 155538 0 11337 0 7405 0 12031 0 6191 0 192502 0 0 0 KATHERINE PEARSON CHIEF STRATEGY OFFICER 295660 0 71107 0 32741 0 55950 0 12503 0 467961 0 0 0 MARY PETERSEN DIR BEHAV HLTH SVC 143938 0 12333 0 6869 0 8022 0 2652 0 173814 0 0 0 TRACY POELVOORDE CHANCELLOR 142775 0 28780 0 22067 0 12289 0 12371 0 218282 0 0 0 ROCHELLE TINMAN DIR NURSING EXCELLENCE 145550 0 13318 0 590 0 10919 0 6433 0 176810 0 0 0 DOUG GAITHER MD PHYSICIAN-ER/TRAUMA 573623 0 11400 0 30717 0 23243 0 401 0 639384 0 0 0 KEVIN KURTH MD MEDICAL DIRECTOR-ER/TRAUMA 580444 0 4200 0 15806 0 25572 0 19502 0 645524 0 0 0 TOYOSI OLUTADE MD PHYSICIAN HOSPITALIST 621572 1260 3000 0 317 0 27586 63 19210 0 671685 1323 0 0 AAMIR PASHA MD PHYSICIAN HOSPITALIST 510613 0 0 0 834 0 20295 0 24728 0 556470 0 0 0 WILLIAM ROGERS III MD PHYSICIAN-ER/TRAUMA 537959 0 11400 0 30499 0 20295 0 21276 0 621429 0 0 0 TOM TIBBITTS TO 610 FORMER INTERIM PRESIDENT/CEO 0 0 0 0 0 159620 0 1559 0 0 0 161179 0 159620 CINDA BATES TO 212 FORMER UTILIZATION MGMT SPECIALIST 150405 0 3023 0 7525 0 11551 0 20700 0 193204 0 0 0 KATHLEEN CUNNINGHAM TO 511 FORMER VP QUALITY 0 215973 0 59454 0 15143 0 13238 0 6698 0 310506 0 0 RICHARD MURPHY FORMER CFO RYC 72148 0 8538 0 20620 0 6196 0 8254 0 115756 0 0 0 BOBETTE PATTERSON FORMER DIR OPERATIONS/DIR CARDIOVASC 119005 0 8800 0 20892 0 10428 0 19866 0 178991 0 0 0 PART I, LINE 1A TRAVEL FOR COMPANIONS: SPOUSES SOMETIMES ACCOMPANY BOARD MEMBERS AND/OR OFFICERS ON ORGANIZATIONAL ACTIVITIES, INCLUDING BOARD RELATED TRAVEL. THE ADDITIONAL COST ATTRIBUTABLE TO THE SPOUSE IS TREATED AS TAXABLE COMPENSATION TO THE BOARD MEMBER OR OFFICER AND REPORTED AS APPROPRIATE TO THE IRS. PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: DAVID DEOPERE $6,703, GREG PAGLIUZZA JR. $49,005, KATHERINE PEARSON $35,655, RICHARD SEIDLER $146,008, TOM TIBBITTS $1,559, AND JAY WILLSHER $71,731. THE FOLLOWING INDIVIDUAL RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: TOM TIBBITTS $159,620. ADVANCED IMAGING CENTER LC COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE 940000 INVESTMENT 0 CARDIOVASCULAR MEDICINE PC COMMON BOARD MEMBER/OFFICER 1873455 PROFESSIONAL SERVICES 0 IOWA HEALTH SYSTEM CONTRACTING SERVICES LC COMMON BOARD MEMBER/OFFICER 1490842 PERFORMANCE OF SERVICE 0 KAREN SCOTT FAMILY MEMBER OF KEY EMPLOYEE DAVID DEOPERE 111735 EMPLOYMENT 0 MEDICAL ARTS ASSOCIATES LTD PC COMMON BOARD MEMBER/OFFICER 943216 RENT AND MEDICAL SERVICES 0 METRO MRI CENTER LIMITED PARTNERSHIP COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE 1103000 INVESTMENT AND IMAGING SERVICES 0 MISSISSIPPI VALLEY SURGERY CENTER COMMON BOARD MEMBER/OFFICER 549270 INVESTMENT 0 QUAD CITY AMBULATORY SURGERY CENTER LLC COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE 3355000 INVESTMENT 0 REGIONAL HEALTH PARTNERS LLC COMMON BOARD MEMBER/OFFICER 356786 INVESTMENT 0 REVA BESWICK FAMILY MEMBER OF KEY EMPLOYEE SUSAN BESWICK 15295 EMPLOYMENT 0 THOMAS MEEGAN FAMILY MEMBER OF KEY EMPLOYEE TAMMY PAUWELS 47229 EMPLOYMENT 0 TRINITY BETTENDORF ORTHOPEDIC CO-MANAGEMENT COMPANY LLC COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE 345918 INVESTMENT AND MANAGEMENT SERVICES 0 TRINITY ONCOLOGY SERVICES CO-MANAGEMENT COMPANY LLC COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE 813057 INVESTMENT AND MANAGEMENT SERVICES 0 TRINITY PHYSICIAN HOSPITAL ORGANIZATION LTD COMMON BOARD MEMBER/OFFICER/KEY EMPLOYEE 65453 INVESTMENT 0 FORM 990, PART VI, SECTION A, LINE 6 TRINITY REGIONAL HEALTH SYSTEM, A TAX-EXEMPT ILLINOIS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A TRINITY REGIONAL HEALTH SYSTEM'S MAY APPOINT ONE BOARD MEMBER AND APPROVES ALL OTHERS. FORM 990, PART VI, SECTION A, LINE 7B TRINITY REGIONAL HEALTH SYSTEM, AS SOLE MEMBER, APPROVES AMENDMENTS TO ARTICLES, BYLAWS AND MISSION, MAY REMOVE ANY TRUSTEE WITH OR WITHOUT CAUSE, APPOINTS CEO AND VICE PRESIDENT, APPROVES MERGERS, CREATION OF SUBSIDIARY OR AFFILIATE ORGANIZATIONS, AND APPROVES BUDGETS AND LONG-RANGE STRATEGY. TRINITY REGIONAL HEALTH SYSTEM AND IOWA HEALTH SYSTEM MUST APPROVE DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED INTERNALLY BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A DRAFT COPY OF THE RETURN IS PROVIDED TO THE CFO FOR REVIEW. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. SENIOR ADMINISTRATIVE STAFF AT ALL RELATED ORGANIZATIONS PROVIDE INFORMATION TO A CENTRAL COORDINATOR RELATED TO THE IDENTIFICATION OF WHICH INDIVIDUALS SHOULD RECEIVE THE QUESTIONNAIRE FOR COMPLETION. THE RESULTS ARE COMPILED CENTRALLY AND REVIEWED BY THE IOWA HEALTH SYSTEM COMPLIANCE OFFICER AND DIRECTOR OF INTERNAL AUDIT. THE DETAIL RESULTS ARE REPORTED TO A COMMITTEE OF THE SYSTEM BOARD. THE RESULTS RELATED TO SPECIFIC REGIONAL PARENT COMPANIES, THEIR HOSPITALS AND RELATED ORGANIZATIONS, ARE DISTRIBUTED IN DETAIL TO THE CHAIRPERSON OF THE REGIONAL PARENT ORGANIZATION, THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER AND COMPLIANCE MANAGER. THESE INDIVIDUALS ARE ALSO REMINDED OF THE APPROPRIATE PROCESS TO BE FOLLOWED DURING THE YEAR TO ADDRESS POTENTIAL CONFLICTS OF INTEREST THAT RELATE TO MATTERS THAT ARE BROUGHT TO THE BOARD OF DIRECTORS FOR ACTION. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUAL'S HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATION'S BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE ANNUAL REVIEW OF ALL COMPENSATION AND BENEFITS PROVIDED TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INCLUDING THE IHS CHIEF EXECUTIVE OFFICER (THE "CEO"). THIS ANNUAL REVIEW COMPARES THE TOTAL COMPENSATION AND VALUE OF BENEFITS PROVIDED TO EACH EXECUTIVE, ON A POSITION BY POSITION BASIS, TO THAT PROVIDED TO FUNCTIONALLY SIMILAR POSITIONS IN SIMILARLY SITUATED ORGANIZATIONS. THIS REVIEW IS CONDUCTED BY THE COMMITTEE WITH THE ASSISTANCE OF A NATIONAL, INDEPENDENT COMPENSATION CONSULTANT REPORTING DIRECTLY TO THE COMMITTEE. THE COMMITTEE HAS BEEN DELEGATED THE RESPONSIBILITY FOR OVERSIGHT OF EXECUTIVE COMPENSATION AND IS MADE UP ENTIRELY OF INDEPENDENT DIRECTORS WITHIN THE MEANING OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL INCOME TAX INTERMEDIATE SANCTIONS RULES. THE COMPENSATION CONSULTANT HOLDS ITSELF OUT TO THE PUBLIC AS A COMPENSATION CONSULTANT, PERFORMS THESE VALUATIONS ON A REGULAR BASIS, IS QUALIFIED TO MAKE THE VALUATIONS OF THE SERVICES INVOLVED, AND HAS SO INDICATED IN A WRITTEN CERTIFICATION TO THE COMMITTEE. BASED UPON THE ADVICE OF THE COMPENSATION CONSULTANT, AND APPLYING THE BOARD'S COMPENSATION PHILOSOPHY, THE COMMITTEE ESTABLISHES THE OVERALL ADJUSTMENT IN COMPENSATION AND BENEFITS FOR APPROXIMATELY THE TOP FIFTY EXECUTIVES IN THE ENTIRE HEALTH SYSTEM (SEVERAL OF WHICH ARE EMPLOYEES OF THE FILING ORGANIZATION) AND DELEGATES TO THE CEO THE AUTHORITY TO MAKE ADJUSTMENTS, CONSISTENT WITH THE COMMITTEE'S DIRECTION, FOR THE OTHER EXECUTIVES. THE COMMITTEE DETERMINES ALL ASPECTS OF THE COMPENSATION AND BENEFITS OF THE CEO. THE COMMITTEE INTENTIONALLY TAKES ALL THE STEPS NECESSARY TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL INCOME TAX LAW INTERMEDIATE SANCTIONS RULES, INCLUDING CONTEMPORANEOUS SUBSTANTIATION OF ALL COMMITTEE MEETINGS AND ACTIONS. THE ORGANIZATION BELIEVES IT IS IN FULL COMPLIANCE WITH SECTION 4958 OF THE IRC, PROVIDES NO MORE THAN REASONABLE AND FAIR MARKET VALUE COMPENSATION AND BENEFITS FOR ITS EMPLOYEES AND DOES NOT PROVIDE ANY EXCESS COMPENSATION OR BENEFITS AS PROHIBITED BY SECTION 4958. THE ANNUAL REVIEW OF COMPENSATION AND BENEFITS WAS LAST PERFORMED IN DECEMBER 2015 FOR THE FOLLOWING INDIVIDUALS: DAVID DEOPERE, GREG PAGLIUZZA, JR., KATHERINE PEARSON, RICHARD SEIDLER, AND JAY WILLSHER. THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII WAS ESTABLISHED BY AN INDEPENDENT PERSON/COMMITTEE USING AN INDEPENDENT COMPENSATION CONSULTANT AND/OR COMPENSATION SURVEY OR STUDY FOR SIMILARLY QUALIFED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. COMPENSATION AND BENEFITS ARE BASED ON THE FAIR MARKET VALUE OF THE SERVICES PROVIDED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN TRINITY HEALTH FOUNDATION 1,080,176. CHANGE IN BENEFICIAL INTEREST IN INVESTMENTS 290,766. CHANGES IN PENSION LIABILITY -8,721. FORM 990, PART V, LINES 1A & 1B CASH DISBURSEMENTS ARE CENTRALIZED THROUGH THE PARENT ORGANIZATION, IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). THE PARENT MAKES THE PAYMENTS AND FILES THE RELATED FORMS 1099 AND 1096 ON BEHALF OF ALL UNITYPOINT HEALTH SYSTEM RELATED ORGANIZATIONS. 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SCHEDULE R, PARTS I - IV: IOWA HEALTH SYSTEM AND SUBSIDIARIES (D/B/A UNITYPOINT HEALTH) IOWA HEALTH SYSTEM IS AN IOWA NONPROFIT CORPORATION FORMED IN DECEMBER 1994. IOWA HEALTH SYSTEM AND ITS SUBSIDIARIES PROVIDE INPATIENT AND OUTPATIENT CARE AND PHYSICIAN SERVICES FROM 32 HOSPITAL FACILITIES AND VARIOUS AMBULATORY SERVICE AND CLINIC LOCATIONS IN IOWA, ILLINOIS AND WISCONSIN. PRIMARY, SECONDARY AND TERTIARY CARE SERVICES ARE PROVIDED TO RESIDENTS OF IOWA, ILLINOIS, WISCONSIN AND ADJACENT STATES. ON APRIL 16, 2013, IOWA HEALTH SYSTEM BEGAN BEING PUBLICLY KNOWN AS UNITYPOINT HEALTH (THE SYSTEM). THIS NAME CHANGE REFLECTS THE TRANSFORMATION OF CLINICAL PROCESSES UNDERWAY WITHIN THE SYSTEM AND THE ADAPTATION TO BETTER ADDRESS THE HEALTH CARE NEEDS OF COMMUNITIES, INCLUDING BUILDING A MODEL OF DELIVERING HEALTH CARE THAT COORDINATES CARE AROUND THE PATIENT WHILE FOCUSING ON IMPROVING THE QUALITY OF CARE AND REDUCING COSTS. THE LEGAL NAME OF THE PARENT REMAINS IOWA HEALTH SYSTEM, WITH THE UNITYPOINT HEALTH NAME REFLECTING A DOING BUSINESS AS (D/B/A).