2015-11-16T09:30:28-06:00 2014-12-31 990 2014-01-01 390806367 MERITER HOSPITAL INC MERI 6084176000 202 SOUTH PARK STREET MADISON WI 537151596 BETH ERDMAN CFO 6084176000 2015-11-11 2014 2016-02-25 16:41:14Z ARTHUR NIZZA 202 SOUTH PARK STREET MADISON WI 537151596 1363190071 0 X WWW.MERITER.COM X 1898 WI MERITER HOSPITAL, INC. IS A NOT FOR PROFIT, LOCALLY GOVERNED COMMUNITY HOSPITAL. MERITER HOSPITAL PROVIDES A COMPREHENSIVE ARRAY OF PATIENT-FOCUSED INPATIENT AND OUTPATIENT SERVICES TO MEET THE HEALTH-RELATED NEEDS OF OUR COMMUNITY. 17 14 3077 508 489373 0 225340 544696 386834240 394459556 10498408 30477178 10034961 3321875 407592949 428803305 203518 1195125 0 0 183210637 179691393 0 0 876418 167714315 169634269 351128470 350520787 56464479 78282518 732436308 842927895 289641337 340941079 442794971 501986816 X MERITER HOSPITAL, INC. IS DEDICATED TO PROVIDING EXCEPTIONAL HEALTH CARE AND LIVING BY ITS MISSION TO HEAL, TEACH AND SERVE. 0 0 309495712 1195125 393957919 MERITER HOSPITAL, INC. IS A 448-BED COMMUNITY HOSPITAL FOCUSED ON DELIVERING QUALITY CARE AND PATIENT SAFETY. MERITER PROVIDES SOLUTIONS TO MANY COMMUNITY HEALTH CARE NEEDS, AND PROVIDES THE REGION'S ONLY AVAILABLE CHILD AND ADOLESCENT PSYCHIATRY SERVICES, AND SANE (SEXUAL ASSAULT NURSE EXAMINER) SERVICES. MERITER IS PROUD TO DELIVER MORE BABIES THAN ANY OTHER HOSPITAL IN WISCONSIN AND RECEIVED NUMEROUS AWARDS IN 2014, INCLUDING HEALTHCARE'S MOST WIRED AWARD (4TH CONSECUTIVE YEAR), CERTIFICATION AS A BABY-FRIENDLY BIRTH FACILITY (8TH CONSECUTIVE YEAR), GOLD ACHIEVEMENT AWARD FOR HEART FAILURE FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION (AHA/ASA), ACCREDITATION FOR MERITER MAMMOGRAPHY FROM THE AMERICAN COLLEGE OF RADIOLOGY (ACR), THE NCDR ACTION REGISTRY GWTG PLATINUM AWARD, AND THE NATIONAL RESEARCH CORPORATION TOP PERFORMING ORGANIZATION RECOGNITION. 309495712 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 157 0 1 3077 1 1 1 0 0 0 0 0 0 0 0 0 X 17 14 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X RON SCHROEDER 6084175832 202 SOUTH PARK STREET MADISON WI 537151596 DAVID BOYER BOARD MEMBER 3.00 4.00 X 0 15218 0 JACK COTTON FR 614 BOARD MEMBER 1.00 1.00 X 0 0 0 HOLLY CREMER-BERKENSTADT BOARD MEMBER 1.00 1.00 X 0 0 0 SEAN DILWEG BOARD MEMBER 1.00 1.00 X 0 0 0 CATHERINE DURHAM BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA FINLEY BOARD MEMBER 1.00 1.00 X 0 0 0 MICHAEL GOLDROSEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 VIRGINIA GRAVES BOARD CHAIR 3.00 4.00 X X 12500 17500 0 PETAR IGIC MD FR 314 BOARD MEMBER 1.00 1.00 X 0 0 0 GEORGE KAMPERSCHROER BOARD VICE CHAIR 2.00 2.00 X X 0 0 0 BRAD MANNING MD BOARD MEMBER 1.00 1.00 X 0 0 0 EILEEN MERSHART BOARD MEMBER 1.00 1.00 X 0 0 0 MARGARET NOREUIL RN PHD BOARD MEMBER 1.00 1.00 X 0 0 0 CATHERINE RANHEIM MD TO 214 BOARD MEMBER 1.00 1.00 X 0 0 0 LARRY ROTHSTEIN MD BOARD MEMBER 1.00 1.00 X 0 0 0 JULIE SCHURR MD BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA SWAN TO 814 BOARD MEMBER 1.00 1.00 X 0 0 0 PETER THOREEN FR 714 BOARD MEMBER/INTERIM CEO 1.00 40.00 X X 0 490534 188075 JAMES WOODWARD TO 714 CEO/PRESIDENT/BOARD MEMBER 15.00 35.00 X X 0 2223456 21056 BETH ERDMAN SECRETARY/TREASURER 35.00 15.00 X 0 258512 10993 SUSAN ERICKSON EXECUTIVE/ASST TREASURER 15.00 35.00 X 0 367586 22529 GEOFFREY PRIEST MD CMOASST SEC INTERIM PRESIDENT (FR 7/14) 5.00 45.00 X 0 708878 24252 JAMES ARNETT EXECUTIVE 15.00 45.00 X 0 231179 20970 PATRICIA GRUNWALD CHIEF NURSING OFFICER 45.00 5.00 X 0 432182 23650 KERRA GUFFEY TO 614 CHIEF INFORMATION OFFICER 38.00 12.00 X 0 332967 14528 TAMARA SAUNAITIS TO 414 CHIEF HUMAN RESOURCE OFFICER 45.00 5.00 X 0 474976 10228 LUIS S BRYSH PHYSICIAN 50.00 0.00 X 271754 0 25487 SHERRY CASALI DIR EMERGENCY SERVICES 50.00 0.00 X 189008 0 16853 WILLIAM J HERBERT DIR PHARMACY & MTL SVCS 50.00 0.00 X 213214 0 23946 CHRISTINA JACKSON DIR PERIOPERATIVE SVCS 50.00 0.00 X 179685 0 21129 LINDA WONOSKI DIR CARDIOVASCULAR SVCS 50.00 0.00 X 171002 0 26571 LINDA HOFF FORMER OFFICER 0.00 0.00 X 0 581438 323 MARY REINKE FORMER OFFICER 0.00 0.00 X 0 256307 1046 1037163 6390733 451636 104 1 1 0 UNIVERSITY OF WISCONSIN HOSPITAL AND CLI 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS, RESIDENTS, MED-FLIGHT & TEACHIN 3977870 UW MEDICAL FOUNDATION 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS AND RESIDENTS 2950656 EPIC 1979 MILKY WAY LANE VERONA WI 53593 INFORMATION SYSTEMS 2400686 UNIVERSITY OF WISCONSIN 750 HIGHLAND AVENUE MADISON WI 53792 MEDICAL SERVICES 2246488 JH FINDORFF AND SON INC 300 SOUTH BEDFORD STREET MADISON WI 53703 CONSTRUCTION 1790729 52 544696 544696 NET PATIENT REVENUE 900099 376158149 376158149 SUBS & JOINT VENTURES 900099 7040561 7040561 MGMT & SUPPORT SVCS 900099 1925682 1925682 9335164 8634648 36756 663760 394459556 16625620 16625620 2666584 2618670 47914 47914 86802 -38888 944692765 688560 931219597 310170 13473168 378390 13851558 13851558 437208 238329 198879 198879 CAFETERIA/FOOD SVCS 722210 1242471 1434 1241037 CHILDCARE SERVICES 624410 1015515 364381 651134 PARKING REVENUE 722100 817096 817096 3075082 428803305 393957919 489373 33811317 1156125 1156125 39000 39000 12500 12500 139419755 133441267 5978488 3583232 3457819 125413 26689455 25755324 934131 9986451 9636925 349526 16977557 208521 16769036 407971 407971 19412552 18530418 882134 1840836 1463036 377800 11579623 10984430 595193 224189 212666 11523 8403365 8403365 875000 875000 21760822 20642316 1118506 865653 821158 44495 MEDICAL SUPPLIES 47534560 45091284 2443276 MISCELLANEOUS EXPENSES 23414386 21963278 1449690 1418 STATE REVENUE ASSESSMEN 11559346 11559346 EQUIPMENT RENTAL & MAIN 4778409 4532799 245610 350520787 309495712 40148657 876418 157101 186749 42431403 55374648 33050779 33644628 147555936 150467357 4635740 4397117 3465292 2325417 257948514 21331530 209940581 236616984 252846623 297179041 38352853 62735954 732436308 842927895 43012846 47357917 28867 4202 215663272 0 11468856 7839985 19467496 285738975 289641337 340941079 X 437286276 497421321 5204693 4261493 304002 304002 442794971 501986816 732436308 842927895 X 78282518 -10770259 -8320414 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 54714033 54714033 136492259 9660431 126831828 1051776 53617 998159 56658037 11133392 45524645 9032409 484090 8548319 236616984 DUE FROM AFFILIATES 6791660 OTHER LONG-TERM ASSETS 309386 INVESTMENT IN JOINT VENTURES 55634908 62735954 -34346 RETIREMENT LIABILITY 79271063 HEALTH & WELFARE INS RESERVES 1017704 ASSET RETIREMENT OBLIGATION 735843 DUE TO AFFILIATES 204748711 285738975 X PART X, LINE 2: UNITYPOINT HEALTH AND MOST OF ITS SUBSIDIARIES ARE CLASSIFIED AS TAX-EXEMPT ORGANIZATIONS AS DESCRIBED IN SECTIONS 501(C)(3) AND 501(C)(2) OF THE INTERNAL REVENUE CODE (THE CODE). TAX-EXEMPT ORGANIZATIONS ARE NOT SUBJECT TO FEDERAL AND STATE INCOME TAXES ON RELATED INCOME, PURSUANT TO SECTION 501(A) OF THE CODE. THESE ORGANIZATIONS ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES TO THE EXTENT THEY HAVE UNRELATED BUSINESS INCOME AS DESCRIBED UNDER PROVISIONS OF SECTION 511 OF THE CODE. THE SYSTEM FILES FORM 990 FOR SUBSTANTIALLY ALL OF ITS OPERATING ENTITIES IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY TAX AUTHORITIES FOR THE YEARS BEFORE 2011. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE CORPORATIONS HAVE ACCUMULATED NET OPERATING LOSS CARRYFORWARDS THAT ARE AVAILABLE TO OFFSET FUTURE TAXABLE INCOME, IF ANY, DURING THE CARRYFORWARD PERIOD. DEFERRED TAX ASSETS AND LIABILITIES RELATED TO THESE SUBSIDIARIES WERE NOT MATERIAL. 1 1 1 X 1 X 500.000000000000 1 1 0 1 1 18521 4326552 0 4326552 0.01230 26999 64171766 44650871 19520895 0.05570 568 1172058 817825 354233 0.00100 46088 69670376 45468696 24201680 0.06900 6680 1572316 9615 1562701 0.00450 5762 6164599 12815 6151784 0.01760 5608 1844000 0 1844000 0.00530 6462 886130 2500 883630 0.00250 24512 10467045 24930 10442115 0.02990 70600 80137421 45493626 34643795 0.09890 3382 3382 0.00000 17939 17939 0.00010 519510 519510 0.00150 36330 36330 0.00010 3712 3712 0.00000 580873 580873 0.00170 0 1098719 0 84160269 93597632 -9437363 X 1 1 1 1 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 53715 WWW.MERITER.COM 316 X X X X X MERITER HOSPITAL INC 1 0 0 1 X X X X X X X X X 12 1 1 1 1 X WWW.MERITER.COM X X 1 13 0 1 0 1 X 200.000000000000 500.000000000000 X X X 1 1 X X X X 1 X X X X X 1 X 0 X X X X 1 X 0 0 MERITER HOSPITAL, INC. PART V, SECTION B, LINE 5: FOUR FOCUS GROUPS WERE SCHEDULED IN AUGUST 2012 TO SEEK INPUT AND PRIORITIZE THE HEALTH ISSUES. HEALTHY DANE USED THE HEALTHY PEOPLE 2020 CATEGORIES TO GUIDE THE INVITATION LIST OF KEY COMMUNITY STAKEHOLDERS. FORTY-ONE COMMUNITY STAKEHOLDERS PARTICIPATED IN THE FOCUS GROUPS. A HEALTHY DANE MEMBER SERVED AS THE FOCUS GROUP HOST AND PRESENTED HCI DATA ON THE TOP SIX HEALTH ISSUES. FOCUS GROUP MEMBERS WERE ASKED TO COMPLETE A COMMUNITY ADVISORY PRIORITIZATION MATRIX AND SELECT THE RATING (5-STRONGLY AGREE, 4-AGREE, 3-NEUTRAL, 2-DISAGREE, 1-STRONGLY DISAGREE) THAT BEST DESCRIBED THEIR AGREEMENT WITH THE FOLLOWING STATEMENTS:-IN MY OPINION, THIS IS A SERIOUS HEALTH NEED WITHIN THIS COMMUNITY (SEVERITY)-IN MY OPINION, ADDRESSING THIS HEALTH NEED IS VERY IMPORTANT TO THIS COMMUNITY (IMPORTANCE)-IN MY OPINION, ADDRESSING THIS HEALTH NEED WILL IMPROVE THE QUALITY OF LIFE WITHIN THIS COMMUNITY (IMPACT)-IN MY OPINION, THERE ARE NO RESOURCES FOR ADDRESSING THIS HEALTH NEED WITHIN THIS COMMUNITY (EXISTING RESOURCES)ATTENDEES INCLUDED:BOB POWER, EXEC DIREC,COLONIAL CLUB SENIOR CENTER; CHRISTINE RADER, DIVISION DIR,MARCH OF DIMES; BONNIE LOUGHRAN, EXEC DIR,NAMI OF DANE COUNTY; BRENDA DOTTL, RN,STOUGHTON HOSPITAL HOME HEALTH; ALISON PRANGE, EXEC DIR,AMERICAN CANCER SOCIETY; CARRIE WALL, EXEC DIR, YMCA OF DANE COUNTY; NICOLE L VESELY, PROGRAM COORD UW HEALTH; JENNIFER ELLESTAD, COMM ADVOCACY, DEAN CLINIC; KRISTIN BURKI, DIRECTOR OF SERVICES,DOMESTIC ABUSE INTERVENTION SERVICES; SALLY ZIRBEL DONISCH, HEALTH SERVICES,MADISON METROPOLITAN SCHOOL DISTRICT; BRADLEY D. SCHROEDER, EMPLOYEE BENEFIT SPECIALIST,STOUGHTON BUSINESS OWNER-INSURANCE; CINDY MCGLYNN, DIRECTOR,STOUGHTON SENIOR CENTER; AMY L. MILLER, COMMUNITY EDUCATION DIRECTOR,OREGON SCHOOL DISTRICT; DONNA OLSON, MAYOR,CITY OF STOUGHTON-GOVERNMENT; CATHY RIGDON, DIRECTOR, STOUGHTON EMERGENCY MANAGEMENT SERVICES; LYNN GREEN, EXEC DIR, DANE COUNTY HUMAN SERVICES; DR. FLOYD ROSE, EXEC DIR,100 BLACK MEN OF MADISON; KELLY ANDERSON, EXEC DIR, RAPE CRISIS CENTER; MICHELLE HEITZINGER, EXEC DIR, SUSAN G. KOMEN OF SOUTH CENTRAL WI; EVA BRUMMEL, LEARNING COORDINATOR,WISCONSIN PERINATAL ASSOCIATION; DAN FOLEY, EXEC DIR, NEIGHBORHOOD HOUSE COMMUNITY CENTER; BOBBY PETERSON, EXEC DIR, ABC FOR HEALTH; PENNY KASPRZAK, ASSOC DIRL AMERICAN DIABETES ASSOCIATION; SHIVA BIDAR-SIELAFF, CO-CHAIR, LATINO HEALTH COUNCIL; TOM LUEDTKE, CORP EVENTS DIR, AMERICAN HEART ASSOCIATION; LANNIA SYREN STENZ, EXEC DIR,GILDA'S CLUB OF MADISON; KEN TAYLOR, EXEC DIR, WISCONSIN COUNCIL ON CHILDREN AND FAMILIES; SANDY ERICKSON, DIRECTOR COMMUNITY IMPACT, UNITED WAY DANE COUNTY; STEVE HINIKER, EXEC DIR, 1000 FRIENDSKENT CRAIG, EXEC DIR, CENTRO HISPANO; MURIEL NAGLE, DIRECTOR OF HEALTH PROMOTION,UNIVERSITY HEALTH SERVICES; LORRI WENDORF-CORRIGAN, NEIGHORHOOD SERVICES COORD, COMMUNITY DEVELOPMENT DIVISION, CITY OF MADISON; JULIE WILLEMS VAN DIJK, RN, PHD UW-MADISON, POPULATION HEALTH DEPT. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 6A: UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS, ST. MARY'S HOSPITAL - SSM HEALTHCARE, STOUGHTON HOSPITAL MERITER HOSPITAL, INC. PART V, SECTION B, LINE 7D: THE HOSPITAL CONDUCTED A PUBLIC LAUNCH OF A HEALTHDANE WEBSITE - IN ADDITION TO POSTING ON MERITER.COM MERITER HOSPITAL, INC. PART V, SECTION B, LINE 11: TO ADDRESS THE NEEDS SELECTED FOR FOCUS, MERITER SHIFTED FINANCIAL RESOURCES WITHIN ITS COMMUNITY SUPPORT TO EMPHASIZE EFFORTS THAT ADDRESSED TYPE 2 DIABETES AND HEALTHY BIRTH OUTCOMES. ORGANIZATIONS RECEIVING FUNDS FOCUSED ON BRINGING HEALTHY FOOD INTO LOW-INCOME FOOD DESSERT NEIGHBORHOODS, EXPANDING SAFE SLEEP EDUCATION, SMOKING CESSATION FOR PREGNANT WOMEN, COMMUNITY BASED DIABETES EDUCATION, AND LOCAL CHILDHOOD OBESITY PREVENTION EFFORT. SUPPORT WAS SPECIFICALLY FOCUSED ON COMMUNITIES OF GREATEST NEED AND WITH DISPARATE HEALTH OUTCOMES. MERITER HAD ALSO ADOPTED MENTAL HEALTH AND ORAL HEALTH AS A SECONDARY FOCUS, AS THE ORGANIZATION HAD PROGRAMMATIC SERVICES SERVING THESE NEEDS AND UNIQUE TO MERITER. SPECIFICALLY, MERITER HOUSED THE ONLY DENTAL PROGRAM IN THE STATE OF WISCONSIN WHICH SERVED THE NEEDS OF DISABLED ADULTS AND CHILDREN WHO NEEDS DENTAL CARE UNDER ANESTHESIA. THIS PROGRAM ALSO PROVIDED COMPREHENSIVE DENTAL CARE AND A DENTAL HOME TO CHILDREN AND ADULTS ON MEDICAL ASSISTANCE. MERITER IS AMONG THE FEW IN THE COUNTY THAT OFFERS DENTAL CARE TO THIS GROUP. MERITER ALSO HAD THE ONLY INPATIENT CHILD AND ADOLESCENT PSYCHIATRY PROGRAM WITHIN ITS REGION OF THE STATE AND THE ONLY STREET MEDICINE PROGRAM SERVING HOMELESS INDIVIDUALS, MANY OF WHOM HAVE MENTAL HEALTH DIAGNOSIS OR CONCERNS. MERITER DOES NOT ADDRESS ALL NEEDS IDENTIFIED IN THE ASSESSMENT. THESE AREAS INCLUDE: CANCER, SEXUALLY TRANSMITTED INFECTIONS, STROKE/UNCONTROLLED HYPERTENSION, ASTHMA , DRUGS/UNINTENTIONAL POISONINGS. MANY OF THESE CONCERNS ARE BEING ADDRESSED BY MERITER AND OTHER COMMUNITY ORGANIZATIONS THROUGH PROGRAMS AND SERVICES ALTHOUGH NOT AS A PRIORTITY AREA. AS MERITER FOCUSES ON THE MANY FACTORS ITS PRIORITY AREAS AFFECTING BIRTH OUTCOMES AND DIABETES, AREAS SUCH AS HYPERTENSION, CANCER AND ASTHMA WILL LIKELY BE IMPROVED FROM THE EFFORTS. CERTAINLY, THESE HEALTH NEEDS ARE IMPORTANT AND MERIT FOCUSED ATTENTION. HOWEVER, DUE TO LIMITED RESOURCES, MERITER CANNOT ADDRESS ALL CONCERNS AT THE SAME LEVEL WITHIN THIS IMPLEMENTATION PLAN. FURTHERMORE, SOME OF THE ISSUES ARE BEING ADDRESSED BY OTHER HOSPITALS IN THE AREA (SPECIFICALLY ASTHMA AND HYPERTENSITON). 7 MAX W POHL DENTAL CLINIC 202 S PARK ST MADISON WI 53715 DENTAL SERVICES MERITER REHABILITATION MEDICINE 202 S PARK ST MADISON WI 53715 REHABILITATION SERVICES WOMAN CARE CLINIC 202 S PARK ST MADISON WI 53715 GYNECOLOGICAL SERVICES CHILD & ADOLESCENT PSYCHIATRY 8001 RAYMOND ROAD MADISON WI 53719 INPATIENT PSYCHIATRY SERVICES MERITER NEWSTART 1015 GAMMON LANE MADISON WI 53719 SUBSTANCE ABUSE TREATMENT PROGRAM MERITER WELLNESS CENTER 501 W BELTLINE HWY SUITE 207 MADISON WI 53713 CARDIOVASCULAR & PULMONARY REHAB & NUTRITION CENTER FOR PERINATAL CARE 202 S PARK ST MADISON WI 53715 PREGNANCY CARE PART I, LINE 6A: A COMMUNITY BENEFIT REPORT IS FILED ON BEHALF OF MERITER HEALTH SERVICES; MERITER HOSPITAL IS A SUBSIDIARY. THE COMMUNITY BENEFIT TEXT IN THIS RETURN REPRESENTS THE HOSPITAL. PART I, LINE 7: THE RATIO OF COSTS TO CHARGES IS BASED ON WORKSHEET 3 OF SCHEDULE H. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $3,035,386 IS NOT INCLUDED IN THE TOTALOPERATING EXPENSES FOR PURPOSES OF CALCULATING THE PERCECNTAGE OF TOTALEXPENSE IN PART I, LINE 7, COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: MERITER STRIVES TO HELP CREATE A HEALTHY COMMUNITY INCLUDING A SAFE ENVIRONMENT, INTERCONNECTED NEIGHBORHOODS WITH ADEQUATE AND AFFORDABLE HOUSING, STRONG SCHOOLS AND A PREPARED AND DIVERSE WORKFORCE.THROUGH PARTNERSHIPS WITH AREA NON-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS, MERITER IS WORKING TO STRENGTHEN THE COMMUNITY THROUGH SPONSORSHIPS AND INVOLVEMENT IN BAYVIEW COMMUNITY FOUNDATION, GREENBUSH DAY COMMUNITY CELEBRATION, NEIGHBORHOOD HOUSE, AND HABITAT FOR HUMANITY, AND SUPPORT OF A NEIGHBORHOOD HOUSING INITIATIVE. ALL OF THESE GROUPS, AND OTHERS, CREATE OPPORTUNITIES FOR SAFE AND AFFORDABLE HOUSING, FAMILY-BASED EVENTS, AND STRENGTHENING THE NEIGHBORHOODS THROUGH RAISING AWARENESS OF COMMUNITY RESOURCES AND NEIGHBORHOOD ASSETS. NEIGHBORHOOD HOUSE, IN PARTICULAR, HAS EXPANDED ITS AFTERSCHOOL ACTIVITIES AND SUMMER CAMP PROGRAM. THIS PROGRAM INTRODUCED CHILDREN TO AREAS OF THE COMMUNITY MANY HADN'T EXPERIENCED INCLUDING FIELD TRIPS TO THE UNIVERSITY, ZOO AND TO A LOCAL COMMUNITY GARDEN. BAYVIEW FOUNDATION IS PART OF BAYVIEW TOWNHOMES, A CDA HOUSING COMMUNITY LOCATED NEXT TO MERITER. THE VAST MAJORITY OF BAYVIEW RESIDENTS ARE IMMIGRANTS WITH APPROXIMATELY 80% OF THE TOTAL RESIDENTS IDENTIFYING AS HMONG. THE FOUNDATION'S AFTER-SCHOOL, SCHOOL -AGE AND OTHER PROGRAMS ARE VITALLY IMPORTANT TO ASSISTING THE FAMILIES AND THE CHILDREN WITH ASSIMILATION. THE PROGRAMS PROVIDE AFTER-SCHOOL TUTORING, COMPUTER SKILLS, ENGLISH LANGUAGE COMPETENCY AND SCHOOL READINESS, SUMMER EDUCATIONAL PROGRAMS AND A FREE LENDING LIBRARY. WITHOUT THESE PROGRAMS, THE CHILDREN IN BAYVIEW WOULD FALL DISASTROUSLY BEHIND IN SCHOOL AND LACK THE SOCIAL SKILLS NEEDED FOR ACADEMIC AND EMPLOYMENT SUCCESS. THEY WOULD STRUGGLE WITH BASIC LITERACY, SEVERELY IMPAIRING THEIR ABILITY TO EARN A LIVING OR READ A PHYSICIAN'S INSTRUCTIONS. IT IS WELL DOCUMENTED THAT LITERACY AND EMPLOYMENT STATUS HAVE AN IMPACT ON HEALTH AS A SOCIAL DETERMINANT. MERITER'S EFFORTS IN SUPPORT OF BAYVIEW FOUNDATION, NEIGHBORHOOD HOUSE AND OTHER PROGRAMS ASSOCIATED WITH EMPLOYMENT ARE INVESTMENTS IN THE FUTURE OF THE COMMUNITY. WE HOPE TO CREATE A MORE EDUCATED AND BETTER PREPARED COMMUNITY - WHICH WILL BE HEALTHIER.MERITER LED THE WAY IN ESTABLISHING A WORK-FORCE HOUSING INITIATIVE FOR A RAPIDLY CHANGING NEIGHBORHOOD. THE INITIATIVE, WHICH INCLUDES PARTNERS FROM OTHER AREA EMPLOYERS, HAS GROWN IN TO A SEPARATE ORGANIZATION WHICH PROVIDES HOME-BUYER EDUCATION, BUDGETING, AND OTHER FINANCIAL LITERACY. FINALLY, MERITER IS WORKING WITH COMMUNITY GROUPS SUCH AS THE URBAN LEAGUE TO FUND TRAINING PROGRAMS, SCHOLARSHIPS AND TUTORING PROGRAMS. THROUGH SUPPORT OF EDUCATIONAL PROGRAMS, MERITER IS HELPING INCREASE JOB OPPORTUNITIES FOR AREA RESIDENTS, THEREBY INCREASING JOB SECURITY. PART III, LINE 3: AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, MERITER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED MERITER. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE MERITER'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATION, THE SHARE OF BAD DEBT EXPENSE IN 2014 WAS $3,036,000 AT CHARGED ($1,098,719 AT COST). 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. 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 HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITAL'S CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: WE NOTIFY PATIENTS OF THEIR FINANCIAL RESPONSIBILITY AS WELL AS OUR CHARITY CARE POLICY. OUR COLLECTION AGENCIES ARE EDUCATED ON OUR FAHCP (FINANCIAL ASSISTANCE FOR HEALTH CARE PROGRAM) AND WE FOLLOW WHA (WISCONSIN HOSPITAL ASSOCIATION) GUIDELINES. OUR POLICY STATES "PATIENT ACCOUNTS IN THE PROCESS OF FINANCIAL AID REVIEW WILL NOT KNOWINGLY BE SENT TO COLLECTIONS." PART VI, LINE 2: MERITER JOINED THREE OTHER HOSPITALS IN DANE COUNTY, UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS, STOUGHTON HOSPITAL, AND ST. MARY'S - SSM OF WISCONSIN, ALONG WITH PUBLIC HEALTH MADISON AND DANE COUNTY IN THE ASSESSMENT OF THE HEALTH OF DANE COUNTY. SECONDARY DATA WAS COLLECTED AND AGGREGATED BY HEALTHY COMMUNITIES INSTITUTE. THE DATA WAS VERIFIED IN COMMUNITY FOCUS GROUPS AND THE GROUPS PROVIDED INSIGHT AND IDEAS TO ADDRESS IDENTIFIED NEEDS. PART VI, LINE 3: WE NOTIFY PATIENTS OF THEIR FINANCIAL RESPONSIBILITY AS WELL AS OUR CHARITY CARE POLICY. OUR COLLECTION AGENCIES ARE EDUCATED ON OUR FAHCP (FINANCIAL ASSISTANCE FOR HEALTH CARE PROGRAM) AND WE FOLLOW WHA (WISCONSIN HOSPITAL ASSOCIATION) GUIDELINES. OUR POLICY STATES "PATIENT ACCOUNTS IN THE PROCESS OF FINANCIAL AID REVIEW WILL NOT KNOWINGLY BE SENT TO COLLECTIONS." PART VI, LINE 4: DANE COUNTY IS THE SECOND MOST DENSELY POPULATED COUNTY IN WISCONSIN, AND MADISON IS THE SECOND LARGEST CITY IN THE STATE. THE POPULATION OF DANE COUNTY GREW 14.4% BETWEEN 2000 AND 2010, BRINGING THE TOTAL POPULATION TO 488,073. MADISON HAS 233,209 RESIDENTS, ALMOST HALF OF THE COUNTY'S POPULATION. AMONG ITS RESIDENTS ARE MORE THAN 42,000 UW STUDENTS.THE ETHNIC/RACIAL DEMOGRAPHICS OF DANE COUNTY ARE CHANGING. SINCE 2000, THE PERCENTAGE OF THE POPULATION THAT IS WHITE DECREASED FROM 87.4% TO 81.9%. THE GREATEST GROWTH AMONG MINORITY GROUPS WAS SEEN IN THE HISPANIC POPULATION. COMPARED WITH WISCONSIN AS A WHOLE, DANE COUNTY HAS MORE ETHNIC DIVERSITY, A LARGER PERCENT OF FOREIGN-BORN RESIDENTS (7.4%), AND A LARGER PERCENT THAT SPEAKS A LANGUAGE OTHER THAN ENGLISH IN THE HOME (11% IN DANE COUNTY; 14.8% IN MADISON). MINORITIES ARE MORE CONCENTRATED IN THE CITY OF MADISON. OVER HALF OF ALL STUDENTS IN MADISON PUBLIC SCHOOLS ARE OF RACIAL/ETHNIC MINORITY GROUPS. HMONG ARE ONE OF THE LARGEST ASIAN GROUPS IN DANE COUNTY, AND DANE COUNTY HAS ONE OF THE LARGEST HMONG POPULATIONS IN WISCONSIN. EXAMINATION OF DATA FOR DANE COUNTY REVEALS A LARGE GAP IN EDUCATION AND INCOME BETWEEN AN AFFLUENT MAJORITY POPULATION AND A GROWING LOW-INCOME, LESS EDUCATED POPULATION. THE PERCENT OF THE POPULATION THAT HAS AT LEAST A BACHELOR'S DEGREE IS MUCH HIGHER IN DANE COUNTY THAN IN WISCONSIN AND THE U.S., AND IT IS HIGHER YET IN MADISON (DANE COUNTY 45.4%, MADISON 52.2%, WISCONSIN 25.8%, U.S. 27.9%).8 HOWEVER, DANE COUNTY'S CURRENT 86% HIGH SCHOOL GRADUATION RATE IS ONE OF THE LOWEST AMONG WISCONSIN COUNTIES. 9 LATELY, MUCH ATTENTION HAS BEEN PAID TO THE "ACHIEVEMENT GAP" AND LOWER GRADUATION RATES FOR SOME RACIAL MINORITY GROUPS IN MADISON, BUT OTHER OF DANE COUNTY'S 16 PUBLIC SCHOOL DISTRICTS FACE THE SAME CHALLENGE. IN 2011, THE FOUR-YEAR GRADUATION RATE FOR ALL STUDENTS IN THE MADISON METROPOLITAN SCHOOL DISTRICT WAS 73.7% (NOT INCLUDING GED OR OTHER HIGH SCHOOL CERTIFICATES) BUT THERE WAS CONSIDERABLE VARIATION BY RACIAL GROUP.THE MEDIAN HOUSEHOLD INCOME FOR DANE COUNTY IS $60,519 AS COMPARED TO $51,598 IN WISCONSIN.11 MADISON'S MEDIAN HOUSEHOLD INCOME IS $52,550, WHICH IS LOWER THAN HOUSEHOLD INCOMES IN THE REMAINDER OF DANE COUNTY. DESPITE THE HIGH MEDIAN HOUSEHOLD INCOME AND A RELATIVELY LOW UNEMPLOYMENT RATE (5.4%), DANE COUNTY IS FACED WITH AN INCREASING NUMBER OF PEOPLE LIVING IN POVERTY. 11.6% OF DANE COUNTY RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL (2006-2010), A STATISTIC THAT IS COMPARABLE TO THE STATE POVERTY RATE.13 IN MADISON, THE POVERTY RATE IS HIGHER AT 17.9%.14 ACCORDING TO THE CENTER ON WISCONSIN STRATEGY, 31.5% OF STUDENTS IN DANE COUNTY ARE ELIGIBLE FOR FEDERAL FREE OR REDUCED-PRICE SCHOOL LUNCH IN 2012, AN INCREASE FROM 2000 WHEN ONLY 17.4% OF STUDENTS WERE ELIGIBLE. IN THE CITY OF MADISON, OVER HALF OF ALL PUBLIC SCHOOL STUDENTS ARE ELIGIBLE. POVERTY LEVELS ARE PARTICULARLY STRIKING FOR CHILDREN IN THE COUNTY.TO BE EFFECTIVE, HEALTH PROGRAMS MUST BE MEETING A TANGIBLE NEED OF THE COMMUNITY. TO MEET THE NEED, THEY MUST BE PRESENTED TO AND ACCESSIBLE BY THE VERY PEOPLE WHO NEED THEM MOST. A STUDY OF DEMOGRAPHICS IS NECESSARY TO ENLIGHTEN THE PLANNING AND MARKETING PROCESS AND, ULTIMATELY, TO MOVE THE DIAL TOWARD BETTER COMMUNITY HEALTH. PART VI, LINE 5: MERITER IS A LOCALLY MANAGED AND A LOCALLY GOVERNED HOSPITAL. THE COMMUNITY-BASED BOARD OF DIRECTORS IS COMMITTED TO PROTECTING THE HEALTH OF THE COMMUNITY THROUGH SUSTAINING SEVERAL OF MERITER'S PROGRAMS AND SERVICES THAT ONLY MERITER PROVIDES. SEVERAL YEARS AGO, THE BOARD MADE A PLEDGE TO CONTINUE TO PROVIDE CHILD AND ADOLESCENT PSYCHIATRIC SERVICES EVEN WHEN OTHER PROVIDERS CHOSE NOT TO PROVIDE SUPPORT. SIMILARLY, MERITER PROVIDES THE ONLY HOSPITAL BASED DENTAL RESIDENCY PROGRAM IN THE AREA. THIS SERVICE OFFERS AN OPTION FOR THOSE WHO CANNOT BE SEEN IN A STANDARD DENTAL OFFICE WHETHER THAT REASON IS FOR AN ILLNESS OR A BEHAVIORAL OR COGNITIVE DISABILITY. FURTHERMORE, THE MERITER'S DENTAL CLINIC IS ONE OF ONLY A HANDFUL OF DENTAL CLINICS INT EH COUNTY THAT ACCEPTS MEDICAL ASSISTANCE. BOTH OF THESE SERVICES OFTEN OPERATE AT A LOSS FOR THE ORGANIZATION. HOWEVER, THE BOARD AND LEADERSHIP ARE COMMITTED TO ENSURING THAT MERITER CONTINUE TO PROVIDE THIS RESOURCE TO THE COMMUNITY. PART VI, LINE 6: THE HOSPITAL IS PART OF IOWA HEALTH SYSTEM (D/B/A UNITYPOINT HEALTH). 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 $3.7 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 2014, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $443 MILLION OF COMMUNITY BENEFIT. THE CONTRIBUTIONS TO THEIR COMMUNITIES BY UNITYPOINT HEALTH AND ITS AFFILIATES ARE REPORTED IN DETAIL IN STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (PART III) OF THE IRS FORM 990 OF THOSE AFFILIATES. PART VI, LINE 7, REPORTS FILED WITH STATES WI 0 MERITER FOUNDATION 202 S PARK STREET MADISON WI 537151596 237098688 501(C)(3) 78220 HOSPITAL PROGRAMS MERITER HEALTH SEREVICES 202 S PARK STREET MADISON WI 537151596 391412318 501(C)(3) 29217 HEALTH SERVICES PROGRAMS MADISON COMMUNITY HEALTH CENTER INC DBA ACCESS COMMUNITY HEALTH CENTERS 2901 W BELTLINE HWY NO 120 MADISON WI 537134231 391391134 501(C)(3) 1000000 DENTAL PROGRAM 3 0 HOSPITAL SCHOLARSHIPS 27 3900 0 PART I, LINE 2: EXPLANATION: GRANTS ARE MADE UPON A SPECIFIC PROJECT REQUEST AND ONLY MADE TO ORGANIZATIONS THAT WE HAVE A WORKING RELATIONSHIP WITH AND SHARE A COMMON GOAL OF COMMUNITY BENEFIT. GRANTS ARE ONLY MADE TO 501 (C)(3) ORGANIZATIONS WHICH MUST COMPLETE FORM 990S AND ANNUAL REPORTS. PART III - SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS WHO HAVE SUBMITTED REQUIRED APPLICATION AND SUPPORTING DOCUMENTATION. A SELECTION COMMITTEE REVIEWS THE REQUESTS, EVALUATES EACH APPLICATION BASED UPON FINANCIAL NEED, ACADEMIC RECORD, EXTRA CURRICULAR WORK/VOLUNTEERING, RECOMMENDATION AND ESSAY. X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 PETER THOREEN FR 714 BOARD MEMBER/INTERIM CEO 0 337104 0 81992 0 71438 0 167694 0 20381 0 678609 0 0 JAMES WOODWARD TO 714 CEO/PRESIDENT/BOARD MEMBER 0 317584 0 974120 0 931752 0 3673 0 17383 0 2244512 0 0 BETH ERDMAN SECRETARY/TREASURER 0 194315 0 61269 0 2928 0 3273 0 7720 0 269505 0 0 SUSAN ERICKSON EXECUTIVE/ASST TREASURER 0 239485 0 90111 0 37990 0 3715 0 18814 0 390115 0 0 GEOFFREY PRIEST MD CMOASST SEC INTERIM PRESIDENT (FR 7/14) 0 379449 0 121602 0 207827 0 3900 0 20352 0 733130 0 0 JAMES ARNETT EXECUTIVE 0 180955 0 44905 0 5319 0 2501 0 18469 0 252149 0 0 PATRICIA GRUNWALD CHIEF NURSING OFFICER 0 244567 0 96038 0 91577 0 3639 0 20011 0 455832 0 0 KERRA GUFFEY TO 614 CHIEF INFORMATION OFFICER 0 136241 0 97596 0 99130 0 3900 0 10628 0 347495 0 0 TAMARA SAUNAITIS TO 414 CHIEF HUMAN RESOURCE OFFICER 0 72866 0 81595 0 320515 0 2694 0 7534 0 485204 0 0 LUIS S BRYSH PHYSICIAN 213193 0 41417 0 17144 0 3900 0 21587 0 297241 0 0 0 SHERRY CASALI DIR EMERGENCY SERVICES 152628 0 29571 0 6809 0 2517 0 14336 0 205861 0 0 0 WILLIAM J HERBERT DIR PHARMACY & MTL SVCS 178968 0 33042 0 1204 0 2532 0 21414 0 237160 0 0 0 CHRISTINA JACKSON DIR PERIOPERATIVE SVCS 156940 0 21932 0 813 0 2755 0 18374 0 200814 0 0 0 LINDA WONOSKI DIR CARDIOVASCULAR SVCS 153253 0 17294 0 455 0 10583 0 15988 0 197573 0 0 0 LINDA HOFF FORMER OFFICER 0 0 0 148045 0 433393 0 323 0 0 0 581761 0 0 MARY REINKE FORMER OFFICER 0 53765 0 202542 0 0 0 1046 0 0 0 257353 0 0 PART I, LINE 1A FIRST CLASS OR CHARTER TRAVEL: THERE WERE TWO CHARTER FLIGHTS RELATED TO THE AFFILIATION WITH UNITYPOINT HEALTH. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: BUSINESS CLUB DUES WERE PAID FOR ONE PERSON. THE BUSINESS CLUB IS AN IRS SECTION 501(C)(7). PART I, LINE 1B IF BENEFITS PAID ARE NOT PART OF AN ESTABLISHED COMPENSATION OR BENEFIT PROGRAM, THE VP OF HUMAN RESOURCES (HR) WORKS WITH OUR HR CONSULTING FIRM TO ENSURE THAT TOTAL COMPENSATION IS WITHIN THE ORGANIZATION'S PHILOSOPHY AND IS REASONABLE. DEPARTURES FROM THE ESTABLISHED GUIDELINES MUST BE REVIEWED BY THE EXTERNAL CONSULTANT, PROPOSED TO THE COMPENSATION COMMITTEE OF THE BOARD, AND APPROVED IN ADVANCE. PART I, LINES 4A-B SEVERANCE PAYMENT OR CHANGE OF CONTROL PAYMENT: SEVERANCE PAYMENTS WERE RECEIVED BY THE FOLLOWING INDIVIDUAL(S): MARY REINKE $200,906; TAMARA SAUNAITIS $216,667, JAMES WOODWARD $299,350. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THREE INDIVIDUALS WERE PAID SUPPLEMENTAL NONQUALIFIED RETIREMENT: LINDA HOFF $21,560, GEOFFREY PRIEST $104,615, JAMES WOODWARD $430,223. THE FOLLOWING INDIVIDUAL PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGE TO THEIR ACCOUNT: PETER THOREEN $186,878. FORM 990, PART VI, SECTION A, LINE 4 -MERITER HEALTH SERVICES, SOLE MEMBER OF MERITER HOSPITAL, INC., AFFILIATED WITH IOWA HEALTH SYSTEM (D/B/A/ UNITYPOINT HEALTH) EFFECTIVE 1/1/2014. -AMENDMENTS TO GOVERNING DOCUMENTS MUST BE APPROVED, IN WRITING, BY THE BOARD OF DIRECTORS OF UNITYPOINT HEALTH, SOLE MEMBER OF MERITER HEALTH SERVICES, INC. -DISTRIBUTIONS OF ASSETS, UPON DISSOLUTION, ARE SUBJECT TO THE APPROVAL OF UNITYPOINT HEALTH, SOLE MEMBER OF MERITER HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 6 MERITER HEALTH SERVICES, INC., A TAX-EXEMPT, WISCONSIN NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A MERITER HEALTH SERVICES, INC., AS SOLE MEMBER, SHALL APPOINT ALL MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B MERITER HEALTH SERVICES, INC., AS SOLE MEMBER, SHALL AUTHORIZE OR APPROVE THE FOLLOWING ACTIONS: (A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; (C) A SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; (D) THE ESTABLISHMENT, FORMATION, ACQUISITION, MERGER, CONSOLIDATION OR DISSOLUTION OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; (E) THE ADOPTION OF THE AGGREGATE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (F) AGGREGATE BORROWING FOR PERIODS OF ONE (1) YEAR OR LESS FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME; AND AGGREGATE BORROWING FOR PERIODS OF MORE THAN ONE (1) YEAR FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME. FOR THE PURPOSE OF THIS SUBPARAGRAPH, THE TERM AGGREGATE BORROWING MEANS BORROWINGS NOT PREVIOUSLY INCLUDED IN THE OPERATING AND/OR CAPITAL BUDGETS, AND INCLUDES BUT IS NOT LIMITED TO LEASE AGREEMENTS AND CONTRACTS FOR SALE; (G) THE PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, AND ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME, NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET; (H) THE APPOINTMENT OF THE INDEPENDENT AUDITOR AND CORPORATE COUNSEL. FORM 990, PART VI, SECTION B, LINE 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 HOSPITAL BOARDS OF DIRECTORS CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ON A PROACTIVE BASIS, DECLARATIONS OF POTENTIAL CONFLICTS OF INTEREST ARE SIGNED WHEN EACH DIRECTOR JOINS THE BOARD AND ANNUALLY THEREAFTER. THE CEO AND BOARD CHAIR MONITOR THE POTENTIAL CONFLICTS DISCLOSED BY BOARD MEMBERS AND MANAGE ATTENDANCE AT MEETINGS AND PARTICIPATION IN VOTES ACCORDING TO THE ISSUE ON THE AGENDA. INDIVIDUAL DIRECTORS ALSO MONITOR THEIR POTENTIAL CONFLICTS AND RECUSE THEMSELVES FROM BOARD DISCUSSION AND/OR VOTES AS REQUIRED BY THE CIRCUMSTANCES. THE PROCESS OF MANAGING CONFLICTS OF INTEREST IS RECORDED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE IOWA HEALTH SYSTEM BOARD OF DIRECTORS ("COMMITTEE") CONDUCTS A COMPREHENSIVE 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 2014 FOR THE FOLLOWING INDIVIDUALS: BETH ERDMAN, SUE ERICKSON, PATRICIA GRUNWALD, GEOFFREY PRIEST AND PETER THOREEN. FOR THE COMPENSATION AND BENEFITS OF THE OTHER PERSONS LISTED ON FORM 990, PART VII, THE MERITER HEALTH SERVICES, INC. BOARD OF DIRECTORS APPROVES COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS AUTHORIZES A SUB-COMMITTEE OF THE BOARD TO MAKE COMPENSATION DECISIONS WHILE RETAINING OVERSIGHT OF SAID COMMITTEE. EXTERNAL HUMAN RESOURCES CONSULTING FIRM IS ENGAGED BY THE BOARD OF DIRECTORS' SUB-COMMITTEE. THIS FIRM COLLECTS AND REVIEWS ALL ORGANIZATIONAL INFORMATION, COMPENSATION DATA, AND BACKGROUND INFORMATION MATCHING ALL EXECUTIVE POSITIONS TO SURVEY BENCHMARKS. USING THIS INFORMATION THE CONSULTING FIRM PRODUCES ESTIMATED MARKET VALUES FOR EACH EXECUTIVE AND RECOMMENDS ANY NECESSARY CHANGES WITH EXECUTIVE COMPENSATION TO THE BOARD COMMITTEE FOR THEIR DECISION. COMPENSATION FOR NON-EXECUTIVES IS DETERMINED BY THE MERITER COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 18 BECAUSE THE ORGANIZATION FILED ITS FORM 1023 BEFORE JULY 1987 AND DID NOT HAVE A COPY OF FORM 1023 ON THAT DATE, IT IS NOT REQUIRED TO MAKE ITS FORM 1023 AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST THROUGH THE IOWA HEALTH SYSTEM, OUR PARENT ORGANIZATION, LEGAL DEPARTMENT. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ON THE IOWA HEALTH SYSTEM WEBSITE, WWW.UNITYPOINT.ORG. FORM 990, PART XI, LINE 9: CHANGES IN PENSION LIABILITY -2,385,710. ASSETS RELEASED FROM RESTRICTION -392,911. RELEASED FOR CAPITAL AND OTHER 395,166. FMV PURCHASE ACCOUNTING ADJUSTMENT & BOND -5,912,838. TEMPORARY RESTRICTED TRANSFER FOUNDATION 716,755. OTHER -740,876. ALLEN COLLEGE 1825 LOGAN AVENUE WATERLOO IA 50703 421351526 EDUCATE AND DEVELOP HEALTHCARE PROFESSIONALS IA 501(C)(3) 170(B)(1) (A)(II) ALLEN HEALTH SYSTEMS INC 0 ALLEN HEALTH SYSTEMS INC 1825 LOGAN AVENUE WATERLOO IA 50703 421201924 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 ALLEN MEMORIAL HOSPITAL CORPORATION 1825 LOGAN AVENUE WATERLOO IA 50703 420698265 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) ALLEN HEALTH SYSTEMS INC 0 ANAMOSA AREA AMBULANCE SERVICE 101 GRANT WOOD DRIVE ANAMOSA IA 52205 421466284 PROVIDE AMBULANCE SERVICES IA 501(C)(3) 509(A)(2) ST LUKE'SJONES REGIONAL MEDICAL CENTER 0 CENTRAL IOWA HEALTH PROPERTIES CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 421233759 PROPERTY HOLDING COMPANY IA 501(C)(2) CENTRAL IOWA HEALTH SYSTEM 0 CENTRAL IOWA HEALTH SYSTEM 1200 PLEASANT STREET DES MOINES IA 50309 421189791 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 CENTRAL IOWA HOSPITAL CORPORATION 1200 PLEASANT STREET DES MOINES IA 50309 420680452 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) CENTRAL IOWA HEALTH SYSTEM 0 DES MOINES AREA MEDICAL EDUCATION CONSORTIUM INC 1415 WOODLAND AVE SUITE 130 DES MOINES IA 50309 421412497 COORDINATION OF MEDICAL EDUCATION PROGRAMS IA 501(C)(3) 509(A)(3), TYPE III 0 FINLEY TRI-STATES HEALTH GROUP INC 350 NORTH GRANDVIEW AVENUE DUBUQUE IA 52001 421307495 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 HULT CENTER FOR HEALTHY LIVING INC 5409 N KNOXVILLE AVE PEORIA IL 61614 363510390 HEALTH EDUCATION TO THE COMMUNITY IL 501(C)(3) 170(B)(1) (A)(VI) PROCTOR HOSPITAL 0 IOWA HEALTH FOUNDATION 1415 WOODLAND AVE SUITE E-200 DES MOINES IA 50309 421467682 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) CENTRAL IOWA HEALTH SYSTEM 0 IOWA HEALTH SYSTEM 1776 WEST LAKES PKWY 400 WEST DES MOINES IA 50266 421435199 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IA 501(C)(3) 509(A)(3), TYPE III 0 IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION 8101 BIRCHWOOD COURT JOHNSTON IA 50131 421411630 PRIMARY HEALTH CARE SERVICES IA 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM 0 MEMORIAL FOUNDATION OF ALLEN HOSPITAL 1825 LOGAN AVENUE WATERLOO IA 50703 421201138 CHARITABLE FUNDRAISING IA 501(C)(3) 170(B)(1) (A)(VI) ALLEN HEALTH SYSTEMS INC 0 MERITER FOUNDATION INC 202 SOUTH PARK STREET MADISON WI 53715 237098688 CHARITABLE FUNDRAISING WI 501(C)(3) 170(B)(1) (A)(VI) MERITER HEALTH SERVICES INC 0 MERITER HEALTH SERVICES INC 202 SOUTH PARK STREET MADISON WI 53715 391412318 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE WI 501(C)(3) 509(A)(3), TYPE II IOWA HEALTH SYSTEM 0 MERITER HOSPITAL INC 202 SOUTH PARK STREET MADISON WI 53715 390806367 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) MERITER HEALTH SERVICES INC 0 MERITER MEDICAL GROUP INC 202 SOUTH PARK STREET MADISON WI 53715 050545222 SUPPORT SERVICES FOR MEDICAL CARE AND HEALTH SERVICES WI 501(C)(3) 509(A)(3), TYPE II MERITER HOSPITAL INC 1 METHODIST HEALTH SERVICES CORPORATION 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 371111135 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 509(A)(3), TYPE III IOWA HEALTH SYSTEM 0 METHODIST MEDICAL CENTER FOUNDATION 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 510186460 CHARITABLE FUNDRAISING IL 501(C)(3) 170(B)(1) (A)(VI) METHODIST HEALTH SERVICES CORPORATION 0 METHODIST MEDICAL CENTER OF ILLINOIS 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 370661223 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 METHODIST SERVICES INC 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 371111134 OFFICE RENTAL IL 501(C)(3) 509(A)(2) METHODIST HEALTH SERVICES CORPORATION 0 NELLIE R SHERWOOD TRUST 1026 A AVENUE NE CEDAR RAPIDS IA 52402 426061621 PAY MEDICAL BILLS OF RETIRED TEACHERS UNABLE TO PAY IA 501(C)(3) 509(A)(3), TYPE I ST LUKE'S METHODIST HOSPITAL 0 NORTH CENTRAL IOWA MENTAL HEALTH CENTER INCORPORATED 720 KENYON 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MERITER MEDICAL GROUP L 138981 BASED ON GAAP, CASH, AND/OR FMV. MERITER MEDICAL GROUP M 1528234 BASED ON GAAP, CASH, AND/OR FMV. 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 SEVENTEEN 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).