2015-11-16T09:30:28-06:00 2014-12-31 990 2014-01-01 421487967 ST LUKE'SJONES REGIONAL MEDICAL CENTER STLU 3194626131 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 ERIC BRIESEMEISTER PRESIDENT/CEO 3194626131 2015-11-12 2014 2016-04-25 22:37:26Z JONES REGIONAL MEDICAL CENTER ERIC BRIESEMEISTER 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 21900649 0 X WWW.UNITYPOINT.ORG/ANAMOSA X 1998 IA TO PROVIDE QUALITY SERVICES AND TO PROMOTE HEALTHY LIFESTYLES TO OUR CUSTOMERS. 9 4 228 96 0 0 23520 1228 21414142 21767888 806751 20430 99435 108507 22343848 21898053 10508742 43200 0 0 9090583 8499670 0 0 0 9881803 10710630 29481128 19253500 -7137280 2644553 21481749 27329854 2156748 5040218 19325001 22289636 X TO PROVIDE QUALITY SERVICES IN AN EFFICIENT, COST-EFFECTIVE MANNER AND TO PROMOTE HEALTHY LIFESTYLES TO OUR CUSTOMERS. 0 0 15716253 33819 21793408 HEALTH-CARE SERVICESST. LUKE'S/JONES REGIONAL 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, MENTAL HEALTH CARE, REHABILITATION, SKILLED NURSING, 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, 2014, ST. LUKE'S/JONES REGIONAL MEDICAL CENTER DISCHARGED 596 PATIENTS RESULTING IN A TOTAL OF 2,742 PATIENT DAYS. OUTPATIENT VISITS TOTALED 146,829 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 940. THERE WERE ALSO 9,407 EMERGENCY ROOM VISITS. 615204 9381 0 COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: ST. LUKE'S/JONES REGIONAL 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 $203,520 IN 2014. OFTENTIMES, ST. LUKE'S/JONES REGIONAL MEDICAL CENTER RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $495,711.OTHER BENEFITS: ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; HEALTH PROFESSIONAL'S EDUCATION; SUBSIDIZED HEALTH SERVICES; RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $119,493. 16331457 1 0 0 0 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 22 0 1 228 1 0 0 0 0 0 0 0 0 0 0 X 9 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X X RACHEL VONBEHREN FISCAL SERVICES 3194816302 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 MILTON AUNAN II BOARD MEMBER/VP FIN/CFO 1.00 40.00 X X 0 407294 86380 CHARLIE BECKER BOARD CHAIR 1.00 0.00 X X 0 0 0 ERIC BRIESEMEISTER BOARD MEMBER/ADMINISTRATOR 40.00 1.00 X X 0 162032 28209 VICTOR HAMRE BOARD VICE CHAIR 1.00 1.00 X X 0 0 0 JOHN HARMS BOARD MEMBER 1.00 0.00 X 0 0 0 MICHELLE NIERMANN BOARD SECRETARY/TREASURER & VP OPERATIONS 1.00 40.00 X X 0 407508 81770 JILL PARHAM BOARD MEMBER 1.00 1.00 X 0 0 0 THEODORE TOWNSEND JR BOARD MEMBER/PRES/CEO 1.00 40.00 X X 0 683464 204085 MICHAEL WESTON BOARD MEMBER 1.00 40.00 X 0 240446 33748 DEANNA COOK CHIEF NURSING OFFICER/DON 40.00 0.00 X 109465 0 3355 MARY MOSHER PHARMACY DIRECTOR 40.00 0.00 X 104986 0 4939 214451 1900744 442486 2 0 1 0 GRAHAM CONSTRUCTION 421 GRAND AVE DES MOINES IA 50309 CONSTRUCTION SERVICES 1164482 EAST CENTERAL IOWA ACUTE CARE LLP 1026 A AVE NE CEDAR RAPIDS IA 52402 ER DOCTOR STAFFING 785541 HEALTH ENTERPRISES OF IOWA 5825 DRY CREEK LANE NE CEDAR RAPIDS IA 52402 ECHO AND THERAPIES 472041 RICCOLO & SEMELROTH 425 2ND ST SE 1140 CEDAR RAPIDS IA 52401 LEGAL SERVICES 175000 EASTERN IOWA SLEEP CENTER LLC 600 7TH STREET SE CEDAR RAPIDS IA 52401 SLEEP STUDIES 166000 6 1228 1228 NET PATIENT REVENUE 900099 17063531 17063531 PHARMACY REVENUE 446110 4634622 4634622 RENTAL INCOME 531100 47772 47772 MANAGEMENT, IT AND SUPPORT SERVIC 561000 25463 25463 MISCELLANEOUS REVENUE 900099 -3500 -3500 21767888 20430 20430 9493 2596 6897 6897 CAFETERIA/FOOD SVCS 722210 76090 76090 SUBS & JOINT VENTURES 900099 24033 24033 MISCELLANEOUS REVENUE 900099 1487 1487 101610 21898053 21793408 0 103417 X 41000 41000 2200 2200 190241 190241 6708419 5994904 713515 105588 94358 11230 1020974 912382 108592 474448 423985 50463 1089780 1089780 29072 29072 38692 23660 15032 4347712 4183642 164070 33157 961 32196 354874 270771 84103 1033068 809318 223750 376593 340153 36440 48202 36096 12106 36408 31553 4855 489 489 1276780 1269897 6883 126822 126822 MEDICAL SUPPLIES 1887162 1883773 3389 MISCELLANEOUS EXPENSE 31819 12804 19015 19253500 16331457 2922043 0 4295529 6032370 37536 1775348 3229480 3816767 87311 121288 238613 263331 66443 74660 20024047 6243599 12400074 13780448 1126763 1436766 28876 21481749 27329854 1613480 2238321 1834109 76907 687575 466361 280213 2156748 5040218 X 18194523 20849156 1130478 1440480 19325001 22289636 21481749 27329854 X 2644553 320082 X 0 1 X 1 0 X 1130478 320083 10081 1440480 10726749 1098318 10694589 1130478 6755517 3978500 7268 10726749 6892721 -92142 45062 6755517 3068174 3533384 746263 455100 6892721 0.00000 0.00000 1.00000 0 1 1 297612 297612 5336524 1411972 3924552 11876186 4825569 7050617 2513725 6058 2507667 13780448 BENEFICIAL INTEREST IN JONES REGIONAL MEDICAL CENTER FOUNDATION 1436766 F 1436766 DUE TO AFFILIATES 280213 280213 X 22479000 633425 633425 21845575 52478 52478 21898053 19658000 450973 450973 19207027 46473 46473 19253500 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 2011. THE SYSTEM HAS NO MATERIAL UNCERTAIN TAX POSITIONS. CERTAIN SUBSIDIARIES ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. SOME OF THESE COPORATIONS 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: ELIMINATE SUBSIDIARY (ANAMOSA AREA AMBULANCE SERVICE) 619,645. SPECIAL EVENT EXPENSES 2,596. REVENUES IN TEMPORARILY RESTRICTED FUND BALANCE 10,081. ROUNDING 1,103. PART XI, LINE 4B - OTHER ADJUSTMENTS: IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATE 24,033. ELIMINATING ENTRIES 22,000. REVENUES IN UNRESTRICTED FUND BALANCE 6,445. PART XII, LINE 2D - OTHER ADJUSTMENTS: ELIMINATE SUBSIDIARY (ANAMOSA AREA AMBULANCE SERVICE) 448,377. SPECIAL EVENT EXPENSES 2,596. PART XII, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES 22,000. IOWA HEALTH SYSTEM CONTRACTING SERVICES PURCHASE REBATE 24,033. ROUNDING 440. 1 1 X 1 X 1 X 1 1 1 0 1 1 203520 203520 0.01060 517639 225448 292191 0.01520 721159 225448 495711 0.02580 100220 100220 0.00520 6459 6459 0.00030 12814 12814 0.00070 119493 119493 0.00620 840652 225448 615204 0.03200 4785 4785 0.00020 13636 13636 0.00070 3379 3379 0.00020 21800 21800 0.00110 0 524470 0 0 1 1 1 1 ST LUKE'SJONES REGIONAL MEDICAL CENTER 1795 HIGHWAY 64 EAST SUITE 2 ANAMOSA IA 52205 WWW.UNITYPOINT.ORG/ANAMOSA 530110H X X X X ST LUKE'SJONES REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X 13 1 1 0 1 X WWW.UNITYPOINT.ORG/ANAMOSA X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X 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 ST. LUKE'S/JONES REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: ST. LUKE'S METHODIST HOSPITAL, ST. LUKE'S CARE COMPANY (CONTINUING CARE HOSPITAL) AND JONES REGIONAL MEDICAL ARE ADDRESSING THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT BY CONTINUING TO MAKE PROGRESS ON AND MEETING THE OBJECTIVES IDENTIFIED IN THEIR RESPECTIVE PLANS. MANY OBJECTIVES THAT WE IDENTIFIED AND ARE IMPLEMENTING GET SPREAD ACROSS OUR REGION THAT INCLUDES ALL THREE ENTITIES, HOWEVER, WE WOULD LIKE TO HIGHLIGHT A FEW SPECIFIC TO THE SITES.OBESITYST. LUKE'S METHODIST HOSPITAL AND CONTINUING CARE HOSPITAL HELD HEALTHY EATING PROMOTION PROGRAMS INCLUDING COOKING WITH THE CARDIOLOGIST. WE ARE A BLUE ZONE WORKSITE. IN ADDITION, UNITYPOINT CLINICS HAVE BEEN ROLLING OUT PATIENT CENTERED MEDICAL HOMES WHICH HELP PATIENTS WITH HEALTHY EATING. THE MAJORITY OF CLINICS WILL HAVE MOVED TO THIS MODEL AND HAVE RECEIVED DESIGNATION AS SUCH. THESE CLINICS ALSO ARE IN THE JONES COUNTY AREA. STAFF ACROSS THE CONTINUUM WERE ALSO TRAINED IN CHRONIC DISEASE MANAGEMENT IN 2014 AND 2015 TO SUPPORT OUR PATIENTS ON IDENTIFYING THEIR GOALS, MOTIVATIONAL INTERVIEWING AND SIGNS AND SYMPTOMS IF THEY HAVE A CONDITION. THIS IS NOW AN ONGOING PART OF ORIENTATION FOR APPLICABLE TEAM MEMBERS.JONES REGIONAL MEDICAL CENTER CAFETERIA OFFERS HEALTHY FOODS AND EMPLOYEES ARE ENCOURAGED TO BE PHYSICALLY ACTIVE, AND 'BUY FRESH BUY LOCAL. WE SUPPORT WEIGHT WATCHERS AND COMMUNITY RUNS. WE OFFER CHRONIC DISEASE CLASSES, AND MONTHLY 'LUNCH AND LEARN" EDUCATION TO THE COMMUNITY. CANCERST. LUKE'S METHODIST HOSPITAL AND CONTINUING CARE HOSPITAL HAVE OFFERED FOUR COMMUNITY CANCER PREVENTION PROGRAMS IN THE AREAS OF LUNG CANCER SCREENING/PREVENTION, SKIN CANCER PREVENTION, ORAL/HEAD AND NECK SCREENING. WE HAVE INCREASED THE NUMBER OF INDIVIDUALS RECEIVING A LUNG CHECK TO SCREEN FOR LUNG CANCER AND ASSOCIATED RISK FACTORS FROM 120 IN 2015 COMPARED TO 13 IN 2014. WE HAVE COLLABORATED WITH AREA HIGH SCHOOLS TO DEVELOP AND IMPLEMENT A VERY SUCCESSFUL SKIN CANCER PREVENTION SOCIAL MARKETING CAMPAIGN. WE HAD A 2015 FREE MAMMOGRAPHY AND PAP EVENT IN COLLABORATION WITH COMMUNITY PARTNERS WHERE WE PROVIDED FOR WOMEN AGE 40-64 WITH NO MEDICAL INSURANCE QUALIFY - INCOME GUIDELINES DO APPLY.ALL PATIENTS WERE SIGNED UP FOR THE CARE FOR YOURSELF AND ESPECIALLY FOR YOU PROGRAMS WITH LINN COUNTY PUBLIC HEALTH, RECEIVED INFORMATION REGARDING INSURANCE SIGN UP AND ACCESS TO OTHER SERVICES BY EASTERN IOWA HEALTH CENTER. NINETEEN TOTAL INDIVIDUALS WERE SEEN WITH 19 CBE AND MAMMOGRAMS PERFORMED WITH 9 PAP TESTS PERFORMED.AT JONES REGIONAL MEDICAL CENTER, WE FACILITATE A CANCER SUPPORT GROUP, HAVE STAFF CERTIFIED SMOKING CESSATION EDUCATION AND SCREEN ALL INPATIENT ADMISSIONS FOR SMOKING CESSATION NEEDS.SUBSTANCE ABUSEAT JONES REGIONAL MEDICAL CENTER, ALL INPATIENT ADMISSIONS ARE SCREENED FOR SMOKING CESSATION NEEDS. IN ADDITION, STAFF CERTIFIED SMOKING CESSATION EDUCATION IS AVAILABLE.MENTAL HEALTHST. LUKE'S METHODIST HOSPITAL AND CONTINUING CARE HOSPITAL HAVE BEEN FURTHERING OUR OBJECTIVES TO SUPPORT MENTAL HEALTH NEEDS. IN THE CONTINUING CARE HOSPITAL, WE HAVE PROVIDED EDUCATION TO ALL CLINICAL STAFF AT THE ANNUAL SKILLS FAIR IN OCTOBER 2015. A 2 QUESTIONS DEPRESSION SCREEN HAS BEGUN TO BE COMPLETED ON ADMISSION FOR EACH PATIENT IN THE CONTINUING CARE HOSPITAL AS WELL AS IN ALL UNITYPOINT CLINICS. WE ARE PLANNING TO ROLE THIS OUT IN THE HOSPITAL AS WELL. WE ENSURE MENTAL HEALTH IS PART OF PATIENT CARE TEAM CONFERENCE DISCUSSIONS AND CARE PLANS FOR ALL PATIENTS FROM JANUARY 2014 - DECEMBER 2015. THIS IS PART OF THE WEEKLY DISCUSSION AT OUR PATIENT CARE TEAM MEETINGS. RECOMMENDATIONS IN REGARDS TO MENTAL HEALTH TREATMENTS ARE BROUGHT TO THE PROVIDER BY CASE MANAGEMENT FOLLOWING THE MEETING. IN ADDITION, WE HAVE INCLUDED A BEHAVIORAL HEALTH REPRESENTATIVE IN OUR ST. LUKE'S MEETINGS TO ADDRESS HIGH RISK PATIENT NEEDS, AND HAVE STARTED TO INTEGRATED BEHAVIORAL HEALTH INTO THE PATIENT CENTERED MEDICAL HOMES. OBJECTIVES WE ARE CONTINUING TO WORK ON ARE RELATED TO OUR ADOLESCENT LIFE PROGRAM WITH IMPLEMENTING YOUTH SUICIDE SCREENING. ONE OF THE LARGE HIGH SCHOOLS HAS IMPLEMENTED A GOOD SCREENING, BUT THERE IS ADDITIONAL OPPORTUNITY IN OTHER SCHOOLS. IN ADDITION, WE ARE CONSISTENTLY MAKING SURE MOST OF OUR KIDS SEE A THERAPIST (FAMILY OR INDIVIDUAL). HOWEVER WE DO NOT HAVE A THERAPIST WHO COMES TO WORK WITH THE FAMILIES. AT JONES REGIONAL, COUNSELING SERVICES AVAILABLE AND THE THERAPIST FREQUENTLY GOES TO THE ADJACENT UNITYPOINT CLINIC TO MEET INDIVIDUALS. PUBLIC HEALTH AND LINN COUNTY RESOURCES ARE ALSO MADE AVAILABLE.ACCESS TO CAREST. LUKE'S METHODIST HOSPITAL AND JONES REGIONAL MEDICAL CENTER SUPPORTED INDIVIDUALS IN OUR COMMUNITY WHO DIDN'T HAVE INSURANCE WITH SIGNING UP FOR THE IOWA HEALTH AND WELLNESS PROGRAM. WE TRAINED INDIVIDUALS IN THE HOSPITAL ON HOW TO BE DESIGNATED COUNSELORS TO ASSIST AND MAINTAINED SCHEDULED HOURS IN THE HOSPITAL AND VOLUNTEERED IN COMMUNITY SITES TO ASSIST. WE ARE AN ACTIVE MEMBER IN THE LINN COUNTY COMMUNITY COALITION, A COLLECTIVE EFFORT IN THE COMMUNITY TO PROMOTE, SUPPORT AND OFFER INSURANCE SIGN UP ASSISTANCE. OUR COMMUNITY COALITION EFFORTS WERE RECOGNIZED BY IOWA REPRESENTATIVES IN CONGRESS AS WELL AS MEMBERS IN STATE LEADERSHIP.TO REDUCE THE USE OF THE EMERGENCY ROOM FOR NON-EMERGENT CARE BY PROVIDING A PLAN OF CARE IN CONJUNCTION WITH THE PRIMARY CARE PROVIDER, OUR EMERGENCY DEPARTMENT CONSISTENT CARE PROGRAM (EDCCP) HAS CONTINUED TO EXPAND THE CARE PLANS FOR INDIVIDUALS. IN ADDITION, THIS PROGRAM IS NOW AT JONES REGIONAL MEDICAL CENTER AS WELL AS HAS BEEN SPREAD THROUGHOUT UNITYPOINT HEALTH IN 3 STATES. THE EDCCP TEAM MEETS QUARTERLY TO DISCUSS OPPORTUNITIES, AS WELL AS HOSTS QUARTERLY CALLS WITH OTHER EDCCP PROGRAMS IN THE HEALTH SYSTEM AND A YEARLY FACE TO FACE MEETING. NEW STAFF COMING INTO OUR ED DEPARTMENT RECEIVES TRAINING ON EDCCP.IN 2014, WE ESTABLISHED A POPULATION HEALTH STEERING COMMITTEE TO ADDRESS THE HEALTH OF OUR POPULATION AND ACCESS TO SERVICES. REPRESENTATIVES OF ST. LUKE'S, CONTINUING CARE HOSPITAL AND JONES ARE PARTICIPANTS. IN 2014 A MEMBER OF THE CCH TEAM SERVED AS THE ELDERLY CONSORTIUM SECRETARY. CCH AND ST. LUKE'S HAVE JOINTLY HOSTED AT LEAST ONE ELDERLY CONSORTIUM MEETING IN 2014 AND 2015. CCH HAS ALSO PROVIDED EDUCATION TO THE CONSORTIUM IN 2014 AND 2015. ST. LUKE'S, JONES REGIONAL AND CCH ALL WORK WITH EACH PATIENT INDIVIDUALLY TO ENSURE THEY ARE ASSIGNED TO A PRIMARY CARE PROVIDER PRIOR TO DISCHARGE AND ASSIGNED TO AN AREA CARE COORDINATOR OR CARE NAVIGATOR (FOR HIGH RISK PATIENTS).JRMC FACILITATES A COMMUNITY CROSS CONTINUUM COMMITTEE; PARTICIPANTS INCLUDE HOME HEALTH, NURSING HOME, AND PUBLIC HEALTH, PHARMACY, AND JRMC STAFF. J RMC'S WIDE RANGE OF SERVICES IS ADVERTISED IN MULTIPLE COMMUNITY NEWSPAPERS.SEXUAL HEALTHPER OUR OBJECTIVES, WE HAVE A REPRESENTATIVE THAT REGULARLY ATTENDS THE SEXUAL HEALTH ALLIANCE OF LINN AND JOHNSON COUNTIES. OUR FAMILY HEALTH CENTER PROVIDES WEEKLY CLINICS AT JONES REGIONAL AND OTHER LOCATIONS. IN ADDITION, 24 EDUCATION / OUTREACH EFFORTS HAVE BEEN COMPLETED BY OUR FAMILY HEALTH CENTER SERVING OVER 2000 PARTICIPATING STUDENTS.ORAL HEALTHOUR DR. RHYS B. JONES DENTAL HEALTH CENTER CARES FOR LOW-INCOME CHILDREN AND DEVELOPMENTALLY-DISABLED INDIVIDUALS FROM EAST CENTRAL IOWA. IN 2015 YEAR TO DATE, THE CENTER HAS PROVIDED OVER 4500 VISITS TO THIS POPULATION. OF THESE VISITS, THEY HAVE SERVED 900 NEW PATIENTS IN 2015. THEY CONTINUE TO DO DENTAL SCREENINGS FOR THE MAJORITY OF SCHOOLS THROUGHOUT LINN COUNTY. ST. LUKE'S/JONES REGIONAL MEDICAL CENTER 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 U.S. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM, FAMILY INVESTMENT PROGRAM, BARNABAS UPLIFT, MISSION HEALTH, AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. LINE 16B WWW.UNITYPOINT.ORG/ANAMOSA/FINANCIAL-ASSISTANCE.ASPX PART I, LINE 6A: ST. LUKE'S/JONES REGIONAL MEDICAL CENTER'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE IOWA HEALTH SYSTEM COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED AT WWW.UNITYPOINT.ORG. THIS SYSTEM-WIDE REPORT IS COMPLETED IN ADDITION TO THE COMMUNITY BENEFIT REPORT FOR THE HOSPITAL AND ITS REGIONAL AFFILIATES. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. PART II, COMMUNITY BUILDING ACTIVITIES: 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. 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 ST. LUKE'S JONES REGIONAL 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 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. LINE 16A WWW.UNITYPOINT.ORG/ANAMOSA/FINANCIAL-ASSISTANCE.ASPX PART VI, LINE 2: ST. LUKE'S/JONES REGIONAL MEDICAL CENTER CONTINUALLYMONITORS COMMUNITY NEEDS SPECIFIC TO ITS SERVICE LINES AND THE RESOURCES IT CAN LEVERAGE TO ADDRESS THEM. INDIVIDUAL DEPARTMENTS WORK TO IDENTIFY SPECIFIC NEEDS RELATED TO THEIR SERVICES AND THE POPULATION THEY IMPACT. ALSO, MANY STAFF MEMBERS SERVE ON COMMITTEES OR BOARDS FOR ORGANIZATIONS IN THE COUNTY AND GATHER FEEDBACK FOR HEALTH NEEDS THROUGH THOSE RELATIONSHIPS. IN ADDITION, STAFF MEMBERS PRESENT TO MANY COMMUNITY GROUPS THROUGHOUT THE YEAR AND RECEIVE FEEDBACK ON HEALTH NEEDS THROUGH THESE VENUES. PART VI, LINE 3: ST. LUKE'S JONES REGIONAL MEDICAL CENTER PERFORMS THE FOLLOWING ACTIVITIES TO COMMUNICATE THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE TO ALL PATIENTS: 1) PLACES SIGNAGE, INFORMATION, AND/OR BROCHURES IN APPROPRIATE AREAS OF THE PROVIDER (E.G., THE EMERGENCY DEPARTMENT, AND REGISTRATION AND CHECK-OUT/CASHIER AREAS) STATING THE PROVIDER/PHYSICIAN PRACTICE OFFERS CHARITY CARE AND DESCRIBES HOW TO OBTAIN MORE INFORMATION ABOUT FINANCIAL ASSISTANCE, 2) PLACES A NOTE ON THE HEALTH-CARE BILL AND STATEMENTS REGARDING HOW TO REQUEST INFORMATION ABOUT FINANCIAL ASSISTANCE, 3) DESIGNATES INDIVIDUALS WHO CAN EXPLAIN THE PROVIDER'S CHARITY CARE POLICY, AND 4) INSTRUCTS STAFF WHO INTERACT WITH PATIENTS TO DIRECT QUESTIONS REGARDING THE CHARITY CARE POLICY TO THE PROPER PROVIDER REPRESENTATIVE. PART VI, LINE 4: ST. LUKE'S JONES REGIONAL MEDICAL CENTER IS A 22-BED COMMUNITY HOSPITAL SERVING EAST CENTRAL IOWA. ST. LUKE'S JONES REGIONAL MEDICAL CENTER IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF ST. LUKE'S JONES REGIONAL MEDICAL CENTER MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF JONES. ST. LUKE'S JONES REGIONAL MEDICAL CENTER ADMITS APPROXIMATELY 513 INPATIENTS AND CARES FOR 8,724 EMERGENCY PATIENTS PER YEAR. THE MEDIAN HOUSEHOLD INCOME IS $55,041 AND THE AVERAGE POVERTY RATE IS 8.3%. 88% OF ST. LUKE'S JONES REGIONAL MEDICAL CENTER INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. ST. LUKE'S JONES REGIONAL DEMOGRAPIC REGION IS COMPRISED OF 95% CAUCASION, 2% AFRICAN AMERICAN AND 1% 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 $3.7 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 IA 1 JONES REGIONAL MEDICAL CENTER FOUNDATION 1795 HIGHWAY 64 EAST ANAMOSA IA 52205 421429225 501(C)(3) 40000 PROGRAM SUPPORT 1 0 PART I, LINE 2: THE ORGANIZATION 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 X 0 1 0 0 0 0 0 0 0 MILTON AUNAN II BOARD MEMBER/VP FIN/CFO 0 280405 0 92926 0 33963 0 73851 0 12529 0 493674 0 0 ERIC BRIESEMEISTER BOARD MEMBER/ADMINISTRATOR 0 142135 0 16652 0 3245 0 8432 0 19777 0 190241 0 0 MICHELLE NIERMANN BOARD SECRETARY/TREASURER & VP OPERA 0 289636 0 85054 0 32818 0 60789 0 20981 0 489278 0 0 THEODORE TOWNSEND JR BOARD MEMBER/PRES/CEO 0 451685 0 164469 0 67310 0 183351 0 20734 0 887549 0 0 MICHAEL WESTON BOARD MEMBER 0 223188 0 15950 0 1308 0 12988 0 20760 0 274194 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED RETIREMENT PLAN WITH THE FOLLOWING CHANGES TO THEIR ACCOUNTS: MILTON AUNAN II $51,224, MICHELLE NIERMANN $47,789, AND THEODORE TOWNSEND, JR. $143,405. A CITY OF ANAMOSA IOWA 426004229 2014-08-29 8250000 CONSTRUCT AND EQUIP HOSPITAL AND CLINIC FACILITIES OF THE ORGANIZATION 0 0 0 A 8250000 8250000 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 HEALTH ENTERPRISES OF IOWA COMMON BOARD MEMBER/OFFICER 486154 PURCHASED IMAGING SERVICES 0 FORM 990, PART VI, SECTION A, LINE 6 ST. LUKE'S HEALTHCARE, A TAX-EXEMPT IOWA NONPROFIT CORPORATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A ST. LUKE'S HEALTHCARE CAN APPOINT FIVE BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B ST. LUKE'S HEALTHCARE, AS SOLE MEMBER SHALL APPROVE ARTICLE AND BYLAW AMENDMENTS, DISSOLUTIONS, APPOINT FIVE BOARD MEMBERS AND APPROVE APPOINTMENT OF PRESIDENT. 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 2014 FOR THE FOLLOWING INDIVIDUALS: MILTON AUNAN II, MICHELLE NIERMANN, THEODORE TOWNSEND, JR. 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 IX, LINE 11G HEALTHCARE PROFESSIONALS : PROGRAM SERVICE EXPENSES 3,762,714. MANAGEMENT AND GENERAL EXPENSES 68,939. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,831,653. MISC PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 420,928. MANAGEMENT AND GENERAL EXPENSES 95,131. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 516,059. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST OF JONES REGIONAL MEDICAL CENTER FOUNDATION 320,082. 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 1 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 0 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 DRIVE FORT DODGE IA 50501 420937390 MENTAL HEALTH CARE IA 501(C)(3) 170(B)(1) (A)(III) TRINITY HEALTH SYSTEMS INC 0 NORTHWEST IOWA HOSPITAL CORPORATION 2720 STONE PARK BLVD SIOUX CITY IA 51104 421019872 HOSPITAL IA 501(C)(3) 170(B)(1) (A)(III) IOWA HEALTH SYSTEM 0 PROCTOR HEALTH CARE INCORPORATED 5409 N KNOXVILLE AVE PEORIA IL 61614 371133412 SUPPORT AFFILIATES' MISSION TO IMPROVE HEALTH CARE IL 501(C)(3) 170(B)(1) (A)(III) METHODIST HEALTH SERVICES CORPORATION 0 PROCTOR HEALTH SYSTEMS 5409 N KNOXVILLE AVE PEORIA IL 61614 364147437 PRIMARY HEALTH CARE SERVICES IL 501(C)(3) 170(B)(1) (A)(III) PROCTOR HEALTH CARE INCORPORATED 0 PROCTOR HOSPITAL 5409 N KNOXVILLE AVE PEORIA IL 61614 370681540 HOSPITAL IL 501(C)(3) 170(B)(1) (A)(III) PROCTOR HEALTH CARE INCORPORATED 0 SELF INSURANCE TRUST AGREEMENT EST BY METHODIST MEDICAL CENTER OF ILLINOIS 221 NORTHEAST GLEN OAK AVENUE PEORIA IL 61636 376181831 FUND SELF-INSURANCE PLAN IL 501(C)(3) 509(A)(3), TYPE I METHODIST MEDICAL CENER OF ILLINOIS 0 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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).