4A (Expenses $ 105419909 including grants of $ 461999) (Revenue $ 126365322)
HEALTH-CARE SERVICESTHE FINLEY HOSPITAL IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE IOWA, ILLINOIS AND WISCONSIN TRI-STATE AREA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH-CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. THE FINLEY HOSPITAL 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, HOME HEALTH, INTENSIVE CARE AND CRITICAL CARE, MENTAL HEALTH CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, BEHAVIORAL DISORDER PROGRAMS, MATERNAL/CHILD CARE, LABORATORY, PALLIATIVE CARE, PHARMACEUTICAL DRUGS, EMERGENCY SERVICES, OUTPATIENT CLINICS, CHECK-UPS AND RADIOLOGY. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2021, THE FINLEY HOSPITAL DISCHARGED 3,884 PATIENTS RESULTING IN A TOTAL OF 55,172 PATIENT DAYS. TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 5,037. THERE WERE ALSO 21,824 EMERGENCY ROOM VISITS AND 586 BABIES DELIVERED.

4B (Expenses $ 11623991 including grants of $ 23074) (Revenue $ 0)
COMMUNITY BENEFITS, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: THE FINLEY HOSPITAL 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 COST OF $677,547 IN 2021. IT IS MORE COMMON FOR FINLEY HOSPITAL TO RECEIVE PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. THE FINLEY HOSPITAL PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. THE FINLEY HOSPITAL'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $7,860,732 FOR 2021. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $8,538,279.OTHER BENEFITS: THE FINLEY HOSPITAL 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. THE FINLEY HOSPITAL COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. THE FINLEY HOSPITAL HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $3,085,712.

THE FINLEY HOSPITAL
PART V, SECTION B, LINE 5: THE FINLEY HOSPITAL PARTICIPATED IN A COMMUNITY STEERING COMMITTEE COMPRISED OF REPRESENTATION FROM VARIOUS HEALTHCARE ORGANIZATIONS AND DUBUQUE COUNTY GOVERNMENT AGENCIES. THE STEERING COMMITTEE CONVENED SEVERAL TASK FORCES TO SOLICIT INPUT FROM LOCAL EXPERTS AND KEY COMMUNITY STAKEHOLDERS. THE TASK FORCE MEETINGS WERE DESIGNED TO SHARE INFORMATION AND DATA BETWEEN ORGANIZATIONS, IDENTIFY STRENGTHS, WEAKNESSES, OPPORTUNITIES AND BARRIERS WITHIN THE COMMUNITY, AND ESTABLISH GOALS AND PRIORITIES FOR INCLUSION IN THE CHNA & HIP. ADDITIONALLY, THE STEERING COMMITTEE CONDUCTED A COUNTY-WIDE SURVEY TO GAUGE PUBLIC PERCEPTION OF COMMUNITY HEALTH NEEDS. SEE 6B FOR A ROSTER OF PARTICIAPTING COMMUNITY LEADERS

THE FINLEY HOSPITAL
PART V, SECTION B, LINE 6A: MERCYONE - DUBUQUE & DYERSVILLE

THE FINLEY HOSPITAL
PART V, SECTION B, LINE 6B: CITY OF DUBUQUE, DUBUQUE COUNTY HEALTH DEPARTMENT, HILLCREST FAMILY SERVICES AND VISITING NURSE ASSOCIATION

THE FINLEY HOSPITAL
PART V, SECTION B, LINE 11: IN 2018, UNITYPOINT HEALTH-FINLEY HOSPITAL IDENTIFIED SEVERAL HIGH PRIORITY HEALTH NEEDS; OPIOID USE AND ABUSE, OBESITY AND OVERWEIGHT, ALCOHOL USE AND ABUSE, MENTAL HEALTH ACCESS, INFLUENZA IMMUNIZATION, HEALTHY HOMES, PRIMARY CARE ACCESS, EMERGENCY AND DISASTER PLANNING, DRINKING WATER PROTECTION, DENTAL CARE ACCESS, SPECIALTY CARE ACCESS, ELDER CARE ACCESS, HIV AND AIDS SCREENING AND PREVALENCE AND STD AND STI SCREENING AND PREVALENCE.UNITYPOINT HEALTH-FINLEY HOSPITAL WORKED WITH MERCYONE DUBUQUE & DYERSVILLE, CRESCENT COMMUNITY HEALTH CENTER, THE CITY OF DUBUQUE AND THE DUBUQUE COUNTY HEALTH DEPARTMENT TO DEVELOP THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT. IT WAS DETERMINED THAT THE SIGNIFICANT HEALTH NEEDS BE DIVIDED INTO FOUR UNIQUE CATEGORIES: 1) HEALTHY BEHAVIORS AND LIFESTYLES, 2) DISEASE INFECTION CONTROL, 3) HEALTHCARE ACCESS AND 4) ENVIRONMENTAL HEALTH WITH NEEDS ADDRESSED AS FOLLOWS:HEALTHY BEHAVIORS AND LIFESTYLESUNITYPOINT HEALTH-FINLEY HOSPITAL'S GOAL OF REDUCING THE OVERWEIGHT POPULATION IN DUBUQUE COUNTY WAS ADDRESSED BY BEING A MEMBER OF THE DUBUQUE COUNTY WELLNESS COALITION AND SPEAKING ON THE BENEFITS OF BEING A MEMBER. IN ADDITION, FINLEY PARTICIPATES IN THE ANNUAL BIKE RODEO TO SUPPORT ADOLESCENT PHYSICAL ACTIVITY AND PROVIDES HELMETS TO PROMOTE SAFETY. NEXT, FINLEY HOSPITAL HAS AN EXTENSIVE DIABETES PROGRAM THAT HELPS INDIVIDUALS WITH HEALTHY DIETS AND MANAGING DIABETES. THIS PROGRAM HAS BEEN KNOWN TO SUPPORT PATIENTS IN MANAGING THEIR DIABETES WITH DIET INSTEAD OF INSULIN. FINALLY, UNITYPOINT HEALTH PROMOTES LOCAL FOOD INITIATIVES SUCH AS DOUBLE-UP FOOD BUCKS, DUBUQUE FARMER'S MARKET AND COMMUNITY GARDENING PROJECTS. UNITYPOINT HEALTH PROVIDES MEALS TO THE MISSION MONTHLY TO SUPPORT HEALTHY EATING FOR THOSE THAT ARE DISPOSSESSED.DISEASE INFECTION CONTROLUNITYPOINT HEALTH VISITING NURSE ASSOCIATION (VNA) HAS SERVED HUNDREDS OF PEOPLE LIVING WITH HIV BY PROVIDING CASE MANAGEMENT SERVICES, ORAL HEALTH MANAGEMENT, MEDICATION ACCESS AS WELL AS FINANCIAL SUPPORT. THIS WORK RESULTED IN A 78% VIRAL LOAD SUPPRESSION RATE FOR 2020. NEXT, UNITYPOINT HEALTH PROVIDED FLU VACCINES FOR CHILDREN AND ADULTS AT NO COST. OVER THE LAST FEW MONTHS, THE VNA HAS BEEN INSTRUMENTAL IN PROVIDING THE COMMUNITY COVID-19 VACCINES AND HAS OPEN CLINICS THROUGHOUT THE COMMUNITY NEARLY EVERY DAY. ADDITIONALLY, THE VNA PROVIDES VACCINATIONS TO CHILDREN 0-18 ENROLLED IN MEDICAID, UNDERINSURED AND UNINSURED. THESE EFFORTS RESULTED IN 2,089 CHILDREN RECEIVING VACCINATIONS IN 2020 ALONE. FINALLY, UNITYPOINT HEALTH INCREASED THE NUMBER OF HIV TESTING IN ALL ITS CLINIC LOCATIONS TO DECREASE THE NUMBER OF UNDIAGNOSED INDIVIDUALS.HEALTHCARE ACCESS UNITYPOINT HEALTH-FINLEY HOSPITAL DEVELOPED AND INITIATED A CARE MANAGEMENT PROGRAM IN JUNE 2020. THIS PROGRAM SERVES PATIENTS IN OUR NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION (ACO) WHO ARE AT A 30% OR GREATER RISK FOR READMISSION. GOALS OF THE CARE MANAGEMENT PROGRAM INCLUDE IMPROVED CONTINUITY OF CARE, MAXIMIZING RESOURCES TO SERVE THE GREATEST NUMBER OF HIGH-RISK PATIENTS, GAIN COST EFFICIENCIES, AND UTILIZATION COST AVOIDANCE. SUCCESS METRICS INCLUDE A DECREASE IN READMISSIONS, DECREASE IN AVOIDABLE ADMISSIONS AND DECREASE IN UNNECESSARY ED UTILIZATION. THE CARE MANAGEMENT PROGRAM IS ACTIVE IN ALL DUBUQUE REGION UPH CLINICS AND IN GRAND RIVER MEDICAL GROUP. THE PROGRAM HAS 117 PATIENTS ENROLLED. NEXT, PATIENT COMMUNICATION WITH NURSE NAVIGATORS CONTINUES TO BE A WELL UTILIZED SERVICE THROUGHOUT THE HOSPITAL SERVING OVER 1,050 PATIENTS PER YEAR. ANOTHER AREA OF ACCESS THAT IS PROVIDED TO THE COMMUNITY IS THE ACCESS FOR EMS, NURSING, THERAPY AND RADIOLOGY STUDENTS THAT TOUR, SHADOW AND COMPLETE CLINICALS IN OUR ORGANIZATION. THESE PROGRAMS ARE ABLE TO SERVE OVER 300 STUDENTS PER YEAR AND SUPPORT OUR NEED FOR HEALTHCARE PROFESSIONALS. FINALLY, THE VISITING NURSE ASSOCIATION PROVIDES ACCESS TO UNDERINSURED AND UNINSURED INDIVIDUALS BY PROVIDING DENTAL SCREENINGS THROUGH ISMILE, PROVIDING MENTAL HEALTH SERVICES FOR EARLY DETECTION AND PROVIDING MOM BABY SERVICES FOR MOTHERS, NEWBORNS AND PREGNANT WOMEN.ENVIRONMENTAL HEALTHUNITYPOINT HEALTH-VNA PROVIDES LEAD TESTING, EDUCATION, HOME ASSESSMENTS AND CASE MANAGEMENT TO CHILDREN 0-6 YEARS OF AGE. THIS PROGRAM HAS INCREASED THE NUMBER OF LEAD TESTS GIVEN BY 12.5% SINCE 2014. ADDITIONALLY, THE VNA WORKS DIRECTLY WITH THE HOME ADVOCACY PROGRAM TO SUPPORT HEALTHY HOMES. THIS WORK PROVIDES SOCIAL WORK HOME VISITS, EDUCATION, RESOURCE CONNECTIONS AND ASSESSMENT TO FAMILIES. DIRECT IMPACT ON DRINKING WATER PROTECTION IS ADDRESS BY CITY AND COUNTY RESOURCES AND SUPPORTED BY THE HOSPITAL IF THE NEED ARISES.

THE FINLEY HOSPITAL
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. STATE LAW REQUIREMENTS THAT OFFER ADDITIONAL AND/OR MORE STRINGENT ELIGIBILITY REQUIREMENTS WILL BE FOLLOWED FOR THOSE STATES.

PART I, LINE 6A:
THE FINLEY HOSPITAL'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 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 $ -25,000.

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. THE FINLEY HOSPITAL CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. I.E. FINLEY SPONSORS A MEAL SERVED AT THE LOCAL MISSION WITH STAFF SERVING AND FINLEY SUPPLYING THE FOOD ON A MONTHLY BASIS, SPACE IS PROVIDED FOR THE SHIIP PROGRAM (SENIOR HEALTH INSURANCE INFORMATION PROGRAM), ANNUALLY A HOLIDAY MEAL WITH SANTA, PRESENTS, AND A MEAL PROVIDED TO LOCAL FAMILIES IN NEED. 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. THE HOSPITAL EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, THE HOSPITAL 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 THE FINLEY HOSPITAL. 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 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 4:
THE FINLEY HOSPITAL IS A 126 BED COMMUNITY HOSPITAL SERVING THE MIDWEST REGION. THE FINLEY HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF THE FINLEY HOSPITAL MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF CLAYTON, DELAWARE, DUBUQUE, JACKSON AND GRANT. THE FINLEY HOSPITAL ADMITS APPROXIMATELY 4,600,INPATIENTS AND CARES FOR 21,000 EMERGENCY PATIENTS PER YEAR. THERE ARE 2 OTHER HOSPITALS WITHIN THE COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOME IS $64,493 AND THE AVERAGE POVERTY RATE IS 9.9%.64.2% OF FINLEY HOSPITAL'S INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID.

PART VI, LINE 2:
THE FINLEY HOSPITAL CONTINUALLY WORKS WITH COMMUNITY PARTNERS IN THE REGION TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. SPECIFICALLY, THE FINLEY HOSPITAL IS ACTIVELY ENGAGED IN THE WORK ON THE DUBUQUE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT & HEALTH IMPROVEMENT PLAN (CHNA/HIP). THE CHNA/HIP IS A COMMUNITY COLLABORATIVE MANDATED BY IOWA CODE REQUIRING ALL IOWA COUNTIES' BOARDS OF HEALTH TO COMPLETE EVERY FIVE YEARS. THE FINLEY HOSPITAL PROVIDES LEADERSHIP AND ASSISTANCE TO THE BOARD OF HEALTH TO COMPLETE THE CHNA/HIP AND IMPLEMENT ACTION PLANS DEVELOPED DURING THE PROCESS. THE CHNA/HIP ASSESSES COMMUNITY HEALTH NEEDS BASED ON DATA ON SPECIFIC INDICATORS, PRIORITIZES AND ADDRESSES NEEDS IN THE HEALTH IMPROVEMENT PLAN, AND THEN ASSISTS THE BOARD OF HEALTH TO IMPLEMENT WITH COMMUNITY PARTNERS. THROUGHOUT THE CHNA/HIP PROCESS THE FINLEY HOSITAL ASSISTS THE COMMUNITY AND BOARD OF HEALTH TO DEVELOP A HEALTH AGENDA BY IDENTIFYING SPECIFIC HEALTH PRIORITIES THAT ARE RELEVANT TO THE COMMUNITY. THE FINLEY HOSPITAL WORKS COLLECTIVELY WITH THE BOARD OF HEALTH AND THE COMMUNITY TO ADDRESS THE PRIORITIES THROUGH LEVERAGING THE RESOURCES OF THE COMMUNITY. THE FINLEY HOSPITAL ACTIVELY CONTRIBUTES TO THIS PROCESS AND ENGAGES IN THE IDENTIFIED PRIORITIES THAT MATCH ITS MISSION AND CAPACITY. FINLEY HOSPITAL IS ALSO A SPONSORING PARTNER FOR THE VISITING NURSE ASSOCIATION AND CRESCENT COMMUNITY HEALTH CENTER, WHICH ENABLE COMMUNITY RESIDENTS TO MORE EASILY ACCESS HEALTH AND DENTAL CARE.THE CORE INITIATIVES FINLEY IDENTIFIED IN THE CHNA/HIP INCLUDE THE DEVELOPMENT OF RESOURCES FOR SEXUALLY TRANSMITTED DISEASE TESTING AND TREATMENT. FINLEY IS ACTIVELY INVOLVED IN THE RYAN WHITE HIV/AIDS PROGRAM WHICH INCLUDES THE IMPLEMENTATION OF TELEHEALTH RESOURCES IN THE CLINICS. THE CHNA-HIP IDENTIFIED ACCESS TO MENTAL HEALTH PROVIDERS AS A CORE INITITIAVE. THE FINLEY HOSPITAL HAS CONTRACTED SERVICES THROUGH HORIZON HEALTH TO OPERATE AN INPATIENT HOSPITAL UNIT. ADDITIONALLY, HORIZON PROVIDES RESOURCES TO OPERATE AN INTENSIVE OUTPATIENT PROGRAM. THE FINLEY HOSPITAL IS ALSO INCREASING BEHAVIORAL HEALTH OUTREACH PROVIDER ACCESS TO ITS CLINIC LOCATIONS. A THIRD INITIATIVE IS TO EXPAND SUBSTANCE USE PRVENTION AND TRAINING RESOURCES. THE FINLEY HOSPITAL IS ACTIVELY ENGAGED IN A MULTI-DISCIPLINARY TASKFORCE COMPRISED OF REGIONAL AGENCIES TO COORDINATE PREVENTION AND TREATMENT INITIATIVES. FINLEY HOSPITAL PARTICIPATES ACTIVELY IN THE ANNUAL UNITED WAY CAMPAIGN TO HELP FUND THE UNITED WAY PROGRAMS. FINLEY HOSPITAL HAS BEEN A LEADER IN LIVE HEALTHY IOWA FOR SEVERAL YEARS LEADING TO VERY SUCCESSFUL CAMPAIGNS IN DUBUQUE TO IMPROVE RESIDENT'S HEALTH.

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 5:
THE FINLEY 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). AS THE NATION'S 13TH LARGEST NONPROFIT HEALTH SYSTEM, UNITYPOINT HEALTH PROVIDES PROGRESSIVE AND HIGH QUALITY SERVICES ACROSS ITS 9 REGIONS WHICH SPAN IOWA, WESTERN ILLINOIS AND SOUTHERN WISCONSIN. THIS REGIONAL CARE MODEL HAS BEEN SUCCESSFUL IN ACHIEVING STANDARDIZED LEVELS OF PERFORMANCE AND KEEPING CARE LOCAL. WITH $4.9B IN TOTAL OPERATING REVENUE, UNITYPOINT HEALTH EMPLOYS APPROXIMATELY 33,000 TEAM MEMBERS AND OPERATES 20 REGIONAL HOSPITALS, 19 COMMUNITY NETWORK HOSPITALS AND OVER 435 CLINICS. AS A KEY COMPONENT OF UNITYPOINT HEALTH, UNITYPOINT CLINIC IS A 1,180 PROVIDER MULTISPECIALTY GROUP THAT IS BUILT ON THE FOUNDATION OF CARE DELIVERY, INNOVATION AND EXPERIENCE. REPRESENTED BY OVER 40 SPECIALTIES, UPC IS A FORWARD-THINKING DELIVERY PROVIDER AND IS ON THE LEADING EDGE OF CARE DELIVERY WITH ITS TELEHEALTH, AMBULATORY AND URGENT CARE PROGRAMS. THE DIVERSIFIED HEALTH SYSTEM ALSO INCLUDES UNITYPOINT ACCOUNTABLE CARE, UNITYPOINT HEALTH COLLEGES, UNITYPOINT AT HOME AND EXTENDS HEALTH COVERAGE THROUGH THE HEALTHPARTNERS UNITYPOINT INSURANCE PLAN. UNITYPOINT HEALTH AND ITS AFFILIATES ENGAGE IN COMMUNITY HEALTH PROGRAMS AND SERVICES AND WORK WITH VOLUNTEER AND CIVIC ORGANIZATIONS, SCHOOLS, BUSINESSES, INSURERS AND INDIVIDUALS TO SUPPORT ACTIVITIES THAT BENEFIT PEOPLE THROUGHOUT THEIR REGIONS. IN 2021, UNITYPOINT HEALTH AND ITS AFFILIATES PROVIDED MORE THAN $672 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
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