4A (Expenses $ 12087861 including grants of $ 0) (Revenue $ 16468535)
LORING HOSPITAL IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE SAC COUNTY COMMUNITY RELIES ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTHCARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. THE 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, CRITICAL CARE, CARDIOLOGY, ONCOLOGY, REHABILITATION, LABORATORY SERVICES, PHARMACEUTICAL DRUGS, RADIOLOGY, AND MANY OTHER ROUTINE AND ANCILLARY SERVICES. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST IN THE FISCAL PERIOD ENDED JUNE 30, 2022. THE HOSPITAL ADMITTED 126 PATIENTS RESULTING IN A TOTAL OF 398 PATIENT DAYS. OUTPATIENT REGISTRATIONS TOTALED 24,145. THERE WERE ALSO 2,381 EMERGENCY ROOM VISITS.

4B (Expenses $ 1082115 including grants of $ 0) (Revenue $ 686189)
LORING 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 HEALTHCARE 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 TO PATIENTS AT A VALUE OF $2,368. OFTENTIMES, THE HOSPITAL RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. THE HOSPITAL PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTHCARE PROGRAMS. THE HOSPITAL'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $377,502. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE $379,870. THE 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, AND CASH AND IN KIND CONTRIBUTIONS TO COMMUNITY GROUPS. THE HOSPITAL COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE, AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. THE HOSPITAL HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE $33,369.

LORING HOSPITAL
PART V, SECTION B, LINE 5: LORING HOSPITAL TOOK INTO ACCOUNT INPUT FROM THE SAC COUNTY WELLNESS COALITION. THIS GROUP WAS FORMED IN 2012 TO ADDRESS THE WELLNESS NEED OF SAC COUNTY. MEMBERS INCLUDE APPROXIMATELY 20 REPRESENTATIVES ACROSS MANY DIFFERENT SECTORS OF THE COMMUNITY.

LORING HOSPITAL
PART V, SECTION B, LINE 11: THREE TOP PRIORITIES WERE IDENTIFIED. THESE INCLUDE MENTAL HEALTH, NUTRITION, OBESITY & WELLNESS, AND SUBSTANCE ABUSE. DUE TO CORRELATION OF THESE NEEDS OUR STRATEGY IS TO INCREASE AWARENESS, COORDINATE SERVICES TO IMPROVE ACCESS TO ASSISTANCE, AND EXPAND COMMUNITY WIDE INITIATIVES TO REDUCE THE DEPENDENCY WHILE INTRODUCING WAYS TO INCREASE MENTAL HEALTH MAINTENANCE.

LORING HOSPITAL
PART V, SECTION B, LINE 13H: PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM AN APPROVED LIST OF PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSITANCE. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND, IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENT'S INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE.

PART I, LINE 6A:
THE HOSPITAL'S COMMUNITY BENEFIT REPORT IS NOT PREPARED BY A RELATED ORGANIZATION.

PART I, LINE 7:
CHARITY CARE WAS CALCULATED BASED ON AN OVERALL COST TO CHARGE RATIO. MEDICAID WAS CALCULATED BASED ON THE MEDICAID COST REPORT. OTHER BENEFITS WERE CALCULATED USING ACTUAL EXPENSES PLUS AN ALLOCATION OF INDIRECT EXPENSES. THE HOSPITAL USED THE WORKSHEETS PROVIDED ON THE IRS INSTRUCTIONS FOR SCHEDULE H IN ADDITION TO THE INTERNAL COST ACCOUNTING SYSTEM.

PART II, COMMUNITY BUILDING ACTIVITIES:
OFTEN THE MOST EFFECTIVE WAYS 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 NONPROFITS, DONATIONS OF DURABLE MEDICAL EQUIPMENT AND SUPPLIES TO FREE CLINICS OR AGENCIES, OR THROUGH LEADERSHIP AND EDUCATIONAL EXPERTISE. THE HOSPITAL AND EMPLOYEES CONTRIBUTE IN VARIOUS WAYS TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. THIS ALLOWS OTHER 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.

PART III, LINE 2:
THE AMOUNT REPORTED ON LINE 2 WAS CALCULATED USING AN OVERALL COST TO CHARGE RATIO, FROM THE FACILITY COST REPORT. THIS RATIO WAS APPLIED TO THE BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS TO ARRIVE AT THE BAD DEBTS EXPENSE AT COST REPORTED IN LINE 2.

PART III, LINE 3:
THE ESTIMATED AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY IS CHARITY CARE AS A PERCENTAGE OF TOTAL REVENUES APPLIED TO BAD DEBT.

PART III, LINE 4:
THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT. THE HOSPITAL 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 HOSPITAL 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. PRIOR TO ANY ACCOUNT BEING CLASSIFIED AS BAD DEBT, ALL DISCOUNTS ARE TAKEN, ALL PAYMENTS ARE APPLIED, AND EVERY EFFORT IS MADE WITH THE PATIENT IN AN ATTEMPT TO COLLECT THE OUTSTANDING BALANCE. PATIENTS ARE ENCOURAGED TO COMPLETE FINANCIAL ASSISTANCE FORMS AND PAYMENT PLANS ARE PRESENTED AS OPTIONS. THE HOSPITAL WORKS WITH PATIENTS TO ESTABLISH PAYMENT PLANS THAT ARE TAILORED TO THEIR ABILITY TO PAY.

PART III, LINE 8:
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. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH THE TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT.

PART III, LINE 9B:
AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY.

PART VI, LINE 2:
THE HOSPITAL COLLABORATES WITH THE COUNTY HEALTH DEPARTMENT IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. USAGE DATA FROM THE IOWA HOSPITAL ASSOCIATION IS REVIEWED ON THE PRIMARY MEDICAL DIAGNOSIS IN OUR COMMUNITIES.

PART VI, LINE 3:
THE HOSPITAL'S BUSINESS OFFICE PERSONNEL WORK WITH PATIENTS UPON ADMISSION, AT DISCHARGE, AND AFTER DISCHARGE DISCUSSING THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR OTHER FEDERAL OR STATE PROGRAMS, AND ALSO ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS WHERE APPLICABLE. PATIENTS ARE ALSO INFORMED OF THE HOSPITAL FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION. STAFF WHO INTERACT WITH PATIENTS ARE INSTRUCTED TO DIRECT THEM TO BUSINESS OFFICE PERSONNEL. PATIENTS ARE ENCOURAGED TO COMPLETE FINANCIAL ASSISTANCE FORMS AND PAYMENT PLANS ARE PRESENTED AS OPTIONS.

PART VI, LINE 7, REPORTS FILED WITH STATES
IA

PART VI, LINE 4:
THE HOSPITAL IS A LICENSED 25 BED PRIVATE, NONPROFIT HOSPITAL THAT IS LOCATED IN SAC CITY, SAC COUNTY, IOWA. THE HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE. IN 2019, THE POPULATION FOR SAC COUNTY WAS 9,800 PEOPLE. THE HOSPITAL'S SERVICE AREA IS A 20 MILE RADIUS SURROUNDING OUR COMMUNITY. THIS AREA CONSISTS OF MANY SMALL, RURAL COMMUNITIES THAT ARE AGRICULTURAL BASED. IN 2022, THE HOSPITAL ADMITTED 126 INPATIENTS AND SAW 2,381 PATIENTS IN THE EMERGENCY ROOM. MEDIAN HOUSEHOLD INCOMES FOR THE HOSPITAL'S PATIENT POPULATION IS $57,446, AND THE AVERAGE POVERTY RATE IS 10.5%. SAC COUNTY, IOWA, IS 94.9% CAUCASIAN AND 3.0% HISPANIC. THE PATIENT BASE CONSISTS OF A LARGE MEDICARE POPULATION. FOR THE FISCAL YEAR ENDING JUNE 30, 2022, THE MEDICARE PAYOR MIX WAS 52%.

PART VI, LINE 5:
THE HOSPITAL IS ORGANIZED AND OPERATES EXCLUSIVELY FOR CHARITABLE PURPOSES WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITIES IT SERVES. THE BOARD MEMBERS ALL RESIDE IN THE PRIMARY COMMUNITIES OF OUR SERVICE AREA. BOARD MEMBERS ARE NOT EMPLOYED BY LORING AND NONE ARE FAMILY MEMBERS. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY EXCEPT FOR PHYSICIANS WITH PENDING QUALITY ISSUES. THE HOSPITAL APPLIES SURPLUS FUNDS TO FURTHER OUR CHARITABLE PURPOSE TO IMPROVE PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH THROUGH THE NORMAL BUDGET AND CAPITAL BUDGET PROCESSES. THE HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITY BY OPERATING AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY, PARTICIPATING IN GOVERNMENT-SPONSORED HEALTH PROGRAMS, AND VOLUNTEERING IN THE COMMUNITY.

PART VI, LINE 6:
THE HOSPITAL IS MANAGED BY TRINITY HEALTH SYSTEM, WHICH IS A PART OF IOWA HEALTH SYSTEM(D/B/A UNITYPOINT HEALTH). UNITYPOINT HEALTH ENTITIES EMPLOY THE STATE'S LARGEST NONPROFIT WORKFORCE, WITH MORE THAN 28,000 EMPLOYEES WORKING TOWARD INNOVATIVE ADVANCEMENTS TO DELIVER THE BEST OUTCOME FOR EVERY PATIENT EVERY TIME. EACH YEAR, UNITYPOINT HEALTH HOSPITALS AND CLINICS PROVIDE A FULL RANGE OF CARE TO PATIENTS AND FAMILIES. UNITYPOINT HEALTH 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. 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.