4A (Expenses $ 484457290 including grants of $ 0) (Revenue $ 652517898)
HOSPITAL DISCHARGES 7,120, NURSING HOME ADMISSIONS 204, BIRTHS 797, OUTPATIENT VISITS 1,090,343.MHSC CONTINUES ITS TRADITION OF GIVING BACK TO EACH OF THE COMMUNITIES WE SERVE IN A WIDE VARIETY OF FASHIONS. ONE OF THE LARGER AREAS OF CONTRIBUTION IS IN THE AREA OF PUBLIC HEALTH SERVICES. THIS INCLUDES EXTENSIVE DONATIONS OF TIME AND SUPPLIES TO HEALTHNET OF ROCK COUNTY, A LARGE FREE PRIMARY CARE CLINIC SERVING THE REGION. MORE THAN EIGHTY PERCENT OF THE PHYSICIAN SERVICES PROVIDED AT THE CLINIC ARE SUPPLIED THROUGH MHSC. WE HAVE A SIMILAR COMMITMENT TO OPEN ARMS FREE CLINIC THAT SERVICES LOW INCOME RESIDENTS IN WALWORTH COUNTY. ADDITIONALLY, WE PROVIDE HEALTH SCREENING AND RELATED SERVICES AT NUMEROUS EVENTS IN ROCK AND WALWORTH COUNTIES IN WISCONSIN AND MCHENRY COUNTY IN ILLINOIS.MHSC ALSO PROVIDES FINANCIAL AND IN KIND CONTRIBUTIONS TO OTHER PRIVATE AND NOT FOR PROFIT HEALTH RELATED AGENCIES AND ORGANIZATIONS IN OUR SERVICE AREA. BENEFICIARIES INCLUDED BUT ARE NOT LIMITED TO THE AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, UNITED WAY ORGANIZATIONS IN ROCK, WALWORTH, AND MCHENRY COUNTIES, YWCA CARE HOUSE, YMCA, AMERICAN LUNG ASSOCIATION, WALWORTH COUNTY ALLIANCE FOR CHILDREN, TURNING POINT WOMEN'S CENTER IN MCHENRY, OPEN ARMS FREE CLINIC, AND THE RED CROSS, TO NAME JUST A FEW RECIPIENTS.MHSC ALSO ENCOURAGES ITS PARTNERS (EMPLOYEES) TO DONATE THEIR TIME AND ENERGY TO SUPPORT A WHOLE HOST OF COMMUNITY BASED CAUSES. THOUSANDS OF HOURS EACH YEAR ARE DONATED TO NOT FOR PROFIT AND PUBLIC AGENCIES THROUGHOUT OUR SERVICE AREA. EXAMPLES OF VOLUNTEER ACTIVITIES BEING SUPPORTED INCLUDE NURSING SERVICES AT COMMUNITY AND FREE CLINICS THROUGHOUT THE REGION, MEALS ON WHEELS DELIVERY ACTIVITIES, ACTIVE INVOLVEMENT AS GOVERNING BOARD MEMBERS FOR SUCH ORGANIZATIONS AS UNITED WAY, CRIME STOPPERS, ROTARY BOTANICAL GARDENS, HEALTHNET, AND MANY OTHER ORGANIZATIONS.ANOTHER EXAMPLE OF MHSC'S COMMITMENT TO COMMUNITY IS ITS SUPPORT OF THE OPERATIONS THROUGH OFFERING SAFE RESIDENCE TO HOMELESS WOMEN AND THEIR CHILDREN AT THE HOUSE OF MERCY HOMELESS CENTER. IT OPENED IN 1996 AND SERVES ABOUT 255 INDIVIDUALS A YEAR, MANY WHO ARE CHILDREN. THE CENTER OFFERS A SAFE HARBOR FOR THESE INDIVIDUALS AS WELL AS CASE MANAGEMENT, ASSISTANCE WITH JOB SEARCHES, FINDING PERMANENT HOUSING AND EDUCATION.

MERCYHEALTH HOSPITAL AND TRAUMA CENTER-JANESVILLE
PART V, SECTION B, LINE 5: MERCYHEALTH CORPORATION CONDUCTED A COMMUNITY NEEDS ASSESSMENT DESIGNED TO IDENTIFY HEALTH AND QUALITY OF LIFE ISSUES IN ROCK COUNTY. A THIRTY-FOUR QUESTION SURVEY WAS DISTRIBUTED PRINT VERSION ON OCTOBER 21, 2019, TO 2,550 RANDOM HOUSEHOLDS IN JANESVILLE AND BELOIT AND WAS ALSO DISTRIBUTED BY SEVERAL ORGANIZATION IN ROCK COUNTY. THE SURVEY COVERED VARIOUS TOPICS, INCLUDING HEALTH ISSUES IN THE COMMUNITY, UNHEALTHY BEHAVIORS IN THE COMMUNITY, WELL-BEING, ACCESSIBILITY TO HEALTHCARE, AND HEALTHY BEHAVIORS. IT INCLUDED A BAR-CODE SO THAT THE SURVEY COULD BE ACCESSED ELECTRONICALLY VIA SURVEY MONKEY. A LINK TO THE SURVEY IN BOTH SPANISH AND ENGLISH WAS ALSO INCLUDED IN THE MERCYHEALTH HEALTH NEWS ON-LINE NEWSLETTER, THE MERCYHEALTH ROCK COUNTY FACEBOOK PAGE, AND THE MERCYHEALTH WIRE. A RESPONSE WAS RECEIVED FROM 389 HOUSEHOLDS. COMMUNITY LEADERS AND STAKEHOLDERS PARTICIPATED IN KEY INFORMANT INTERVIEWS. WITH THEIR PARTICULAR KNOWLEDGE AND UNDERSTANDING, THEY COULD PROVIDE INSIGHT ON THE NATURE OF PROBLEMS AND THEREBY FURTHER ENHANCE THE VERSATILITY OF THE DATA UTILIZED IN THIS SURVEY.A DETAILED ANALYSIS OF SECONDARY DATA WAS USED TO ASSESS THE COMMUNITY PROFILE, AND ITS HEALTH STATUS. SECONDARY DATA WAS DERIVED FROM A VARIETY OF PUBLICLY AVAILABLE SOURCES, INCLUDING THE UNITED STATES CENSUS BUREAU, AMERICAN COMMUNITY SURVEY; US BUREAU OF LABOR STATISTICS; COMMUNITY COMMONS; US DEPARTMENT OF HEALTH & HUMAN SERVICES, WISCONSIN OFFICE OF RURAL HEALTH AND WISCONSIN DEPARTMENT OF HEALTH SERVICES; UNIVERSITY OF WISCONSIN, POPULATION HEALTH INSTITUTE, COUNTY HEALTH RANKINGS 2019; AND CENTERS FOR DISEASE CONTROL & PREVENTION. SECONDARY SOURCE DATA, WHEN COMBINED WITH THE INFORMATION GATHERED FROM THE HOUSEHOLD SURVEYS, AND KEY INFORMANT SURVEYS HELPED TO IDENTIFY CONCERNS RELATING TO THE HEALTH OF THE COMMUNITY, WHILE ASSESSING AREA-BASED PROGRAMS AND ORGANIZATIONS AVAILABLE TO ADDRESS THE COMMUNITY'S NEEDS. THESE NEEDS WERE PRIORITIZED BASED ON LEVEL OF IMPORTANCE TO THE COMMUNITY; IT PROVIDED A PICTURE OF WHAT IS WORKING WELL IN ADDITION TO IDENTIFYING OPPORTUNITIES FOR IMPROVEMENT FOR THE HEALTHCARE INFRASTRUCTURE OF ROCK COUNTY AND THE COMMUNITY AS A WHOLE.

MERCYHEALTH HOSPITAL AND MEDICAL CENTER-WALWORTH
"PART V, SECTION B, LINE 5: A RANGE OF PROVIDERS, POLICY-MAKERS, AND OTHER LOCAL EXPERTS AND COMMUNITY MEMBERS (""KEY INFORMANTS"") PROVIDED RANKINGS OF THE MOST IMPORTANT PUBLIC HEALTH ISSUES FOR THE COUNTY BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN. ALONG WITH THE RANKINGS, KEY INFORMANTS PROVIDED ADDITIONAL INFORMATION ON THESE ISSUES RANGING FROM EXISTING OR ADDITIONAL STRATEGIES NEEDED, BARRIERS AND CHALLENGES TO ADDRESSING THE ISSUE, KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH, AND THE WAYS AND MEANS TO TARGET EFFORTS.THESE FINDINGS WERE A CRITICAL SUPPLEMENT TO THE WALWORTH COUNTY COMMUNITY HEALTH SURVEY CONDUCTED THROUGH A PARTNERSHIP BETWEEN THE AURORA HEALTH CARE, CHILDREN'S WISCONSIN, FORT HEALTHCARE, MERCYHEALTH AND THE WALWORTH COUNTY DIVISION OF PUBLIC HEALTH."

MERCYHEALTH HOSPITAL AND TRAUMA CENTER-JANESVILLE
PART V, SECTION B, LINE 6A: MHTC/JANESVILLE HOSPITAL - ROCK COUNTY RESPONSE IS NOWALWORTH HOSPITAL -WALWORTH CO RESPONSE IS YES.

MERCYHEALTH HOSPITAL AND MEDICAL CENTER-WALWORTH
PART V, SECTION B, LINE 6A: AURORA HEALTH CARE, CHILDREN'S WISCONSIN, AND FORT HEALTHCARE.

MERCYHEALTH HOSPITAL AND TRAUMA CENTER-JANESVILLE
PART V, SECTION B, LINE 6B: JANESVILLE/MHTC - NOWALWORTH HOSPITAL-YES

MERCYHEALTH HOSPITAL AND MEDICAL CENTER-WALWORTH
PART V, SECTION B, LINE 6B: WALWORTH COUNTY DIVISION OF PUBLIC HEALTH.

MERCYHEALTH HOSPITAL AND TRAUMA CENTER-JANESVILLE
PART V, SECTION B, LINE 11: CONSISTENT WITH THE ROCK AND WALWORTH COUNTY COMMUNITY NEEDS ASSESSMENT ACTION PLANS, MERCY CONTINUES TO ROLL OUT ITS IMPLEMENTATION PLANS. MERCY'S PLAN IN ROCK COUNTY IS TO IMPROVE THE HEALTH OF PATIENTS WITH MENTAL HEALTH, SUBSTANCE ABUSE, AND ALCOHOL ABUSE ISSUES THROUGH INCREASED ACCESS TO EDUCATION AND CARE FOR THESE PATIENTS. TO THIS END, MHSC CONTINUES TO DEVELOP AND OFFER VARIOUS ACCESS SITES, MONITORS ITS CURRENT PROGRAMS, AND PARTNERS WITH LOCAL AGENCIES TO PROVIDE EDUCATION AND SUPPORT FOR PATIENTS AND THEIR FAMILIES. MERCY IS WORKING TO REDUCE THE LIKELIHOOD OF OPIOID ADDITION BEGINNING AND/OR CONTINUING. MERCY'S PLAN IS TO IMPROVE THE PHYSICAL HEALTH OF PATIENTS THROUGH EDUCATION AND SUPPORT/SPONSORSHIP OF ATHLETIC EVENTS OR PROGRAMS THAT PROMOTE PHYSICAL ACTIVITY IN THE COMMUNITY. MERCY ESTABLISHED A PROJECT SEARCH PROGRAM THAT PROVIDES JOB TRAINING AND EMPLOYMENT OPPORTUNITIES TO DISABLED YOUNG ADULT COMMUNITY MEMBERS.IN RESPONSE TO COVID-19 AND TO EFFECTIVELY CARE FOR THE NEEDS OF THE COMMUNITY, MERCY PROVIDED ALTERNATIVE EDUCATION TO EMERGENCY MEDICAL SERVICE (EMS) PERSONNEL FOR ENHANCED SAFETY AND TREATMENT PROTOCOLS. MERCY EXPANDED TELEMEDICINE SERVICES TO INCREASE VIRTUAL ACCESS FOR OUR PATIENTS AND ALLOW EMS CREWS TO BE AVAILABLE FOR THOSE WITH CRITICAL ILLNESSES. MERCY PROVIDED COMMUNITY EDUCATION VIDEOS ADDRESSING COVID-19 QUESTIONS AND CONCERNS ALONG WITH HOW TO SAFELY WEAR A MASK.

MERCYHEALTH HOSPITAL AND MEDICAL CENTER-WALWORTH
PART V, SECTION B, LINE 11: CONSISTENT WITH THE ROCK AND WALWORTH COUNTY COMMUNITY NEEDS ASSESSMENT ACTION PLANS, MERCY CONTINUES TO ROLL OUT ITS IMPLEMENTATION PLANS. IN RESPONSE TO COVID-19 AND TO EFFECTIVELY CARE FOR THE NEEDS OF THE COMMUNITY, MERCY PROVIDED ALTERNATIVE EDUCATION TO EMERGENCY MEDICAL SERVICE (EMS) PERSONNEL FOR ENHANCED SAFETY AND TREATMENT PROTOCOLS. MERCY EXPANDED TELEMEDICINE SERVICES TO INCREASE VIRTUAL ACCESS FOR OUR PATIENTS AND ALLOW EMS CREWS TO BE AVAILABLE FOR THOSE WITH CRITICAL ILLNESSES. MERCY PROVIDED COMMUNITY EDUCATION VIDEOS ADDRESSING COVID-19 QUESTIONS AND CONCERNS ALONG WITH HOW TO SAFELY WEAR A MASK.WALWORTH COUNTY'S PLAN IS TO IMPROVE THE GENERAL HEALTH OF INDIVIDUALS LIVING IN WALWORTH COUNTY. MERCY CONTINUES TO DEVELOP AND OFFER VARIOUS ACCESS SITES FOR PRIMARY AND SPECIALTY CARE SERVICES, PROACTIVELY MANAGES MEDICARE POPULATION THROUGH ACO INITIATIVES FOCUSED ON PREVENTIVE CARE, AND PROVIDES HEALTH EDUCATION AND AWARENESS (WITH EMPHASIS TOWARD SCREENING, IMMUNIZATIONS, AND VACCINATIONS). IT IS MERCY'S PLAN TO IMPROVE THE HEALTH STATUS OF INDIVIDUALS WITH CHRONIC ILLNESS AND PROMOTE HEALTHY LIFESTYLES AND TO IMPROVE THE HEALTH OF PATIENTS WITH SPECIFIC NEEDS, SUCH AS GERIATRIC SERVICES AND ALCOHOL AND SUBSTANCE ABUSE. AS IN ROCK COUNTY, MERCY IS LOOKING TO REDUCE THE LIKELIHOOD OF OPIOID ADDICTION BEGINNING AND/OR CONTINUING. IT WILL MONITOR AND INCREASE TESTING, PROVIDE SMOKING CESSATION MATERIALS AND PROGRAMS, PROVIDE FREE BLOOD PRESSURE CHECKS, AND PROMOTE SERVICES FOR SPECIAL NEEDS OF ELDERLY OR THOSE SUFFERING FROM ABUSE ISSUES.MERCY PARTNERS WITH MULTIPLE COMMUNITY BASED ORGANIZATIONS IN ROCK AND WALWORTH COUNTY TO ACCOMPLISH SUCCESSFUL IMPLEMENTATION OF THESE STRATEGIES. DURING THE COURSE OF THIS TAX YEAR 2021 (FISCAL YEAR JULY 1, 2021-JUNE 30, 2022), AND THE PRIOR TAX YEARS, MERCY PARTICIPATED IN NUMEROUS COMMUNITY HEALTH FAIRS, PROVIDED FREE SCREENINGS AT OUR CLINICS AND IN CONJUNCTION WITH COMMUNITY BASED ORGANIZATIONS, OFFERED SCREENINGS TO FREE AND SLIDING FEE SCHEDULE PRIMARY CARE CLINICS, AND SCHOOL DISTRICTS IN BOTH COUNTIES. MERCY ALSO PROVIDES FINANCIAL INCENTIVES FOR THEIR EMPLOYEES TO PARTICIPATE IN SMOKING CESSATION PROGRAMS. ALL OF THESE EFFORTS ARE SUPPORTED THROUGH BROAD BASED MARKETING AND ADVERTISING PROGRAMS DIRECTED TO AUDIENCES IN BOTH COUNTIES PROMOTING THESE PROGRAMS.IN RESPONSE TO COVID-19 AND TO EFFECTIVELY CARE FOR THE NEEDS OF THE COMMUNITY, MERCY PROVIDED ALTERNATIVE EDUCATION TO EMERGENCY MEDICAL SERVICE (EMS) PERSONNEL FOR ENHANCED SAFETY AND TREATMENT PROTOCOLS. MERCY PROVIDED COMMUNITY EDUCATION VIDEOS ADDRESSING COVID-19 QUESTIONS AND CONCERNS ALONG WITH HOW TO SAFELY WEAR A MASK.MERCY PROVIDES EXTENSIVE TELEMEDICINE SERVICES TO INCREASE VIRTUAL ACCESS FOR OUR PATIENTS. MERCY HAS PROVIDERS ON CALL THAT ARE AVAILABLE TO ASSIST EMS CREWS IN THE FIELD WITH TRAUMA-RELATED EMERGENCIES AND CRITICAL ILLNESSES.

PART I, LINE 3C:
MERCY HOSPITALS OFFERS A 25% SELF-PAY DISCOUNT TO ALL UNINSURED PATIENTS ON ALL MEDICALLY NECESSARY SERVICES. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON THE FOLLOWING: INDIVIDUAL OR HOUSEHOLD INCOME, INDIVIDUAL OR HOUSEHOLD ASSETS, HOUSEHOLD SIZE, AND OTHER SOURCES OF PAYMENT FOR SERVICES. THE AMOUNT OF ASSISTANCE IS BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THEIR OUTSTANDING BALANCE. IF PATIENT INCOME AND HOUSEHOLD ASSETS ARE LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES, THEN MERCY WILL COVER 100% OF THEIR OUTSTANDING BALANCE. IF THE PATIENT'S INCOME AND HOUSEHOLD ASSETS FALL BETWEEN 200% AND 300% OF THE FEDERAL POVERTY GUIDELINES, THEN A PATIENT'S REMAINING BALANCE CAN BE REDUCED AS MUCH AS 90% AND PAYMENT ARRANGEMENTS CAN BE EXTENDED FOR AS LONG AS TWENTY-FOUR (24) MONTHS OR LONGER IF THERE ARE EXTENUATING CIRCUMSTANCES.

PART I, LINE 6A:
MERCY HEALTH SYSTEM, CORP (MHS) SUBMITS AN ANNUAL COMMUNITY BENEFIT STATEMENT TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). PERIODICALLY, IT PUBLISHES A PAMPHLET EXPLAINING THE COMMUNITY BENEFITS THAT MERCY HEALTH SYSTEM CORP, AND THE RELATED ORGANIZATIONS OF MHS PROVIDE TO THE COMMUNITIES THEY SERVE. MHS HAS SUPPLIED SUPPLEMENTAL COMMUNITY BENEFIT STATEMENT INFORMATION WITH ITS 990 TAX RETURN SINCE FISCAL YEAR 2006 (TAX FORM 2005).

PART I, LINE 7:
A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE COSTS ASSOCIATED WITH CHARITY CARE, UNREIMBURSED MEDICAID, AND OTHER MEANS TESTED GOVERNMENT PROGRAMS. THE COST-TO-CHARGE RATIO WAS DERIVED FROM IRS WORKSHEET 2: RATIO OF PATIENT CARE COST-TO CHARGE. THE COST OF THE OTHER BENEFITS REFERENCED IN THE TABLE OF LINE 7 (COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS; HEALTH PROFESSIONS EDUCATION; SUBSIDIZED HEALTH SERVICES; CASH AND IN-KIND CONTRIBUTIONS) WERE DETERMINED USING ACTUAL DEPARTMENT/SERVICE SPECIFIC DATA AND /OR COST ACCOUNTING DERIVED DATA.

PART I, LINE 7G:
MERCY SOUTH FAMILY PRACTICE CLINIC WAS INCLUDED IN THIS LINE: EXPENSES IN COLUMN C TOTALED $3,763,448 AND COLUMN E HAD $635,675 OF NET EXPENSES.

PART I, LN 7 COL(F):
BAD DEBT OF $31,829,760 WAS NOT INCLUDED AS AN EXPENSE WHEN CALCULATING THE PERCENTAGE IN THIS COLUMN.

PART III, LINE 2:
THE COST OF BAD DEBT ON LINE 2, PART III, WAS DETERMINED BY APPLYING THE COST-TO-CHARGE RATIO TO THOSE CHARGES ESTIMATED AND EXPENSED AS UNCOLLECTIBLE.

PART III, LINE 3:
THE ESTIMATE OF BAD DEBT DOLLARS THAT MAY HAVE BEEN COVERED THROUGH MERCY HEALTH SYSTEM CORP.'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 16.31%. THIS FIGURE WAS BASED ON THE PERCENT OF BAD DEBT ACCOUNT DOLLARS THAT ARE RECLASSIFIED FOR CHARITY AND/OR BANKRUPTCY PURPOSES.

PART III, LINE 4:
BAD DEBT EXPENSE IS ACCOUNTED FOR IN THE FOLLOWING MANNER (AS DETAILED IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS OF MERCY HEALTH CORPORATION). GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE CORPORATION ALSO PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE CORPORATION ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED JUNE 30, 2022 AND 2021, WAS NOT SIGNIFICANT. CONSISTENT WITH THE CORPORATION'S MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE CORPORATION HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE CORPORATION EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS. THE CORPORATION'S POLICY IS TO PROVIDE A DISCOUNT FROM ESTABLISHED CHARGES TO UNINSURED PATIENTS. THIS POLICY DID NOT CHANGE IN 2022 AND 2021.

PART III, LINE 8:
DATA FOR LINES 5 & 6 OF PART III AND THE MEDICARE SHORTFALL IS BASED ON MERCY HEALTH SYSTEM CORP'S TWO MEDICARE COST REPORTS (MERCY HOSPITAL AND TRAUMA CENTER-JANESVILLE, AND MERCY WALWORTH HOSPITAL).

PART III, LINE 9B:
PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MERCY HEALTH SYSTEM'S (MHS) COMMUNITY CARE PROGRAM, WILL RECEIVE A 25% DISCOUNT FROM MHS'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MHS'S COMMUNITY CARE PROGRAM. PATIENTS MUST APPLY FOR COMMUNITY CARE AND SUPPLY MERCY WITH THE NECESSARY FINANCIAL AND OTHER INFORMATION REQUIRED. PATIENTS WHO QUALIFY FOR COMMUNITY CARE BENEFITS WILL RECEIVE A REDUCTION IN THE BALANCE OWED, EXTENDED PAYMENT TERMS, OR BOTH. THE AMOUNT OF THE COMMUNITY CARE BENEFIT WILL BE BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE.

PART VI, LINE 3:
ALL UNINSURED PATIENTS ARE NOTIFIED OF MERCY'S FINANCIAL AIDE POLICY UPON REGISTRATION. INFORMATION IS ALSO AVAILABLE AT THE HEALTH SYSTEM'S WEBSITE, IN OUR EMERGENCY ROOMS, MEDICAL LABS, ADMITTING DEPARTMENTS, OUTPATIENT RADIOLOGY, REGISTRATION DESKS, PATIENT FINANCIAL SERVICES OFFICES, AND WITH THE PATIENT FINANCIAL COUNSELORS. APPROPRIATE PERSONNEL HAVE BEEN TRAINED ON HOW TO INTERACT WITH PATIENTS ABOUT FINANCIAL AID AVAILABILITY, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL AID STAFF. THE HOSPITALS HAVE TRANSLATION SERVICES AVAILABLE AS NEEDED.

PART VI, LINE 5:
MERCY HEALTH SYSTEM CORP HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREAS. MERCY HEALTH SYSTEM CORP. HAS A GOVERNING BODY COMPRISED OF A MAJORITY OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY.

PART VI, LINE 7, REPORTS FILED WITH STATES
WI,IL

LINE 6
MHSC FILES A COMMUNITY BENEFIT REPORT WITH IN WI WITH THE WISCONSIN HOSPITAL ASSOCIATION.

PART VI, LINE 2:
THE HOSPITALS OF MERCYHEALTH CORPORATION, INC. WORK IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF ROCK (WI), WALWORTH (WI), MCHENRY (IL) AND WINNEBAGO (IL) COUNTIES TO COMPLETE. COLLABORATIVE EXAMPLES OF MERCYHEALTH ORGANIZATIONS PROVIDING CARE TO THE COMMUNITY INCLUDE (BUT AREN'T LIMITED TO):I) RONALD MCDONALD CARE MOBILE: THE MOBILE UNIT PROVIDES FREE DENTAL AND MEDICAL CARE TO UNINSURED AND UNDERINSURED CHILDREN IN FIVE NORTHERN ILLINOIS COUNTIES. SINCE ITS INCEPTION IN 2003, IT HAS PROVIDED $2.4 MILLION IN FREE CARE TO MORE THAN 10,000 CHILDREN. THE CARE MOBILE IS COMPLETELY FUNDED BY PHILANTHROPY FROM THE MERCYHEALTH DEVELOPMENT FOUNDATION, JAVON BEA HOSPITAL AUXILIARY, AND THE RONALD MCDONALD CHARITIES OF MADISON.II) HEALTHNET FREE CLINIC IN JANESVILLE; FAMILY HEALTH PARTNERSHIP CLINIC AND WELL CHILD CLINIC IN WOODSTOCK, IL; HARVARD FREE CLINIC IN MCHENRY COUNTY, IL; AND THE BRIDGE CLINIC OF ROCKFORD, IL., ARE SOME OF THE VENUES FOR UNINSURED OR UNDERINSURED INDIVIDUALS TO RECEIVE CARE. MANY MERCYHEALTH PHYSICIANS AND OTHER HEALTH CARE PROVIDERS VOLUNTEER THEIR SERVICES AT THESE CLINICS.III) ROCKFORD RESCUE MISSION: MERCYHEALTH RESIDENTS VOLUNTEER THEIR TIME TO PROVIDE CARE AT THE ROCKFORD RESCUE MISSION HOMELESS SHELTER. IV) JAVON BEA HOSPITAL PARTNERS WITH A SILVER LINING FOUNDATION TO PROVIDE SCREENING MAMMOGRAMS AND OTHER BREAST RELATED SERVICES FOR UNINSURED OR UNDERINSURED WOMEN.V) RED CROSS: MERCYHEALTH HOSTS REGULAR BLOOD DRIVES AND PARTNERS IN COOPERATIVE VOLUNTEER EFFORTS.VI) UNITED WAY: MERCYHEALTH HOSTS AN ANNUAL GIVING FUND RAISING CAMPAIGN TO RAISE MONEY FOR UNITED WAY IN ALL ITS COUNTIES. VII) AREA POLICE AND FIRE DEPARTMENTS: PROVIDE FREE OR REDUCED-COST PARAMEDIC/EMT EDUCATIONAL OPPORTUNITIES.VIII) AREA POLICE AND FIRE DEPARTMENTS: PROVIDE FREE OR REDUCED-COST PARAMEDIC/EMT EDUCATIONAL OPPORTUNITIES.IX) EMPLOYEE PARTICIPATION ON COMMUNITY BOARDS. AN EXAMPLE: COMMUNITY ACTION, INC. (A NOT-FOR-PROFIT ORGANIZATION OFFERING PROGRAMS TO FIGHT POVERTY IN ROCK AND WALWORTH COUNTIES.)

PART VI, LINE 4:
MERCY HOSPITAL AND TRAUMA CENTER:MERCY HOSPITAL AND TRAUMA CENTER IS LOCATED IN JANESVILLE, WI: ROCK COUNTY. IT IS ONE OF TWO ACUTE CARE HOSPITALS IN JANESVILLE, WI. IT IS LICENSED FOR 240 ACUTE BEDS. IT HAS 24/7 EMERGENCY SERVICES, WITH A TRAUMA II DESIGNATION. IT IS A TEACHING HOSPITAL WITH A RESIDENCY PROGRAM.UNEMPLOYMENT IN ROCK COUNTY (2018) WAS AT 3.2% WHILE THE STATE (WI) AND THE NATION WERE AT 3% AND 3.9%, RESPECTIVELY. MEDIAN HOUSEHOLD INCOME (2018) WAS $57,037 IN ROCK COUNTY, WHICH IS LOWER THAN BOTH THE STATE'S $60,773 AND NATIONAL MEDIAN OF $61,937. IN 2018, 13.6% OF ROCK COUNTY RESIDENTS LIVED BELOW THE POVERTY LEVEL; THIS IS LARGER THAN THE STATE'S AVERAGE OF 11.9%, BUT LESS THAN THE NATIONAL AVERAGE OF 14.1%. MERCY WALWORTH HOSPITAL:MERCY WALWORTH HOSPITAL IS LOCATED IN LAKE GENEVA WI WHICH IS IN WALWORTH COUNTY, WI. IT IS A CRITICAL ACCESS HOSPITAL LICENSED FOR 25 ACUTE BEDS THAT PROVIDES 24/7 EMERGENCY SERVICES. PER THE US CENSUS, MEDIAN HOUSEHOLD INCOME FOR WALWORTH COUNTY (IN 2019 DOLLARS) 2015-2019 WAS $63,776; PERSONS IN POVERTY 9.5%. BOTH THESE INDICATORS ARE BETTER THAN THE STATE'S AVERAGE OF $61,747 AND 10.4%, RESPECTIVELY. HOWEVER, WALWORTH HAS A 8.2% RATE OF PERSONS WITHOUT HEALTH INSURANCE (UNDER AGE 65) WHEREAS THE STATE'S AVERAGE IS 6.8%.MERCY HEALTH SYSTEM CORP'S PAYOR DEMOGRAPHICS FOR ITS HOSPITALS INCLUDE 52.14% MEDICARE, AND 13.56% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2021 - JUNE 30, 2022 (AS DETERMINED BY CHARGES BILLED).

PART VI, LINE 6:
"MERCY HEALTH SYSTEM CORPORATION HAS TWO HOSPITALS THAT PROVIDE ACUTE CARE SERVICES IN ROCK AND WALWORTH COUNTIES OF WISCONSIN. MERCY HEALTH SYSTEM CORP ALSO OPERATES COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND ILLINOIS. IT IS PART OF A LARGER INTEGRATED HEALTHCARE SYSTEM AND IS AFFILIATED WITH OTHER SEPARATELY REPORTED ORGANIZATIONS COLLECTIVELY KNOWN AS ""MERCYHEALTH"".MERCY HEALTH CORPORATION IS THE ULTIMATE PARENT COMPANY OF MERCY HEALTH SYSTEM CORPORATION, MERCY HARVARD HOSPITAL, INC., AND MERCY ASSISTED CARE INC. MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY, ILLINOIS, ALONG WITH JAVON BEA HOSPITAL (ROCKFORD), ROCKFORD HEALTH PHYSICIANS, AND MERCYHEALTH VISITING NURSES ASSOCIATION. MERCY ASSISTED CARE PROVIDES HOME HEALTH SERVICES, HOSPICE, AND DME (DURABLE MEDICAL EQUIPMENT) SERVICES; THUS PROVIDING CONTINUATION OF CARE TO MERCYHEALTH PATIENTS AND THE COMMUNITY AS A WHOLE.JAVON BEA HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO RESIDENTS OF ROCKFORD, ILLINOIS AND THE SURROUNDING COMMUNITIES. THE ROCKFORD HEALTH PHYSICIANS PROVIDE PHYSICIAN AND AMBULATORY CARE SERVICES AT SEVERAL ILLINOIS SITES.MERCY HEALTH SYSTEM CORP. WORKS WITH THE MERCYHEALTH DEVELOPMENT FOUNDATION, INC. TO OPERATE A HOMELESS SHELTER IN JANESVILLE, WI: THE HOUSE OF MERCY HOMELESS CENTER PROVIDES SHELTER, SUPPORT, AND TRAINING TO WOMEN, CHILDREN, AND FAMILIES TO HELP FIGHT HOMELESSNESS. IT OPENED IN 1996, AND NOW SHELTERS AN AVERAGE OF 184 INDIVIDUALS PER YEAR, BASED ON THE PRIOR THREE YEARS.MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCY'S VOLUNTEERS. VOLUNTEERS NUMBERED 314 IN CALENDAR YEAR 2021. THIS ORGANIZATION NOT ONLY SUPPORTS MERCY'S SERVICES, BUT PROVIDES BENEFITS TO THE COMMUNITY AS A WHOLE. IN CONJUNCTION WITH MERCY HEALTH SYSTEM'S MEAL PREPARATION, THE VOLUNTEERS PARTICIPATE IN AND OVERSEE A MEALS-ON-WHEELS PROGRAM: PARTICIPANT/NUTRITION SPECIFIC MEALS ARE PREPARED AND DELIVERED TO THE ELDERLY NEEDING ASSISTANCE IN JANESVILLE. THE VOLUNTEER ASSOCIATION RUNS A HOSPITALITY HOUSE IN WHICH FAMILY MEMBERS OF PATIENTS ARE OFFERED FREE HOUSING DURING THEIR LOVED ONES EXTENDED HOSPITAL STAY AND REHABILITATION."