4A (Expenses $ 393684893 including grants of $ 3972987) (Revenue $ 521131079)
SINCE IT WAS FOUNDED IN 1875, BLESSING HOSPITAL HAS PROVIDED QUALITY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF RACE, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. IN SERVING ALL MEMBERS OF ITS COMMUNITIES, BLESSING HOSPITAL CONTINUES THIS TRADITION BY PROVIDING FREE/SUBSIDIZED CARE, CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT LESS THAN FULL CHARGES, AND COMMUNITY HEALTH/EDUCATION/WELLNESS PROGRAMS. FOR FISCAL YEAR 2022, THE COST OF CHARITY CARE PROVIDED WAS 6,244,283 AND MEDICARE SHORTFALLS WERE 98,960,351. BLESSING HOSPITAL TREATED PATIENTS THROUGH THE FOLLOWING SERVICES DURING FISCAL YEAR 2022: 35,361 EMERGENCY CENTER VISITS; 373,176 OUTPATIENT VISITS; 13,052 SURGICAL OPERATIONS, INCLUDING 152 OPEN HEART SURGERIES, 14,202 INPATIENT ADMISSIONS, AND 973 BABIES. OUTPATIENT SERVICES INCLUDED 99,096 CARDIOPULMONARY/CARDIOLOGY PROCEDURES, 1,036,556 LABORATORY TESTS, 119,299 RADIOLOGY PROCEDURES, AND 134,679 PHYSICAL THERAPY/REHABILITATION VISITS. BLESSING HOSPITAL PROVIDED ADDITIONAL BENEFITS OF 10,792,422 TO THE COMMUNITY DURING FISCAL YEAR 2022 AS FOLLOWS: HEALTH PROFESSIONALS EDUCATION SIU RESIDENCY PROGRAM 4,436,201 BLESSING-RIEMAN COLLEGE OF NURSING 2,908,235 NURSING EDUCATIONAL PRECEPTORS 21,205 SUB TOTAL HEALTH PROFESSIONALS EDUCATION 7,365,641 COMMUNITY HEALTH IMPROVEMENT SERVICES PSYCHIATRIC SERVICES TO SIU CENTER FOR FAMILY MEDICINE - QUINCY, CHADDOCK, AND TRANSITIONS OF WESTERN ILLINOIS 207,303 ADAMS COUNTY HEALTH DEPARTMENT DENTAL PROGRAM 100,000 PATIENT TRANSPORTATION AND LODGING 301,718 CHARITY PHARMACY PRESCRIPTIONS 98,665 HEALTH SCREENINGS/TESTS 137,967 MEDICAL SUPPLIES/SERVICES FOR PATIENTS 34,570 BEHAVIORAL HEALTH EDUCATIONAL PROGRAMS 11,567 MEDICAL INTERPRETING SERVICES 23,417 SUB TOTAL COMMUNITY HEALTH IMPROVEMENT SERVICES 915,207 SIU CENTER FOR FAMILY MEDICINE - QUINCY, CHADDOCK, AND TRANSITIONS OF WESTERN ILLINOIS SUBSIDIZED HEALTH SERVICES CARE COORDINATION 1,781,756 HOME HEALTHCARE 516,002 SKILLED NURSING UNIT 123,116 SUB TOTAL SUBSIDIZED HEALTH SERVICES 2,420,874 IN-KIND CONTRIBUTIONS/DONATIONS DONATIONS/SPONSORSHIPS 90,700 SUB TOTAL IN-KIND CONTRIBUTIONS/DONATIONS 90,700 BLESSING HOSPITAL'S STRATEGIC OBJECTIVES FOR THE UPCOMING YEARS ARE AS FOLLOWS: -ACHIEVE TOP DECILE QUALITY AND SAFETY -ENHANCE ACCESS TO CARE -STRENGTHEN ENGAGEMENT WITH PROVIDERS AND STAFF

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 3E
"COMMUNITY PRIORITIES WERE IDENTIFIED BY THE COMMUNITY BUILDING COUNCIL (""CBC"") MEMBERS UTILIZING THE DATA OBTAINED THROUGH THE NEEDS ASSESSMENT PROCESS. CBC MEMBERS ARE COMMUNITY LEADERS REPRESENTING WORKFORCE/BUSINESSES, FOUNDATIONS, HUMAN SERVICE PROVIDERS, FAITH, LAW ENFORCEMENT, MEDIA, EDUCATION, PUBLIC HEALTH, HEALTHCARE-INCLUDING BLESSING HOSPITAL (WHICH IS THE ONLY LOCAL HOSPITAL) AND OUTPATIENT PROVIDERS, COMMUNITY MEMBERS, AND GOVERNMENT. COMMUNITY PRIORITIES WERE CHOSEN BASED ON THE MAGNITUDE OF THE PROBLEM, THE SEVERITY OF THE PROBLEM, THE NEED AMONG VULNERABLE POPULATIONS, THE COMMUNITYS CAPACITY AND WILLINGNESS TO ACT ON THE ISSUE, THE ABILITY TO HAVE A MEASURABLE IMPACT ON THE ISSUE, EXISTING INTERVENTIONS FOCUSED ON THE ISSUE AND OPPORTUNITY TO INTERVENE AT THE PREVENTION LEVEL. THREE COMMUNITY PRIORITIES WERE IDENTIFIED AND INCLUDE: 1. HOUSING: GOOD HEALTH DEPENDS ON HAVING HOMES THAT ARE SAFE AND FREE FROM PHYSICAL HAZARDS. POOR QUALITY AND INADEQUATE HOUSING CONTRIBUTE TO HEALTH PROBLEMS SUCH AS INFECTIOUS AND CHRONIC DISEASES, INJURIES, AND POOR CHILD DEVELOPMENT. 2. POVERTY: POVERTY IS LINKED WITH NEGATIVE CONDITIONS SUCH AS SUBSTANDARD HOUSING, HOMELESSNESS, INADEQUATE NUTRITION, FOOD INSECURITY, AND UNDER-RESOURCED SCHOOLS. POOR CHILDREN AND TEENS ARE AT A GREATER RISK FOR NEGATIVE OUTCOMES SUCH AS POOR ACADEMIC ACHIEVEMENT, SCHOOL DROPOUT, ABUSE AND NEGLECT, BEHAVIORAL AND SOCIOEMOTIONAL PROBLEMS, PHYSICAL HEALTH PROBLEMS, AND DEVELOPMENTAL DELAYS. 3. BEHAVIORAL HEALTH: BEHAVIORAL HEALTH ISSUES SIGNIFICANTLY IMPACT PEOPLE, FAMILIES, COMMUNITIES, AND SOCIETIES. MANY FACTORS ARE LINKED TO BEHAVIORAL HEALTH, INCLUDING GENETICS, AGE, INCOME, EDUCATION, EMPLOYMENT, AND ENVIRONMENTAL CONDITIONS. SUBSTANCE ABUSE IS A CHRONIC BUT TREATABLE BRAIN DISORDER. PEOPLE ADDICTED CANNOT CONTROL THEIR NEED FOR ALCOHOL OR OTHER DRUGS, EVEN IN THE FACE OF NEGATIVE HEALTH, SOCIAL OR LEGAL CONSEQUENCES."

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 5
ADAMS COUNTY HAS BEEN CONDUCTING A COMMUNITY ASSESSMENT FOR 20 YEARS. IN 2021-2022, THE UNITED WAY OF ADAMS COUNTY, BLESSING HEALTH SYSTEM, ADAMS COUNTY HEALTH DEPARTMENT, AND THEIR PARTNERS OPTED TO DIG DEEPER TO PAINT A MORE ROBUST PICTURE OF ADAMS COUNTY, AND PROVIDE A FOUNDATION FOR PROBLEM IDENTIFICATION AND SOLVING ON BEHALF OF THE COMMUNITY. THE SURVEY INSTRUMENT WAS OVERHAULED AND AN EFFORT WAS LAUNCHED TO GET A MORE DIVERSE REPRESENTATION OF THE COMMUNITY. WE WERE ABLE TO SECURE FEEDBACK FROM 861 RESPONDENTS VIA TWO SURVEY INSTRUMENTS. RESPONDENTS FROM THE SURVEYS WERE 93 PERCENT WHITE OR CAUCASIAN, 55 PERCENT FEMALE, AND THE RATIO OF QUINCY TO RURAL ADAMS COUNTY RESIDENTS WAS AROUND 80/20. THESE DEMOGRAPHICS GENERALLY MATCH THE DEMOGRAPHICS OF THE ADAMS COUNTY REGION. IN ADDITION TO THE SURVEY, THE FOLLOWING DATA WAS INCLUDED IN THE CHNA: O 535 2-QUESTION COMMUNITY THEMES SURVEY RESPONSES O 36 KEY INFORMANT INTERVIEWS O 290 KEY INFORMANT SURVEY RESPONSES O 64% RESPONSE RATE TO KEY INFORMANT SURVEY AND INTERVIEWS O KEY INFORMANTS WERE IDENTIFIED WITH THE HELP OF THE COMMUNITY BUILDING COUNCIL AND INCLUDE REPRESENTATIVES FROM COMMUNITY SECTORS SUCH AS GOVERNMENT, SOCIAL SERVICE, CHURCHES/FAITH, HEALTHCARE, BUSINESS, EDUCATION, AND NONPROFIT ORGANIZATIONS. FOLLOWING THE ASSESSMENT, A GROUP OF 40 COMMUNITY LEADERS AND FRONTLINE WORKERS IN THE AREAS OF EDUCATION, SOCIAL SERVICES, AND HEALTH (INCLUDING 4 LEADERS FROM BLESSING) CONVENED FOR AN ALL-DAY PLANNING SESSION. THE PURPOSE OF THE SESSION WAS TO DEVELOP FOCUS AREAS, SHARED GOALS, AND COMMUNITY-WIDE INITIATIVES THAT SUPPORT THE HEALTH AND WELL-BEING OF ALL ADAMS COUNTY RESIDENTS. IN ADDITION, FIVE FOCUS GROUPS AND NINE ONE-ON- ONE INTERVIEWS WERE CONDUCTED WITH 43 PARTICIPANTS. A STRUCTURED GUIDE WAS USED TO GATHER PARTICIPANT EXPERIENCES WITH AND PERSPECTIVES ON THE IDENTIFIED COMMUNITY PRIORITY AREAS. THE COMMUNITY BUILDING STRUCTURE, FACILITATED BY THE UNITED WAY OF ADAMS COUNTY IS ANOTHER SOURCE OF COMMUNITY FEEDBACK AND INPUT FOR THE CHNA. THE STRUCTURE INCLUDES TEAMS OF INDIVIDUALS WITH REPRESENTATION FROM BLESSING HEALTH SYSTEM, THE ADAMS COUNTY HEALTH DEPARTMENT, MENTAL HEALTH PROFESSIONALS, SOCIAL WORKERS, AND MANY OTHER COMMUNITY PROFESSIONALS. IN TOTAL, APPROXIMATELY 125 VOLUNTEERS PARTICIPATE IN ALL ASPECTS OF COMMUNITY BUILDING, ENGAGING IN MEANINGFUL AND RISK DISCUSSIONS TO LEARN ABOUT COMMUNITY ISSUES AND PROMISING PRACTICES. THEY HAVE A LEAD ROLE IN THE FORMATION, IMPLEMENTATION, AND UPDATING OF LONG-RANGE VISIONS AND GOALS TO MEET THE MOST CRITICAL NEEDS IN OUR COMMUNITY THROUGH STUDYING TRENDS THAT AFFECT OUR COMMUNITY AND RECOMMENDING WAYS IN WHICH WE CAN MAKE AN IMPACT ON THESE TRENDS THROUGH THE MOBILIZATION OF FINANCIAL, VOLUNTEER, AND COMMUNITY RESOURCES.

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 6B
THE CHNA IS LED IN PARTNERSHIP WITH THE UNITED WAY OF ADAMS COUNTY, ADAMS COUNTY HEALTH DEPARTMENT, AND THE BLESSING HEALTH SYSTEM. IN ADDITION THE FOLLOWING ENTITIES ARE ON THE COMMUNITY BUILDING COUNCIL LEADERSHIP STEERING COMMITTEE: PHIBRO ANIMAL HEALTH (BUSINESS SECTOR), TRANSITIONS MENTAL HEALTH FACILITY, QUANADA WOMEN'S SHELTER, QUINCY UNIVERSITY, PUBLIC SCHOOLS, YMCA, UWCA, TRI-STATE VETERANS SUPPORT, SIU MEDICAL, TRACY FAMILY FOUNDATION, JOHN WOOD COMMUNITY COLLEGE, QUINCY YOUNG LIFE, COMMUNITY FOUNDATION, WORKFORCE OFFICE OF WESTERN ILLINOIS, QUINCY CHAMBER OF COMMERCE, THE MOORMAN FOUNDATION, J.W. GARDNER II FOUNDATION, QUINCY POLICE DEPARTMENT, GREAT RIVER ECONOMIC DEVELOPMENT FOUNDATION, CITY OF QUINCY, TRINITY UNITED CHURCH OF CHRIST, KHQA-TV, AND QUINCY HOUSING AUTHORITY.

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 7D
SINCE THE RELEASE OF THE CHNA, REPRESENTATIVES FROM THE UNITED WAY OF ADAMS COUNTY AND THE CONSULTANT WHO ASSISTED IN THE CREATION OF THE REPORT, HAVE PRESENTED THE KEY FINDINGS OF THE REPORT TO NUMEROUS COMMUNITY GROUPS IN ADAMS COUNTY. IN ADDITION TO THE PRESENTATIONS, THREE ONLINE MEETINGS WERE HELD IN WHICH A VARIETY OF COMMUNITY LEADERS AND INTERESTED STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION ON THE CHNA. TIME WAS ALLOCATED FOR PARTICIPANTS TO ASK QUESTIONS AND TO PROVIDE FEEDBACK. ALSO, A GROUP OF 40 COMMUNITY LEADERS AND FRONTLINE WORKERS CONVENED IN AN ALL-DAY PLANNING SESSION TO DISCUSS THE CHNA AND IDENTIFY COMMUNITY PRIORITIES. THE PRESENTATIONS PROVIDED AN OPPORTUNITY TO CREATE BROAD COMMUNITY AWARENESS OF THE ISSUES AND OPPORTUNITIES ADDRESSED IN THE CHNA. THE CHNA IS SHARED WITH THE COMMUNITY BUILDING COUNCIL MEMBERS AS WELL AS THE COMMUNITY SOLUTIONS TEAM MEMBERS TO GUIDE THEIR STRATEGIC PLANNING AROUND THE IDENTIFIED COMMUNITY PRIORITIES. THE UNITED WAY MEMBER ORGANIZATIONS ALSO RECEIVE A COPY OF THE CHNA AND ARE REQUIRED TO DISCUSS HOW THEIR PROGRAMMING MEETS THE NEEDS IDENTIFIED IN THE CHNA DURING THE ANNUAL FUNDING PROCESS.

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 11
IN 2021, BLESSING CONTINUED ITS STRONG PARTNERSHIP WITH THE UNITED WAY OF ADAMS COUNTY AND THE ADAMS COUNTY HEALTH DEPARTMENT IN FUNDING AND CONDUCTING THE CHNA. THE ADAMS COUNTY COMMUNITY BUILDING COUNCIL (CBC) GUIDES THE COMMUNITY NEEDS ASSESSMENT AND PLANNING PROCESS THROUGH THE DEVELOPMENT OF PROGRAMS, PARTNERSHIPS, AND COLLABORATIONS WORKING TO ADDRESS THE NEEDS IDENTIFIED IN THE 2021 CHNA. CBC MEMBERS ARE COMMUNITY LEADERS REPRESENTING WORKFORCE/ BUSINESSES, FOUNDATIONS, HUMAN SERVICE PROVIDERS, FAITH, LAW ENFORCEMENT, MEDIA, EDUCATION, PUBLIC HEALTH, HEALTHCARE- INCLUDING BLESSING HOSPITAL (WHICH IS THE ONLY LOCAL HOSPITAL) AND OUTPATIENT PROVIDERS, COMMUNITY MEMBERS, AND GOVERNMENT. THE CBC IS CO-CHAIRED BY STAFF OF BLESSING HOSPITAL AND THE ADAMS COUNTY HEALTH DEPARTMENT. REPORTING TO THE CBC ARE SIX COMMUNITY SOLUTIONS TEAMS (CST) COMPRISED OF COMMUNITY EXPERTS IN THE AREAS OF THE STRATEGIC PRIORITIES. THE COMMUNITY SOLUTIONS TEAMS ARE CHARGED WITH ESTABLISHING GOALS AND WORK PLANS TO CREATE POSITIVE IMPACT ON THE GAPS IDENTIFIED IN THE CHNA. BLESSING HOSPITAL STAFF ARE ACTIVE IN EITHER LEADERSHIP OR MEMBERSHIP OF THE CSTS THAT ALIGN WITH BLESSING HOSPITAL'S IDENTIFIED FOCUS AREAS. THREE TOP HEALTH PRIORITIES WERE IDENTIFIED IN ORDER TO PROVIDE A COLLECTIVE FOCUS FOR VARIOUS ENTITIES TO SUPPORT EFFORTS RESULTING IN POSITIVE, LASTING CHANGE FOR ADAMS COUNTY: 1.HOUSING INSTABILITY/HOMELESSNESS 2.POVERTY/FINANCIAL INSTABILITY 3.BEHAVIORAL HEALTH BLESSING HOSPITAL IDENTIFIED BEHAVIORAL HEALTH AS ITS HEALTH PRIORITY AS IT MOST CLOSELY ALIGNS WITH THE ORGANIZATION'S GOALS. THIS PRIORITY AREA AND STRATEGIES WERE DETERMINED BY TAKING INTO ACCOUNT THE PROGRAMMING, RESOURCES, AND PRIORITIES OF THE HOSPITAL. BLESSING HOSPITAL'S BEHAVIORAL HEALTH STRATEGY INCLUDES: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE DISORDER SERVICES. INCREASE AWARENESS AND NORMALIZE TREATMENT OF MENTAL HEALTH. DECREASE THE PERCENTAGE OF ADAMS COUNTY ADULTS WHO REPORT 14 OR MORE DAYS OF POOR MENTAL HEALTH PER MONTH. TARGET: 12% BY 2025; BASELINE: 14%; DATA SOURCE: 2021 COUNTY HEALTH RANKINGS, BRFSS DECREASE THE NUMBER OF MENTALLY UNHEALTHY DAYS REPORTED BY ADAMS COUNTY RESIDENTS IN THE PAST 30 DAYS. TARGET: 3.8% BY 2025; BASELINE: 4.5%; DATA SOURCE: 2021 COUNTY HEALTH RANKINGS, BRFSS DECREASE THE PERCENTAGE OF EMERGENCY DEPARTMENT VISITS FOR MENTAL AND BEHAVIORAL DISORDERS AT BLESSING HOSPITAL. TARGET 30% BY 2025; BASELINE 35% DATA SOURCE: BLESSING HEALTH SYSTEM DATA ANALYTICS, 2021 DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO REPORT THAT THEY EXPERIENCE DEPRESSION. TARGET: 38 % BY 2025; BASELINE 43%; DATA SOURCE: 2020 ILLINOIS YOUTH SURVEY DECREASE THE PERCENTAGE OF THE ADAMS COUNTY POPULATION THAT IS AT RISK FOR BINGE DRINKING (5 OR MORE DRINKS ON ONE OCCASION FOR MEN, 4 OR MORE DRINKS ON ONE OCCASION FOR WOMEN). TARGET: 15% BY 2025; BASELINE: 19.2%; DATA SOURCE: ILLINOIS COUNTY BEHAVIORAL RISK FACTOR SURVEY, 2015-2019. DECREASE THE PERCENTAGE OF THE ADAMS COUNTY POPULATION THAT IS AT RISK FOR HEAVY DRINKING (2 OR MORE DRINKS PER DAY FOR MEN, 1 OR MORE DRINK PER DAY FOR WOMEN). TARGET: 6.4 % BY 2025; BASELINE 6.9%; DATA SOURCE: ILLINOIS COUNTY BEHAVIORAL RISK FACTOR SURVEY, 2015-2019. DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO CONSIDERED SUICIDE. TARGET 19%; BASELINE 21%; DATA SOURCE: 2020 ILLINOIS YOUTH SURVEY. DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO REPORT THAT THEY EXPERIENCE DEPRESSION. TARGET: 38% BY 2025; BASELINE 43%; DATA SOURCE: 2020 ILLINOIS YOUTH SURVEY. DECREASE THE NUMBER OF NON-FATAL OPIOID OVERDOSE PER 10,000 POPULATION IN ADAMS COUNTY. TARGET: 3% BY 2025; BASELINE 3.8%; DATA SOURCE: ILLINOIS DEPARTMENT OF PUBLIC HEALTH. DECREASE THE NUMBER OF DRUG OVERDOSE DEATHS IN ADAMS COUNTY. TARGET 1% REDUCTION IN NUMBER BY 2025; BASELINE: 41 PEOPLE; DATA SOURCE: ILLINOIS DEPARTMENT OF PUBLIC HEALTH. DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO USE TOBACCO OR VAPE. TARGET 5% BY 2025; BASELINE 7%; DATA SOURCE 2020 ILLINOIS YOUTH SURVEY. BLESSING HOSPITAL DEVELOPS AN INTERNAL STRATEGY THAT ALIGNS WITH THE IDENTIFIED COMMUNITY GOALS AND OBJECTIVES. BLESSING HOSPITAL'S BEHAVIORAL HEALTH STRATEGY AIMS TO INCREASE ACCESS, REDUCE BEHAVIORAL HEALTH ADMISSIONS TO THE EMERGENCY DEPARTMENT, AND INCREASE COMMUNITY PARTICIPATION. TACTICS UTILIZED TO ACHIEVE THIS GOAL INCLUDE: RECRUITMENT-ADD ADDITIONAL THERAPISTS, PSYCHOLOGISTS, PMHNP, AND PSYCHIATRISTS RETENTION-RETAIN EXISTING THERAPISTS, PSYCHOLOGISTS, PMHNP, AND PSYCHIATRISTS MARKETING/SOCIAL MEDIA TACTICS TO CONTINUE EFFORTS OF PROMOTING BEHAVIORAL HEALTH SERVICES CONTINUE TO GROW THE PARTIAL HOSPITALIZATION PROGRAM INCREASE TELEHEALTH USAGE FOR BEHAVIORAL HEALTH SERVICES, INCLUDING THE RURAL CLINICS UTILIZE THE BEHAVIORAL HEALTH INTEGRATION MODEL TO IMPROVE THE QUALITY OF BEHAVIORAL HEALTH SERVICES IN PRIMARY AND SPECIALTY CARE CLINICS CRISIS STABILIZATION MODEL FOR EMERGENCY ROOM-DEVELOP A MODEL FOR CRISIS STABILIZATION FOR PATIENTS WHO PRESENT WITH BEHAVIORAL HEALTH CONCERNS IN THE EMERGENCY DEPARTMENT EVIDENCE-BASED TRAINING-PROVIDE TRAINING TO ALL STAFF THROUGHOUT THE SERVICE LINE STRENGTHEN CLINICAL INTERVENTION STRATEGIES AND TREATMENT IN INPATIENT UNITS THE REMAINING PRIORITY AREAS ARE NOT BEING DIRECTLY ADDRESED BY BLESSING HOSPITAL, ALTHOUGH BLESSING CONTINUES TO SUPPORT THE INITIATIVES AND HAS REPRESENTATION ON ALL OF THE COMMUNITY SOLUTION TEAMS. THE REASON THAT BLESSING HOSPITAL IS NOT WORKING ON THESE DIRECTLY IS THAT THEY DON'T FIT WITHIN THE STRATEGIC PRIORITIES OF THE HEALTH SYSTEM, AND THERE ARE OTHER ENTITIES WITHIN THE COMMUNITY BETTER EQUIPPED TO ADDRESS THESE IMPORTANT COMMUNITY PRIORITIES: POVERTY- THE POVERTY TEAM IS CO-CHAIRED BY THE WORKFORCE DEVELOPMENT COMMITTEE MEMBERS. THE GOAL IS TO LIFT FAMILIES OUT OF POVERTY THROUGH SUSTANED FINANCIAL STABILITY. BLESSING HAS THREE REPRESENTATIVES ON THE COMMITTEE. OTHER MEMBERS REPRESENT QUANADA, UNIVERSITY OF ILLINOIS EXTENSION, BELLA EASE, COMMUNITY FOUNDATION, ADAMS COUNTY HEALTH DEPARTMENT, HORIZONS, UNITED WAY OF ADAMS COUNTY, THE CROSSING CHURCH, SIU, SAFE AND LIVABLE HOUSING COMMITTEE, WESTERN ILLINOIS WORKS, QUINCY PUBLIC SCHOOLS, FIRST BANKER'S TRUST, SALVATION ARMY, AND WEST CENTRAL CHILDCARE CONNECTION. HOUSING- A REPRESENTITIVE FROM THE YWCA AND THE GREAT RIVER ECONOMIC DEVELOPMENT OFFICE CO-CHAIRS THE HOUSING TEAM. THERE ARE TWO SUBCOMMITTEES- SUPPLY AND ACCESS. THE COMMITTEE'S GOAL IS TO INCREASE THE NUMBER OF RESIDENTS IN AFFORDABLE, SAFE, AND LIVABLE HOUSING. THE KEY STRATEGIES ARE IDENTIFYING THE NUMBER OF AFFORDABLE HOUSING UNITS AVAILABLE TO RESIDENTS IN ADAMS COUNTY AND INCREASING AND REMOVING BARRIERS TO HOUSING FOR LOW-INCOME RESIDENTS. BLESSING HAS FOUR REPRESENTATIVES ON THE COMMITTEE. OTHER MEMBERS REPRESENT THE ADAMS COUNTY BOARD, CONNECT CHILD AND FAMILY SOLUTIONS, LOCAL REALTORS, FIRST BANKER'S TRUST, KROC CENTER, QUINCY HUMAN RIGHTS COMMISSION, TRANSITIONS, QUANADA WOMEN'S SHELTER, TWO RIVERS, BELLA EASE, HORIZONS, QUINCY HOUSING AUTHORITY, QUINCY SAFE AND LIVABLE HOUSING COMMITTEE, SALVATION ARMY, AND THE ADAMS COUNTY HEALTH DEPARTMENT.

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 13B
PATIENTS ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE IF THEIR INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES AND THEIR MEDICAL BILLS EXCEED 20% OF THEIR TOTAL REPORTED FAMILY INCOME. ELIGIBILITY IS BASED ON AN INDIVIDUAL'S FAMILY'S TOTAL INCOME AND FAMILY SIZE. PATIENTS EXPERIENCING CATASTROPHIC MEDICAL INDIGENCE ARE ELIGIBLE FOR A DISCOUNT OF 85%.

GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 16J
THE UNITED WAY SHARES BLESSING HOSPITALS FINANCIAL ASSISTANCE POLICY TO THOSE IN NEED OF MEDICAL CARE OR FACING MEDICAL DEBT THROUGH THEIR HELPLINE AND THEIR UNMET NEEDS GROUP. THE HELPLINE IS A FREE INFORMATION AND REFERRAL SERVICE THAT ASSISTS RESIDENTS IN FINDING THE HELP THEY NEED. WHETHER THOSE CALLING NEED A PHONE NUMBER OR INFORMATION ABOUT AVAILABILITY OF A SERVICE OR THEY NEED ASSISTANCE IN FINDING HEALTHCARE, HOUSING, FOOD, UTILITY AND RENT ASSISTANCE, SENIOR SERVICES, SUBSTANCE ABUSE PROGRAMS, OR LEGAL SERVICES, THE UNITED WAY HELPLINE OFFERS THAT HELP. THE UNITED WAY ALSO SHARES THE INFORMATION THROUGH THE QUINCY AREA PARTNERSHIP FOR UNMET NEEDS. THIS GROUP IS A NETWORK OF SOCIAL SERVICE AGENCIES AND FAITH-BASED ORGANIZATIONS. MEMBER AGENCIES PRESENT CASES FOR CONSIDERATION AT UNMET NEEDS MEETINGS. CLIENTS IN NEED OF ASSISTANCE CONTACT A MEMBER AGENCY WITH THEIR SPECIFIC NEED. AS THE CASES ARE DISCUSSED, ENTITY REPRESENTATIVES TALK ABOUT PROGRAMS THEY HAVE THAT COULD ASSIST THE PATIENT. BLESSING IS REPRESENTED AT THESE MEETINGS. THE UNITED WAY ALSO HAS AN INTERAGENCY COUNCIL THAT MEETS MONTHLY. SEVERAL AGENCIES FROM THROUGHOUT THE COMMUNITY ATTEND THIS MEETING. THEY HAVE A PRESENTER AT MOST MEETINGS. BLESSING HAS PRESENTED IN THE PAST, FOCUSING ON CARE COORDINATION AND TOUCHING ON THE FINANCIAL ASSISTANCE PROGRAM. BLESSING HOSPITAL HAS ALSO ESTABLISHED A CARE COORDINATION DEPARTMENT THAT WORKS WITH PATIENTS IN THE AMBULATORY SETTING TO ASSIST THEM IN MEETING THEIR HEALTHCARE NEEDS. ONE OF THE TARGETED AREAS OF THE CARE COORDINATION PROGRAM IS TO HELP PATIENTS ESTABLISH A PRIMARY CARE HOME. THIS CAN INCLUDE PROVIDING EDUCATION TO PATIENTS ABOUT SERVICES AVAILABLE IN THE COMMUNITY AND IF APPLICABLE HOW TO ACCESS THE FINANCIAL ASSISTANCE PROGRAMS WITHIN THOSE AGENCIES.

SCHEDULE H, PART I, LINE 3C
PATIENTS ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE IF THEIR INCOME EXCEEDS 250% OF THE FEDERAL POVERTY GUIDELINES AND THEIR MEDICAL BILLS EXCEED 20% OF THEIR TOTAL REPORTED FAMILY INCOME. ELIGIBILITY IS BASED ON AN INDIVIDUAL'S OR FAMILY'S TOTAL INCOME AND FAMILY SIZE. PATIENTS EXPERIENCING CATASTROPHIC MEDICAL INDIGENCE ARE ELIGIBLE FOR A DISCOUNT OF 85%.

SCHEDULE H, PART I, LINE 7G
BLESSING HOSPITAL DOES NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.

SCHEDULE H, PART I, LINE 7, COLUMN (F)
BAD DEBT EXPENSE OF 8,224,654 IS SUBTRACTED FROM TOTAL EXPENSES OF 536,357,023 REPORTED ON LINE 25, COLUMN A OF FORM 990, PART IX, FOR A NET TOTAL EXPENSE OF 528,132,369.

SCHEDULE H, PART I, LINE 7
WHEN POSSIBLE, CALCULATIONS OF DIRECT AND INDIRECT COSTS ASSOCIATED WITH THE SERVICES PROVIDED ARE REPORTED. IF NOT AVAILABLE, A COST-TO-CHARGE RATIO IS USED TO CALCULATE THE COST AMOUNTS. THIS RATIO IS COMPUTED USING BLESSING HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES.

SCHEDULE H, PART II
IN PARTNERSHIP WITH THE ALLIANCE FOR BUILDING COMMUNITY, BLESSING HOSPITAL PROVIDES FUNDS TO PAY FOR THE POSITION OF THE DIRECTOR OF COMMUNITY IMPACT, A KEY INDIVIDUAL IN THE COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT.

SCHEDULE H, PART III, LINE 2
BAD DEBT EXPENSE IS CALCULATED ON THE NET PATIENT ACCOUNT BALANCE AFTER THE BALANCE HAS BEEN REDUCED FOR ANY PAYMENTS RECEIVED OR DISCOUNTS/ADJUSTMENTS THAT ARE KNOWN. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE ARE RECOGNIZED AS CHARITY CARE ACCOUNTS WHEN SUFFICIENT INFORMATION IS RECEIVED TO DETERMINE THEIR ELIGIBILITY. PRIOR TO THIS POINT, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CALCULATED ON UNINSURED ACCOUNTS. THIS ALLOWANCE IS REVERSED IF THE ACCOUNT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE.

SCHEDULE H, PART III, LINE 3
A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY FOR THEIR MEDICAL EXPENDITURES BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE. THE HOSPITAL USES FINANCIAL AND OTHER INFORMATION OF SUCH PATIENTS OTHERWISE AVAILABLE TO THE HOSPITAL TO IDENTIFY THOSE PATIENTS THAT WOULD QUALIFY FOR CHARITY CARE IF THEY COMPLETED THE PAPERWORK. THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES THE PERCENTAGE OF THE BAD DEBT EXPENSE THAT IS EVENTUALLY REVERSED DUE TO PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE. THE HOSPITAL APPLIES THAT PERCENTAGE TO THE BAD DEBT EXPENSE TO ESTIMATE THE AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE THAT WILL BE FOUND TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE BAD DEBT EXPENSE ASSOCIATED WITH SUCH PATIENTS' ACCOUNTS ARE TREATED AS COMMUNITY BENEFIT.

SCHEDULE H, PART III, LINE 4
SEE NOTE (2) ON PAGES 13-16 OF THE HOSPITAL'S ATTACHED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
THE HOSPITAL USES A COST-TO-CHARGE RATIO TO CALCULATE COST AMOUNTS. THIS RATIO IS COMPUTED USING BLESSING HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.

SCHEDULE H, PART III, LINE 9B
COLLECTION PRACTICES ARE NOT PURSUED IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION HAS BEEN RETURNED AND APPROVED.

SCHEDULE H, PART VI, LINE 2
BLESSING HOSPITAL HAS WORKED IN PARTNERSHIP WITH THE COMMUNITY PUBLIC HEALTH DEPARTMENT, THE LOCAL UNITED WAY AGENCY AND OTHER AREA AGENCIES IN CONDUCTING A NEEDS ASSESSMENT. THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2021.

SCHEDULE H, PART VI, LINE 3
BLESSING HOSPITAL FINANCIAL ACCOUNT SPECIALISTS (FAS) ATTEMPT TO CONTACT SELF-PAY INPATIENTS WITHIN 24 HOURS OF ADMISSION. IF THIS ATTEMPT TO MEET WITH THE PATIENT IS UNSUCCESSFUL, FURTHER ATTEMPTS ARE MADE LATER DURING THEIR STAY OR AT THEIR HOME. THE PATIENT IS SCREENED FOR GOVERNMENT PROGRAMS AND ELIGIBILITY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. OUTPATIENTS ARE CONTACTED ONCE THE PATIENT'S CONDITION HAS BEEN STABILIZED AND ARE SCREENED IN THE SAME MANNER AS INPATIENTS. FOR SCHEDULED TESTING, FAS CONTACT UNINSURED PATIENTS PRIOR TO THEIR SERVICE AND PROVIDE ESTIMATES OF CHARGES AND EDUCATION ON AVAILABLE PROGRAMS. IF THE FAS ARE NOT AVAILABLE TO MEET WITH THE PATIENT PRIOR TO SERVICE, CONTACT INFORMATION IS GIVEN TO THE PATIENT IF ASSISTANCE IS NEEDED.

SCHEDULE H, PART VI, LINE 7
ILLINOIS

SCHEDULE H, PART VI
BLESSING HOSPITAL'S COMMUNITY BENEFIT REPORT IS PRESENTED TO THE COMMUNITY AS AN ADVERTISEMENT IN THE HERALD-WHIG, QUINCY, ILLINOIS' LOCAL NEWSPAPER, ONCE A YEAR. IN THIS AD, INFORMATION IS PROVIDED TO DIRECT PEOPLE TO THE HOSPITAL'S WEBSITE FOR A COMPREHENSIVE INVESTMENT REPORT.

SCHEDULE H, PART VI, LINE 4
FOR 149 YEARS, BLESSING HOSPITAL HAS SERVED THE HEALTH CARE NEEDS OF THE PEOPLE OF WEST CENTRAL ILLINOIS, NORTHEAST MISSOURI AND SOUTHEAST IOWA. APPROXIMATELY 235,000 PEOPLE LIVE WITHIN A 50 MILE RADIUS OF BLESSING HOSPITAL. THE HOSPITALS PRIMARY MARKET AREA COVERS SIX COUNTIES, FOUR IN WEST CENTRAL ILLINOIS (ADAMS, BROWN, HANCOCK AND PIKE) AND TWO IN NORTHEAST MISSOURI (MARION AND LEWIS). THE REGIONS ECONOMY IS HEAVILY AGRICULTURAL, WITH A MIX OF MANUFACTURING, COMMERCIAL/RETAIL BUSINESS, AND RESTAURANTS MAKING UP THE REST OF THE LOCAL ECONOMY. BLESSING HOSPITAL IS THE LARGEST EMPLOYER IN ITS REGION. QUINCY, ILLINOIS, THE CITY IN WHICH THE MAIN BLESSING HOSPITAL CAMPUS IS LOCATED, IS THE HUB OF NON-FARM EMPLOYMENT AND RETAIL TRADE IN THE MARKET AREA. THE MEDIAN HOUSEHOLD INCOME IN ILLINOIS IS 72,563. THE MEDIAN HOUSEHOLD INCOME IN THE FOUR ILLINOIS COUNTIES IN BLESSINGS PRIMARY MARKET AREA IS BELOW THE ILLINOIS AVERAGE, RANGING FROM 13,200 TO 21,000 LOWER. THE MISSOURI MEDIAN HOUSEHOLD INCOME IS 61,043. IN THE TWO MISSOURI COUNTIES IN BLESSINGS PRIMARY MARKET AREA THE MEDIAN HOUSEHOLD INCOME IS BELOW THE STATE AVERAGE BETWEEN 4,800 AND 14,800. THE PERCENTAGE OF RESIDENTS OVER THE AGE OF 65 IN ILLINOIS IS 16.6 PERCENT. THE ILLINOIS COUNTIES IN BLESSINGS PRIMARY MARKET AREA, WITH THE EXCEPTION OF BROWN COUNTY, EXCEED THAT RATE BY AN AVERAGE OF 5.5 PERCENTAGE POINTS. THE PERCENTAGE OF RESIDENTS OVER THE AGE OF 65 IN MISSOURI IS 17.6 PERCENT. THE MISSOURI COUNTIES IN BLESSINGS PRIMARY MARKET AREA EXCEED THE STATE AVERAGE BY APPROXIMATELY 1.4 PERCENTAGE POINTS. THE ILLINOIS POVERTY RATE IS 12.1 PERCENT. FOR THE FOUR COUNTIES IN BLESSINGS PRIMARY MARKET IN ILLINOIS, THE AVERAGE POVERTY RATE IS 13.5 PERCENT, WHICH IS 1.4 PERCENTAGE POINTS ABOVE THE STATE AVERAGE. THE MISSOURI POVERTY RATE IS 12.7 PERCENT. FOR THE TWO MISSOURI COUNTIES IN BLESSINGS PRIMARY MARKET, THE POVERTY RATE AVERAGES 14.4 PERCENT, WHICH IS 1.7 PERCENTAGE POINTS ABOVE THE STATE AVERAGE. THE OBESITY RATE AVERAGE ACROSS THE FOUR ILLINOIS COUNTIES IN BLESSINGS PRIMARY MARKET IS 36.0 PERCENT, 1.8 PERCENT ABOVE THE STATE AVERAGE OF 34.2 PERCENT. IN MISSOURI, THE OBESITY RATE AVERAGE IS 39.5 PERCENT IN THE TWO COUNTIES IN BLESSINGS PRIMARY MARKET, 2.2 PERCENT ABOVE THE STATE AVERAGE OF 37.3 PERCENT.

SCHEDULE H, PART VI, LINE 5
BLESSING HOSPITAL OFFERS A WIDE RANGE OF SPECIALTY SERVICES IMPORTANT TO PROMOTING THE HEALTH AND WELL-BEING OF ADAMS COUNTY AND THE SURROUNDING AREA. INCLUDED IN THESE ARE THE CANCER CENTER, THE HEART AND VASCULAR CENTER, THE BREAST CENTER, PSYCHIATRIC SERVICES, AND HOSPICE AND HOME CARE PROGRAMS. SURPLUS FUNDS GENERATED FROM HOSPITAL OPERATIONS ARE USED TO FUND CAPITAL EXPENDITURES AND THE EXPANSION OF HEALTH CARE SERVICE LINES TO THE COMMUNITY WE SERVE. BLESSING HOSPITAL OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THE ABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY OF BLESSING HOSPITAL ENABLES PATIENTS TO HAVE ACCESS TO AREA RESOURCES TO ASSIST THEM WITH PAYMENT OF MEDICAL EXPENSES. BLESSING HOSPITAL IS AFFILIATED WITH THE BLESSING-RIEMAN COLLEGE OF NURSING, WHICH OFFERS A BACHELOR OF SCIENCE IN NURSING DEGREE AND A MASTER OF SCIENCE IN NURSING DEGREE, ALONG WITH OTHER PROGRAMS. THE COLLEGE HAS OVER A 100 YEAR HISTORY IN THE COMMUNITY AND IS CURRENTLY ACCREDITED BY THE HIGHER LEARNING COMMISSION. BLESSING HOSPITAL IS THE LARGEST EMPLOYER IN THE AREA WITH 3,554 EMPLOYEES. OF SIGNIFICANT IMPORTANCE ARE THE VOLUNTEERS WHO SERVE THE HOSPITAL. IN FISCAL YEAR 2022, BLESSING HOSPITAL HAD 337 ACTIVE VOLUNTEERS WHO SERVED FOR A TOTAL OF 26,896 HOURS. IN ADDITION TO THE VOLUNTEERS ACTIVELY WORKING IN THE HOSPITAL, BLESSING'S BOARD OF TRUSTEES IS COMPRISED OF VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, PHYSICIANS, AND OTHER COMMUNITY LEADERS.

SCHEDULE H, PART VI, LINE 6
BLESSING CORPORATE SERVICES, INC. IS THE PARENT ORGANIZATION OF A GROUP OF RELATED ORGANIZATIONS AND PROVIDES OVERALL DIRECTION TO ALL ENTITIES WITHIN THE STRUCTURE. DURING THE YEAR ENDED SEPTEMBER 30, 2005, BLESSING CORPORATE SERVICES, INC. BEGAN OPERATING A DIVISION COMPRISED OF PRACTICING PHYSICIANS. THE GROUP IS RELATED BY BLESSING CORPORATE SERVICES, INC. CONTROL OVER THE RELATED ORGANIZATION'S BOARD. THE FOLLOWING IS A BRIEF DESCRIPTION OF EACH MEMBER OF THE GROUP. ORGANIZATION - BLESSING HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN QUINCY, ILLINOIS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS, NORTHEASTERN MISSOURI, AND SOUTHEASTERN IOWA. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 1873. ORGANIZATION - THE BLESSING FOUNDATION, INC. RAISES, MANAGES, AND DISTRIBUTES CHARITABLE DONATIONS ON BEHALF OF THE BLESSING HEALTH SYSTEM. ORGANIZATION - DENMAN SERVICES, INC. IS A TAXABLE CORPORATION THAT IS ENGAGED PRIMARILY IN THE BUSINESS OF SELLING AND RENTING MEDICAL EQUIPMENT AND OPERATING A COMMERCIAL LAUNDRY. THE ENTITY IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN PITTSFIELD, ILLINOIS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 2000. ORGANIZATION - ILLINI HEALTH SERVICES, LLC CONDUCTS A DURABLE MEDICAL EQUIPMENT BUSINESS IN PITTSFIELD, ILLINOIS. THE ENTITY IS OWNED NINETY- FIVE PERCENT (95%) BY DENMAN SERVICES, INC. AND FIVE PERCENT (5%) BY BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL. ORGANIZATION - CHS HOLDING COMPANY IS A TAXABLE CORPORATION THAT PROVIDES HEALTH INSURANCE PRODUCTS AND SERVICES. ORGANIZATION - BLESSING WALK-IN CLINIC, LLC DBA BLESSING CONVENIENT CARE OPERATES HEALTH CLINICS IN RETAIL FACILITIES. ORGANIZATION - CROSSRIVER QUALITY HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF REGIONAL PHYSICIANS DEDICATED TO ENHANCING HEALTH CARE QUALITY AND EFFICIENCY ACROSS ILLINOIS, MISSOURI, AND IOWA. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - BLESSING ASSURANCE COMPANY IS A WHOLLY OWNED FOREIGN SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. AND IS A PROVIDER OF SELF-INSURANCE TO THE AFFILIATED GROUP. ORGANIZATION - THE HANNIBAL CLINIC, INC. IS A TAXABLE CORPORATION THAT OPERATES A PHYSICIAN CLINIC PROVIDING MULTI-SPECIALTY OUTPATIENT SERVICES TO THE REGION. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - THE BROWN DRUG COMPANY IS A TAXABLE CORPORATION THAT OPERATES A RETAIL PHARMACY. ORGANIZATION - KEOKUK HEALTH SYSTEMS, INC. IS A PARENT COMPANY OF FOUR ENTITIES, THREE OF WHICH ARE NOT-FOR-PROFIT: KEOKUK AREA HOSPITAL DBA BLESSING HEALTH KEOKUK, KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY INC., AND KEOKUK AREA HOSPITAL FOUNDATION. TRI-STATE MEDICAL GROUP INC. IS A TAXABLE ENTITY. ORGANIZATION - RIVERCROSS DIAGNOSTICS, LLC IS A LABORATORY THAT SERVICES BLESSING HEALTH SYSTEM AND OTHER AREA MEDICAL SERVICE PROVIDERS.