4A (Expenses $ 787853419 including grants of $ 29009899) (Revenue $ 959700323)
HEALTH-CARE SERVICESCENTRAL IOWA HOSPITAL CORPORATION IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE CENTRAL IOWA COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. CENTRAL IOWA HOSPITAL CORPORATION 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, SKILLED NURSING, 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, CENTRAL IOWA HOSPITAL CORPORATION ADMITTED 33,810 PATIENTS RESULTING IN A TOTAL OF 191,501 PATIENT DAYS. OUTPATIENT VISITS TOTALED 200,810 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 13,534. THERE WERE ALSO 106,333 EMERGENCY ROOM VISITS AND 5,318 BABIES DELIVERED.

4B (Expenses $ 83262566 including grants of $ 203681) (Revenue $ 0)
CHARITY CARE, MEANS-TESTED PROGRAMS AND OTHER COMMUNITY BENEFITSCHARITY CARE AND MEANS-TESTED PROGRAMS: CENTRAL IOWA HOSPITAL CORPORATION 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 $3,946,458 IN 2021. OFTENTIMES, CENTRAL IOWA HOSPITAL CORPORATION RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. CENTRAL IOWA HOSPITAL CORPORATION PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. IOWA METHODIST MEDICAL CENTER, IOWA LUTHERAN HOSPITAL AND BLANK CHILDREN'S HOSPITALS' NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $50,771,093 FOR 2021. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $54,717,551.OTHER BENEFITS: CENTRAL IOWA HOSPITAL CORPORATION 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. CENTRAL IOWA HOSPITAL CORPORATION COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. CENTRAL IOWA HOSPITAL CORPORATION HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL NET OTHER BENEFITS REPORTED VALUE: $28,545,015.

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: IOWA METHODIST MEDICAL CENTER, - FACILITY 2: IOWA LUTHERAN HOSPITAL, - FACILITY 3: METHODIST WEST HOSPITAL

GROUP A-FACILITY 1 -- IOWA METHODIST MEDICAL CENTER PART V, SECTION B, LINE 5:
THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY BY USING THE EXPERTISE OF NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM PRC. THE ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWED FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE PRC COMMUNITY HEALTH SURVEY USED FOR THE STUDY WAS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY THE STUDY SPONSORS AND PRC. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THIS PROCESS AND INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROVIDERS, SOCIAL SERVICE PROVIDERS AND COMMUNITY LEADERS. IN ALL, 66 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.

GROUP A-FACILITY 1 -- IOWA METHODIST MEDICAL CENTER PART V, SECTION B, LINE 6A:
THE HOSPITALS INCLUDED MERCYONE DES MOINES, BROADLAWNS MEDICAL CENTER AND UNITYPOINT HEALTH - DES MOINES.

GROUP A-FACILITY 1 -- IOWA METHODIST MEDICAL CENTER PART V, SECTION B, LINE 6B:
BROADLAWNS MEDICAL CENTER, POLK COUNTY HEALTH DEPARTMENT, DALLAS COUNTY HEALTH DEPARTMENT, WARREN COUNTY HEALTH SERVICES, UNITED WAY OF CENTRAL IOWA, EVERYSTEP & MID IOWA HEALTH FOUNDATION.

GROUP A-FACILITY 1 -- IOWA METHODIST MEDICAL CENTER PART V, SECTION B, LINE 11:
UNITYPOINT HEALTH-DES MOINES CONDUCTED ITS LAST CHNA IN 2019 AND REVIEWED THE HEALTH PRIORITIES DENTIFIED THROUGH THAT ASSESSMENT. TAKING INTO ACCOUNT THE TOP-IDENTIFIED NEEDS AS WELL AS HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES IT WAS DETERMINED AT THAT TIME THAT UNITYPOINT HEALTH-DES MOINES WOULD FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE:1. ENSURE EQUAL ACCESS TO HEALTH CARE FOR ALL. OPENED BEHAVIORAL HEALTH URGENT CARE CENTER CLINIC; DEVELOPED COMMUNITY PARTNERSHIPS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH; FOCUSED ON HEALTH EQUITY AND INCLUSION EFFORTS FOR STAFF AND COMMUNITY. 2. ESTABLISH COMMUNITIES AND NEIGHBORHOODS THAT ARE SAFE, ACCESSIBLE AND AVAILABLE TO EVERYONE INCLUDING PUBLIC GATHERING PLACES FOR DIVERSE AND INTEGRATED ENGAGEMENT, AND PROMOTE HEALTHY RELATIONSHIPS. FACILITATED FARMERS MARKET/YOGA IN PARK; PARTICIPATED IN HEALTHY HOMES IN DES MOINES FOR CHILDREN WITH ASTHMA; AND IOWA LUTHERAN HOSPITAL GIVING GARDEN3. IMPROVE THE SOCIAL/EMOTIONAL WELLBEING OF THE COMMUNITY. EXPANDED EMBACING U PROGRAM; FOCUSED ON ACES/TIC INTERNALLY AT UPH; ADVOCATED AND SUPPORTED THE DEVELOPMENT OF A STATEWIDE CHILDREN'S MENTAL STRATEGY. 4. INCREASE THE CAPACITY (SIZE AND SKILLS) OF THE HEALTH CARE WORKFORCE TO CREATE AND SUSTAIN HEALTH. EXPANDED APPRENTICESHIPS; PARTNERED WITH EDUCATION AND EMPLOYMENT ORGANIZATION TO EXPAND HEALTHCARE CAREER ACCESS; AND IMPLEMENTED DEI TRAINING FOR UPH STAFF

GROUP A-FACILITY 1 -- IOWA METHODIST 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 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.

GROUP A-FACILITY 2 -- IOWA LUTHERAN HOSPITAL PART V, SECTION B, LINE 5:
THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY BY USING THE EXPERTISE OF NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM PRC. THE ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWED FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE PRC COMMUNITY HEALTH SURVEY USED FOR THE STUDY WAS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY THE STUDY SPONSORS AND PRC. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THIS PROCESS AND INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROVIDERS, SOCIAL SERVICE PROVIDERS AND COMMUNITY LEADERS. IN ALL, 66 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.

GROUP A-FACILITY 2 -- IOWA LUTHERAN HOSPITAL PART V, SECTION B, LINE 6A:
THE HOSPITALS INCLUDED MERCYONE DES MOINES, BROADLAWNS MEDICAL CENTER AND UNITYPOINT HEALTH - DES MOINES.

GROUP A-FACILITY 2 -- IOWA LUTHERAN HOSPITAL PART V, SECTION B, LINE 6B:
BROADLAWNS MEDICAL CENTER, POLK COUNTY HEALTH DEPARTMENT, DALLAS COUNTY HEALTH DEPARTMENT, WARREN COUNTY HEALTH SERVICES, UNITED WAY OF CENTRAL IOWA, EVERYSTEP & MID IOWA HEALTH FOUNDATION.

GROUP A-FACILITY 2 -- IOWA LUTHERAN HOSPITAL PART V, SECTION B, LINE 11:
UNITYPOINT HEALTH-DES MOINES CONDUCTED ITS LAST CHNA IN 2019 AND REVIEWED THE HEALTH PRIORITIES DENTIFIED THROUGH THAT ASSESSMENT. TAKING INTO ACCOUNT THE TOP-IDENTIFIED NEEDS AS WELL AS HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES IT WAS DETERMINED AT THAT TIME THAT UNITYPOINT HEALTH-DES MOINES WOULD FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE:1. ENSURE EQUAL ACCESS TO HEALTH CARE FOR ALL. OPENED BEHAVIORAL HEALTH URGENT CARE CENTER CLINIC; DEVELOPED COMMUNITY PARTNERSHIPS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH; FOCUSED ON HEALTH EQUITY AND INCLUSION EFFORTS FOR STAFF AND COMMUNITY. 2. ESTABLISH COMMUNITIES AND NEIGHBORHOODS THAT ARE SAFE, ACCESSIBLE AND AVAILABLE TO EVERYONE INCLUDING PUBLIC GATHERING PLACES FOR DIVERSE AND INTEGRATED ENGAGEMENT, AND PROMOTE HEALTHY RELATIONSHIPS. FACILITATED FARMERS MARKET/YOGA IN PARK; PARTICIPATED IN HEALTHY HOMES IN DES MOINES FOR CHILDREN WITH ASTHMA; AND IOWA LUTHERAN HOSPITAL GIVING GARDEN3. IMPROVE THE SOCIAL/EMOTIONAL WELLBEING OF THE COMMUNITY. EXPANDED EMBACING U PROGRAM; FOCUSED ON ACES/TIC INTERNALLY AT UPH; ADVOCATED AND SUPPORTED THE DEVELOPMENT OF A STATEWIDE CHILDREN'S MENTAL STRATEGY. 4. INCREASE THE CAPACITY (SIZE AND SKILLS) OF THE HEALTH CARE WORKFORCE TO CREATE AND SUSTAIN HEALTH. EXPANDED APPRENTICESHIPS; PARTNERED WITH EDUCATION AND EMPLOYMENT ORGANIZATION TO EXPAND HEALTHCARE CAREER ACCESS; AND IMPLEMENTED DEI TRAINING FOR UPH STAFF

GROUP A-FACILITY 2 -- IOWA LUTHERAN 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.

GROUP A-FACILITY 3 -- METHODIST WEST HOSPITAL PART V, SECTION B, LINE 5:
THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY BY USING THE EXPERTISE OF NATIONALLY RECOGNIZED HEALTH CARE CONSULTING FIRM PRC. THE ASSESSMENT INCORPORATES DATA FROM MULTIPLE SOURCES, INCLUDING PRIMARY RESEARCH (THROUGH THE PRC COMMUNITY HEALTH SURVEY AND PRC ONLINE KEY INFORMANT SURVEY), AS WELL AS SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). IT ALSO ALLOWED FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. THE PRC COMMUNITY HEALTH SURVEY USED FOR THE STUDY WAS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE FINAL SURVEY INSTRUMENT WAS DEVELOPED BY THE STUDY SPONSORS AND PRC. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED AS PART OF THIS PROCESS AND INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROVIDERS, SOCIAL SERVICE PROVIDERS AND COMMUNITY LEADERS. IN ALL, 66 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.

GROUP A-FACILITY 3 -- METHODIST WEST HOSPITAL PART V, SECTION B, LINE 6A:
THE HOSPITALS INCLUDED MERCYONE DES MOINES, BROADLAWNS MEDICAL CENTER AND UNITYPOINT HEALTH - DES MOINES.

GROUP A-FACILITY 3 -- METHODIST WEST HOSPITAL PART V, SECTION B, LINE 6B:
BROADLAWNS MEDICAL CENTER, POLK COUNTY HEALTH DEPARTMENT, DALLAS COUNTY HEALTH DEPARTMENT, WARREN COUNTY HEALTH SERVICES, UNITED WAY OF CENTRAL IOWA, EVERYSTEP & MID IOWA HEALTH FOUNDATION.

GROUP A-FACILITY 3 -- METHODIST WEST HOSPITAL PART V, SECTION B, LINE 11:
UNITYPOINT HEALTH-DES MOINES CONDUCTED ITS LAST CHNA IN 2019 AND REVIEWED THE HEALTH PRIORITIES DENTIFIED THROUGH THAT ASSESSMENT. TAKING INTO ACCOUNT THE TOP-IDENTIFIED NEEDS AS WELL AS HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS AND STRATEGIC PRIORITIES IT WAS DETERMINED AT THAT TIME THAT UNITYPOINT HEALTH-DES MOINES WOULD FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE:1. ENSURE EQUAL ACCESS TO HEALTH CARE FOR ALL. OPENED BEHAVIORAL HEALTH URGENT CARE CENTER CLINIC; DEVELOPED COMMUNITY PARTNERSHIPS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH; FOCUSED ON HEALTH EQUITY AND INCLUSION EFFORTS FOR STAFF AND COMMUNITY. 2. ESTABLISH COMMUNITIES AND NEIGHBORHOODS THAT ARE SAFE, ACCESSIBLE AND AVAILABLE TO EVERYONE INCLUDING PUBLIC GATHERING PLACES FOR DIVERSE AND INTEGRATED ENGAGEMENT, AND PROMOTE HEALTHY RELATIONSHIPS. FACILITATED FARMERS MARKET/YOGA IN PARK; PARTICIPATED IN HEALTHY HOMES IN DES MOINES FOR CHILDREN WITH ASTHMA; AND IOWA LUTHERAN HOSPITAL GIVING GARDEN3. IMPROVE THE SOCIAL/EMOTIONAL WELLBEING OF THE COMMUNITY. EXPANDED EMBACING U PROGRAM; FOCUSED ON ACES/TIC INTERNALLY AT UPH; ADVOCATED AND SUPPORTED THE DEVELOPMENT OF A STATEWIDE CHILDREN'S MENTAL STRATEGY. 4. INCREASE THE CAPACITY (SIZE AND SKILLS) OF THE HEALTH CARE WORKFORCE TO CREATE AND SUSTAIN HEALTH. EXPANDED APPRENTICESHIPS; PARTNERED WITH EDUCATION AND EMPLOYMENT ORGANIZATION TO EXPAND HEALTHCARE CAREER ACCESS; AND IMPLEMENTED DEI TRAINING FOR UPH STAFF

GROUP A-FACILITY 3 -- METHODIST WEST 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:
CENTRAL IOWA HOSPITAL CORPORATION'S COMMUNITY BENEFIT REPORT IS CONTAINED WITHIN THE UNITYPOINT HEALTH 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, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $-267,242.

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. CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH-DES MOINES CONTRIBUTES FINANCIALLY TO A WIDE VARIETY OF COMMUNITY ORGANIZATIONS THAT ADDRESS THE BROADER NEEDS OF THE COMMUNITY. 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. OTHER DONATIONS SUCH AS FOOD OR OTHER DURABLE GOODS PROVIDE AREA SHELTERS AND OTHER ORGANIZATIONS IN THE AREA. THIS ALLOWS THESE ORGANIZATIONS TO MAXIMIZE THE RESOURCES THEY HAVE TO WORK WITH. CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH-DES MOINES EMPLOYEES ARE ACTIVE IN EDUCATING PARTNERS ON A WIDE VARIETY OF HEALTH SUBJECTS THAT ADVANCE THEIR WORK. FURTHER, CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH-DES MOINES EMPLOYEES ARE MEMBERS OF MANY NON-PROFIT BOARDS TO PROVIDE LEADERSHIP OR COMMUNITY COLLABORATIVE COLLECTIVELY WORKING TO ADDRESS COMPLEX HEALTH. 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' 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 CENTRAL IOWA HOSPITAL CORPORATION. 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 SURPLUS 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 2:
THE COMMUNITY ENGAGEMENT TEAM AT UNITYPOINT HEALTH-DES MOINES CONTINUALLY ENGAGES WITH VARIOUS PARTNERS TO MONITOR ON-GOING NEEDS WITHIN OUR COMMUNITY. AS AN EXAMPLE, WE PARTICIPATE IN THE UNITED WAY OF CENTRAL IOWA'S HEALTH, EDUCATION AND INCOME CABINETS TO SUPPORT THE PRIORITIES THAT IT HAS IDENTIFIED. WE WORK CLOSELY TO ASSIST IN ADDRESSING THIS SET OF COMMUNITY PRIORITIES.

PART VI, LINE 7, REPORTS FILED WITH STATES
IA

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 4:
CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH DES MOINES IS A 779-BED COMMUNITY HOSPITAL SYSTEM SERVING CENTAL IOWA. CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH DES MOINES IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE.80% OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH DES MOINES' MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTIES OF DALLAS, GUTHRIE, JASPER, MADISON, MARION, POLK, STORY, AND WARREN. CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH DES MOINES ADMITS 35,000 INPATIENTS AND CARES FOR 108,000 EMERGENCY PATIENTS PER YEAR. THERE ARE 34 OTHER HOSPITALS WITHIN THE 30-COUNTY SERVICE AREA. MEDIAN HOUSEHOLD INCOMES RANGE FROM $73,468 TO $115,745 AND THE AVERAGE POVERTY RATE IS 19.79%. 56% OF CENTRAL IOWA HOSPITAL CORPORATION D/B/A UNITYPOINT HEALTH DES MOINES PATIENTS ARE ELIGIBLE FOR MEDICARE (41%) OR MEDICAID (15%). POLK AND STORY COUNTIES ARE THE ONLY COUNTIES IN THE SERVICE AREA WITH SIGNIFICANT MINORITY POPULATIONS. POLK COUNTY IS 8.5 PERCENT HISPANIC, 7.0 PERCENT AFRICAN AMERICAN AND STORY COUNTY IS 8.0 PERCENT ASIAN.

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). 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.