Schedule H, Part VI, Line 7 States with which the organization files a community benefit report.
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The state of Kansas does not require hospitals to file community benefit reports; but VCH distributes our community benefit totals and activities annually in press releases, as well as, in our annual report.
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Schedule H, Part I, Line 6a Community Benefit Report
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Via Christi Health, Inc. produces a consolidated annual report for all ministries in their periodical magazine called "Via Christi Life". Within the report, several pages describe the Community Benefit activities that have taken place over the last year and the monetary value to the Wichita area. Community Benefit Report: Via Christi Rehabilitation Hospital, Inc. ("VCRH") is a member of Via Christi Health, Inc. ("VCH"). As a Catholic health system, VCRH has its origins in faith-based responses to health needs of our communities, with a particular concern for those living in poverty and who are vulnerable. The obligation to reach out to those in need and improve community health flows directly from our identity as a faith-based healing ministry. As a mission-driven organization, we provide community benefit because we are committed to our core values of: - Service of the Poor - Generosity of spirit, especially for persons most in need. - Reverence - Respect and compassion for the dignity and diversity of life. - Integrity - Inspiring trust through personal leadership. - Wisdom - Integrating excellence and stewardship. -Creativity - Courageous innovation. - Dedication - Affirming the hope and joy of our ministry. According to the VCRH mission statement, "As a part of Via Christi Health, Inc., we share this mission: Inspired by the Gospel and our Catholic tradition, we serve as a healing presence with special concern for our neighbors who are vulnerable." The financial information in this report was prepared in accordance with the Catholic Health Association's (CHA) A Guide for Planning and Reporting Community Benefit Guidelines (2012). Per these guidelines, we report the net expense for community benefit services (e.g. the total community benefit expense minus any associated revenue from patients, residents, payers and other external sources). The CHA guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health for all. The following are VCRH's definitions for quantifiable community benefits reports. Charity Care - free or discounted health services provided to persons who cannot afford to pay and who meet VCH's criteria for financial assistance. Charity care is reported in terms of costs, not charges. Charity care does not include bad debt. Government Sponsored Means-Tested Health Care - includes unpaid costs of public programs for low-income persons. The shortfall created when VCH receives payments that are less than the cost of caring for public program beneficiaries. This payment shortfall is not the same as a contractual allowance, which is the full difference between charges and government payments. For Fiscal Year Ended June 30, 2015 Community Benefit (VCRH): 1. Charity Care, at cost: $46.2 million 2. Government Sponsored Health Care, net expense: Unpaid cost of public indigent care programs (includes Medicaid, SCHIP and other safety net programs; does not include Medicare shortfall): $15.5 million 3. Community Benefit programs, net expense: $20.8 million 4. Total Quantifiable Community Benefit: $82.5 million
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Schedule H, Part III, Line 1 BAD DEBT IN ACCORDANCE WITH STATEMENT NO. 15
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VCRH reports bad debt in accordance with generally accepted accounting principles (GAAP). Healthcare Financial Management Statement No. 15 is followed to the extent that it aligns with the guidelines set forth by GAAP.
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Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
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The cost of providing charity care, means tested government programs, and community benefit programs is estimated using cost data and is calculated in compliance with Catholic Health Association (CHA) guidelines. The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied.
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Schedule H, Part II Community Building Activities
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As active members of the chamber and other networking coalitions, staff is in position to assist in the recruitment of new health care providers wanting to move into the geographic area resulting in more access to healthcare providers for all residents. In addition, engaging in community building organizations that increase economic development in the area, providing community support, providing leadership development and training for community members, and promoting workforce development also helps to encourage young professionals to look at the variety of health care career options available to them through area colleges and technical schools. Via Christi Hospitals offer youth an opportunity to shadow health care professionals on the job as a way to enlighten and encourage more health care career choices.
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Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
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Bad debt expense at cost is determined using the same cost-to-charge ratio that is used for charity care and Medicaid shortfall. VCRH follows the guidance from CHA and does not consider bad debt as a community benefit.
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Schedule H, Part III, Line 3 Bad Debt Expense Methodology
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VCRH has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients.
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Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
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From the audited financial statements of Ascension Health Alliance (which include the activity of Via Christi Rehabilitation Hospital, Inc.): The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the System follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by the System. Accounts receivable are written off after collection efforts have been followed in accordance with the System's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. VCRH's bad debt deduction was $123,149 at charges and $52,322 at cost (after the cost to charge ratio was applied to the amount of charges).
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Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
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VCRH follows the CHA guidelines regarding Medicare and does not include it as community benefit. However, the methodology described in the instructions to Schedule H, Part III, Section B, Line 7 for reporting Medicare shortfall does not take into account all costs incurred by VCRH and does not represent the total Medicare shortfall. The Medicare shortfall reported on Schedule H, Part III, Section B, Line 7 was determined using information from the organization's Medicare cost report (using the Medicare cost report step-down methodology of allocating costs). However, utilizing an internal cost accounting system actually results in a smaller Medicare surplus of $222,336. The most common reason for a difference between the Medicare shortfall reported on Schedule H and the actual shortfall reported above include - inclusion of Medicare advantage revenue and expenses; inclusion of Medicare Part B revenue and expenses; inclusion of other fee schedule revenue; other timing issues; and costs that are considered unallowable on the Medicare cost report that are, in fact, related to Medicare Patient care.
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Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
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It is the policy of VCRH to promote socially just practices for billing and collections for all patients receiving care. The policy is intended to further VCRH's mission by requiring ethical conduct in billing and collecting self-pay balances from patient/guarantor's regardless of ability to pay. The policy ensures that prior to turning an account over to a Third Party Collection Agent (Agent) for collection activity, VCRH will perform a reasonable review of each account to verify that the patient/guarantor is not potentially eligible for any government assistance program (e.g.: Medicaid, Medicare, etc.) and would likely not qualify for charity care. VCRH will direct its staff and Agents to periodically assess each patient/guarantor's ability to pay or to determine eligibility for charity care. The review and assessment should include but may not be limited to the following: a. Ensure the patient/guarantor has been notified of VCRH's financial assistance policy; b. Ensure the patient/guarantor was offered a financial assistance application; c. Ensure documentation of any known extraordinary financial circumstances of the patient/guarantor or if they are medically indigent.
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Schedule H, Part V, Section B, Line 16b FAP Application website
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- Via Christi Rehabilitation Hospital, Inc.: Line 16b URL: https://www.viachristi.org/sites/default/files/pdf/billing/FAA%20Proposed%2010-29-14.pdf;
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Schedule H, Part VI, Line 2 Needs assessment
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In addition, to the CHNAs conducted every 3 years by the hospital, VCRH makes use of other research conducted in the community, for example, Sedgwick County Health Department's annual plan, the United Way's Environmental Scan, up-to-date downloads from the Census Bureau, as well as Kansas University's Institute for Policy and Social Research. Specific research may be conducted when applying for grants and targeted research focusing on patients who come into our ERs and/or other departments are useful in looking at population health trends.
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Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
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All patients registered at Via Christi Rehabilitation Hospital, Inc. receive a Patient Admissions Brochure which includes information on the financial assistance policy and how to contact a financial counselor. Signage is also posted in each registration area. Financial assistance information is also provided on the Via Christi website. The information included in the brochure is: "At Via Christi Hospital, patients receive necessary medical care regardless of their ability to pay. Services are provided without regard to culture, age, gender, race, color, national origin, sexual orientation, spiritual beliefs, socioeconomic status, language or disability. Trained financial counselors are available to discuss individual needs. We will review your eligibility for financial assistance and assist you in making payment arrangements".
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Schedule H, Part VI, Line 4 Community information
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The primary counties for Via Christi Hospitals in Wichita include Sedgwick and Butler Counties. Sedgwick County has a land area of 998 square miles with an estimated 2014 population of 508,803. Butler County has a land area of 1,430 square miles with an estimated 2014 population of 66,227. Sedgwick County's population includes 81.0% white, 9.5% Black, 1.4% American Indian, 4.4% Asian and 13.9% persons of Hispanic or Latino origin. The diversity of the population in Sedgwick County is greater than for either Butler County or the State of Kansas as a whole. Racial breakout for Butler County includes: 93.6% white, 1.9% Black, 1.1% American Indian, 1.0% Asian persons, and 4.5% persons of Hispanic or Latino origin. It was reported by 13.6% of the Sedgwick County and 3.2% of the Butler County residents that a language other than English is spoken at home. When it comes to education, 88.6% of Sedgwick County residents completed high school and 28.7% had a bachelor's degrees or higher. This compares to 92.8% for high school graduates and 26.7% for bachelor's degrees for Butler County. Median household income for Sedgwick County residents between the years of 2009-2013 was $49,865 compared to $56,454 for Butler County. The median value of owner- occupied housing units during the same time period in Sedgwick County was $124,000 compared to $127,800 for Butler County residents. Sedgwick County reports 15.3% of its residents are below poverty level compared to 8.4% for Butler County. The Statewide poverty level is around 13.7%.
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Schedule H, Part VI, Line 5 Promotion of community health
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VCRH enriches the Wichita area through a community board, open medical staff, and taking care of patients regardless of their ability to pay. Community representation on the Governing Body The Board of Trustees is the governing body of VCRH. The majority of its members are external members comprised of persons who reside in or around Sedgwick County and have overall responsibility for the charitable mission of the organization as set forth in its Articles of Incorporation and Bylaws. These trustees represent areas of expertise in healthcare, finance, education, and local government. The Board actively debates and sets policy and strategic direction for the ministry, but does not get involved in issues related to daily operations. 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 surplus funds generated by the organization which are reinvested in the ministry in order to allow the ministry to sustain its mission and prepare for the future. Open Medical Staff The medical staff is open with over 1,100 physicians having medical privileges at Via Christi Hospitals in Wichita, including VCRH. Approximately 300 of these physicians are employed through Via Christi Clinics. Primary care physicians are providing medical home services to Medicare and Medicaid patients, especially those with multiple chronic diseases. Community Boards/Committees/Coalitions VCRH staff participates in the community on boards and committees of other not-for-profit organizations, government entities, foundations, area colleges and university committees, state-wide coalitions and national healthcare related not-for-profit organizations. Via Christi Rehabilitation Hospital, Inc. has representatives who regularly serve in some capacity to fulfill the missions of the following organizations located in Sedgwick County - Safe Kids Wichita Area Coalition, South Central Regional Trauma Council, Drowning Prevention Coalition, American Heart Association, StepStone and Dear Neighbor Board, Butler Community College Nursing Advisory Council, Central Plains Regional Healthcare Foundation, Kansas High School Athletic Association Sports Medicine Advisory Committee, YMCA Board, American Lung Association/COPD Committee, Family Life/Natural Family Planning Committee, Grace Med Clinic, Guadalupe Clinic, Wichita Center for Graduate Medical Education, Independent Living Resource Center and more. VCRH encourages participation of outside non-profit groups to use their ministries to promote their missions such as the Newman University and Wichita State University nursing students, employees of the State's Medicaid enrollment program, University of Kansas Psychiatry clerkship, American Red Cross blood donation program and others. Not-for-profit groups needing space to hold their meetings, trainings and/or routine work are encouraged to use conference room facilities for no cost at VCRH. VCRH staff present numerous educational talks during the course of the year on various topics dealing with health related issues for news media wanting to inform the public about specific illnesses, brain injuries, new mobility aids, and technology, which is improving the quality of life for many who have suffered losses due to accidents and other tragedies.
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Schedule H, Part VI, Line 6 Affiliated health care system
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Via Christi Rehabilitation Hospital, Inc. (VCRH) is an affiliate of Via Christi Health, Inc. (VCH) and Ascension Health. VCH's affiliates are large multi-faceted, integrated, not-for-profit ministries including hospital and non-hospital ministries (physician group practices, hospital organizations, research, home health, durable medical equipment, and senior facilities). These ministries work together to care for patients, joined by common systems and a philosophy of serving as a healing presence with special concern for our neighbors, especially those who are vulnerable. This community benefit happens through its focus on patient care, education and research. The organizations work together to serve their communities at the local, state, and national level. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 states and the District of Columbia. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi - US/Caribbean Province. Mission: The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs: - Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured. - Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons. - Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. - Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care. Certain costs such as graduate medical education and certain other activities are excluded from total operating expenses for purposes of this computation.
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