SCHEDULE H, PART I, LINE 7, COLUMN (F):
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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 $4,766,718. SCHEDULE H, PART II, COMMUNITY BUILDING ACTIVITIES: HILLSDALE COMMUNITY HEALTH CENTER PROVIDES NUMEROUS COMMUNITY ACTIVITIES IN SUPPORT OF THE RESIDENTS OF HILLSDALE COUNTY, INCLUDING SENIOR SUNDAY WHERE LUNCH IS SERVED TO THE SENIOR COMMUNITY MEMBERS AND A SPEAKER DISCUSSES HEALTH ISSUES AND OTHER TOPICS RELATING TO THIS AGE GROUP. IN ADDITION, THERE ARE SEVERAL SUPPORT GROUPS AND CLASSES, INCLUDING THE BREAST CANCER SUPPORT GROUP, BREAST FEEDING CLASSES, BIRTHING CLASSES, NUTRITION EDUCATION AND DIABETES EDUCATION CLASSES. THERE ARE PERIODIC HEALTH SCREENINGS SUCH AS VARICOSE VEIN, FOOT PAIN, CHOLESTEROL, AND COPD SCREENINGS. HILLSDALE COMMUNITY HEALTH CENTER ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM. NUMEROUS HIGH SCHOOL AND COMMUNITY LOANS HAVE BEEN GRANTED FOR FULL TUITION FOR ALLIED HEALTH DEGREES. REPAYMENT OF LOANS IS FULFILLED THROUGH A TIME COMMITMENT TO THE HILLSDALE COMMUNITY HEALTH CENTER. SCHEDULE H, PART III, SECTION A, LINE 2 ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES. AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS STRATIFIED BY PAYOR AND NUMBER OF DAYS THE ACCOUNTS ARE OUTSTANDING. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
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SCHEDULE H, PART III, SECTION A, LINE 3
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HILLSDALE HOSPITAL SAW $3,351,571 OF ACCOUNTS WRITTEN OFF TO BAD DEBT THAT WERE ATTRIBUTED TO PATIENTS WITH NO INSURANCE COVERAGE. THE AVERAGE DISCOUNT APPLIED TO ACCOUNTS THROUGH OUR FINANCIAL ASSISTANCE PROGRAM WAS 67.5%. WE APPLIED THAT PERCENTAGE TO THOSE ACCOUNTS WRITTEN OFF WITH NO INSURANCE.
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SCHEDULE H, PART III, SECTION A, LINE 4
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The Hillsdale Community Health Center reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Hillsdale Community Health Center 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 Hillsdale Community Health Center bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospital's allowance for doubtful accounts for self-pay patients increased from 68% of self-pay accounts receivable at June 30, 2015, to 71% of self-pay accounts receivable at June 30, 2016. In addition, the Hospital's write-offs decreased approximately $594,000 from approximately $5,811,000 for the year ended june 30, 2015, to approximately $5,217,000 for the year ended June 30, 2016. Both changes were caused by a shift in payer mix which resulted in a decrease in private pay patients and increase in governmental payers patients in 2016 as a result of health care reform. SCHEDULE H, PART III, SECTION B, LINE 8 THE COST TO CHARGE RATIO IS USED TO DETERMINE MEDICARE SURPLUS AT COST. THE MEDICARE ALLOWABLE COSTS REPORTED DO NOT INCLUDE ALL MEDICARE CHARGES. HAD ALL CHARGES BEEN INCLUDABLE THE RESULT WOULD BE A SHORTFALL. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THIS IS THE EXTENT TO WHICH COSTS RELATED TO MEDICARE SERVICES GO UNPAID.
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SCHEDULE H, PART III, SECTION C, LINE 9B
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AFTER INSURANCE PAYMENTS, THE SELF PAY PORTION IS BILLED TO THE PATIENT ON A MONTHLY STATEMENT. THE STATEMENT INCLUDES INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND HOW TO APPLY. AFTER THREE CYCLES, IF THE AMOUNT IS NOT PAID, THE GUARANTOR RECEIVES THREE CYCLES OF COLLECTION LETTERS. IF THE AMOUNT IS STILL NOT PAID, THE GUARANTOR CONTINUES TO RECEIVE LETTERS UNTIL THE ACCOUNT IS WRITTEN OFF TO THE COLLECTION AGENCY. DURING THE TIME THE GUARANTOR IS RECEIVING THE STATEMENTS AND LETTERS, SEVERAL TELEPHONE CALLS ARE PLACED TO THE GUARANTOR TO TRY TO DISCUSS THE PAYMENT OR OTHER OPTIONS AVAILABLE TO THE GUARANTOR SUCH AS A PAYMENT PLAN OR FINANCIAL ASSISTANCE.
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SCHEDULE H, PART VI, LINE 2
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HCHC PARTNERED WITH THE HUMAN SERVICES NETWORK, A COMMUNITY COLLABORATIVE BODY MADE UP OF A MAJORITY OF THE COUNTY'S HUMAN SERVICE, EDUCATIONAL, FAITH BASED, AND NON-PROFIT ORGANIZATIONS WITHIN HILLSDALE COUNTY. THIS GROUP SERVED AS THE STEERING GROUP FOR THE PROJECT, ALONG WITH ITS EXECUTIVE COMMITTEE.
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SCHEDULE H, PART VI, LINE 3
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IF A PATIENT PRESENTS TO HCHC FOR SERVICES AND INDICATES THEY HAVE NO INSURANCE, THEY ARE PROVIDED A COPY OF THE FAP PLAIN LANGUAGE SUMMARY ALONG WITH A LISTING OF THOSE ORGANIZATIONS THAT ARE AVAILABLE TO PROVIDE ADDITIONAL HELP AND SERVICES. WE ALSO HAVE TWO STATE DSH WORKERS ON SITE WHO ARE AVAILABLE TO WORK WITH THE PATIENTS TO DETERMINE THEIR ELIGIBILITY FOR MEDICAID OR OTHER SERVICES. EACH STATEMENT MAILED TO THE GUARANTOR INCLUDES A STATEMENT REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW TO APPLY OR GET ADDITIONAL INFORMATION. AS COLLECTION CALLS ARE MADE TO THE GUARANTOR THEY ALSO INFORM THEM ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. THERE ARE INFORMATIONAL POSTERS IN THE PATIENT WAITING ROOMS, AND FAP INFORMATION IS INCLUDED IN EACH DISCHARGE PACKET PROVIDED TO ADMITTED PATIENTS. THE COMPLETE FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY IS PROVIDED ON THE HOSPITAL WEBSITE.
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SCHEDULE H, PART VI, LINE 4
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HILLSDALE MICHIGAN IS THE COUNTY SEAT OF HILLSDALE COUNTY. ITS POPULATION IS 8,200 WITH A HOUSEHOLD MEDIAN INCOME OF $32,022. THE CURRENT UNEMPLOYMENT RATE IS 7.5% FOR THE CITY OF HILLSDALE, AND 4.9% FOR HILLSDALE COUNTY. THE COUNTY IS BOUNDED ON THE NORTH BY CALHOUN AND JACKSON COUNTIES, ON THE EAST BY LENAWEE COUNTY, ON THE WEST BY GRANCH COUNTY, AND ON THE SOUTH BY STEUBEN COUNTY INDIANA AND WILLIAMS COUNTY OHIO. THE EXTREME SOUTHWEST CORNER OF HILLSDALE COUNTY IS WHERE THREE STATES OF MICHIGAN, OHIO AND INDIANA MEET. ON MAPS, THE COUNTY IS SITUATED AT 42 NORTH LATITUDE AND 8430' WEST LONGITUDE, AND COMPRISES ABOUT 617 SQUARE MILES, OR 394,880 ACRES. THE LAND LIES AN AVERAGE OF 630 FEET ABOVE LAKE ERIE AND 616 FEET ABOVE LAKE MICHIGAN.
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SCHEDULE H, PART VI, LINE 5
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HCHC FACILITATES MANY DIFFERENT SUPPORT GROUPS INCLUDING THE BREAST CANCER SUPPORT GROUP, COPD SUPPORT GROUP, AND THE BARIATRIC SUPPORT GROUP. WE ALSO OFFER SEVERAL EDUCATIONAL CLASSES INCLUDING BREAST FEEDING, BIRTHING, NUTRITION, AND DIABETES EDUCATION, AS WELL AS SEVERAL PERIODIC HEALTH SCREENINGS INCLUDING VARICOSE VEIN, FOOT PAIN, ACID REFLUX, CHOLESTEROL, AND COPD SCREENINGS, AS WELL AS PROVIDES FREE FLU SHOTS TO THE MEMBERS OF THE COMMUNITY. HCHC OWNS AND OPERATES A RURAL HEALTH CLINIC IN READING, MICHIGAN THAT PROVIDES HEALTHCARE SERVICES TO THE MEDICAID AND SELF INSURED POPULATION. HCHC ALSO PROVIDES FREE SUPPORT TO ST. PETER'S FREE CLINIC AND PARTICIPATES IN THE LOCAL ALLIED HEALTH STUDENT PROGRAM.
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