Part I Line 3c
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WVU Hospital WVUH uses 200 Federal Poverty Guideline FPG to determine free care eligibility. However, WVUH does not offer discounted care to individuals who fail the 200 FPG test.
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Part I Line 6a
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WVUH community benefit numbers are reported in total with the other hospitals within West Virginia United Health System. The most recent amounts can be found in the WVU Medicine Annual Report available at the following web address https//wvumedicine.org/wp-content/uploads/2018/07/WVU-Medicine-Annual-Report-2017.pdf
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Part I Line 7
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Total community benefit expense for 2017 is 334,052,783 and is 36.66 of total net expenses. To calculate net expense, bad debt of 24,927,418 was deducted from total expenses of 1,079,419,333 as shown in Part IX line 25 of the core Form 990, for a net expense of 1,054,491,915.
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Part I Line 7
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Worksheet 2 from the IRS Schedule H instructions was used to derive the Cost-to-Charge ratio, which was used to calculate Charity Care, Unreimbursed Medicaid and other means-tested government programs at cost.
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Part II
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Physical improvements and housing - WVUH employees spend a weekday afternoon - on work time - volunteering at a social service agency to do repairs and maintenance on homes for residents of Monongalia County.
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Part II
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Community Support - The WVUH Emergency Management Coordinator participates in the following activities related to disaster preparedness above and beyond what is required by the WVHA WV Hospital Association Region 6/7 Healthcare Threat Preparedness Coordinator, WV Hospital Association Region 6/7 Committee member, Monongalia County Local Emergency Planning Committee member. The Emergency Management Coordinator also organizes or participates in drills and exercise in the community with community emergency responders in order to be prepared in the event of an actual emergency.
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Part II
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Coalition building - WVUH employees participate in community coalitions and other organizations that focus on addressing community health and safety issues. In 2017 employees participated in Senior Health Advisory Groups, Kids in Transition Collaborative groups, and collaborative groups from various counties in WV.
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Part II
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Community Health Improvement Advocacy - WVUH is committed to improving the health and quality of life to West Virginians in the healthcare setting and in the communities served. In 2017, WVUH funded the replacement of the fitness stations along the Mon River Rail-Trail. WVUH also organizes and provides space for a weekly Farmers Market. WVUH does not charge a fee to vendors that wish to come to the farmers market. This famers market is attended by WVUH employees as well as employees of neighboring businesses and commuity members.
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Part II
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WVUH is a collaborative partner with Main Street Morgantown, the City of Morgantown and the Morgantown Parking Authority in supporting the Morgantown Market Place.
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Part II
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Workforce Development The Talent Acquisition team, a subset of the Human Resources Department at WVUH, is committed to workforce development in and around our community. Throughout 2017, the Talent Acquisition team attended 99 events in an effort to better train and recruit healthcare professionals. More specifically, our Recruiters attended 52 Career Fairs, 10 Community Events, 8 Mock Interview Sessions, 16 Open Interview Sessions and more. Our events included attendance at many school/educational events, partnership with the unemployment office Workforce WV, veteran events, and technical programs.
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Part III Line 2
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Bad Debt Expense at cost was calculated by multiplying bad debt expense of 24,927,418 by our cost to charge ratio of 38.13 derived from Worksheet 2 in the IRS Schedule H instructions for a total of 9,504,824.
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Part III Line 3
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Estimated bad debt attributable to patients eligible for charity care was calculated by running a report within our patient revenue software of all bad debt account balances greater than 50,000. The total of that report was 5,514,608 which we then multiplied by our cost to charge ratio of 38.13 for a total of 2,102,720.
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Part III Line 3
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The estimated bad debt attributable to patients eligible for charity care of 2,102,720 should be considered community benefit due to the fact that anyone with outstanding balances of 50,000 or greater usually qualifies as catastrophic if the patient completes the application process.
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In our charity care policy, we define catastrophic care as any illness or injury that will likely require continuous or frequent treatment for more than one year. Regardless, that bad debt should be considered community benefit as we provide services to those in need regardless of their ability to pay.
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WVUHs financial statements are prepared on a consolidated basis as a member of the WV United Health System. The footnote for Accounts Receivable is as follows Patient accounts receivable are reported at net realizable value. Accounts are written off when they are determined to be uncollectible based upon managements assessment of individual accounts. In evaluating the collectability of patient accounts receivable, the System analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. For receivables associated with services provided to patients who have third-party-coverage, the System analyzes contractual amounts due and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For receivables associated with self-pay patients, which includes both patients without insurance and insured patients with deductible and copayment balances, the System records a significant provision for bad debts 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 billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Systems allowance for doubtful accounts for self-pay patients increased to 60 of self-pay accounts receivable at December 31, 2017, from 57 of self-pay accounts receivable at December 31, 2016. In addition, the Systems self-pay write-offs net of recoveries increased to approximately 61,142,000 in 2017, from approximately 51,775,000 in 2016, which is the result of a slightly higher payor mix percentage of individuals without insurance and a slightly higher exposure to self-pay balances from high deductible third-party insurance plans. The System does not maintain a material allowance for doubtful accounts from third-party payors, nor does it have a history of significant write-offs from third-party payors. The System grants credit without collateral to its patients, most of whom are local residents and are insured under third-party payor agreements, primarily with Medicare, Medicaid, and various commercial insurance companies. The System maintains allowances for potential credit losses and such losses have historically been within managements expectations. The mix of receivables at December31, 2017 and 2016 from patients and third-party payors is as follows. For 2017, Medicare 29, Medicaid 14, Blue Cross 21 , Commercial/HMO/Other 32, Patients 4, Total 100. For 2016, Medicare 31, Medicaid 14, Blue Cross 21, Commercial/HMO/Other 30, Patients 4, Total 100.
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Part III Line 4
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For receivables associated with self-pay patients, which includes both patients without insurance and insured patients with deductible and copayment balances, the System records a significant provision for bad debts 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 billed rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.
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Part III Line 8
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The amount reported in Part III Line 6 417,175,867 was calculated using the total Medicare allowable cost from the Medicare cost report, less Medicare reimbursement of direct GME.
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WVUHs shortfall, 94,761,265 of Medicare program reimbursement should be considered a community benefit because we are relieving a government burden by providing care in excess of our costs to these patients. WVUH has the only Level 1 Trauma Center in the area, and we serve an aging population that relies on WVUH to provide the most state-of-the-art care available in the area.
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WVUH does have a debt collection policy. When a patient has been approved for financial assistance under our charity care policy, they will not be sent to bad debt. Additionally, if a patient is being evaluated for charity, the patient will not be sent to bad debt agency pending charity guarantor status until the pending status has been finalized approved/denied. All other patients with outstanding balances will be processed through billing and collections pursuant to our Financial Policy.
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Part VI Line 2
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In 2016 WVUH updated their CHNA utilizing faculty members of the WVU School of Public Health. The CHNA can be found herehttps//wvumedicine.org/ruby-memorial-hospital/wp-content/uploads/sites/3/2017/04/2016-Community-Health-Needs-Assessment-Monongalia-County.pdf
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For the 2016 process, the CHNA Leadership Team, in collaboration with WVUH defined the community served as the Monongalia County geographic area. It should be noted that the mission of WVUH, as the tertiary teaching hospital for West Virginia University, is statewide. Although we focus this effort on Monongalia County and the Primary Service Area PSA, only one-fourth of all WVUH patients reside in this county and fewer than half in the PSA. The hospital is an active participant in a wide range of additional activities whose goal is improving health among people across all of West Virginia. Hospital leadership and specialist representatives have worked directly with state health officials on efforts to establish a statewide stroke care system, improve trauma response and care, establish a state health information network, and upgrade the health systems disaster readiness.
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WVUH employs 8.5 financial counselors to meet with patients and discuss eligibility to qualify for charity care. WVUH provides brochures discussing charity care and the qualifications for receiving charity care. These brochures are available at each registration area in the facility. WVUH provides financial assistance to patients who do not qualify for any state or federal programs.
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Our charity care eligibility guidelines are also listed on our website at www.wvumedicine.com under the Billing and Insurance - Online Bill Pay section of the Patient and Visitor page. WVUH also has contracted a third party organization to be on-site to help patients, that qualify for charity care, Medicaid, or other types of financial assistance, complete the required applications and provide the correct documentation to receive these benefits.
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WVUH serves the entire state of West Virginia and portions of the neighboring states of Maryland and Pennsylvania. WVUH considers its Primary Service Area PSA to include Monongalia County, WV, Marion County, WV, Taylor County, WV and Preston County, WV. The 2016 market share for our PSA is 46.13 with 27.61 of WVUH patients covered by Medicaid. The largest non-profit competitors within our PSA include Monongalia General Hospital and Fairmont General Hospital. Non-Profit competitors within our overall services area, including Pennsylvania, include Charleston Area Medical Center CAMC and University of Pittsburgh Medical Center.
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The U.S. Census Bureau estimated the Monongalia County population to be 105,030 in 2017 with a median household income of 47,060 and an unemployment rate of 3.8. 22.2 of residents fell below the federal poverty guideline for 2017. Marion Countys estimated population is 56,337, average household income of 46,430 and unemployment of 5.1. 16.7 of Marion County residents fell below FPG in 2017.
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Part VI Line 4
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WVUH offers a comprehensive range of healthcare, from well-child visits with a pediatrician to life-saving surgery. While our central mission is to provide state-of-the-art care to the people of West Virginia and the surrounding areas, the excellence of our services brings people from every U.S. state, and our international program serves patients from countries around the world. WVUH also provides support throughout the entire state of West Virginia by making sure that health care is available to all, regardless of income or health insurance by supporting important educational and social welfare activities within our immediate community and to the entire state of West Virginia and surrounding areas and by providing financial support to the health professions education programs of West Virginia University.
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37.7 of West Virginias adult residents suffered from obesity, according to a study by the Center for Disease Control and Prevention. Obesity is defined as a body mass index BMI of 30 or greater. Obesity is a major risk factor for cardiovascular disease, certain types of cancer, and Type 2 Diabetes. WVUH participates in many different programs that address obesity throughout West Virginia The Coronary Artery Risk Detection in Appalachian Communities CARDIAC, Healthy Hearts A Web-based Instructional Module for Children on Cardiovascular Health, Choosy Kids, Helping Educators Attack CVD Risk Factors Together HEART, Walk 100 Miles in 100 days, which is the states largest sustained exercise program, and the WV Healthy Lifestyles Act on Education Practices and Childhood Obesity. WVUH physicians also participate in day camps that promote healthy activities to children in our community.
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West Virginia is also faced with high rates of deaths due to cancer and cardiovascular disease. WVUH operates the Mary Babb Randolph Cancer Center MBRCC, this center is West Virginias premier cancer facility with a national reputation of excellence in cancer treatment, prevention and research. MBRCC is recognized by the American College of Surgeons Commission on Cancer for providing the best in cancer care.
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In 2017, the new WVU Heart and Vascular Institute HVI opened. The new clinic treats adult patients who need services related to cardiology, cardiothoracic surgery, vascular surgery, thoracic surgery, and cardiac rehabilitation. The HVI provides a comprehensive cardiac care program using the most current diagnostic procedures to detect and evaluate mild to life-threatening heart problems. Our board-certified cardiac experts include medical and interventional cardiologists, surgeons, cardiac electro-physiologists and others who treat people with all types of heart problems-from congenital heart issues to heart attacks.
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We offer both traditional and the latest, minimally invasive interventions, followed by cardiac rehabilitation and heart disease management programs. After surgery or other procedures, we work with the primary care doctor to facilitate patient rehabilitation.
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WVUHs board of directors is a diverse board, with six of the fifteen members living in or around Morgantown, WV. Seven of the nine remaining board members live outside the PSA for WVUH, but still live within our overall service area. Having members living outside our PSA allows us to be more aware of the healthcare needs in other areas of West Virginia. Thirteen of the sixteen board members are neither employees nor independent contractors of WVUH, nor family members thereof.
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As a university medical center WVUH only extends medical privileges to faculty of the West Virginia University School of Medicine.
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WVUH allocates available funding to capital purchases and expanded services to improve patient care, support of medical education at West Virginia University, and research through support of the Mary Babb Randolph Cancer Center.
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WVU Hospital is responsible for providing educational and clinical facilities primarily for the Universitys Schools of Health, Science, Dentistry and Medicine.
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WVUH is one of 260 hospitals in the U.S. participating in the first national pay-for-performance demonstration of its kind, designed to determine if economic incentives are effective at improving the quality of inpatient care.
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Many WVU Healthcare providers and students volunteer their time at Milan Puskar Health Right, a community health clinic, which provides care at no cost to uninsured or underinsured low-income residents. In addition WVUH organizes Kids Health Fairs, Women Love Your Heart screenings, along with offering free screenings at clinical open houses.
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WVUH is a part of the WV United Health System WVUHS. WVUHS is a not-for-profit corporation formed to serve as part of an integrated health science and healthcare delivery team. WVUHS serves as the parent corporation to an affiliated group of healthcare providing entities. The strategic plan of WVUHS states intent to build a regional health care delivery system in its services area, while offering a variety of options for providers who want to participate. The System maintains a demonstrated commitment to assist rural communities in preserving and improving the health care available to the patients it serves. As a university medical center and the largest hospital of the System, WVUH plays a significant role in improving the general health care of the community.
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WVUHSs management is focused on recruitment of staff and employees to meet the growing needs of the aging population in the Systems service areas. Other hospitals in the System include United Hospital Center in Bridgeport, WV, City Hospital, Inc. in Martinsburg, WV, Jefferson Memorial Hospital in Ranson, WV, Camden-Clark Medical Center in Parkersburg, WV, Potomac Valley Hospital in Keyser, WV, St. Josephs Hospital of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Hospital in Glen Dale, WV.
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WVUHS also includes the physician practices of United Physicians Care, Inc. and Camden-Clark Physician Corp which operate in conjunction with the System hospitals along with United Summit Center, a behavioral health center located in Clarksburg, WV. In addition to these practices, the System also includes WVUH-East, Inc. and Camden-Clark Health Services which operate as management companies for their respective hospitals. The System also includes University Healthcare Foundation in Martinsburg, WV, United Health Foundation in Clarksburg, WV, Camden-Clark Foundation in Parkersburg, WV, St. Josephs Foundation of Buckhannon, Inc. in Buckhannon, WV, and Reynolds Memorial Foundation, in Glen Dale, WV.
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