PART I, LINE 7:
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THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO REPORT FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID AS COMMUNITY BENEFITS.
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PART I, LN 7 COL(F):
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THE AMOUNT OF BAD DEBT EXPENSE RELATED TO PATIENT CARE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), (BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN) IS $3,950,621.
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PART II, COMMUNITY BUILDING ACTIVITIES:
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MARY RUTAN HOSPITAL AND FOUNDATION ARE COMMITTED TO PROVIDING PROFESSIONAL ASSISTANCE TO THE LOGAN COUNTY COMMUNITY THORUGH THE VOLUNTEERING OF TIME AND RESOURCES FOR ECONOMIC DEVELOPMENT TO THE LOGAN COUNTY GREATER AREA CHAMBER OF COMMERCE, THE LOGAN COUNTY COMMUNITY IMPROVEMENT CORPORATION AND INDIAN LAKE CHAMBER OF COMMERCE. IN ADDITION, ADMINISTRATIVE TEAM MEMBERS VOLUNTEER PROFESSIONAL SERVICES AND RESOURCES TO THE UNITED WAY OF LOGAN COUNTY, HILLIKER YMCA, LOGAN COUNTY HEALTH DISTRICT, LOGAN COUNTY MENTAL HEALTH BOARD, LOGAN COUNTY COALITION OF OPIATE RELIEF EFFORTS, LOGAN COUNTY FAMILY AND CHILDREN FIRST COUNCIL, LOGAN COUNTY HEALTHIER LIVING COALITION, LOGAN COUNTY TRANSPORTATION ADVISORY GROUP, LOGAN COUNTY COALITION ADVISORY BOARD, FQHC BOARD-COMMUNITY HEALTH AND WELLNESS PARTNERS OF LOGAN COUNTY AND LUTHERAN COMMUNITY SERVICES PROMOTING AND ESTABLISHING HEALTH, WELLNESS AND NUTRITIONAL SERVICES FOR THOSE IN NEED IN AND AT-RISK AREAS OF THE COMMUNITY.
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PART III, LINE 2:
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BAD DEBT IS PRESENTED AT GROSS CHARGES. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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 STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
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PART III, LINE 3:
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THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS BASED ON AN ESTIMATED PERCENTAGE OF BAD DEBT WRITE OFFS. THE PERCENTAGE IS DERIVED FROM A HISTORICAL REVIEW OF PATIENTS THAT QUALIFIED FOR CHARITY AFTER THEY WERE PLACED IN COLLECTIONS.
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PART III, LINE 4:
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BAD DEBT FOOTNOTE: 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 BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. AN ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS AND INTERIM PAYMENT ADVANCES IS BASED ON EXPECTED PAYMENT RATES FROM PAYORS BASED ON CURRENT REIMBURSEMENT METHODOLOGIES. THIS AMOUNT ALSO INCLUDES AMOUNTS RECEIVED AS INTERIM PAYMENTS AGAINST UNPAID CLAIMS BY CERTAIN PAYORS. FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDE 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 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 DIFFERENECE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. ADDITIONAL INFORMATION: THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THE COMPOSITION OF RECEIVABLES FROM PATIENTS AND THIRD-PARTY PAYORS WAS AS FOLLOWS IN 2018: 19% MEDICARE, 69% COMMERCIAL INSURANCE AND HMOS, 7% MEDICAID, AND 5% SELF PAY.
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PART III, LINE 8:
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MEDICARE COSTS HAVE BEEN PULLED FROM THE 2018 MEDICARE COST REPORT, UTILIZING A COST TO CHARGE RATIO. BASED ON 2010 US CENSUS BUREAU ESTIMATES, 14.7% OF THE LOGAN COUNTY, OHIO POPULATION IS OVER AGE 65. SERVICES PROVIDED TO MEDICARE PATIENTS ACCOUNTED FOR APPROXIMATELY 39% OF PATIENT SERVICE REVENUE IN 2018. WE HAVE INCLUDED MEDICARE SHORTFALLS IN OUR 2018 COMMUNITY BENEFIT REPORT. THE ONGOING CARE OF OUR AGING POPULATION CERTAINLY MEETS A SIGNIFICANT NEED OF THE COMMUNITY. EQUIVALENT HOSPITAL BASED CARE IS NOT AVAILABLE FROM ANY OTHER LOCAL SOURCE. PROVIDING EFFICIENT, COST EFFECTIVE CARE IS ALWAYS A GOAL, BUT SHORTFALLS CAN AND DO OCCUR. THOSE SHORTFALLS ARE ABSORBED BY THE HOSPITAL AND ARE CONSIDERED TO BE A COST OF OUR MISSION TO ACCEPT RESPONSIBILITY FOR MEETING THE HEALTHCARE NEEDS OF OUR COMMUNITY.
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PART III, LINE 9B:
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MARY RUTAN HOSPITAL COMPLIES WITH THE FAIR DEBT COLLECTION PRACTICES ACT AT ALL TIMES. A SELF PAY ACCOUNT IS MANAGED BY AN DEDICATED TEAM AT THE TIME PATIENT LIABILITY IS DETERMINED POST-SERVICE. THE TYPICAL PROCESS IS A SERIES OF LETTERS AND PHONE CALLS . THE TIMELINESS AND STEPS ARE OUTLINED IN MRH'S BAD DEBT & COLLECTIONS POLICY (WHICH IS POSTED IN FULL ONLINE FOR PATIENT REVIEW, ALONG WITH A PLAIN LANGUARY SUMMARY). IF THERE IS NO RESPONSE TO THE TEAM'S STATEMENTS AND CALLS, THEN THE ACCOUNT IS PULLED FOR REVIEW, REVIEWED TO VALIDATE THAT IT BALANCES ARE CORRECT, WRITTEN OFF TO BAD DEBT, AND SENT TO A COLLECTION AGENCY. WHEN A PATIENT HAS INITIATED THE CHARITY APPLICATION PROCESS AND HAS APPLIED FOR ONE OF OUR PROGRAMS, THAT PATIENT REMAINS IN THAT STATUS WITHOUT ANY COLLECTION EFFORTS OF ANY KIND UNTIL FINAL ELIGIBILITY FOR ASSISTANCE CAN BE DETERMINED. APPLICABLE ASSISTANCE/DISCOUNTS ARE APPLIED TO THE ACCOUNT BALANCE IF QUALIFIED. PATIENTS WHO DO NOT QUALIFY ARE NOTIFIED AND NORMAL COLLECTION EFFORTS BEGIN/RESUME AT THAT TIME.
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PART VI, LINE 2:
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COLLABORATION WITH LOCAL HUMAN SERVICE ORGANIZATIONS IS KEY IN IDENTIFYING NEEDS ON AN ONGOING BASIS. MARY RUTAN HOSPITAL AND MARY RUTAN FOUNDATION PROGRAMS ARE TARGETED TOWARD SPECIFIC POPULATIONS IN NEED, AS WELL AS DESIGNATED AT-RISK AREAS. GENERAL HEALTH AND WELLNESS PROMOTIONS EDUCATE THE COMMUNITY ABOUT PREVENTATIVE MEASURES AGAINST CHRONIC ILLNESSES. HEALTH AND WELLNESS EDUCATION, AS WELL AS FREE SCREENING, ARE PROVIDED MONTHLY AT SUBSIDIZED SENIOR HOUSING UNITS AND AT FOOD PANTRIES. OTHER EXAMPLES INCLUDE POWER-UP 4 FITNESS, FIELD TO FORK AND BILLY BONES, WHICH ARE PROGRAMS EDUCATING STUDENTS ON THE IMPORTANCE OF EXCERCISE AND PROPER NUTRITION IN THE FIGHT AGAINST CHILDHOOD OBESITY. THIS PROGRAM IS DONE IN COLLABORATION WITH ALL AREA SCHOOLS. IN ADDITION, MARY RUTAN HOSPITAL UTILIZES THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS REPORT. MRH FACILITATES CREATING A HEALTHIER ME AND MATTER OF BALANCE COURSES TARGETED FOR THE ADULT POPULATION ADDRESSING PROPER NUTRITION, DIET AND EXCERCISE. MRH LEADS OTHER COMMUNITY PARTNERS ON THE HEALTHY LIVING COALITION REVIEWING AT-RISK AREAS IN THE COMMUNITY AND ESTABLISHING EDUCATIONAL PROGRAMS AND RESOURCES TO ADDRESS THOSE NEEDS. MARY RUTAN HOSPITAL ALSO SERVICES AS AN ACTIVE MEMBER OF THE LOGAN COUNTY FAMILY AND CHILDREN FIRST COUNCIL TO PROVIDE ORGANIZATION UPDATES REGARDING ONGOING PROJECTS AND TO DISCUSS AND IDENTIFY COMMUNITY NEEDS. THIS COUNCIL IS COMPRISED OF SENIOR LEADERS OF THE HOSPITAL, HEALTH DEPARTMENT, CHILDREN'S SERVICES, JOB AND FAMILY SERVICES, AND MENTAL HEALTH BOARD AS WELL AS OTHER HEALTH AND HUMAN SERVICE AGENCIES, LAW ENFORCEMENT, AND AREA SCHOOL DISTRICTS. MRH IS ALSO AN ACTIVE MEMBER OF THE LOGAN COUNTY COALITION FOR OPIATE RELIEF EFFORTS, IMPLEMENTING PROGRAMS AND SERVICES TO COMBAT THE HEROIN AND OPIATE ABUSE ISSUES IN LOGAN COUNTY. IN ADDITION, MRH SENIOR LEADERSHP SERVES ON THE LOGAN COUNTY COALTION ADVISORY BOARD CREATED TO ASSIST AND BE A RESOURCE FOR AT RISK FINDINGS OF THE NEEDS ASSESSMENT OF OBESITY, CHRONIC DISEASE, DRUG ABUSE, MENTAL HEALTH, ACCESS TO SERVICES, HOUSING AND HOMELESSNESS AND WORKFORCE DEVELOPMENT.
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PART VI, LINE 3:
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A VARIETY OF MEANS IS USED TO PROVIDE INFORMATION ON FINANCIAL ASSISTANCE ELIGIBILITY TO ALL PATIENTS. NOTICES ARE POSTED AT ALL POINTS OF REGISTRATION, IN OUR CLINICS, AND IN OUR OFF-SITE BUSINESS OFFICE LOCATION. HANDOUTS AND APPLICATIONS FOR HCAP/CHARITY CARE ARE ALSO AVAILABLE AT REGISTRATION. FINANCIAL ASSISTANCE INFORMATION IS INCLUDED IN PATIENT BILLING BROCHURES, ON THE MARY RUTAN HOSPITAL WEBSITE, ON BILLING STATEMENTS, AND IN A SEPARATE LETTER INCLUDED WITH ALL SELF PAY ACCOUNT BILLING STATEMENTS. MRH REPRESENTATIVES ALSO ATTEMPT TO EDUCATE PATIENTS PRIOR TO AND CONCURRENT WITH SERVICE ABOUT OUR ASSISTANCE PROGRAMS.
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PART VI, LINE 4:
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MARY RUTAN HOSPITAL'S PRIMARY SERVICE AREA IS RURAL LOGAN COUNTY. ALTHOUGH MARY RUTAN HOSPITAL DOES SERVE SOME INDIVIDUALS FROM ADJOINING COUNTIES (INCLUDING HARDIN, CHAMPAIGN, SHELBY AND UNION), INPATIENT VOLUMES EQUAL 26% AND OUTPATIENT SERVICE VOLUMES EQUAL 55% OF LOGAN COUNTY RESDIENTS. THE LOGAN COUNTY POPULATION IS APPROXIMATELY 45,358 AND, BASED ON 2018 US CENSUS BUREAU ESTIMATES, MEDIAN HOUSEHOLD INCOME IS $53,051. AN ESTIMATED 11.1% OF THE COUNTY POPULATION IS BELOW THE FEDERAL POVERTY LEVEL.
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PART VI, LINE 5:
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THE HOSPITAL FAMILY INCLUDES PARENT CORPORATION, MARY RUTAN HEALTH ASSOCIATION, AND SUBSIDIARIES MARY RUTAN HOSPITAL, MARY RUTAN FOUNDATION, LOGAN VIEW, INC., AND LOGAN COUNTY CANCER SOCIETY. THERE IS A COORDINATED EFFORT TO MEET THE HEALTHCARE NEEDS OF OUR COMMUNITY. DOLLARS ARE BUDGETED ANNUALLY THROUGH MARY RUTAN FOUNDATION TO SUPPORT COMMUNITY HEALTH ACTIVITIES ORGANIZED AND SPONSORED BY MARY RUTAN FOUNDATION. THE GOVERNING BODIES OF EACH CORPORATION ARE MADE UP OF RESIDENTS OF OUR COMMUNITY WHO ARE FAMILIAR WITH THE HEALTH AND WELLNESS ISSUES FACING LOGAN COUNTY AND THE SURROUNDING AREA. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. IN ADDITION, ANNUALLY MARY RUTAN FOUNDATION AWARDS COMMUNITY HEALTH AND WELLNESS GRANTS TO AREA SCHOOLS, SOCIAL SERVICE AND NOT FOR PROFIT ORGANIZATIONS FOCUSED ON THE AREAS OF RISK AND NEED IDENTIFIED IN THE COMMUNITY TO EXPAND OUTREACH EFFORTS PAST THE PROGRAMS AND SERVICES PROVIDED BY THE HOSPITAL AND FOUNDATION. DUE TO LACK OF FUNDING BY AREA SCHOOLS AND INABILITY TO EMPLOYEE ATHLETIC TRAINERS, MARY RUTAN HOSPITAL FUNDS AND PROVIDES ATHLETIC TRAINERS AT EACH (6) AREA HIGH SCHOOL FOR THE HEALTH, WELLBEING AND SAFETY OF AREA STUDENT ATHLETES.
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PART VI, LINE 6:
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MARY RUTAN HEALTH ASSOCIATION IS THE PARENT CORPORATION. THE HEALTH ASSOCIATION OPERATES CARDIAC REHAB AND CORPORATE HEALTH CLINICS, PROVIDES MANAGEMENT SERVICES TO THE HOSPITAL AND PARTICIPATES IN VARIOUS HEALTH FAIRS AND SCREENINGS THROUGHOUT THE COMMUNITY EACH YEAR. MARY RUTAN FOUNDATION'S MISSION IS TO CREATE PHILANTHROPIC RELATIONSHIPS TO SUPPORT PATIENT CARE SERVICES, AWARD MEDICAL SCHOLARSHIPS, PURCHASE NEEDED MEDICAL EQUIPMENT AND DEVELOP CAPITAL, WHILE PROMOTING HEALTH AND WELLNESS THROUGH EDUCATIONAL PROGRAMS AND SERVICES. LOGAN COUNTY CANCER SOCIETY PROVIDES FINANCIAL ASSISTANCE TO RESIDENTS OF LOGAN COUNTY WHO HAVE CANCER OR CANCER RELATED ILLNESSES, WHILE PROMOTING EDUCATION IN THE DETECTION AND TREATMENT OF CANCER. OPERATION AND FACILITATION OF ALL SERVICES PROVIDED BY THE LOGAN COUNTY CANCER SOCIETY ARE PROVIDED BY EMPLOYEES OF MARY RUTAN HOSPITAL AND MARY RUTAN HEALTH ASSOCIATION AND NO SALARIES OR BENEFITS ARE CHARGED TO THE ORGANIZATION FOR THIS SERVICE. LOGAN VIEW LLC ALSO SPONSORS A VARIETY OF HEALTH AND WELLNESS PROGRAMS IN THE COMMUNITY.
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