Part I Line 3c
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When a patient does not provide a Financial Assistance Application or supporting documentation, Southwest may utilize other sources of information to make an individual assessment of financial need. Southwest General Health Center may utilize a third-party to conduct an electronic review of patient information to assess financial need. Relief granted using this method will be identified as presumptive financial assistance. The patient will be notified in writing if the discount is less than 100 and will have an opportunity to submit a financial assistance application if the patient believes that he or she may qualify for more assistance. The review utilizes a healthcare industry- recognized predictive model that is based on public record data basis. The models rule based electronic technology is calibrated to the historical approvals for financial assistance under the general application process and is designed to statistically match the hospitals policy. The model considers multiple decision criteria designed to assess each patient to the same standards as defined in this policy. This ensures that Southwest grants assistance only to patients with characteristics similar to the patients who have qualified based on criteria defined in this policy. This predictive model calculates a socio-economic and financial capacity score that includes estimates for income, assets and liquidity. The data returned from this electronic eligibility review will constitute adequate documentation of financial need under this policy.
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Part I Line 6a
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Community Benefits are reported in the annual report sent to the Board and members of the community.
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Part I Line 7
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A cost-to-charge ratio was used to complete the charity care Line 7a and means-tested government programs Line 7b. The cost- to- charge ratio was derived from Worksheet 2 that accompanies the instructions to this schedule.
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Part I Line 7
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The hospitals accounting records were used to complete the community health improvement services and community benefit operations Line 7e and health professions education Line 7f.
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Part I Line 7
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g Subsidized health services include costs and direct offsetting revenue for the following services Inpatient Mental Health, Geriatric Mental Health, Coumadin Clinic, and Breakthru Therapy. The hospitals cost accounting system was used to determine revenue and costs on all services.
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Part I Line 7
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column f. In calculating the percent of total expense reported in column f, the total expense as reported on Form 990 Pt IX, Line 25, column a was reduced by 22,564,282 - the amount of bad debt reported on line 24 a.
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Part III Line 2
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A patient care cost to charge ratio is applied to the financial statement provision for bad debt expense of 22,564,282 to estimate the bad debt amount.
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Part III Line 4
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The System adopted ASU 2014-09 on January 1, 2018 using the modified retrospective method of transition. The System performed an analysis of revenue streams and transactions under ASU 2014-09. In particular, for net patient service revenue, the System performed an analysis into the application of the portfolio approach as a practical expedient to group patient contracts with similar characteristics, such that revenue for a given portfolio would not be materially different than if it were evaluated on a contract-by-contract basis. Upon adoption, the majority of what was previously classified as provision for bad debts and presented as a reduction to net patient service revenue on the consolidated statements of operations and changes in net assets is treated as a price concession that reduces the transaction price, which is reported as net patient service revenue. The new standard also requires enhanced disclosures related to the disaggregation of revenue and significant judgments made in measurement and recognition.
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Part III Line 8
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Medicare shortfall is considered a community benefit of the Health Center. Medicare shortfall uses Medicare revenue and allowable costs as reported in the Medicare Cost Report less net subsidized health services reported in Part 1 line 7g and health professions education reported in Part 1 line 7f.
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Part III Line 8
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In addition to traditional Medicare costs reported in Part III line 7, the Health Center incurred an additional 11,327,795 in Medicare Advantage plans shortfall. This shortfall is calculated using charges and costs from a cost accounting system.
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Part III Line 9b
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Under all circumstances, the collection practices of Southwest are performed in a professional and compassionate manner, consistent with our mission and values and the Federal Fair Debt Collection Practices Act. In fairness to those patients who pay for their services, Southwest will pursue patient accounts through appropriate financial assistance plans for those who are legitimately unable to pay for the care they received.
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Part VI Line 2
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Since its founding by local communities more than 95 years ago, Southwest General has enjoyed a unique partnership with the communities it serves. Representatives from these communities serve on Southwest Community Health System, the Parent of Southwest General Health Center, helping to promote effective communication between the Health Center and its constituencies.
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Part VI Line 3
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We provide financial assistance information via the Southwest General website and patient statements. We provide the contact information for customer service representatives as 1-844-530-1996. We will also discuss the financial assistance program with patients in person and over the telephone in the various registration areas as well as in the Financial Clearance Department at 440-816-4701. Signage is posted that lists the Federal Poverty Guidelines at the following locations Emergency, Seidman Cancer Center, Oakview Outpatient, Physical Medicine SWGHC, Physical Medicine LifeWorks, Timeshare, Lab, Strongsville Hospice, Cashier, Patient Registration, and Strongsville Outpatient.
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Part VI Line 4
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Southwest General draws the majority of its patients from southwestern Cuyahoga, eastern Lorain, and northern Medina counties in Ohio. The primary service area is based on the following cities Berea, Brook Park, Brunswick, Columbia Station, Middleburg Heights, Olmsted Falls, and Strongsville. The secondary service area is comprised of the cities of Hinckley, Parma, Medina, North Royalton, Valley City and the West Park area of Cleveland.
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Part VI Line 5
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Community Nurse and Transition Coach RN Program Health screenings and educational programs are provided to community members of all ages. Services are provided in convenient neighborhood locations such as recreation and senior centers, libraries and local meeting places. Transition Coach RN program provided home visits and telephone support for 30 days post discharge for high risk patients in the community.
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Part VI Line 5
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School Health Program Provides school nurses for the Berea City School District which is comprised of the following three of our taxing communities Berea, Brook Park, and Middleburg Heights. Nurses provide basic first aid, medication assistance, control of communicable diseases and state-mandated health screenings.
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Part VI Line 5
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The Family Life program offers educational classes focusing on helping expectant couples prepare for a healthy pregnancy, labor and birth. Clients within the taxing district receive a discount on class charges. The following programs are offered Family and Friends CPR, Boot Camp for New Dads, Breastfeeding, Grandparenting, Infant Care, Happiest Baby on the Block, Sibling Class, Southwest Safe Sitter, Southwest Safe Sitter-to-Go, and Maternity Tours in Childbirth classes. Staff also participate in health fairs within the surrounding communities to promote classes and provide family health and safety information.
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Part VI Line 5
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Van Transportation Free van transportation is provided for residents of Berea, Brook Park, Columbia Township, Middleburg Heights, Olmsted Falls, Strongsville, and Brunswick who are unable to provide their own transportation to doctor appointments, tests and other clinical services at Southwest Generals Main Campus and off-site buildings.
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Part VI Line 5
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EMS Education Program Certification education for paramedics, Emergency Medical Technicians EMT and 9-1-1 dispatchers, including educational requirements to maintain certification for the state of Ohio and National Registry accreditation for Homeland Security and County Training Academy for Citizens Emergency Response Training as well as American Heart Association accreditation to provide Basic Life Support, Advanced Cardiac Life Support, Pediatric Advanced Life Support and Internal Trauma Life Support courses for professionals and community members. Education is provided at the hospital, community venues, and local fire stations.
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Part VI Line 5
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EMS Medical Control Emergency Medical Technicians EMT must function under the direction of a medical director/physician. They follow written patient care protocols and act on behalf of a physician in the field. Southwest General provides medical control for the following departments Cleveland Hopkins International Airport, Burke Lakefront Airport, Berea Fire, NASA Glenn Research Center at Lewis Field, Brunswick Fire/ Dispatchers, Brunswick Hills Township Fire, Columbia Township Fire, Brook Park Fire, Middleburg Heights Fire, Strongsville Fire/Dispatchers, and Olmsted Falls Fire.
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Part VI Line 5
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Health Connection Free physician referral and health information phone service staffed by a registered nurse.
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Part VI Line 5
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The Drug Replacement program provides patients with up-to-date information regarding medication assistance programs, disease-based assistance, and insurance eligibility including federal and state subsidies.
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Part VI Line 5
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Medication Disposal Program Allows residents to drop off unused medication at Southwest General for appropriate disposal, keeping water sources cleaner.
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Part VI Line 5
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The SANE program provides care for Sexual Abuse victims that come to Southwest Generals Emergency department as referred by the police department. Trained nurses are on call for the program.
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Part VI Line 6
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Southwest General Health Center is part of a Partnering Agreement with University Hospital Health System UHHS, a large integrated delivery system. UHHS brought Rainbow Babies and Children, MacDonald Womens, and Seidman Cancer UHHS Programs to Southwest Generals facilities. Under the Partnering Agreement, UHHS obtained 50 representation on Southwest General Health Centers Board of Directors.
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