Part I, Line 3c:
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MONROE HEALTH SERVICES USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE AND DISCOUNTED CARE. IF THE PATIENT'S INCOME LEVEL IS 0-100% OF THE FEDERAL POVERTY LEVEL (FPL), AN ADJUSTMENT OF 100% OF THE HOSPITAL'S STATED CHARGES WILL BE MADE. IF THE PATIENT'S INCOME LEVEL IS 101-150% OF THE FPL, A DISCOUNT OF THE HOSPITAL'S STATED CHARGES WILL BE PRO-RATED BASED ON THE PATIENT'S GROSS FAMILY INCOME AS A PERCENTAGE OF THE FPL. FOR PATIENTS WHOSE FAMILY GROSS INCOME IS EQUAL TO OR GREATER THAN 150% OF THE FPL, THE HOSPITAL MAY OFFER DISCOUNTED RATES ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE.
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Part I, Line 6a:
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Monroe Health Service's community benefit information is included in the community benefit report of its parent company, North Mississippi Health Services, Inc. North Mississippi Health Services (NMHS) is a diversified regional health care organization, which serves 24 counties in north Mississippi and northwest Alabama from headquarters in Tupelo, MS. The NMHS organization covers a broad range of acute diagnostic and therapeutic services, offered through North Mississippi Medical Center in Tupelo; a community hospital system with locations in Eupora, Iuka, Pontotoc, West Point, Amory, MS, and Hamilton AL; North Mississippi Medical Clinics, a regional network of 27 primary and specialty clinics; and nursing homes. NMHS offers a comprehensive portfolio of managed care plans.
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Part I, Line 7, column (f):
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Bad Debt Expense of $11,367,044 was included in total expense on Form 990, Part IX, Line 25, Column (A), but was subtracted from total expense for purposes of calculating the percentage of total expense in column (F).
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Part I, Line 7:
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A cost to charge ratio was used for the amounts reported in the table for Line 7. The cost to charge ratio for Line 7 was calculated using Worksheet 2.
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Part III, Line 2-4:
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Monroe Health Services's financial statements do not include a footnote specifically concerning bad debt. Bad debt is shown as a separate line item on the face of the income statement. The amount of bad debt booked each year is based on a review of outstanding receivables and their age from date of service. The older the account, the higher the reserve percentage used to estimate bad debt. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluations and specific circumstances of the account. Bad debt expense reported in part III line 2 matches the amount of bad debt expense reported on Monroe Health Services's audited financial statements. Monroe Health Services (MHS) follows the Catholic Health Association guidelines and does not include bad debt in any community benefit amounts. MHS, however, believes that some portion of bad debt results from patients who could qualify for charity care but has no way of making an estimate of the amount and therefore has answered "zero" for Part III Line 3. THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED SEPTEMBER 30, 2019. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.
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Part III, Line 8:
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The ratio of cost to charges used in the calculation of costs for Medicare was taken from the Medicare Cost Report. Lines 5, 6, & 7 do not include certain Medicare programs and costs and thus do not reflect all of the organization's revenues and costs associated with its participation in Medicare programs. Additional revenues and costs not reported on Lines 5, 6, & 7 include those associated with the organization's Medicare outpatient lab, ambulance and therapy services. Total revenues from these activities were $438,544 and total costs were $643,100 for a net shortfall of $204,556. When combined with the surplus reported on Line 7, the net surplus from all Medicare programs is $273,405.
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Part III, Line 9b:
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Monroe Health Services does not pursue collection of amounts determined to qualify as charity care. For patients who qualify for charity care or financial assistance and who are cooperating in good faith to resolve their discounted hospital bills, the hospitals may offer extended payment plans, will not send unpaid bills to outside collection agencies, and will cease all collection efforts.
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Part VI, Line 2:
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Needs Assessment Monroe Health Services utilizes varied but complimentary methods to assess the health care needs of the community it serves. Monroe Health Services and Monroe County are included in the North Mississippi Health Services Community Health Assessment which is performed every three years and provides information on health status, utilization of health services, healthy beliefs and satisfaction with health care services. The North Mississippi Health Services Community Health Assessment covers the 24 county service area including Monroe County and provides information by county. In addition, the North Mississippi Health Services Community Relations Facilitator conducts routine visits with our internal and external stakeholders across the entire service area including Monroe County. The information gathered through several qualitative survey questions is used to determine our community's needs for the entire service area as well as the local service area for each hospital such as Monroe Health Services.
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Part VI, Line 3:
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Patient Education of Eligibility for Assistance Explanations of the Monroe Health Services charity care policy are communicated in a variety of forms including signage at all admission and registration areas, on the web site, on bills and statements, and in admission packets. Financial counselors assist the patient and responsible parties with determining eligibility for government programs, primarily Medicaid, and charity care status. The patient can apply for charity care at any time from the date of service through the collection process and once qualified and approved all collection efforts are stopped.
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Part VI, Line 4:
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Community Information Monroe Health Services serves more than 35,000 people in Monroe County, MS and the surrounding area. The population for the service area is projected to remain essentially flat over the next five years. According to the 2019 census, age demographics for the service area show that approximately 23% of the population is under 18 years of age, approximately 58% is between 18 and 64 years of age and that 19% is 65 or older. Caucasians make up 68% of the service area's population while African Americans make up 31% and Hispanics and other make up 1%. Median household income for 2014-2018 was $40,940 for the service area, which is below the overall average for Mississippi and significantly less than the nationwide average. The patient population for Monroe Health Services is covered by insurance or is uninsured as follows: 40.09% Medicare, 0% Medicare Advantage, 16.74% Medicaid, 0.04% MS CAN, and 32.36% private insurance with 10.77% being uninsured.
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Part VI, Line 5
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Promotion of Community Health Monroe Health Services has a commitment to a wide variety of community health outreach activities, which are coordinated by the community health coordinator and are staffed by Monroe Health Services employees who volunteer their time to help with these events and activities. The community health coordinator assists in educating the community on health-related issues by organizing and presenting various health fairs and seminars. These events are held at local businesses, schools and community organizations and address a variety of health-related topics. In addition, the hospital sponsors cholesterol, blood pressure, vision, memory, and heart-risk screening events, through which tests are made available to the public for a nominal fee or at no charge with the majority of the costs incurred absorbed by the hospital. hospital.
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Part VI, Line 6:
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Affiliated Health Care System As noted above, Monroe Health Services (MHS) is part of North Mississippi Health Services (NMHS). NMHS operates North Mississippi Medical Center, five other community hospitals in addition to MHS, as well as, North Mississippi Medical Clinics, which operates more than 36 medical clinics. Some of these facilities operate at an ongoing financial loss and NMHS provides operating funds in the form of working capital loans that have no set repayment date. These working capital loans have historically been converted to capital transfers in many cases, and therefore, the loans are forgiven such that the facility never makes repayment. NMHS does this in order to provide access to a variety of services across the service area and is an intentional part of its business model. The Community Health department that is part of NMMC coordinates a variety of community health activities across the service area as well.
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Part VI, Line 7:
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State Filing of Community Benefit Report Monroe Health Services does not file a community benefit report with the state of Mississippi as there is no requirement to do so.
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