PART I, LINE 7:
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KDOH USED WORKSHEET 2 PROVIDED IN THE SCHEDULE H INSTRUCTIONS (FORM 990) TO CALCULATE A COST TO CHARGE RATIO. THIS RATIO WAS USED TO CALCULATE CHARITY CARE AT COST (A. ABOVE). TO CALCULATE THE UNPAID COSTS OF MEDICAID (B), THE HOSPITAL'S COST ACCOUNTING SYSTEM WAS USED. REMAINING ITEMS WERE REPORTED AT NET EXPENSE.
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PART I, LN 7 COL(F):
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THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $2,133,555.
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PART III, LINE 2:
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BAD DEBT EXPENSE IS RECORDED AFTER ANY DISCOUNTS AND PAYMENTS ARE MADE ON PATIENT ACCOUNTS. KDOH USED WORKSHEET 2 PROVIDED IN THE SCHEDULE H INSTRUCTIONS (FORM 990) TO CALCULATE A COST OF CHARGE RATIO. THIS RATIO WAS USED TO CALCULATE BAD DEBT EXPENSE AT COST.
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PART III, LINE 3:
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BAD DEBT EXPENSE IS RECORDED AFTER ANY DISCOUNTS AND PAYMENTS ARE MADE ON PATIENT ACCOUNTS. THE BUSINESS OFFICE DOES NOT KEEP TRACK OF "NO-RESPONSE" APPLICATIONS ANNUALLY AND DOES NOT FEEL THAT THE PORTION CONSIDERED TO BE A COMMUNITY BENEFIT IS MATERIAL.
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PART III, LINE 4:
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PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE MEDICAL CENTER 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 SERVICE PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER 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 MEDICAL CENTER 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 HOSPITAL CONTINUES TO PROVIDE CARE TO ALL PRESENTING AND ADMITTED PATIENTS, REGARDLESS OF ABILITY TO PAY. NOTWITHSTANDING THE COSTS TO PROVIDE CARE, RECEIVING "LESS" THAN WHAT IT COSTS TO PROVIDE ADEQUATE CARE TO MEDICARE COVERED LIVES DOES THE HOSPITAL A DISSERVICE. THE SHORTFALL SHOULD COUNT AS A COMMUNITY BENEFIT. THE HOSPITAL USES ALLOWABLE COSTS PER THE MEDICARE COST REPORT, FY2020 COST REPORT DATA, AND PROVIDER SUMMARY REPORT (PSR) WAS USED TO COMPUTE THE INFORMATION.
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PART III, LINE 9B:
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THE HOSPITAL HAS A WRITTEN POLICY FOR BAD DEBT. UNINSURED PATIENTS ARE SCREENED FOR ELIGIBILITY FOR MEDICARE, MEDICAID, AND OTHER SUCH PROGRAMS BY A CONTRACTED VENDOR. ALL PATIENTS, INSURED AND UNINSURED, WITH VALID MAILING ADDRESSES RECEIVE POST-DISCHARGE BILLING STATEMENTS OVER THE COURSE OF A 120 DAY PERIOD. IF THERE ARE NO ACTIVE DISPUTES OR OTHER PAYMENT SOURCES AVAILABLE, AND THE BALANCE IS UNPAID AT THE END OF THE STATEMENT PERIOD, THE ACCOUNT WILL BE PLACED WITH A COLLECTION AGENCY TO REPORT AS A BAD DEBT. EACH STATEMENT INCLUDES INFORMATION REGARDING THE AVAILABILITY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM ALONG WITH A NUMBER WHERE REPRESENTATIVES CAN BE REACHED FOR ASSISTANCE.
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PART VI, LINE 2:
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IN 2019 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED AS A COLLABORATIVE EFFORT BETWEEN KDOH, SOUTHERN OHIO MEDICAL CENTER, LOCAL HEALTH DEPARTMENTS, THE SCIOTO COUNTY HEALTH COALITION, OTHER NON-PROFITS, AND THE CHNA ADVISORY GROUP. THE ASSESSMENT WAS CONDUCTED FOR KDOH'S PRIMARY MARKET OF SCIOTO COUNTY. PRIMARY DATA WAS COLLECTED THROUGH PRC FROM FOCUS GROUPS, A COMMUNITY QUESTIONNAIRE, KEY INFORMANT SURVEY AND BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM RESULTS. THE PRIMARY DATA WAS COMPARED TO SECONDARY DATA COLLECTED USING LOCAL, STATE, AND NATIONAL STATISTICS FOR SCIOTO COUNTY. FROM THESE MULTIPLE DATA SOURCES, THE KDOH LEADERSHIP TEAM ADOPTED THE NEEDS TO BE MET.THE CHNA HELPED KDOH DETERMINE WHAT AGENCIES WERE DOING TO MEET AND OR IMPROVE HEALTHCARE NEEDS IN THE COUNTY; LEARN WHAT HEALTHCARE NEEDS WERE NOT BEING MET AND WHY; DETERMINE THE STRENGTHS AND WEAKNESSES OF CURRENT RESOURCES AND TO INVESTIGATE WHAT CAN BE DONE TO IMPROVE THE HEALTH OF THE COMMUNITY.ALL PRIMARY NEEDS THE 2019 CHNA IDENTIFIED ARE BEING ADDRESSED IN THE IMPLEMENTATION PLAN.
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PART VI, LINE 3:
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THE MEDICAL CENTER'S FINANCIAL ASSISTANCE POLICY PROVIDES DIRECTION FOR FREE OR DISCOUNTED SERVICES TO RESIDENTS OF THE COMMUNITY WHO HAVE INADEQUATE FINANCIAL RESOURCES TO PAY FOR NECESSARY HEALTHCARE SERVICES PROVIDED BY KING'S DAUGHTERS. THE POLICY STATES THAT THE MEDICAL CENTER WILL NOT DENY CARE TO ANY PATIENT REQUIRING CARE DUE TO THEIR INABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY PROVIDES GUIDANCE TO PROVIDING ASSISTANCE BASED ON SLIDING SCALE METHODOLOGY AND THE FEDERAL POVERTY GUIDELINES ESTABLISHED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. PATIENTS REQUIRING CARE WITH INCOME BELOW 300% OF THE FEDERAL POVERTY LEVEL QUALIFY FOR FREE OR REDUCED COST SERVICES. KING'S DAUGHTERS ALSO CONTRACTS WITH OUTSIDE VENDORS TO ASSIST PATIENTS IN GOVERNMENT ENROLLMENT PROGRAMS. THERE ARE SIGNS POSTED IN VARIOUS REGISTRATION AREAS INFORMING PATIENTS OF THE PHONE NUMBER TO CALL IF THEY NEED FINANCIAL ASSISTANCE. ON EACH PATIENT STATEMENT THE INFORMATION IS ALSO PRINTED WITH THE PHONE NUMBER. ALL SELF-PAY PATIENTS RECEIVE CORRESPONDENCE AND PHONES CALLS AND INPATIENTS RECEIVE VISITS FROM OUR MEDICAID ELIGIBILITY VENDOR IN REFERENCE TO GOVERNMENT PROGRAMS.
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PART VI, LINE 4:
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THE SERVICE AREA FOR KING'S DAUGHTERS OHIO IS SCIOTO COUNTY, OHIO. ACCORDING TO THE US CENSUS BUREAU, ESTIMATES AVAILABLE AS OF APRIL 26, 2021, A TOTAL OF 75,314 PEOPLE LIVE IN THE COUNTY, WHICH COVERS 610.2 SQUARE MILES. THE POPULATION DENSITY IS APPROXIMATELY 123 PERSONS PER SQUARE MILE. THE AREA IS PREDOMINANTLY RURAL (47.19%), WITH AN URBAN POPULATION AT 35.3% AND SUBURBAN (17.5%). OF THE POPULATION, 94.4% ARE WHITE, 2.7% ARE BLACK, 1.4% HISPANIC/LATINO AND 1.5% MAKE UP ALL OTHER RACES. THERE ARE MORE FEMALES (50.8%) THAN MALES (49.2%) IN THE AREA. THE MEDIAN FAMILY INCOME IS $41,530, COMPARED TO OHIO ($56,602). PER CAPITA INCOME IS $23,719, COMPARED TO OHIO ($31,552). APPROXIMATELY 21.9% OF THE POPULATION LIVES IN POVERTY. NEARLY SEVEN-PERCENT (6.8%) OF THE POPULATION UNDER THE AGE OF 65 IS WITHOUT ANY FORM OF HEALTHCARE COVERAGE. AS OF APRIL 2021, THE UNEMPLOYMENT RATE FOR THE FOUR-COUNTY AREA IS 5.9%.
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PART VI, LINE 5:
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KDOH PROVIDES FREE EDUCATIONAL AND SCREENING SERVICES IN SCIOTO COUNTY, THE PRIMARY MARKET. KDOH WORKS WITH CHURCHES, SCHOOLS, BUSINESSES, AND COMMUNITY GROUPS TO HELP IMPROVE HEALTH THROUGHOUT THE COUNTY. THE FOLLOWING ACTIVITIES, WHICH CONTRIBUTE TO COMMUNITY HEALTH, BUT ARE NOT SPECIFIC TO THE IMPLEMENTATION PLAN GOALS AND OBJECTIVES WERE PROVIDED:1) COVID RESPONSE: COVID-19 HIT THE AREA IN MARCH OF 2020. IN RESPONSE TO THE PANDEMIC, KDOH PROVIDED ACCESS TO COVID-19 SCREENING USING LABS OUTSIDE THE HEALTH SYSTEM FOR THE RESULTS. THIS PROCESS WAS VERY SLOW, WITH RESULTS OFTEN TAKING DAYS TO BE RECEIVED; SO KDOH PARTNERED WITH SISTER HOSPITAL KDMC WHO PURCHASED NEW LAB EQUIPMENT THAT COULD PROVIDE RESULTS IN A MORE-TIMELY MANNER. BEGINNING IN MAY 2020, KDMC'S LAB STARTED PROCESSING THE TESTS FOR COVID-19; PROVIDING THE RESULTS TO PATIENTS IN LESS THAN 24 HOURS. DURING THE FISCAL YEAR, KDOH PROVIDED MORE THAN 58,300 COVID-19 SCREENING TESTS AND 652 SARS COV-2 IGG ANTIBODY TESTS. 2) OTHER SCREENING AND HEALTH EDUCATION ACTIVITIES:SCREENINGS, IMMUNIZATIONS AND PHYSICALS:- SPORTS PHYSICALS- 90 YOUTH SERVED- LOW-COST BLOOD PROFILES 334 SERVED- LOW-COST A1C TESTS 255 SERVEDHEALTH EDUCATION:- FLU 3 ADULTS; 10 CHILDREN/YOUTH SERVED- HANDWASHING 3,058 ADULTS; 10 CHILDREN/YOUTH SERVED- HYPERTENSION 100 ADULTS SERVED- PROSTATE CANCER 2,085 ADULTS SERVED- SKIN CANCER 457 ADULTS SERVED- STROKE 1,102 ADULTS SERVED- CHRONIC PAIN SUPPORT GROUP 60 ADULTS SERVEDOTHER COMMUNITY ACTIVITIES:- BLOOD DRIVES: KDOH PARTNERED WITH THE KENTUCKY BLOOD BANK TO INCREASE BLOOD DONATIONS BY ENCOURAGING TEAM MEMBERS TO PARTICIPATE IN LOCAL BLOOD DRIVES DURING WORK HOURS.- COAT DRIVE: KDOH TEAM MEMBERS, DONATED COATS, HATS, AND GLOVES TO THE SALVATION ARMY FOR THOSE IN NEED. THIRTY (30) NEW COATS WERE COLLECTED, INCLUDING PROVIDING WINTER GEAR FOR A PATIENT AND FAMILY IN NEED.- BACKPACK PROGRAM: TEAM MEMBERS DONATED OVER 100 ITEMS OF SCHOOL SUPPLIES, DISINFECTING, AND MASKS TO PORTSMOUTH EAST ELEMENTARY SCHOOL CHILDREN TO ENSURE STUDENTS START THE YEAR WITH THE NECESSARY SCHOOL SUPPLIES.- ADOPT-A-FAMILY: TEAM MEMBERS ADOPTED ONE FAMILY WITH A TOTAL OF FIVE FAMILY MEMBERS AT CHRISTMAS PROVIDING GIFTS AND FOOD.- SALVATION ARMY: COVID-19 PREVENTED KDOH TEAM MEMBERS FROM DONATING TIME AT THE SALVATION ARMY CHRISTMAS EVENT, BUT FOOD AND GIFTS WERE PROVIDED.
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PART VI, LINE 6:
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KING'S DAUGHTERS MEDICAL CENTER OHIO IS PART OF AN AFFILIATED HEALTH CARE DELIVERY SYSTEM. THE SYSTEM OPERATES ANOTHER HOSPITAL, KING'S DAUGHTERS MEDICAL CENTER (KDMC) IN ASHLAND, KY. KDOH HAS BEEN SPECIFICALLY DESIGNED TO MEETING THE HEALTHCARE NEEDS OF PORTSMOUTH AND ITS SURROUNDING AREAS. KDOH OFFERS SURGICAL AND URGENT CARE SERVICES. KDOH PROVIDES CHARITY CARE AND PARTICIPATES IN GOVERNMENT PROGRAMS. THE SYSTEM PROVIDES PHYSICIAN SERVICES THROUGH KING'S DAUGHTERS MEDICAL SPECIALTIES, INC. ("KDMS"). KDMS PROVIDES CHARITY CARE AND PARTICIPATES IN GOVERNMENT PROGRAMS. KING'S DAUGHTERS ALSO INCLUDES TWO OTHER AFFILIATES - KING'S DAUGHTERS MEDICAL TRANSPORT, WHICH SEEKS TO CONTINUOUSLY IMPROVE THE PRE- AND POST-HOSPITAL HEALTHCARE PROVIDED IN ALL OF ITS SERVICES AREAS WHILE ENSURING THAT EMERGENCY AND NON-EMERGENCY AMBULANCE SERVICE WILL BE AVAILABLE TO ALL THOSE IN NEED; AND KINGSBROOK NURSING HOME, WHICH PROVIDES QUALITY CARE TO PATIENTS, MEETING THE NEEDS AND DESIRES OF RESIDENTS AT VARIOUS LEVELS OF CARE, INCLUDING SHORT-TERM AND LONG-TERM CARE.
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