SCHEDULE H, PART I LINE 7
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EXPLANATION OF COSTING METHODOLOGY TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST, A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP-BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCURRED. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE CARLE FOUNDATION HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE CARLE FOUNDATION HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO BE RECORDED WITHIN BAD DEBTS. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION SUBSIDIZED HEALTH SERVICES ARE NET COSTS FOR BILLED SERVICES THAT ARE SUBSIDIZED BY THE HOSPITAL. THESE INCLUDE SERVICES OFFERED DESPITE A FINANCIAL LOSS BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND EITHER OTHER PROVIDERS ARE UNWILLING TO PROVIDE THE SERVICES OR THE SERVICES WOULD OTHERWISE NOT BE AVAILABLE IN SUFFICIENT AMOUNT. INCLUDED AS UNREIMBURSED COSTS WAS $22,839,379.
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SCHEDULE H, PART II
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OTHER COMMUNITY BENEFITS / COMMUNITY BUILDING: ALTHOUGH COMMUNITY BUILDING ITEMS ARE NOT COUNTED AS COMMUNITY BENEFIT, THIS SUPPORT IS AN IMPORTANT ASPECT OF CONTRIBUTING TO THE ECONOMIC VIABILITY OF THE COMMUNITY. IN TOTAL, CARLE FOUNDATION HOSPITAL CONTRIBUTED MORE THAN $326,000 IN COMMUNITY BUILDING ACTIVITIES IN 2020. THROUGH A VARIETY OF ACTIVITIES INCLUDING SIGNIFICANT DONATIONS, SCHOLARSHIP PROGRAMS, AND PHYSICIAN, NURSE AND ALLIED-HEALTH EDUCATION, MORE THAN $18 MILLION WAS INVESTED IN PROGRAMS THAT ADDRESS COMMUNITY-WIDE WORKFORCE AND EDUCATION ISSUES, STRENGTHENING THE TRAINING AND AVAILABILITY OF PROFESSIONALS TO CARE FOR OUR COMMUNITIES' HEALTHCARE NEEDS NOW AND IN THE FUTURE. - GRADUATE MEDICAL EDUCATION MAINTAINED SIX MEDICAL RESIDENCY PROGRAMS AT THE CARLE FOUNDATION HOSPITAL LOCATION - FAMILY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, ORAL AND MAXILLOFACIAL SURGERY (OMS), PSYCHIATRY, AND VASCULAR SURGERY. THROUGHOUT 2020, GRADUATE MEDICAL EDUCATION WORKED TO EXPAND THE FOOTPRINT BY OPENING THE VASCULAR SURGERY PROGRAM WITH TWO RESIDENTS, EXPANDING THE TOTAL NUMBER OF RESIDENTS IN THE OMS AND GENERAL SURGERY PROGRAMS, AS WELL AS ADDING THREE RESIDENCIES BASED AT CARLE BROMENN MEDICAL CENTER. IN 2020, GRADUATE MEDICAL EDUCATION APPLIED FOR A CARDIOVASCULAR DISEASE FELLOWSHIP AND AN OB/GYN RESIDENCY WITH THE PLAN OF ADMITTING THE FIRST FELLOWS AND RESIDENTS TO BEGIN JULY 2022. DURING ACADEMIC YEAR 2020-2021, THERE ARE 101 RESIDENTS IN GME PROGRAMS. - CONTINUING MEDICAL EDUCATION STRIVES TO PROVIDE QUALITY AND WORLD-CLASS, EVIDENCE-BASED MEDICAL EDUCATION TO HEALTHCARE PROFESSIONALS BOTH LOCALLY AND REGIONALLY. AS AN INTERPROFESSIONAL CE PROVIDER, CARLE IS AN APPROVED PROVIDER OF CONTINUING EDUCATION CREDIT FOR 16 DIFFERENT DISCIPLINES. IN 2020, MORE THAN 10 MULTI-DISCIPLINARY SEMINARS, OPEN TO LOCAL, REGIONAL AND NATIONAL HEALTHCARE PROFESSIONALS, WERE PROVIDED IN ADDITION TO CONTINUING EDUCATION OPPORTUNITIES IN MULTIPLE DISCIPLINES THROUGHOUT CARLE FOUNDATION HOSPITAL. INCLUDED IN OVERALL CARLE HEALTH SYSTEM FIGURES AND NOT SPECIFIC TO THE HOSPITAL, CARLE CONTINUED SUPPORT OF THE CARLE ILLINOIS COLLEGE OF MEDICINE, THE WORLD'S FIRST ENGINEERING-BASED COLLEGE OF MEDICINE. IN 2020, CARLE ILLINOIS ADDED ANOTHER 48 MEDICAL STUDENTS TO THE PREVIOUS 32, WHO WILL CONTINUE TO THRIVE IN A RICH CLINICAL RESEARCH ENVIRONMENT THAT SUPPORTS STUDENT INNOVATIONS TO IMPROVE PATIENT CARE. LOOKING FORWARD, CARLE'S FOCUS FOR THE COLLEGE IS ON FACULTY AND PHYSICIAN RECRUITMENT TO MAXIMIZE OPPORTUNITIES FOR NEW RESEARCH IN CARLE'S KEY PILLAR AREAS. OVERALL, CARLE PLEDGED TO DONATE $100 MILLION TO THE COLLEGE OVER 10 YEARS, REPORTED AS A $10 MILLION GIFT FROM THE CARLE FOUNDATION EVERY YEAR. RESEARCH: CARLE FOUNDATION HOSPITAL'S RESEARCH PROGRAM CONTINUES TO EXPAND TO SERVE THE NEEDS OF THE COMMUNITY AND ADVANCE THE TRANSLATION OF NEW DISCOVERIES INTO CLINICAL SOLUTIONS. CARLE WORKS WITH INDUSTRY SPONSORS, FEDERAL AGENCIES, FOUNDATIONS AND START-UPS IN A VARIETY OF CLINICAL AREAS, INCLUDING CANCER, NEUROSCIENCES, DIGESTIVE HEALTH, MATERNAL-CHILD HEALTH, HEART AND VASCULAR, SPORTS MEDICINE, OPHTHALMOLOGY AND HEARING. AS OF DECEMBER 31, 2020, THERE WERE 399 ACTIVE CLINICAL RESEARCH STUDIES CONDUCTED AT THE STEPHENS FAMILY CLINICAL RESEARCH INSTITUTE; A 39% INCREASE SINCE 2017. OVER 2,000 PATIENTS PARTICIPATED IN CLINICAL RESEARCH STUDIES DURING 2020, JOINING OVER 600 ADDITIONAL PATIENTS WHOSE PARTICIPATION CONTINUED FROM THE PREVIOUS YEAR. IN 2020 CARLE AND THE UNIVERSITY OF ILLINOIS AT URBANA CHAMPAIGN (UIUC) FORMED THE CARLE ILLINOIS ADVANCED IMAGING CENTER AND ACCEPTED DELIVERY OF THE FIRST SIEMENS 7 TESLA MRI SYSTEM APPROVED FOR CLINICAL USE IN THE STATE OF ILLINOIS. THE CARLE CANCER CENTER IS A STRONG EXAMPLE OF THE BENEFITS OF RESEARCH. CARLE CANCER CENTER, A DESIGNATED NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH PROGRAM, IS THE PREMIER CANCER TREATMENT AND SUPPORT CENTER IN EAST CENTRAL ILLINOIS, OFFERING THE MOST ADVANCED RESOURCES TO HELP PATIENTS FIGHT CANCER. THE CARLE CANCER CENTER IS ONE OF ONLY 32 COMMUNITY SITES IN THE NATION BRINGING CANCER CLINICAL TRIALS TO INDIVIDUALS IN THEIR OWN COMMUNITIES THROUGH THE NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH PROGRAM ("NCORP"). IN 2020, CARLE ADDED TWO ADDITIONAL PARTNER SITES TO ITS NCORP NETWORK, BRINGING CUTTING-EDGE CANCER CLINICAL TRIALS TO UNDERSERVED AREAS IN EAST CENTRAL ILLINOIS AND WESTERN INDIANA. CARLE WAS THE TOP RECRUITING SITE IN THE COUNTRY AND THIRD HIGHEST ACCRUING SITE IN THE WORLD FOR THE TMIST 2D VS. 3D MAMMOGRAPHY CLINICAL TRIAL. CARLE WAS DESIGNATED AS A HIGH PERFORMING SITE BY THE NCI NCORP PROGRAM RESULTING IN A SIGNIFICANT INCREASE IN NCI SUPPORT TO EXPAND CLINICAL TRIALS ACROSS CARLE'S SERVICE AREA. CARLE REMAINS COMMITTED TO PURSUING INNOVATIVE RESEARCH THAT ADVANCES PATIENT CARE AND SAVES LIVES. ECONOMIC DEVELOPMENT CASH AND IN-KIND: A LARGE PORTION OF CARLE'S COMMUNITY-BUILDING ACTIVITIES FOCUSED ON ECONOMIC DEVELOPMENT, INCLUDING CASH, IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS AND OTHER PROGRAMS IN CHAMPAIGN COUNTY. IN ADDITION TO THE MORE THAN $44,000 IN CASH DONATIONS, LEADERSHIP PROVIDED IN-KIND SUPPORT BY SERVING ON BOARDS FOR CHAMPAIGN COUNTY CHAMBER OF COMMERCE, CHAMPAIGN COUNTY ECONOMIC DEVELOPMENT CORPORATION, VISIT CHAMPAIGN COUNTY AND MORE. THOUGH NOT INCLUDED IN THIS REPORT SINCE CARLE'S LEADERSHIP IS PAID BY A SEPARATE COST CENTER OUTSIDE OF CARLE FOUNDATION, IN-KIND SUPPORT OUTSIDE OF THE CASH DONATIONS TOTALED OVER $113,000 IN 2020. DISASTER READINESS/EMERGENCY MANAGEMENT: EMERGENCY MANAGEMENT CONTINUED TO BE A PRIORITY OF CARLE FOUNDATION HOSPITAL, AND INITIATIVES IN THIS AREA INCLUDE TRAINING THE FACILITY AND THE COMMUNITY, LEADERSHIP IN PLANNING COMMUNITY-WIDE RESPONSES TO VARIOUS SCENARIOS, AND STATE-LEVEL LEADERSHIP FOR THE 21-COUNTY REGIONAL HOSPITAL COORDINATING CENTER REGION (REGION 6). CARLE'S FOCUS IS TO PREPARE ITS STAFF AND SURROUNDING REGIONAL HOSPITALS TO BE READY TO RESPOND TO ANY NATURAL DISASTER, PANDEMIC OR ACT OF TERRORISM. IN A WORLD WITH INCREASED TRAVEL AND CHANGING WEATHER PATTERNS, DISEASES ONCE ISOLATED IN REMOTE REGIONS, NOW CAN SPREAD RAPIDLY. THE MOVEMENT OF THESE DISEASES CAN LEAD TO GLOBAL OUTBREAKS. CARLE HAS MADE THE COMMITMENT TO BE PREPARED TO CARE FOR AND TREAT HIGHLY INFECTIOUS DISEASE (HID) PATIENTS AS THE NEED ARISES. THE HID UNIT INCLUDES TWO PATIENT ISOLATION SUITES DESIGNED TO BE ABLE TO MANAGE A FULL SPECTRUM OF HIGHLY INFECTIOUS DISEASES RANGING FROM HEMORRHAGIC FEVERS TO RESPIRATORY DISEASES TO MEASLES AWAY FROM THE GENERAL HOSPITAL POPULATION. PREVIOUSLY, CARLE HAD DIRECTLY RECEIVED A FEDERAL GRANT FROM THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ASSISTANT SECRETARY FOR PREPAREDNESS AND RESPONSE (ASPR) TO EXPEND TOWARDS REGIONAL PROJECTS FOR EMERGENCY MANAGEMENT WITHIN THE COMMUNITY. FOR THE PAST FIVE YEARS, THOSE FUNDS HAVE BEEN CONSIDERED "REGIONAL COALITION FUNDSARE OVERSEEN BY THE EMERGENCY MANAGEMENT DIRECTOR FOR USE IN THE REGION. IN 2020, CARLE FOUNDATION HOSPITAL PURCHASED PPE FOR DISTRIBUTION TO AREA HOSPITALS IN RESPONSE TO THE COVID-19 PANDEMIC, WITH CARLE'S TOTAL EXPENSE AFTER THE GRANT BEING OVER $8,000. ADDITIONALLY, CARLE PURCHASED EMERGENCY NOTIFICATION SYSTEMS, VENTILATORS, PAPRS, AND CAPRS FOR AREA HOSPITALS- IN WHICH THE CARLE FOUNDATION HOSPITAL PAID WELL OVER $100,000 IN COMMUNITY SUPPORT OUTSIDE OF THE GRANT FUNDING. IT GOES WITHOUT SAYING THAT CARLE FOUNDATION HOSPITAL, LIKE MANY OTHERS ACROSS THE COUNTRY, DEDICATED ITS WORK TO SERVE ITS COMMUNITY AGAINST THE COVID-19 PANDEMIC. WHILE THE TIME OF FRONT LINE STAFF AND LEADERS FROM EVERY LEVEL DROPPED EVERYTHING TO COMBAT THE PANDEMIC, CARLE CONSERVATIVELY REPORTED ONLY A VERY SMALL NUMBER OF PUBLIC INFORMATION ITEMS- IN WHICH CARLE FOUNDATION HOSPITAL STAFF WORKED TO EDUCATE THE COMMUNITY ON COVID-19, WITH NO EXPECTATION OF ANY BUSINESS IN RETURN. THIS WAS NOT REIMBURSED BY STATE OR FEDERAL FUNDS. WORKFORCE DEVELOPMENT JOB SHADOWING: A LARGE AMOUNT OF COMMUNITY BUILDING EFFORTS - MORE THAN $30,000 - WERE FROM HEALTH CARE MENTORING PROGRAMS AND JOB SHADOWING. CARLE'S JOB SHADOWING PROGRAM, RUN BY THE VOLUNTEER SERVICES DEPARTMENT, HELPS ADDRESS COMMUNITY-WIDE WORKFORCE CONCERNS BY ALLOWING STUDENTS AND COLLEAGUES AN OPPORTUNITY TO FURTHER THEIR HEALTH CARE CAREERS. A TOTAL OF 20 PEOPLE SHADOWED VARIOUS STAFF AT BOTH CARLE FOUNDATION HOSPITAL AND CARLE PHYSICIAN GROUP IN 2020. THE HOSPITAL ALONE ACCOUNTED FOR 171 HOURS AS COMMUNITY BENEFIT, WHICH IS A CONSERVATIVE CALCULATION OF 20-50% OF THE TOTAL NUMBER OF HOURS SPENT WITH A SUPERVISOR. CARLE JOB READINESS AND LEARNING PROGRAM (JRLP): IN ITS FOURTH YEAR, THE CARLE JOB READINESS AND LEARNING PROGRAM PROVIDES EMPLOYMENT AND WORKFORCE TRAINING TO UNDER- AND UNEMPLOYED INDIVIDUALS IN THE COMMUNITY. INDIVIDUALS SELECTED FOR THE PROGRAM ARE HIRED FROM DAY ONE AND EMBARK ON A THREE-WEEK PAID TRAINING PROGRAM
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SCHEDULE H, PART III, SECTION A, LINE 3
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THE CARLE FOUNDATION HOSPITAL USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
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SCHEDULE H, PART III, SECTION A, LINE 4
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THE FOOTNOTE PERTAINING TO BAD DEBT EXPENSE CAN BE FOUND ON PAGE 28 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS.
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SCHEDULE H, PART III, SECTION B, LINE 8
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THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. AS AN ILLINOIS-BASED HOSPITAL, THE CARLE FOUNDATION HOSPITAL IS REQUIRED BY THE COMMUNITY BENEFIT ACT OF 2003 TO REPORT TO THE OFFICE OF THE ATTORNEY GENERAL COMMUNITY BENEFITS PROVIDED. FOR THAT REPORT, ILLINOIS LAW DEFINES GOVERNMENT-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. TO REDUCE PUBLIC CONFUSION CAUSED BY VARIATIONS IN CARLE'S REPORTS, FOR CONSISTENCY, CARLE HAVE PREVIOUSLY INCLUDED A MEDICARE SHORTFALL IN ALL OF ITS COMMUNITY BENEFIT RELATED REPORTS. WHEN THERE IS A SHORTFALL, MANAGEMENT BELIEVES THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, THE CARLE FOUNDATION HOSPITAL IS AUGMENTING THESE GOVERNMENT FUNDING SHORTFALLS, ASSURING CARE TO SENIORS, WHERE 10.8% ARE 65 YEARS OF AGE AND OLDER IN CHAMPAIGN COUNTY ALONE. ACCORDING TO FAMILY SERVICE OF CHAMPAIGN COUNTY, THOSE 85 AND OLDER, THE FASTEST GROWING DEMOGRAPHIC IN THE COUNTY, HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES DETERMINED 20 YEARS AGO.
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SCHEDULE H, PART III, LINE 9B
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CARLE HAS A ROBUST PRESUMPTIVE ELIGIBILITY PROCESS. CARLE PRESUMES ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION, RECIPIENTS OF WIC (WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM), SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM, RECEIPT OF GRANT ASSISTANCE FOR MEDICAL SERVICE, FRANCES NELSON HEALTH CENTER (PROMISE HEALTHCARE FQHC) DISCOUNT REFERRALS, MEDICAID TITLE XIX, XXI, AND IN-NETWORK MEDICAID MANAGED CARE PLANS. IN ADDITION, CARLE UTILIZES A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC., TO PROACTIVELY IDENTIFY PATIENTS WHO MAY BE PRESUMPTIVELY-QUALIFIED FOR ASSISTANCE - NOT ONLY FOR PUBLIC PROGRAMS LIKE MEDICAID, BUT ALSO BASED ON A NUMBER OF KEY FINANCIAL INDICATORS, INCLUDING CREDIT HISTORY, DEMOGRAPHICS AND GROSS INCOME. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE AND AUTOMATICALLY ENROLLED IN THE PROGRAM, OR THEY MAY BE CONTACTED AND ENCOURAGED TO APPLY FOR ASSISTANCE. PATIENTS WHO ARE NOT DEEMED PRESUMPTIVELY-ELIGIBLE WOULD NEED TO REQUEST AND COMPLETE AN APPLICATION. IF THE PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THAT INDIVIDUAL'S RESPONSIBILITY TO PAY. FOR PATIENTS WHO DO NOT QUALIFY FOR CARLE FINANCIAL ASSISTANCE PROGRAM (CFAP), AND WHO MAY BE UNINSURED OR UNDERINSURED, CARLE HAS OTHER DISCOUNT OPTIONS AVAILABLE, SUCH AS PROMPT PAY, ILLINOIS UNINSURED DISCOUNT, AND CAPPED DISCOUNT - WHERE PATIENTS' OUT-OF-POCKET MEDICAL EXPENSES ARE LIMITED TO 40% OF THEIR ANNUAL GROSS INCOME IF THEY EARN AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED, MANAGEMENT MAKES EVERY ATTEMPT TO WORK WITH PATIENTS AND SET UP PAYMENT ARRANGEMENTS ON THE REMAINING BALANCES DUE. THE CURRENT MINIMUM IS 5% OF THE TOTAL BALANCE DUE OR $25.00 A MONTH. IF THEY CANNOT MEET THESE GUIDELINES, OUR IN-HOUSE BILLING STAFF MEMBERS WORK WITH THEM TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT UNTIL THEY CAN MAKE THE MINIMUM PAYMENT. IF THEY ARE UNABLE TO MAKE PAYMENTS ON THE BALANCE DUE, THEN THAT BALANCE MAY BE LISTED WITH AN OUTSIDE COLLECTION AGENCY. WHEN THE ACCOUNT IS STILL IN-HOUSE, THE MINIMUM NOTIFICATION IS MONTHLY ITEMIZED STATEMENTS. IF A PATIENT DOES NOT RESPOND, THE ACCOUNT IS GIVEN A FINAL NOTICE, EITHER BY LETTER OR PHONE, AND SENT TO AN OUTSIDE COLLECTION AGENCY. CARLE WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DOES CARLE AUTHORIZE AN AGENCY TO USE SO-CALLED "BODY ATTACHMENTS." THE CONTRACTED AGENCIES ARE AWARE OF THE CARLE FINANCIAL ASSISTANCE PROGRAM AND ARE TRAINED TO INFORM PATIENTS OF THE PROGRAM AND TO SEND APPLICATIONS, WHEN APPLICABLE. THEY HAVE BEEN INSTRUCTED TO INFORM A CARLE STAFF MEMBER IF THE AGENCY DEEMS THE PATIENT UNABLE TO PAY. CARLE STAFF WILL THEN MAKE ONE MORE ATTEMPT TO WORK WITH THE PATIENT TO SEE IF HELP IS NEEDED. IF CARLE DETERMINES THAT THE PATIENT MIGHT QUALIFY, CARLE WILL ATTEMPT TO ENROLL THE PATIENT THROUGH THE PRESUMPTIVE ELIGIBILITY TOOLS OR, IF ADDITIONAL INFORMATION IS NEEDED, CARLE SENDS THE PATIENT A CFAP APPLICATION. STAFF THEN INSTRUCTS THE AGENCY TO PUT A HOLD ON THE ACCOUNT; THE AVERAGE HOLD IS 60 DAYS. IF THE PATIENT IS THEN APPROVED FOR DISCOUNTS AT 100% FOR FINANCIAL ASSISTANCE, THE BALANCE IS ADJUSTED AND THE ACCOUNT IS CLOSED WITH THE AGENCY. IF THE PATIENT IS APPROVED FOR LESS THAN 100%, THE ADJUSTMENTS ARE REPORTED TO THE AGENCY AND THE AGENCY WILL BEGIN COLLECTION EFFORTS ON ANY REMAINING BALANCE.
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SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT
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CARLE PRIMARILY ADDRESSES HEALTHCARE NEEDS IN ITS COMMUNITY BY BEING A PART OF THE AFOREMENTIONED CHNA IN PARTNERSHIP WITH CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT, OSF HEALTHCARE, AND UNITED WAY OF CHAMPAIGN COUNTY. HOWEVER, CARLE IS ACUTELY AWARE OF THE NEED FOR ACCESS TO CARE, MAKING IT A MAINSTAY OF OUR COMMUNITY BENEFIT EFFORTS. CARLE HAS A STRONG FINANCIAL ASSISTANCE PROGRAM BASED ON A PHILOSOPHY OF DOING THE RIGHT THING FOR THE COMMUNITY AND PATIENTS, BALANCED BY A CAREFUL STEWARDSHIP OF THE COMMUNITY'S RESOURCES. WHILE ACCESS TO CARE WAS NOT SELECTED AS A PRIORITY FOR THE 2020-2022 CHNA, IT WILL CONTINUE TO BE A PRIORITY FOR CARLE. AS A TAX-EXEMPT ORGANIZATION, CARLE FOUNDATION HOSPITAL PROVIDES CARE TO PATIENTS REGARDLESS OF THE ABILITY TO PAY. CARLE'S GENEROUS FINANCIAL ASSISTANCE PROGRAM HAS RESULTED IN MEDICAL CARE REACHING MANY PEOPLE OVER THE YEARS. TO ENSURE CARLE IS ADDRESSING THE NEEDS OF THE COMMUNITY, THE FINANCE AND QUALITY COMMITTEES OF THE CARLE BOARD OF TRUSTEES REVIEW AND EVALUATE CHARITY CARE FIGURES ANNUALLY. MANAGEMENT DOES NOT LIMIT THE AMOUNT OF FINANCIAL ASSISTANCE PROVIDED, AT THIS TIME. REPRESENTATIVES FROM PUBLIC RELATIONS, PATIENT FINANCIAL SERVICES, REGISTRATION, CASE MANAGEMENT AND INSURANCE CONTRACTING DEPARTMENTS CONTINUED TO MEET WITH THE LOCAL COMMUNITY COALITION OF THE CHAMPAIGN COUNTY HEALTH CARE CONSUMERS - SIX TIMES IN 2020 - INCLUDING REPRESENTATION FROM THE LAND OF LINCOLN LEGAL ASSISTANCE FOUNDATION. CARLE VALUES THIS REGULAR OPPORTUNITY FOR COMMUNITY DIALOGUE, WHICH WAS INITIATED MORE THAN A DECADE AGO. CARLE STAFF ALSO CONTINUED MEETING ON A REGULAR BASIS WITH REPRESENTATIVES OF THE LOCAL FREE CLINICS AND FQHC TO DISCUSS OPERATIONAL ISSUES. THIS DIALOGUE IS AN EFFECTIVE CHANNEL FOR LEARNING MORE ABOUT THEIR PATIENTS' EXPERIENCE IN OBTAINING FREE AND DISCOUNTED CARE. OTHER WAYS TO HELP IMPROVE ACCESS TO CARE: IN ADDITION TO CHARITY CARE, CARLE SUPPORTS A WIDE RANGE OF PROGRAMS AND SERVICES TO INCREASE COMMUNITY CAPACITY, HEALTH CARE WORK FORCE EXPANSION, AND SOCIAL SERVICES THAT PROVIDE COMPLEMENTARY HEALTHCARE-RELATED SERVICES. CARLE FOUNDATION HOSPITAL HAS, AND WILL CONTINUE TO, PURSUE THESE INITIATIVES TO IMPROVE ACCESS TO CARE: 1. OFFER A CHARITY CARE PROGRAM 2. COMMUNICATE THE AVAILABILITY OF THE CHARITY CARE PROGRAM 3. RECRUIT MORE PROVIDERS INTO THE CARLE SYSTEM, THEREBY EXPANDING ACCESS/CAPACITY 4. SUPPORT LOCAL COMMUNITY CLINICS TO ENSURE ADDED LOCAL CAPACITY FOR HEALTH CARE 5. SUPPORT PROMISE HEALTH TO ENSURE CAPACITY FOR DENTAL CARE AND PRIMARY CARE 6. SUPPORT UNITED WAY AND OTHER AREA AGENCIES TO IMPROVE AVAILABILITY OF HEALTH SERVICES 7. DONATE TO EXISTING COMMUNITY HEALTH AND DENTAL PROGRAMS 8. PARTICIPATE IN POPULATION HEALTH INITIATIVES THAT ACTIVELY MANAGE THE HEALTH OF MEMBERS 9. SUPPORT OF ECHO/CAOS HEARING PROGRAMS TO EXPAND ACCESS TO THESE SERVICES 10. SUPPORT PARKLAND STUDENTS IN HEALTH CARE FIELDS; GME PROGRAMS TO GROW NUMBER OF FUTURE PHYSICIANS 11. PROMOTE PRESCRIPTION AFFORDABILITY AS A 340B PROVIDER 12. ENHANCE ACCESS-RELATED INITIATIVES THAT WILL IMPROVE PATIENT ACCESS AND ABILITY TO INTERFACE MORE EFFICIENTLY FOR NEEDED SERVICES - PATIENT CONTACT CENTER, PRESCRIPTION REFILL REQUEST PROCESS, E-VISITS, VIRTUAL VISITS AND MORE 13. CONTINUE ACCESS TO CARE THROUGH SUBSIDIZED SERVICES, INCLUDING THE FAITH COMMUNITY NURSE PROGRAM, BREASTFEEDING CLINIC AND LANGUAGE ASSISTANCE SERVICES
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SCHEDULE H, PART VI, LINE 3
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CARLE'S PRACTICE IS TO LOOK AT EACH PATIENT'S FINANCIAL STATUS IN RELATION TO THE CARLE FINANCIAL ASSISTANCE PROGRAM AND THE CRITERIA OF THE UNINSURED PATIENT DISCOUNT ACT, AND TO PROVIDE THE PATIENT WITH THE DEEPEST ELIGIBLE DISCOUNT. BY EXPANDING THE PRESUMPTIVE ELIGIBILITY SCREENING PROCESSES AND DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, CARLE HAS BEEN ABLE TO PINPOINT THOSE NEEDING ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING THE ABILITY TO HELP. STAFF IS ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERE'S ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSISTANCE, AND CARLE AUTO-QUALIFIES CERTAIN PATIENT POPULATIONS FOR CARLE FINANCIAL ASSISTANCE PROGRAM, SUCH AS THE HOMELESS, WIC, SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), MEDICAID, LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP), AND TOWNSHIP ASSISTANCE RECIPIENTS. COMMUNICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE CARLE FOUNDATION HOSPITAL HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THESE INCLUDE: - ADVERTISING CARLE FINANCIAL ASSISTANCE PROGRAM USING PRINT, BILLBOARDS AND WEB; CONTINUED PRESENCE IN APPROPRIATE COMMUNITY PUBLICATIONS; AND ON-SITE VIA DISPLAYS THROUGHOUT THE HOSPITAL AND CLINICS - SIMPLIFIED APPLICATION FORM, INCLUDING A VERSION IN SPANISH, THAT CONTAINS INFORMATION REGARDING THE CARLE FINANCIAL ASSISTANCE PROGRAM - PUBLICATION OF A PLAIN LANGUAGE SUMMARY AND ALL OTHER FINANCIAL ASSISTANCE-RELATED INFORMATION ON CARLE.ORG/FINANCIALASSISTANCE - INFORMATION ABOUT THE CARLE FINANCIAL ASSISTANCE PROGRAM ON ALL STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - CARLE FINANCIAL ASSISTANCE PROGRAM INFORMATION AND APPLICATIONS AT ALL REGISTRATION POINTS, HOSPITAL MAIN LOBBY AND CARLE.ORG - STAFF AT FRANCES NELSON HEALTH CENTER OPERATED BY PROMISE HEALTHCARE, THE LOCAL FQHC, AND COMMUNITY FREE CLINICS ARE EQUIPPED WITH A SUPPLY OF APPLICATIONS AND KNOWLEDGE TO ASSIST THEIR PATIENTS IN COMPLETING THEM - MEETINGS WITH LOCAL LEGISLATORS TO HELP THEM ASSIST CONSTITUENTS WITH HEALTHCARE NEEDS, INCLUDING FINANCIAL ASSISTANCE
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SCHEDULE H, PART VI, LINE 4
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DESCRIPTION OF THE COMMUNITY/POPULATION CARLE'S SERVICE AREA IS GENERALLY DEFINED AS EAST CENTRAL ILLINOIS, INCLUDING ALL OR PARTS OF MORE THAN 40 COUNTIES IN EAST CENTRAL ILLINOIS AND WESTERN INDIANA. FOR THE COMMUNITY BENEFIT IMPLEMENTATION PLAN, RESEARCH AND REMEDIES ARE DIRECTED TOWARDS COMMUNITY HEALTH ISSUES IDENTIFIED IN CARLE'S PRIMARY SERVICE AREA, WITH THE FOCUS ON CHAMPAIGN COUNTY. THIS REPRESENTS CARLE'S HEADQUARTERS AND OTHER COUNTIES WHERE CARLE HAS A THRIVING PRESENCE. CARLE'S REACH EXTENDS INTO 14 ADJOINING, RURAL ILLINOIS COUNTIES. THESE AREAS COMPRISE NEARLY 50% OF THE CARLE SERVICE AREA'S POPULATION OF ABOUT 1.1 MILLION RESIDENTS. POCKETS OF EXTREME POVERTY EXIST THROUGHOUT THIS REGION. THE PROGRAMS WITHIN CARLE'S COMMUNITY BENEFIT PLAN GENERALLY HAVE IMPACT UPON ALL THE TARGETED COMMUNITIES, WITH CERTAIN PROGRAMS DIRECTED AT SPECIFIC POPULATIONS. A GREATER PROPORTION OF RESOURCES WILL BE ALLOCATED IN CHAMPAIGN COUNTY, FOLLOWED BY COLES AND VERMILION COUNTIES, WHERE THE COMMUNITY BENEFIT PROGRAM HAS LONG BEEN ESTABLISHED. CARLE FOUNDATION HOSPITAL SERVES AS THE REGION'S ONLY LEVEL I TRAUMA CENTER AND LEVEL III NEONATAL INTENSIVE CARE UNIT. AS PROVIDER OF THE REGION'S PERINATAL SERVICES, CARLE PROVIDES CARE TO PATIENTS WHO LIVE THROUGHOUT THE GEOGRAPHIC AREA EXTENDING FROM KANKAKEE IN THE NORTH TO THE SOUTHERN-MOST TIP OF ILLINOIS, AND SPANNING FROM AS FAR WEST AS EUREKA AND EAST INTO WESTERN INDIANA. FOR THE PURPOSES OF THE CARLE FINANCIAL ASSISTANCE PROGRAM, COVERAGE ENCOMPASSES THE ENTIRE CARLE SERVICE AREA.
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SCHEDULE H, PART VI, LINE 5
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THE CARLE FOUNDATION HOSPITAL HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY A COMMUNITY BOARD. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, BUILDING RENOVATION OR CONSTRUCTION, CLINICAL SERVICE EXPANSION AND QUALITY IMPROVEMENT. SURPLUS FUNDS ARE ALSO INVESTED INTO THE COMMUNITIES SERVED BY CARLE TO MEET IDENTIFIED HEALTH NEEDS WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE.
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SCHEDULE H, PART VI, LINE 6
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THE HOSPITAL AND ITS ASSOCIATED BUSINESS UNITS UNDER THE CARLE FOUNDATION UMBRELLA ALL PARTICIPATE IN CARRYING OUT THE SAME ANNUAL COMMUNITY BENEFIT PLAN, PARTICIPATING IN PROGRAMS THAT FIT THEIR SPECIFIC MISSIONS.
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SCHEDULE H, PART VI, LINE 7
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ILLINOIS
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