SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
GULF HEALTH HOSPITALS INC DBA
THOMAS HOSPITAL NORTH BALDWIN
Employer identification number

63-0891904
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    7,021,154   7,021,154 2.600 %
b Medicaid (from Worksheet 3, column a) . . . . .     16,661,117 7,934,697 8,726,420 3.230 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     23,682,271 7,934,697 15,747,574 5.830 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     372,248   372,248 0.140 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     222,954 33,965 188,989 0.070 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     20,762   20,762 0.010 %
j Total. Other Benefits . .     615,964 33,965 581,999 0.220 %
k Total. Add lines 7d and 7j .     24,298,235 7,968,662 16,329,573 6.050 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
33,019,521
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
15,909,183
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
53,192,045
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
50,732,547
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
2,459,498
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
 
No
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

 

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 THOMAS HOSPITAL
P O DRAWER 929
FAIRHOPE,AL36533
THOMASHOSPITAL.ORG 		X X         X     1
2 NORTH BALDWIN INFIRMARY
P O BOX 1409
BAY MINETTE,AL36507
NORTHBALDWININFIRMARY.ORG 		X X         X     2
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
1
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
1
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.INFIRMARYHEALTH.OG
b
WWW.INFIRMARYHEALTH.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
1
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
1
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Page 4
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
2
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Page 5
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
2
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.INFIRMARYHEALTH.ORG
b
WWW.INFIRMARYHEALTH.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Page 6
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
2
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Page 7
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
2
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Page 8
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
GROUP 1, FACILITY 1, THOMAS HOSPITAL - PART V, LINE 5 IN PREPARING THE CHNA, DATA WAS GATHERED FROM MULTIPLE SOURCES IN AN EFFORT TO CONSTRUCT A CURRENT AND ACCURATE SNAPSHOT OF THE HEALTH ISSUES IN BALDWIN COUNTY, ALABAMA. INFORMATION WAS OBTAINED FROM NUMEROUS PUBLIC DATABASES AND OPINIONS WERE SOLICITED FROM PUBLIC HEALTH EXPERTS, LOCAL CIVIC LEADERS, AND PATIENTS WITHIN THE COMMUNITY SERVED BY THE ORGANIZATION. THIS INFORMATION WAS THEN SUMMARIZED FOR FINAL CONSIDERATION BY A CHNA COMMITTEE COMPRISED OF REPRESENTATIVES FROM HOSPITAL AND SYSTEM MANANGEMENT, NURSING SERVICES, PATIENT SERVICES, AND ALABAMA QUALITY ASSURANCE FOUNDATION (AQAF), THE QUALITY IMPROVEMENT ORGANIZATION (QIO) FOR THE STATE OF ALABAMA.
GROUP 1, FACILITY 1, THOMAS HOSPITAL - PART V, LINE 6A THOMAS HOSPITAL'S CHNA WAS PREPARED IN CONJUNCTION WITH NORTH BALDWIN INFIRMARY, AS THEY ARE BOTH LOCATED IN BALDWIN COUNTY, ALABAMA.
GROUP 1, FACILITY 1, THOMAS HOSPITAL - PART V, LINE 11 THE 2019 COMMUNITY HEALTH PRIORITIES IDENTIFIED IN THE 2019 CHNA FOR INFIRMARY HEALTH AFFILIATE HOSPITALS INCLUDING: MOBILE INFIRMARY, INFIRMARY LONG TERM ACUTE CARE (ILTAC), THOMAS HOSPITAL AND NORTH BALDWIN INFIRMARY INCLUDE: ACCESS TO CARE, CANCER, DIABETES, HEART DISEASE, AND OBESITY/PHYSICAL INACTIVITY. THE RESULTING PRIORITY AREAS WERE STRATEGICALLY CONDENSED INTO TWO MAIN PRIORITY AREAS TO FEATURE THE APPROACH THAT THE HEALTH SYSTEM WOULD TAKE TO HAVE AN IMPACT ON THE MOST SIGNIFICANT DISEASES IN OUR COMMUNITY: (1) ACCESS TO CARE WITH A FOCUS ON CANCER, DIABETES, AND HEART DISEASE. (2) OBESITY/PHYSICAL ACTIVITY WITH A FOCUS ON DIABETES AND HEART DISEASE. TO ADDRESS ACCESS TO CARE, INFIRMARY HEALTH SEEKS TO ESTABLISH PROGRAMS THAT PROVIDE AFFORDABLE COMPREHENSIVE HEALTHCARE EDUCATIONAL PROGRAMS AND THAT INCLUDE EARLY DETECTION AND PREVENTION MEASURES AND THAT PROMOTE PATIENT ENGAGEMENT AND SELF-MANAGEMENT FOR CANCER, DIABETES, AND HEART DISEASE. THE STRATEGIES TO ACHIEVE THIS WILL INCLUDE BRINGING HEALTH EDUCATION AND OUTREACH TO VULNERABLE COMMUNITIES THROUGH PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND BUSINESSES. THE HEALTH SYSTEM ALSO PLANS TO ESTABLISH A PREHAB CURRICULUM. ONE OF THE KEY WAYS THAT INFIRMARY HOSPITALS WILL IMPROVE ACCESS IS THROUGH ITS MOBILE SCREENING VEHICLE. IT WILL TRAVEL AROUND MOBILE AND BALDWIN COUNTIES PROVIDING SCREENING AND HEALTH EDUCATION IN THE AREAS OF CANCER, DIABETES AND HEART DISEASE. INFIRMARY HEALTH RECOGNIZES THE EFFECTS OF OBESITY ON CHRONIC DISEASES LIKE DIABETES AND HEART DISEASE. AS SUCH THEY PLAN TO ENHANCE AND ESTABLISH PROGRAMS THAT HELP INDIVIDUALS LOSE WEIGHT AND INCREASE THEIR PHYSICAL ACTIVITY LEVELS SO MOBILE AND BALDWIN COUNTIES CAN ACHIEVE THE LOWEST RATES OF DIABETES AND HEART DISEASE IN THE STATE OF ALABAMA. OBESITY CAN CONTRIBUTE TO PREVENTABLE CHRONIC DISEASES AND INCREASES THE RISK OF A POOR OUTCOME IN OTHER ILLNESSES. TO ADDRESS THE IDENTIFIED NEED, MOBILE INFIRMARY, THOMAS HOSPITAL AND NORTH BALDWIN INFIRMARY WILL INCREASE AWARENESS OF THE CAMPAIGN "SCALE BACK ALABAMA", A STATE-WIDE EFFORT TO ENCOURAGE CITIZENS TO PARTICIPATE IN A HEALTHIER LIFESTYLE. INFIRMARY HEALTH IS COMMITTED TO SERVING AS A HOST SITE AND PLANS TO EXPAND ITS PARTICIPATION TO INCREASE THE NUMBER OF INDIVIDUALS WHO ENROLL EACH YEAR. THEY WILL WORK THROUGH THEIR COMMUNITY PARTNERSHIPS TO EXPAND THE NUMBER OF PARTICIPATING WEIGH-IN SITES IN ORDER TO REACH MORE PEOPLE THROUGHOUT THE COMMUNITY.
GROUP 1, FACILITY 1, THOMAS HOSPITAL - PART V, LINE 16J A NOTICE PUBLICIZING THE FINANCIAL ASSISTANCE POLICY (FAP) WAS POSTED IN THE HOSPITAL FACILITY'S ADMISSION OFFICES AND OUTLYING REGISTRATION AREAS INCLUDING THE FACILITY'S EMERGENCY DEPARTMENT, AND THE FACILITY'S BUSINESS OFFICE. A PLAIN LANGUAGE SUMMARY OF THE FAP WAS ADDED TO BILLING AND COLLECTION STATEMENTS. DURING THE YEAR, THE FAP WAS PROVIDED TO CERTAIN COMMUNITY ORGANIZATIONS WHO SERVE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE; THESE ORGANIZATIONS WERE THE MOBILE, BALDWIN, AND ESCAMBIA COUNTY HEALTH DEPARTMENTS, FRANKLIN PRIMARY HEALTH CENTER AND THE HOPE CENTER.
GROUP 2, FACILITY 2, NORTH BALDWIN INFIRMARY - PART V, LINE 5 IN PREPARING THE CHNA, DATA WAS GATHERED FROM MULTIPLE SOURCES IN AN EFFORT TO CONSTRUCT A CURRENT AND ACCURATE SNAPSHOT OF THE HEALTH ISSUES IN BALDWIN COUNTY, ALABAMA. INFORMATION WAS OBTAINED FROM NUMEROUS PUBLIC DATABASES AND OPINIONS WERE SOLICITED FROM PUBLIC HEALTH EXPERTS, LOCAL CIVIC LEADERS, AND PATIENTS WITHIN THE COMMUNITY SERVED BY THE ORGANIZATION. THIS INFORMATION WAS THEN SUMMARIZED FOR FINAL CONSIDERATION BY A CHNA COMMITTEE COMPRISED OF REPRESENTATIVES FROM HOSPITAL AND SYSTEM MANANGEMENT, NURSING SERVICES, PATIENT SERVICES, AND ALABAMA QUALITY ASSURANCE FOUNDATION (AQAF), THE QUALITY IMPROVEMENT ORGANIZATION (QIO) FOR THE STATE OF ALABAMA.
GROUP 2, FACILITY 2, NORTH BALDWIN INFIRMARY - PART V, LINE 6A NORTH BALDWIN INFIRMARY'S CHNA WAS PREPARED IN CONJUNCTION WITH THOMAS HOSPITAL, AS THEY ARE BOTH LOCATED IN BALDWIN COUNTY, ALABAMA.
GROUP 2, FACILITY 2, NORTH BALDWIN INFIRMARY - PART V, LINE 11 THE 2019 COMMUNITY HEALTH PRIORITIES IDENTIFIED IN THE 2019 CHNA FOR INFIRMARY HEALTH AFFILIATE HOSPITALS INCLUDING: MOBILE INFIRMARY, INFIRMARY LONG TERM ACUTE CARE (ILTAC), THOMAS HOSPITAL AND NORTH BALDWIN INFIRMARY INCLUDE: ACCESS TO CARE, CANCER, DIABETES, HEART DISEASE, AND OBESITY/PHYSICAL INACTIVITY. THE RESULTING PRIORITY AREAS WERE STRATEGICALLY CONDENSED INTO TWO MAIN PRIORITY AREAS TO FEATURE THE APPROACH THAT THE HEALTH SYSTEM WOULD TAKE TO HAVE AN IMPACT ON THE MOST SIGNIFICANT DISEASES IN OUR COMMUNITY: (1) ACCESS TO CARE WITH A FOCUS ON CANCER, DIABETES, AND HEART DISEASE. (2) OBESITY/PHYSICAL ACTIVITY WITH A FOCUS ON DIABETES AND HEART DISEASE. TO ADDRESS ACCESS TO CARE, INFIRMARY HEALTH SEEKS TO ESTABLISH PROGRAMS THAT PROVIDE AFFORDABLE COMPREHENSIVE HEALTHCARE EDUCATIONAL PROGRAMS AND THAT INCLUDE EARLY DETECTION AND PREVENTION MEASURES AND THAT PROMOTE PATIENT ENGAGEMENT AND SELF-MANAGEMENT FOR CANCER, DIABETES, AND HEART DISEASE. THE STRATEGIES TO ACHIEVE THIS WILL INCLUDE BRINGING HEALTH EDUCATION AND OUTREACH TO VULNERABLE COMMUNITIES THROUGH PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND BUSINESSES. THE HEALTH SYSTEM ALSO PLANS TO ESTABLISH A PREHAB CURRICULUM. ONE OF THE KEY WAYS THAT INFIRMARY HOSPITALS WILL IMPROVE ACCESS IS THROUGH ITS MOBILE SCREENING VEHICLE. IT WILL TRAVEL AROUND MOBILE AND BALDWIN COUNTIES PROVIDING SCREENING AND HEALTH EDUCATION IN THE AREAS OF CANCER, DIABETES AND HEART DISEASE. INFIRMARY HEALTH RECOGNIZES THE EFFECTS OF OBESITY ON CHRONIC DISEASES LIKE DIABETES AND HEART DISEASE. AS SUCH THEY PLAN TO ENHANCE AND ESTABLISH PROGRAMS THAT HELP INDIVIDUALS LOSE WEIGHT AND INCREASE THEIR PHYSICAL ACTIVITY LEVELS SO MOBILE AND BALDWIN COUNTIES CAN ACHIEVE THE LOWEST RATES OF DIABETES AND HEART DISEASE IN THE STATE OF ALABAMA. OBESITY CAN CONTRIBUTE TO PREVENTABLE CHRONIC DISEASES AND INCREASES THE RISK OF A POOR OUTCOME IN OTHER ILLNESSES. TO ADDRESS THE IDENTIFIED NEED, MOBILE INFIRMARY, THOMAS HOSPITAL AND NORTH BALDWIN INFIRMARY WILL INCREASE AWARENESS OF THE CAMPAIGN "SCALE BACK ALABAMA", A STATE-WIDE EFFORT TO ENCOURAGE CITIZENS TO PARTICIPATE IN A HEALTHIER LIFESTYLE. INFIRMARY HEALTH IS COMMITTED TO SERVING AS A HOST SITE AND PLANS TO EXPAND ITS PARTICIPATION TO INCREASE THE NUMBER OF INDIVIDUALS WHO ENROLL EACH YEAR. THEY WILL WORK THROUGH THEIR COMMUNITY PARTNERSHIPS TO EXPAND THE NUMBER OF PARTICIPATING WEIGH-IN SITES IN ORDER TO REACH MORE PEOPLE THROUGHOUT THE COMMUNITY.
GROUP 2, FACILITY 2, NORTH BALDWIN INFIRMARY - PART V, LINE 16J A NOTICE PUBLICIZING THE FINANCIAL ASSISTANCE POLICY (FAP) WAS POSTED IN THE HOSPITAL FACILITY'S ADMISSION OFFICES AND OUTLYING REGISTRATION AREAS INCLUDING THE FACILITY'S EMERGENCY DEPARTMENT, AND THE FACILITY'S BUSINESS OFFICE. A PLAIN LANGUAGE SUMMARY OF THE FAP WAS ADDED TO BILLING AND COLLECTION STATEMENTS. DURING THE YEAR, THE FAP WAS PROVIDED TO CERTAIN COMMUNITY ORGANIZATIONS WHO SERVE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE; THESE ORGANIZATIONS WERE THE MOBILE, BALDWIN, AND ESCAMBIA COUNTY HEALTH DEPARTMENTS, FRANKLIN PRIMARY HEALTH CENTER, AND THE HOPE CENTER.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 OAKWOOD CENTER FOR LIVING
2010 MEDICAL CENTER DR
BAY MINETTE,AL36507 		SKILLED NURSING FACILITY
2 THOMAS MEDICAL CENTER
27961 US HWY 98
DAPHNE,AL36526 		OP SURGERY CENTER/RADIOLOGY/PHYS OFFICES
3 INFIRMARY CANCER CARE
5 MOBILE INFIRMARY CIRCLE
MOBILE,AL36607 		COORDINATED CANCER CARE
4 THOMAS HOSPITAL FREESTANDING EMERGE
29487 ST HWY 181
DAPHNE,AL36526 		EMERGENCY ROOM
5
6
7
8
9
10
Schedule H (Form 990) 2020
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Schedule H (Form 990) 2020
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART VI SCHEDULE H, PART VI, QUESTION 1 PART I, LINE 7: COSTS WERE CALCULATED USING THE COST-TO-CHARGE RATIO METHODOLOGY OBTAINED FROM WORKSHEET 2 OF THE INSTRUCTIONS. ALL OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. PART I, LINE 7, COLUMN (F); THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN IS 33,319,520 WHICH IS NET OF RECOVERIES. PART III, LINE 2: THE AMOUNT OF BAD DEBT EXPENSE ON PART III, LINE 2 REPRESENTS THE ACTUAL AMOUNT OF CHARGES THAT WERE DEEMED UNCOLLECTIBLE AND WERE WRITTEN OFF TO BAD DEBT PER THE ORGANIZATION'S ACCOUNTING RECORDS. PART III, LINE 3: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS DERIVED USING RATIO ANALYSIS OF PATIENT BAD DEBT ACCOUNTS PROCESSED THROUGH A PRESUMPTIVE QUALIFICATION MODEL. THE ACCOUNTS ARE ANALYZED FOR DEMOGRAPHIC INFORMATION TO DETERMINE HOUSEHOLD INCOME LEVELS, CORRELATED TO FEDERAL POVERTY LEVEL GUIDELINES, AND APPLIED TO THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY CRITERIA. A LARGE NUMBER OF PATIENTS DO NOT COOPERATE WITH THE ELIGIBILITY PROCESS OF THE FINANCIAL ASSISTANCE PROGRAM, WHICH IS READILY AVAILABLE TO THEM. THEREFORE IT IS THE ORGANIZATION'S OPINION THAT THIS PORTION OF BAD DEBT EXPENSE BE TREATED AS A COMMUNITY BENEFIT. PART III, LINE 4: THE TEXT OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS FOOTNOTE REGARDING BAD DEBT EXPENSE STATES: "ALLOWANCES FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND ANALYSIS OF OTHER CURRENT TRENDS AND INFORMATION. DOUBTFUL ACCOUNTS ARE WRITTEN-OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORTS HAVE BEEN EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBTS IF SUBSEQUENTLY COLLECTED". PART III, LINE 8: IT IS IN THE ORGANIZATION'S OPINION THAT FUTURE MEDICARE SHORTFALLS BE TREATED IN TOTAL AS COMMUNITY BENEFIT. HEALTHCARE SERVICES TO THE MEDICARE POPULATION REALISTICALLY MUST BE PROVIDED IN ORDER FOR SOCIETY TO CONTINUE TO FUNCTION AS WE KNOW IT. NEEDS ASSESSMENT PART VI, QUESTION 2: IN ADDITION TO THE CHNA CONDUCTED DURING FISCAL YEAR 2019, THE ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY THROUGH A VARIETY OF OTHER MEANS. CONSTANT COMMUNICATION WITH THE OPEN MEDICAL STAFF OF MORE THAN 650 PHYSICIANS LOCATED THROUGHOUT THE COMMUNITY PROVIDES VALUABLE INSIGHT INTO HEALTH RELATED NEEDS. THE INDEPENDENT BOARD, REPRESENTING MEMBERS OF THE COMMUNITY, PROVIDES INPUT FROM A DIFFERENT PERSPECTIVE. COMMENTS FROM PATIENT SATISFACTION SURVEYS ARE SCRUTINIZED FOR OPPORTUNITIES. FORMAL COMMITTEES IN THE ORGANIZATION, SUCH AS THE STROKE COMMITTEE, ASSESS DATA PROVIDED BY THE AMERICAN HEART ASSOCIATION AND SIMILAR ORGANIZATIONS, TO ASSIST IN IDENTIFYING COMMUNITY NEEDS. THROUGH WEEKLY LEADERSHIP AND STRATEGIC PLANNING MEETINGS HELD AT AFFILIATED HOSPITALS AND ENTITIES LOCATED THROUGHOUT THE SERVICE AREA, NEEDS OF THE COMMUNITIES SERVED ARE CONTINUOUSLY ASSESSED. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, QUESTON 3 THE ORGANIZATION'S ADMITTING AREAS, BUSINESS OFFICE AREAS, AND EMERGENCY DEPARTMENTS HAVE SIGNAGE PROMINENTLY DISPLAYED WHICH INCLUDES SPECIFIC WORDING INTENDED TO INFORM AND PROMPT PATIENTS TO AVAIL THEMSELVES OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. ADDITIONALLY, THE ORGANIZATION INCLUDES SIMILAR WORDING WITHIN PATIENT-ACCOUNT STATEMENTS MAILED TO PATIENTS WHO ARE BILLED FOR SERVICES RENDERED AND ON THE ORGANIZATION'S WEBSITE, WHICH IS AVAILABLE TO THE GENERAL PUBLIC. THE ORGANIZATION ALSO CONTRACTS WITH A THIRD-PARTY VENDOR TO HAVE THEM IDENTIFY, CONTACT, AND ASSIST WITH QUALIFYING PATIENTS WHO MAY BE ELIGIBLE FOR GOVERNMENT ASSISTANCE PROGRAMS. THE VENDOR UTILIZES ADMISSION REPORTS, REFERRALS FROM FINANCIAL COUNSELORS OF THE ORGANIZATION, PATIENT SELF-REFERRALS, AND VARIOUS OTHER FORMS OF PATIENT ELIGIBILITY DATA TO IDENTIFY POTENTIALLY ELIGIBLE PATIENTS. COMMUNITY INFORMATION, SCHEDULE H, PART VI, QUESTION 4 BALDWIN COUNTY, ALABAMA IS LOCATED ON THE SHORES OF THE GULF OF MEXICO AND MOBILE BAY, BORDERED ON THE WEST BY MOBILE COUNTY, ALABAMA, ON THE NORTHWEST BY WASHINGTON AND CLARKE COUNTIES, ALABAMA, ON THE NORTH BY MONROE COUNTY, ALABAMA, ON THE NORTHEAST BY ESCAMBIA COUNTY, ALABAMA, AND ON THE EAST BY ESCAMBIA COUNTY, FLORIDA. WITH A LAND AREA OF 1,590 SQUARE MILES AND 430 SQUARE MILES OF WATER, IT IS THE LARGEST COUNTY IN THE STATE OF ALABAMA AND IS THE 12TH LARGEST COUNTY EAST OF THE MISSISSIPPI RIVER. THE CITY OF BAY MINETTE IS THE COUNTY SEAT FOR BALDWIN COUNTY, AND FAIRHOPE IS THE LARGEST CITY. NORTH BALDWIN INFIRMARY IS LOCATED IN BAY MINETTE WHILE THOMAS HOSPITAL IS LOCATED IN FAIRHOPE. ACCORDING TO THE LATEST STATISTICS PROVIDED BY THE U.S. CENSUS BUREAU FROM 2020, THE POPULATION OF BALDWIN COUNTY WAS APPROXIMATELY 213,000. OF THE 81,000 HOUSEHOLDS, 19,000 HAD CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM, 43,000 WERE MARRIED COUPLES LIVING TOGETHER, AND 27,000 WERE NON-FAMILIES. THE RACIAL MAKEUP OF THE COUNTY WAS 86% WHITE, 9% BLACK OR AFRICAN- AMERICAN, AND 4.5% HISPANIC OR LATINO. THE AVERAGE HOUSEHOLD SIZE WAS 2.5 AND THE PER CAPITA INCOME FOR THE COUNTY WAS 32,626. JUST OVER 7% OF THE POPULATION WAS LIVING AT OR BELOW THE POVERTY LINE. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, QUESTION 5: SEE STATEMENT IN SCHEDULE O RELATED TO PROGRAM SERVICE ACCOMPLISHMENTS (PART III, LINE 4A) FOR ADDITIONAL INFORMATION ON HOW THE ORGANIZATION'S HOSPITAL FACILITIES FURTHER THEIR EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY. AFFILIATED HEALTH CARE SYSTEM, SCHEDULE H, PART VI, QUESTION 6: EACH HOSPITAL AND ENTITY WITHIN INFIRMARY HEALTH SYSTEM HAS ITS OWN LEADERSHIP, AND PROVIDES CERTAIN COMMUNITY BENEFITS AND PROGRAM SERVICES UNIQUELY RELATED TO THE COMMUNITY IT SERVES. HOWEVER, EXECUTIVE LEADERSHIP OF THE SYSTEM PROVIDES GUIDANCE FOR ALL, AND THERE ARE CERTAIN COMMUNITY OUTREACH INITIATIVES AND SERVICES WHICH ARE COORDINATED FROM A SYSTEM PERSPECTIVE IN ORDER TO SERVE NEEDS WITHIN A BROADER SERVICE AREA, OR TO JOINTLY COORDINATE THE EFFORT FOR GREATER EFFICIENCY. ADDITIONALLY, THE ORGANIZATION HAS ESTABLISHED A PROGRAM TO FUND SPECIAL COMMUNITY HEALTH NEEDS IDENTIFIED AND APPROVED BY THE VOLUNTARY BOARD OF THE INFIRMARY FOUNDATION, THE 501(C)3 PHILANTHROPIC AFFILIATE OF THE ORGANIZATION. EACH YEAR AN ACCOUNTING OF THE COMMUNITY BENEFIT FUNDS DISTRIBUTED BY THE FOUNDATION IS REVIEWED BY MANAGEMENT. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, QUESTION 7: A COMMUNITY BENEFIT REPORT IS NOT REQUIRED TO BE FILED WITH ANY STATE.
Schedule H (Form 990) 2020
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