PART I, LINE 3C:
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UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE:-THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.-THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG.-THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP].-THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:-RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS;-HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC;-PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);-FOOD STAMP ELIGIBILITY;-SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY;-ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN);-LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR-PATIENT IS DECEASED WITH NO KNOWN ESTATE.
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PART I, LINE 6A:
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YES, THE CHI HEALTH SYSTEM PRODUCES AN ANNUAL PUBLIC COMMUNITY BENEFIT REPORT THAT IS MAILED TO A CORE CONSTITUENCY, PLACED IN KEY PLACES THROUGHOUT THE ORGANIZATION AND DISTRIBUTED IN COMMUNITY MEETINGS. IT IS ALSO AVAILABLE ON THE COMPANY'S INTRANET SITE, AND ON ITS PUBLIC WEBSITE AT HTTP://WWW.CHIHEALTH.COM/COMMUNITY-BENEFIT.
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PART I, LINE 7:
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A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING WORKSHEET 2 TO COMPUTE THE COST-TO-CHARGE RATIO. THE COST-TO-CHARGE RATIO COVERS ALL PATIENT SEGMENTS.
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PART I, LINE 7G:
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INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THE FOLLOWING PHYSICIAN CLINICS:-CHI HEALTH CORNING RURAL HEALTH CLINIC-CHI HEALTH BEDFORD RURAL HEALTH CLINIC-CHI HEALTH LENOX RURAL HEALTH CLINICTHE TOTAL EXPENSES ASSOCIATED WITH OPERATING THESE CLINICS WERE $2,747,136. REVENUE OFFSETS WERE $1,259,071. ACCORDINGLY, THE TOTAL SUBSIDIZED COST OF THESE NECESSARY SERVICES WAS $1,488,065. THE CLINICS MEET A COMMUNITY NEED FOR PRIMARY CARE SERVICES OUTSIDE OF THE EMERGENCY ROOM SETTING.
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PART II, COMMUNITY BUILDING ACTIVITIES:
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ALEGENT HEALTH-MERCY HOSPITAL, CORNING HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT INVESTMENTS, AS WELL AS HOSPITAL SPECIFIC INVESTMENTS THAT ADDRESS COMMUNITY HEALTH NEEDS WHICH INCLUDE SUPPORT OF LOCAL HEALTH COALITIONS, INVESTMENTS IN PARTNERSHIPS AND PROGRAMS THAT ADDRESS TOP COMMUNITY HEALTH NEEDS, PARTICIPATION IN LOCAL COMMITTEES AND BOARDS TIED TO TOP HEALTH NEEDS, AND INVESTMENTS IN MANY OTHER WAYS AS DESCRIBED IN OTHER AREAS OF THE SCHEDULE H NARRATIVE. BELOW ARE SPECIFIC EXAMPLES OF WORK THAT FALLS WITHIN THE DEFINITION OF COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE CRITICAL IN HELPING BUILD SOCIAL, HEALTH, AND ECONOMIC OPPORTUNITIES IN OUR COMMUNITY THAT ULTIMATELY DRIVE HEALTH STATUS AND QUALITY OF LIFE FOR OUR RESIDENTS: - WORKFORCE DEVELOPMENT-THE FOLLOWING ACTIVITIES WORK TO STRENGTHEN THE COMMUNITY'S CAPACITY TO PROMOTE THE HEALTH AND WELL-BEING OF OUR RESIDENTS BY DRIVING ENTRY INTO HEALTHCARE CAREERS: * PRESENTATIONS TO HIGH SCHOOL STUDENTS ABOUT HEALTHCARE CAREERS * STAFF TIME SPENT WITH HIGH SCHOOL SHADOW STUDENTS- COMMUNITY AND ECONOMIC DEVELOPMENT INCLUDING SUPPORT OF LOCAL CHAMBERS OF COMMERCE - PARTICIPATION IN MEALS ON WHEELS PROVIDING DELIVERY OF MEALS TO INDIVIDUALS THAT ARE UNABLE TO PURCHASE AND/OR PREPARE THEIR OWN
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PART III, LINE 2:
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COSTING METHODOLOGY FOR AMOUNTS REPORTED ON LINE 2 IS DETERMINED USING THE ORGANIZATION'S COST/CHARGE RATIO OF 62.37%. WHEN DISCOUNTS ARE EXTENDED TO SELF-PAY PATIENTS, THESE PATIENT ACCOUNT DISCOUNTS ARE RECORDED AS A REDUCTION IN REVENUE, NOT AS BAD DEBT EXPENSE.
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PART III, LINE 3:
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ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE.
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PART III, LINE 4:
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ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS IS PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF CHANGE.SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 AND 2020 WAS NOT SIGNIFICANT.
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PART III, LINE 8:
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COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS.COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. ALEGENT HEALTH-MERCY HOSPITAL, CORNING IA'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $677,213 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS.
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PART III, LINE 9B:
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THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY.
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PART VI, LINE 2:
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TO CONDUCT THE CURRENT CHNA, MERCY CORNING'S COMMUNITY BENEFIT ACTION TEAM (CBAT) ENGAGED WITH THE COLLECTIVE IMPACT COALITION, BEHAVIORAL HEALTH COALITION OF ADAMS AND TAYLOR COUNTY (BHCATC), AND TAYLOR COUNTY PUBLIC HEALTH (TCPH) WHICH SERVES BOTH ADAMS AND TAYLOR COUNTIES, ON NOVEMBER 1, 2018. THE BHCATC IS A ROBUST AND ACTIVE COALITION WITH MULTIPLE COMMUNITY STAKEHOLDERS FROM KEY COMMUNITY SERVICES AND AGENCIES THAT SERVE BEHAVIORAL HEALTH NEEDS AS WELL AS OTHER NEEDS ACROSS THE TWO COUNTIES. AT THE NOVEMBER MEETING, MERCY CORNING PRESENTED SECONDARY DATA, AND LED A CONVERSATION TO GAIN INPUT FROM THE GROUP AND PRIORITIZE TOP HEALTH NEEDS.DATA REVIEWED WITH BHATC WAS GATHERED FROM A VARIETY OF SOURCES INCLUDING:-CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) WONDER QUERY SYSTEM-CARES ENGAGEMENT NETWORK AND COMMUNITY COMMONS-COUNTY HEALTH RANKINGS-HEALTHYPEOPLE.GOV U.S. DEPT. OF HEALTH & HUMAN SERVICES - OFFICE OF DISEASE PREVENTION AND HEALTH PROMOTION (BENCHMARKING)-IOWA AGING-IOWA CANCER REGISTRY-KIDS COUNT- IOWA REPORT BY COUNTYUPON COMPLETION OF THE DATA PRESENTATION, THE GROUP HELD A ROBUST DISCUSSION OF THE KEY FINDINGS AND BHCATC MEMBERS WERE ASKED TO CONSIDER THE FACTORS AFFECTING HEALTH (BEHAVIORAL, SOCIOECONOMIC, ENVIRONMENTAL, MEDICAL CARE, AND GENETICS) AND WHICH NEEDS WERE MOST PRESSING IN THE COMMUNITY. AFTER CAPTURING THE GROUP'S DISCUSSION, 19 PARTICIPANTS WERE ASKED TO VOTE FOR THE HEALTH NEED THEY BELIEVED TO BE THE MOST IMPORTANT TO ADDRESS IN ORDER FOR THE COMMUNITY TO REALIZE POSITIVE HEALTH OUTCOMES.FOLLOWING THE NOVEMBER MEETING, THE MERCY CORNING CBAT MET TO VALIDATE THE TOP IDENTIFIED NEEDS, AND BEGIN TO DISCUSS THE STRATEGIC PLANNING PROCESS FOR THE NEXT THREE-YEAR IMPLEMENTATION STRATEGY PLAN (ISP), WHICH WAS RELEASED IN THE FALL OF 2019.
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PART VI, LINE 3:
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NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO:-CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS;-NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND-PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT.SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS.PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE.
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PART VI, LINE 4:
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CHI HEALTH MERCY CORNING IDENTIFIED ADAMS AND TAYLOR COUNTIES AS THEIR COMMUNITY FOR THE PURPOSE OF THE CHNA. AS A CRITICAL ACCESS HOSPITAL, MERCY CORNING'S PRIMARY SERVICE AREA IS CONSIDERED THE COUNTY IN WHICH THEY ARE LOCATED (ADAMS COUNTY). WHILE MERCY CORNING IS THE ONLY HOSPITAL LOCATED IN ADAMS COUNTY, THEY ALSO SERVE RESIDENTS FROM TAYLOR COUNTY WHERE THERE ARE NO LOCAL HOSPITALS. THEREFORE, BOTH COUNTIES WERE INCLUDED IN THE COMMUNITY DEFINITION.MERCY CORNING IS LOCATED IN CORNING, IOWA WHICH IS SITUATED NEAR THE CENTER OF ADAMS COUNTY, APPROXIMATELY 80 MILES FROM THE METROPOLITAN AREA OF OMAHA, NEBRASKA AND COUNCIL BLUFFS, IOWA AND 95 MILES FROM THE METROPOLITAN AREA OF DES MOINES, IOWA. ADAMS COUNTY IS IMMEDIATELY NORTH OF AND ADJACENT TO TAYLOR COUNTY, WHICH IS AT THE SOUTHERNMOST BORDER OF IOWA TO MISSOURI. BOTH ADAMS AND TAYLOR COUNTIES, AS WELL AS THE SURROUNDING COUNTIES ARE NON-METROPOLITAN AND LOCATED NEAR THE WESTERN BORDER OF IOWA. ADAMS COUNTY HAS ONE SCHOOL DISTRICT AND 4 INCORPORATED TOWNS: CARBON, CORNING, NODAWAY AND PRESCOTT. CORNING IS THE COUNTY SEAT AND THERE ARE ALSO 10 OTHER TOWNSHIPS. BEDFORD IS THE COUNTY SEAT, AND TAYLOR COUNTY HAS 3 PUBLIC SCHOOL DISTRICTS AND EIGHT INCORPORATED CITIES AND SEVENTEEN TOWNSHIPS.POPULATION DATA SHOWS A PRIMARILY NON-HISPANIC WHITE POPULATION, AND A MUCH HIGHER PERCENTAGE OF RESIDENTS OVER 65 YEARS OF AGE IN ADAMS (22.8%) AND TAYLOR (22.4%) COMPARED TO THE STATE OF IOWA (16.7%). ADAMS COUNTY COVERS APPROXIMATELY 423 SQUARE MILES AND TAYLOR COUNTY COVERS 531 SQUARE MILES. BOTH COUNTIES HAVE A VERY LOW POPULATION DENSITY COMPARED TO THE STATE OVERALL, WHICH HIGHLIGHTS THE RURAL NATURE OF THE AREA.POPULATION DEMOGRAPHICS:ADAMS COUNTY:-3,645 TOTAL POPULATION-9.5 POPULATION DENSITY (POPULATION PER SQUARE MILE) -21.2% OF POPULATION IS UNDER THE AGE OF 18-22.8% OF POPULATION IS OVER AGE 65-50.1% OF POPULATION IS FEMALE-0.3% OF POPULATION IS NON-HISPANIC AFRICAN AMERICAN-0.5% OF POPULATION IS AMERICAN INDIAN & ALASKAN NATIVE-0.7% OF POPULATION IS ASIAN-0.0% OF POPULATION IS NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER-1.3% OF POPULATION IS HISPANIC-96.6% OF POPULATION IS NON-HISPANIC WHITE-$49,745 MEDIAN HOUSEHOLD INCOME-2.4 UNEMPLOYMENT RATE-12.3% OF PERSONS LIVING IN POVERTY (125% OF FEDERAL POVERTY LEVEL)-19% OF CHILDREN LIVING IN POVERTY-93.8% HIGH SCHOOL GRADUATION RATE-17.3% OF INDIVIDUALS 25 YEARS OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER-6.2% ARE UNINSUREDTAYLOR COUNTY:-6,191 TOTAL POPULATION-11.9 POPULATION DENSITY (POPULATION PER SQUARE MILE) -23.2% OF POPULATION IS UNDER THE AGE OF 18-22.4% OF POPULATION IS OVER AGE 65-49.6% OF POPULATION IS FEMALE-0.7% OF POPULATION IS NON-HISPANIC AFRICAN AMERICAN-0.3% OF POPULATION IS AMERICAN INDIAN & ALASKAN NATIVE-0.5% OF POPULATION IS ASIAN-0.0% OF POPULATION IS NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER-8.0% OF POPULATION IS HISPANIC-90.0% OF POPULATION IS NON-HISPANIC WHITE-$46,825 MEDIAN HOUSEHOLD INCOME-2.3 UNEMPLOYMENT RATE-12.3% OF PERSONS LIVING IN POVERTY (125% OF FEDERAL POVERTY LEVEL)-19% OF CHILDREN LIVING IN POVERTY-93.8% HIGH SCHOOL GRADUATION RATE-17.3% OF INDIVIDUALS 25 YEARS OR OLDER HAVE A BACHELOR'S DEGREE OR HIGHER-6.2% ARE UNINSURED
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PART VI, LINE 5:
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THE ORGANIZATION'S HOSPITAL FACILITY(IES) PROMOTE HEALTH FOR THE BENEFIT OF THE COMMUNITY. MEDICAL STAFF PRIVILEGES IN THE HOSPITAL ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. THE ORGANIZATION'S HOSPITAL FACILITY(IES) HAVE AN OPEN MEDICAL STAFF. ITS BOARD OF TRUSTEES IS COMPOSED OF PROMINENT CITIZENS IN THE COMMUNITY. EXCESS FUNDS ARE GENERALLY APPLIED TO EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, AMORTIZATION OF INDEBTEDNESS, IMPROVEMENT IN PATIENT CARE, AND MEDICAL TRAINING, EDUCATION, AND RESEARCH. THE FACILITY(IES) TREAT PERSONS PAYING THEIR BILLS WITH THE AID OF PUBLIC PROGRAMS LIKE MEDICARE AND MEDICAID. ALL PATIENTS PRESENTING AT THE HOSPITAL FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE ARE TREATED REGARDLESS OF THEIR ABILITY TO PAY FOR SUCH TREATMENT.CHI HEALTH HAS A HISTORY OF CENTRALIZED COMMUNITY BENEFIT AND HOSPITAL SPECIFIC COMMUNITY BENEFIT INVESTMENTS TO ADDRESS COMMUNITY HEALTH NEEDS OF THE PARTICULAR SERVICE AREA. EXAMPLES OF HOW CHI HEALTH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY INCLUDE:FINANCIAL ASSISTANCE AND UNPAID COSTS OF MEDICAIDCOMMUNITY HEALTH IMPROVEMENT SERVICES- - COMMUNITY EDUCATION, CLASSES AND PROGRAMS (CPR/FIRST AID, COMMUNITY BEHAVIORAL HEALTH SUPPORT AND EDUCATION, DIABETES, CANCER, PHYSICAL ACTIVITY AND HEALTHY EATING AND COOKING) - SUPPORT GROUPS (CANCER, BEREAVEMENT, YOUTH, ETC.) - COMMUNITY HEALTH EDUCATION/PROMOTION AND SCREENINGS- SCHOOL BASED HEALTHCARE SERVICES- MENTAL HEALTH HOTLINE-STAFF AND OPERATE 717-HOPE MENTAL HEALTH HOTLINE FOR ANYONE IN THE COMMUNITY TO ACCESS. THIS PROGRAM AVERAGES OVER 5,000 PHONE CALLS PER MONTH FROM COMMUNITY MEMBERS IN NEED.- PARISH NURSING PROGRAM AND FAITH COMMUNITY HEALTH NETWORK-THE CHI HEALTH FAITH COMMUNITY HEALTH NETWORK PARTNERS WITH CONGREGATIONS OF ALL FAITHS TO BUILD CAPACITY AND SUPPORT THE GROWTH OF HEALTH MINISTRIES WHICH PROMOTE HEALTH, HEALING AND WHOLENESS IN THE COMMUNITIES SERVED.- 5-4-3-2-1GO!- HEALTHY LIFESTYLE CAMPAIGN FOR KIDS; OPERATED IN SCHOOLS, OUT OF SCHOOL SETTINGS, CLINICS, COMMUNITY SETTINGS IN DOUGLAS, SARPY, CASS, AND COLFAX COUNTIES IN NE. INITIAL WORK COMPLETED BY CHI HEALTH IN FY19 AND FOLLOWING CONTRACTOR DEPARTURE, WORK WAS TRANSITIONED THROUGH A GRANT TO LIVE WELL OMAHA FOR THE BROADER OMAHA COMMUNITY STRATEGY IN DOUGLAS COUNTY AS PART OF A 2-YEAR GRANT. - COUNSELING AND ASSISTANCE IN ENROLLING INDIVIDUALS IN MEANS TESTED INSURANCE PROGRAMS TO IMPROVE ACCESS TO CARE.- SUPPORT TO HEALTH COALITIONS AND INVESTMENTS IN SOCIAL AND ENVIRONMENTAL IMPROVEMENT STRATEGIES. THESE ARE PROGRAMS, ACTIVITIES AND PARTNERSHIPS THAT IMPROVE THE HEALTH OF PERSONS IN THE COMMUNITY BY ADDRESSING THE DETERMINANTS OF HEALTH, WHICH INCLUDES THE SOCIAL, ECONOMIC AND PHYSICAL ENVIRONMENT. SEE SPECIFIC EXAMPLES BY COMMUNITY BELOW:REGIONAL- NEBRASKA APPLESEED TYPICALLY PROVIDES FUNDS TO SUPPORT HUNGER/FOOD ACCESS EFFORTS; THIS INCLUDES SUMMER MEALS PROGRAM OUTREACH, ENRICHMENT PROGRAMMING AT SUMMER MEALS SITES AND SUPPORT TO LAUNCH STATE'S FIRST SNAP EMPLOYMENT & TRAINING (E&T) THIRD PARTY PARTNERSHIP, WHICH PROVIDES JOB TRAINING FOR SNAP RECIPIENTS. IN THIS RECENT YEAR NEBRASKA APPLESEED PROVIDED SNAP OUTREACH TO NEWLY ELIGIBLE INDIVIDUALS THAT WERE EXPERIENCING ECONOMIC HARDSHIP DUE TO COVID19.- FOOD BANK FOR THE HEARTLAND DONATED FUNDS TO HELP SUPPORT THE INCREASED NEED FOR EMERGENCY FOOD BROUGHT ON BY THE PANDEMIC- NEBRASKA EXTENSION-PROVIDED FUNDS TO SUPPORT DOUBLE UP FOOD BUCKS IN OMAHA AND LINCOLN; PROGRAM FOR SNAP RECIPIENTS TO RECEIVE AN ADDITIONAL $1 FOR EVERY $1 THEY SPEND (UP TO $20/DAY) ON FRUITS AND VEGETABLES AT PARTICIPATING SITES; NUTRITION/COOKING EDUCATION IS ALSO PROVIDED AT ALL SITES.CORNING- WELLNESS ACTIVITIES-GROUP EXERCISE CLASSES PROVIDED TO THE COMMUNITY IN CONJUNCTION WITH WELLNESS RELATED NEWSPAPER ARTICLES.- ADAMS/TAYLOR COUNTY FOOD PANTRY DONATED FUNDS TO PROVIDE FRESH FRUITS AND VEGETABLES FOR LOW INCOME FAMILIES IN NEED.HEALTH PROFESSIONAL EDUCATION-- ADMINISTRATION AND STUDENT ONBOARDING COSTS FOR NURSING PRECEPTORSHIPS AND CLINICALS- STAFF TIME FACILITATING THE SMALL-GROUP ETHICS CASE DISCUSSIONS WITH MEDICAL STUDENTS- CLINICAL PASTORAL EDUCATION- ACADEMIC AFFILIATION WITH CREIGHTON UNIVERSITY AND ITS HEALTH PROFESSIONS PROGRAMS, INCLUDING THE SCHOOL OF MEDICINE, COLLEGE OF ARTS & SCIENCES, SCHOOL OF DENTISTRY, SCHOOL OF PHARMACY AND HEALTH PROFESSIONS, COLLEGE OF NURSING.- PHYSICIAN RESIDENCY AND FELLOWSHIP PROGRAMS TRAIN MORE THAN 170 RESIDENTS AND FELLOWS ANNUALLY SUBSIDIZED HEALTH SERVICES - HEALTHCARE SERVICES INCLUDING EMERGENCY CARE AND CLINICAL CARE IN THE RURAL HEALTH SETTINGRESEARCH- - UNFUNDED STAFF SUPPORT OF THE NATIONAL CANCER INSTITUTE COMMUNITY ONCOLOGY RESEARCH PROGRAM (NCORP)- TRAUMA INFORMED CARE-THIS WAS AN IDENTIFIED NEED ON THE COMMUNITY HEALTH IMPROVEMENT PLAN. CHI HEALTH IS PARTNERING TO IMPLEMENT STAFF TRAINING FOR AWARENESS OF TRAUMA AND ITS IMPACT AND COMPLETING A RESEARCH STUDY ON THE EFFECTIVENESS OF THE TRAINING TO HELP BUILD PUBLIC TRAINING AND EDUCATION RESOURCES. FINANCIAL AND IN-KIND CONTRIBUTIONS-- TANZANIA HEALTH MINISTRY-CHI HEALTH IS A MINISTRY PARTNER WITH THE MACHAME LUTHERAN HOSPITAL IN TANZANIA WHICH PROVIDES FULL SERVICE HEALTH CARE IN A DESPERATELY IMPOVERISHED AREA OF THE COUNTRY INCLUDING A FULL SERVICE HOSPITAL, PHARMACY, HOSPICE OUTREACH, CLINICS, CLINICAL OFFICER SCHOOL, AND THE RECENTLY ESTABLISHED SCHOOL OF NURSING. - STAFF SERVICE ON HEALTH RELATED BOARD AND COALITIONS- PARTICIPATION IN AND FUNDING OF MATERNAL HEALTH, SUBSTANCE ABUSE, FOOD ACCESS, VIOLENCE PREVENTION, CANCER AND OTHER COMMUNITY HEALTH COALITIONS.- IN-KIND STAFF TIME ORGANIZING THE DONATION OF ITEMS TO VARIOUS NON-PROFIT GROUPS AND VOLUNTEERING TIME AT FOOD BANK OF THE HEARTLAND- IN-KIND DONATIONS OF SPACE, FOOD AND STAFF TIME PROVIDING STRATEGIC PLANNING, FACILITATION AND CONSULTING SERVICES FOR NOT-FOR-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS- IN-KIND DONATIONS (STAFF TIME, SPACE, ETC.) SUPPORTING GRANTS FOR BEHAVIORAL HEALTH, VIOLENCE PREVENTION, AND COMMUNITY LINK.
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THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF MORE THAN 1,500 CARE SITES, CONSISTING OF 140 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2021, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.5 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.1 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.25 BILLION IN FISCAL YEAR 2021, HAS TOTAL ASSETS OF APPROXIMATELY $54.87 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY.
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