4A (Expenses $ 6424440 including grants of $ 0) (Revenue $ 7524425)
THE HOSPITAL'S PRIMARY PROGRAM IS THE DELIVERY OF HEALTHCARE AND RELATED SERVICES TO RESIDENTS OF OTTAWA COUNTY, KANSAS. PRIMARY SERVICES INCLUDE INPATIENT CARE (ACUTE AND SWING-BED); OUTPATIENT AND ANCILLARY SERVICES (ER, OBSERVATION, LAB, RADIOLOGY, REHABILITATION THERAPIES, ETC.); INTERMEDIATE SWING-BEDS AND LONG-TERM CARE, AND A COMMUNITY WELLNESS/FITNESS CENTER. SEE SCHEDULE O FOR CONTINUATION.

SCHEDULE H, PART V, LINE 5
THE ASSESSMENT PROCESS WAS INITIATED AND CHAIRED JOINTLY BY OTTAWA COUNTY HEALTH CENTER, OTTAWA COUNTY HEALTH DEPARTMENT, OTTAWA COUNTY HEALTH PLANNING COMMISSION AND OTTAWA COUNTY ECONOMIC DEVELOPMENT. A BROAD-BASED GROUP OF COMMUNITY LEADERS AND COUNTY RESIDENTS WERE INVITED TO PARTICIPATE.

SCHEDULE H, PART V, LINE 6B
OTTAWA COUNTY HEALTH DEPARTMENT, OTTAWA COUNTY HEALTH PLANNING COMMISSION AND OTTAWA COUNTY ECONOMIC DEVELOPMENT

SCHEDULE H, PART V, LINE 7A
HTTP://WWW.OTTAWACOUNTYHEALTHCENTER.COM

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HTTP://WWW.OTTAWACOUNTYHEALTHCENTER.COM

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2022 CHNA PRIORITIES: The below priorities and goals were established following our September 2022 Community Health Needs Assessment. OCHC will take steps and create initiatives to address these priorities over the next three years, 2022-2025. PRIORITY 1: OBESITY/PHYSICAL INACTIVITY/LACK OF HEALTHY BEHAVIORS Goal 1: Improve Access to/Increase interest in the Wellness Center Goal 2: Community Health Education PRIORITY 2: LACK OF AWARENESS REGARDING AVAILABLE HEALTH SERVICE IN THE COMMUNITY Goal 1: Promote Ottawa County Health Center's Services Offered Goal 2: Provide Educational Opportunities to Surrounding Area Residents THE HOSPITAL WILL WORK WITH COMMUNITY PARTNERS AND/OR HEALTH ISSUE EXPERTS ON THE FOLLOWING FOR EACH OF THE APPROACHES TO ADDRESSING THE IDENTIFIED HEALTH NEEDS: DEVELOP WORK PLANS TO SUPPORT EFFECTIVE IMPLEMENTATION, CREATE MECHANISMS TO MONITOR AND MEASURE OUTCOMES. AND PROVIDE ON-GOING STATUS AND RESULTS OF THESE EFFORTS TO IMPROVE COMMUNITY HEALTH. WHILE SOME OF THE NEEDS WERE COMBINED IN IDENTIFYING THE ABOVE PRIORITIES, OTHER NEEDS WERE NOT ADDRESSED DUE TO A LACK OF FINANCIAL AND OTHER RESOURCES.

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HTTP://WWW.OTTAWACOUNTYHEALTHCENTER.COM/PATIENT-INFORMATION.HTML

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THE ORGANIZATION USED THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS.

SCHEDULE H, PART I, LINE 7, COLUMN F
NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS.

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THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO.

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HOSPITAL CHARGES THAT ARE NOT COLLECTED AND ARE NOT APPROVED FOR FINANCIAL ASSISTANCE ARE CLASSIFIED AS BAD DEBTS FROM PATIENTS WHO WILL NOT PAY.

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THE COSTING METHODOLOGY IS BASED ON THE ORGANIZATION'S MEDICARE COST-TO-CHARGE RATIO. WHILE WE RECOGNIZE THAT THERE WOULD BE SOME BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, WE HAVE NO REASONABLE BASIS FOR ESTIMATING THIS FIGURE. IF ELIGIBILITY IS KNOWN, THE AMOUNT WOULD FALL UNDER CHARITY CARE AND NOT BAD DEBT.

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NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTS WITH CUSTOMERS.

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THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT ON LINE 6 IS A COST TO CHARGE RATIO.

SCHEDULE H, PART III, LINE 9B
ALL CHARITY CARE CHARGES NOT TO BE COLLECTED DUE TO FINANCIAL ASSISTANCE COMPUTATIONS ARE EXEMPT FROM COLLECTION POLICIES AND PRACTICES. THESE ACCOUNTS ARE REMOVED FROM THE COLLECTION CYCLE.

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THE HOSPITAL HAS SEVERAL AVENUES TO ASSESS THE NEEDS OF THE COMMUNITY: (1) THE COUNTY COMMISSIONERS APPOINT A 5-PERSON GOVERNING BOARD, THE OTTAWA COUNTY HEALTH CENTER BOARD OF TRUSTEES, MADE UP OF LOCAL COUNTY RESIDENTS. THESE BOARD MEMBERS, WHO RESIDE IN VARIOUS AREAS OF THE COUNTY, ARE A VITAL LINK IN COMMUNICATION TO THE COMMUNITY. (2) THE OTTAWA COUNTY HEALTH CENTER BOARD OF TRUSTEES OWNS THE LOCAL PHYSICIAN'S CLINIC BUILDING TO ENSURE THAT HEALTHCARE PROVIDERS HAVE THE SPACE AND OFFICES FROM WHICH TO BASE THEIR PRACTICES AND PROVIDE NECESSARY SERVICES TO THE COMMUNITY. (3) THE HOSPITAL WORKS CLOSELY AND PARTNERS WITH THE COUNTY PUBLIC HEALTH DEPARTMENT TO IDENTIFY PATIENTS WHO REQUIRE SPECIALIZED OR ADDITIONAL CARE AND TO COORDINATE PROGRAMS TO IMPROVE OVERALL COUNTY HEALTH. (4) THE HOSPITAL CONDUCTED A FORMAL NEEDS ANALYSIS IN 2013, 2016, 2019, AND MOST RECENTLY IN SEPTEMBER 2022. THE FINDINGS HAVE BEEN MUCH THE SAME IN EACH ASSESSMENT. BELOW IS INFORMATION ON THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND HOW THE HOSPITAL HAS ADDRESSED THE KEY FINDINGS OVER THE PAST YEAR. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES ARE ALSO NOTED. THESE PRIORITIES WILL BE ADDRESSED IN 2023-2025. OTTAWA COUNTY HEALTH CENTER WORKED WITH FORVIS TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT OF OTTAWA COUNTY. THE ASSESSMENT NOT ONLY MET THE NEW IRS REQUIREMENTS, BUT IT ALSO IDENTIFIED OPPORTUNITIES FOR IMPROVEMENT OF HEALTH AND WELLNESS AND SUPPORTED OTTAWA COUNTY'S STRATEGIC PRIORITY OF LOCALIZING HEALTH CARE FOR THE COMMUNITY. FORVIS RESEARCHED AND ANALYZED COMMUNITY HEALTH DATA, CONDUCTED SURVEYS OF LOCAL KEY STAKEHOLDERS TO DETERMINE RELEVANT ISSUES, AND PROPOSED NECESSARY ACTION PLANS AND IMPLEMENTATION STRATEGIES TO ADDRESS THESE ISSUES. WITH THESE FINDINGS, OTTAWA COUNTY HEALTH CENTER IDENTIFIED TWO GENERAL HEALTH PRIORITIES ON WHICH TO FOCUS AS STRATEGIC INITIATIVES IN OTTAWA COUNTY. THE IMPLEMENTATION STRATEGY IS LISTED BELOW WITH THE GOALS AND STRATEGIES TO ADDRESS EACH INITIATIVE OVER THE NEXT THREE YEARS. 2019 CHNA PRIORITIES: PRIORITY 1: OBESITY/UNHEALTHY EATING/PHYSICAL INACTIVITY GOAL 1: ENCOURAGE USAGE OF AND INTEREST IN THE LOCAL WELLNESS CENTER GOAL 2: SPONSOR ANNUAL 5K RUN TO SUPPORT HEART HEALTH AND WELLNESS GOAL 3: SUPPORT HEALTHY EATING IN THE COMMUNITY PRIORITY 2: INFORMATION ON/ACCESS TO LOCAL MEDICAL SERVICES GOAL 1: PROVIDE GENERAL HEALTH EDUCATION TO THE COMMUNITY GOAL 2: SUPPORT COMMUNITY INITIATIVES RELATED TO HEALTH INFORMATION AND EDUCATION TO ADDRESS THESE GOALS, OTTAWA COUNTY HEALTH CENTER IMPLEMENTED THE IDENTIFIED STRATEGIES AS FOLLOWS: - OCHC recently completed a significant renovation to the Wellness Center, a fitness center and lap pool available to the community. The renovation addressed safety issues, functionality improvements, and general cosmetic updates. The renovation was well received by the community, and we have seen drastic increases in facility usage and membership. The Wellness Center Director is offering additional classes and weight room instruction to help encourage community members to continue an active lifestyle. Members have numerous opportunities to participate in these free group exercise classes and services that include: HIIT class, Water HIIT, water aerobics, group exercises; Beachbody; Blood Pressure and Heart Rate Assessments, etc. In addition, we now offer discounted rates to high school students to help encourage fitness and activity to those individuals. Membership rates are reviewed annually, and the facility is available to the community at reasonable monthly rates. The Wellness Center requires significant funding by the hospital beyond membership dues that are collected. The overall health improvement from having a fitness center available in our small community is a great benefit to area residents. While the Wellness Center does not generate income for Ottawa County Health Center, we recognize its importance and benefit to the community to promote healthier living to county residents. - To help promote wellness in our community and increase the options for physical activity, the hospital sponsored a 5k run/walk in conjunction with our annual county fair. Our plan is to continue this event in coming years and encourage the community to participate to support a healthy lifestyle. - The hospital supports the local Food Pantry as they utilize the hospital as pick-up location/meeting area for local residents needing assistance. In addition, OCHC donated funds to the local Summer Caf initiative that provides healthy meals to local children throughout the summer to ensure they have balanced meals while not in school. - Local healthcare services provided by Ottawa County Health Center are regularly advertised in the county newspaper along with informational articles related to new services. Additionally, the hospital assists local support and educational groups by offering hospital conference rooms to hold meetings for community members. OCHC is looking to expand and improve educational materials regarding available healthcare services. - Ottawa County Health Center leadership maintains regular communication/meetings with local physicians to assess community needs, patient or service issues, and ER coverage needs. We will continue outreach clinics and look for other opportunities to allow our community members to have services available locally so that they don't have to travel outside of the county. - Ottawa County Health Center's Charity Care program continues to be offered to those who qualify. In FY2022, the hospital provided approximately $8,000 in Charity Care and community benefit to area residents. Additionally, the hospital's Social Worker and Patient Financial Coordinator work closely with patients and their families to assist with insurance questions, Medicaid applications, etc. at no cost. Last year, we provided information on Medicare Advantage Plans to the local newspaper and presented to senior centers - Ottawa County Health Center Office Staff, with guidance from Great Plains Health Alliance, reviews hospital charges on at least an annual basis to ensure that charges and fees are accurate, justifiable, and appropriate. Based on these reviews, fees will be revised as needed in an effort to provide quality medical services at reasonable costs to our community. OCHC has compiled a list of all hospital charges for any item or service provided at the hospital; this information has been posted on the hospital website to allow our patrons the opportunity to review potential charges and understand the application of their specific insurance prior to their service. In addition to the Community Health Needs Assessment initiatives, Ottawa County Health Center continues to promote the local fitness center (Wellness Center) through advertising and programs to improve community health. Wellness and fitness tips/information are also posted around the hospital and Wellness Center for hospital staff and community members' education. The hospital has also taken steps to help improve the overall awareness of the local health care services and add new services based on community need. The goal is to ensure that community members know those services that can be offered closer to home. The hospital advertises in the local newspaper whose readership closely matches are primary patient demographic. A listing of services and contact information has been posted in the newspaper frequently. When new hospital services and/or personnel are added, this is an opportunity for the hospital to market those services with articles and information in the newspaper. Participation in local health fairs and senior center presentations has also been a positive way to educate the community on local healthcare services. In addition to the Community Benefit items, the hospital also offers staff assistance to the local ambulance service. When necessary, hospital nurses ride in the ambulance to assist local EMS personnel in transporting patients requiring higher a higher level of care. 2022 CHNA PRIORITIES: The below priorities and goals were established following our September 2022 Community Health Needs Assessment. OCHC will take steps and create initiatives to address these priorities over the next three years, 2022-2025. PRIORITY 1: OBESITY/PHYSICAL INACTIVITY/LACK OF HEALTHY BEHAVIORS Goal 1: Improve Access to/Increase interest in the Wellness Center Goal 2: Community Health Education PRIORITY 2: LACK OF AWARENESS REGARDING AVAILABLE HEALTH SERVICE IN THE COMMUNITY Goal 1: Promote Ottawa County Health Center's Services Offered Goal 2: Provide Educational Opportunities to Surrounding Area Residents

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The Hospital's Patient Financial Coordinator and/or CFO consults with all patients to see if they qualify for the Hospital's financial assistance policy. The Hospital has billing/collection brochures outlining the financial assistance policy that are provided to the public. This brochure is given to all patients upon admission and is also available in Hospital waiting rooms and the Emergency Room. The hospital's Social Worker will also discuss the potential for assistance from Medicaid, if that option is available. Notices of the availability of financial assistance are also included in billing mailings to all patients owing deductibles or coinsurance on their Hospital bills. An 800 bi-lingual telephone service is utilized for those patients that do not speak English. The Hospital's website also references the availability of financial assistance. The Patient Financial Coordinator provides and helps the patients with the financial assistance paperwork as the patients are required to provide bank statements, tax returns, etc.to verify income. Computations based on current Federal Poverty Level Guidelines are completed to see if qualifications are appropriate and the percentage of charges to be written off is determined, based on family size and household income. All instances of financial assistance are approved by upper management of the Hospital. Alternatively, the Social Worker will also work with the patient to file the appropriate forms with Medicaid if the patient qualifies. From 10-1-2021 to 9-30-22, the Hospital provided $7,868.13 in Financial Assistance (Charity Care) and other community benefits.

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The Hospital, located in Minneapolis, Kansas, has a population of approximately 1,950, and primarily serves the residents of Ottawa County. The total population of the County is approximately 5,800 people, which equates to a population density of 8.0 people per square mile - an obviously rural county. Ottawa County is divided into twenty townships. There are 2,686 occupied households with an average size of 2.41 persons residing in Ottawa County. The racial makeup of the County is 95.9% White, 1.4% African American, .6% Native American, 0.4% Asian, 3.2% Hispanic or Latino, and 1.6% Multiracial. The population spread of Ottawa County is 28.3% under the age of 18, 51.1% from age 18 to 65, and 20.6% at or over the age of 65. The median annual income for a household in Ottawa County is $57,455. Approximately 10.7% of the people living in Ottawa County were below the poverty line. The County has a history of stable population. Although the Hospital primarily serves residents of Ottawa County, the Hospital does see some patients from the neighboring counties. The Hospital patient mix is heavily weighted towards Medicare beneficiaries, especially for acute inpatient and swing-bed utilization.

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The Hospital utilizes individual Hospital services and partnerships with other local organizations to promote the health of citizens of Ottawa County. (1) The Hospital partners with the Ottawa County Public Health to offer health fairs for community members. Additionally, the hospital provides space to house the local health department at no cost. (2) The Hospital partners with local health agencies to educate high school seniors prior to graduation on texting while driving, sun damage, and the importance of staying active. (3) The Hospital physical and occupational therapists conduct in-home safety assessments for County residents to prevent trips and falls. (4) The Hospital maintains biohazard equipment that can be used in the case of toxic spills or biohazard events in the County. The equipment would include isolation rooms and decontamination showers. Equipment for airborne pathogens is also available. (5) The Hospital annually participates with Emergency Preparedness Trainings with local police and firefighting units from within the County to prepare for any future emergency situations. (6) The Hospital operates a wellness center catering to single, family, and corporate members. It is the only fitness facility in Minneapolis. (7) The Hospital promotes a healthy lifestyle, educates on heart disease through organizations and sponsorship of a 5K run/walk. (8) The Hospital has open board meetings that allow community members to offer ideas, suggestions, and input on community health needs. (9) The Hospital board authorizes the use of donated monies or surplus funds to specific health initiatives (room remodels, new equipment, etc.). Please note that while some of these initiatives were changed or eliminated in 2020 due to COVID-19, we intend to resume all health promotional activities when we can safely do so.

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THE HOSPITAL PARTICIPATES IN HEALTHCARE PROGRAMS FOR MEDICARE AND MEDICAID AMONG OTHERS. THE HOSPITAL HAS RECEIVED DESIGNATION FROM THE MEDICARE PROGRAM AS A CRITICAL ACCESS HOSPITAL AND IS THE ONLY HOSPITAL IN THE OTTAWA COUNTY. SALINA REGIONAL HOSPITAL IS THE TERTIARY HOSPITAL THAT PARTNERS WITH THE HOSPITAL IN THE CRITICAL ACCESS PROGRAM. THE HOSPITAL'S SERVICES ARE VITAL TO THE HEALTH OF OTTAWA COUNTY RESIDENTS. EDUCATIONAL SESSIONS PROMOTED BY THE HOSPITAL PROVIDE RESIDENTS OF THE COUNTY WITH VITAL TRAINING ON HOW TO MINIMIZE THEIR AFFLICTIONS AND MAXIMIZE THEIR QUALITY OF LIFE. SUCH TRAINING WOULD INCLUDE DIABETIC TRAINING CLASSES FOCUSING ON DIET TO CONTROL SYMPTOMS, SMOKING CESSATION CLASSES, HEART-HEALTH CLASSES AND CPR/ACLS TRAINING. THE HOSPITAL ALSO WORKS CLOSELY WITH THE COUNTY DEPARTMENT OF MENTAL HEALTH TO REFER RESIDENTS TO AN APPROPRIATE MENTAL HEALTH PROFESSIONAL. THE HOSPITAL MAKES AN ANNUAL PRESENTATION TO THE OTTAWA COUNTY BOARD OF COMMISSIONERS ON THE STATUS OF THE HOSPITALS, AND THE SERVICES IT PROVIDES TO THE RESIDENTS OF THE COUNTY. THE HOSPITAL ADMINISTRATOR ALSO ATTENDS MEETINGS OF THE COUNTY COMMISSIONERS, IF NECESSARY OR REQUESTED, TO DISCUSS NEW PROJECTS, BUDGETS, ETC. THE HOSPITAL IS AFFILIATED WITH GREAT PLAINS HEALTH ALLIANCE, INC. (GPHA), A NON-PROFIT 501C3 ORGANIZATION WHICH PROVIDES MANAGEMENT SERVICES AND OPERATIONAL, FINANCE AND ACCOUNTING SUPPORT TO THE HOSPITAL. GPHA DOES NOT PROVIDE SERVICES DIRECTLY TO PATIENTS, BUT IT DOES PROVIDE ACCESS TO PROFESSIONALS THAT MAY NOT BE AFFORDABLE TO THE NORMAL CRITICAL ACCESS HOSPITAL. GPHA PROVIDES EDUCATION AND ASSISTANCE IN AREAS SUCH AS HIPAA, MEDICARE REIMBURSEMENT, MEANINGFUL USE REQUIREMENTS FOR COMPUTER SYSTEMS, ETC. GPHA IS AN AFFILIATION OF CRITICAL ACCESS HOSPITALS IN KANSAS AND NEBRASKA THAT PROVIDES NETWORKING OPPORTUNITIES WITH OTHER RURAL HOSPITALS, COMMUNITIES AND LEADERS. GPHA PROVIDES POLICIES AND GUIDANCE TO ITS CRITICAL ACCESS FACILITIES REGARDING FINANCIAL ASSISTANCE, CONFLICTS OF INTEREST, CORPORATE COMPLIANCE AND MANY OTHER AREAS. GPHA ALSO PROVIDES EDUCATIONAL SESSIONS FOR BOARD MEMBERS, BUSINESS OFFICE MANAGERS, BILLERS, DIRECTOR OF NURSING, MEDICAL RECORDS PERSONNEL AND ADMINISTRATORS. GPHA IS A VITAL LINK IN ALLOWING HOSPITALS TO OPERATE AT A HIGH QUALITY WITHIN THE CASH CONSTRAINTS IMPOSED BY THE CRITICAL ACCESS PROGRAM.