4A (Expenses $ 79269032 including grants of $ 0) (Revenue $ 105056409)
MERCY HOSPITAL ROGERS PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY BY OFFERING ESSENTIAL HEALTH SERVICES TO ITS COMMUNITY. IN ACTIVE PURSUIT OF THIS MISSION, MERCY HOSPITAL ROGERS PROVIDES A WIDE VARIETY OF SERVICES IN THEIR 194 BED FACILITY AND IN FY22, HAD 240,919 TOTAL CASES. MERCY HOSPITAL ROGERS OFFERS COMPREHENSIVE HEART AND VASCULAR SERVICES, A WIDE VARIETY OF TREATMENT OPTIONS AND ADVANCED TECHNOLOGIES TO DIAGNOSE AND TREAT A FULL RANGE OF CONDITIONS. MERCY HOSPITAL ROGERS ALSO PROVIDES A FULL COMPLEMENT OF CARDIAC REHABILITATION, THERAPY AND EDUCATION SERVICES. IN FY22, MERCY HOSPITAL ROGERS HAD 22,615 CASES AND 6,796 PATIENT DAYS FOR THIS SERVICE LINE.

4B (Expenses $ 46232332 including grants of $ 0) (Revenue $ 61272387)
MERCY HOSPITAL ROGERS HAS A GASTROENTEROLOGY TEAM EXPERIENCED IN DIAGNOSING AND TREATING ALL TYPES OF ILLNESSES AFFECTING THE GASTROINTESTINAL TRACT. MERCY'S TEAM CAN ALLEVIATE YOUR SYMPTOMS AND REDUCE OR ELIMINATE DISCOMFORT NO MATTER WHERE IT MAY APPEAR IN YOUR DIGESTIVE SYSTEM, FROM YOUR ESOPHAGUS AND STOMACH TO YOUR SMALL AND LARGE INTESTINES, AS WELL AS THE LIVER, GALLBLADDER AND PANCREAS. IN FY22, MERCY HOSPITAL ROGERS HAD 13,401 CASES AND 7,383 PATIENT DAYS FOR THIS SERVICE LINE.

4C (Expenses $ 28195931 including grants of $ 0) (Revenue $ 37368481)
MERCY HOSPITAL ROGERS HAS A TEAM OF EXPERT DOCTORS, NURSES AND TECHNICIANS THAT BLEND COMPASSIONATE CARE WITH THE LATEST, MOST ADVANCED DIAGNOSTIC AND TREATMENT RESOURCES IN PROVIDING EMERGENCY CARE. MERCY HOSPITAL ROGERS' EMERGENCY DEPARTMENT IS READY 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR WITH FAST, EXPERIENCED AND PROFESSIONAL CARE. IN FY22, MERCY HOSPITAL ROGERS HAD 53,115 CASES FOR THIS SERVICE LINE.

4D (Expenses $ 142764962 including grants of $ 2075103) (Revenue $ 187327552)
IN ADDITION TO THE PROGRAM SERVICES DESCRIBED ABOVE, MERCY HOSPITAL ROGERS ALSO SERVES PATIENTS IN ADDITIONAL SERVICE LINES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING AREAS: LAB; NEUROSCIENCE; PULMONARY; RADIOLOGY; REHABILITATION.

Schedule H, Part V, Section B, Line 3E
THE HOSPITAL FACILITY DID INCLUDE A PRIORITIZED LIST OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IN ITS MOST RECENT CHNA REPORT.

Schedule H, Part V, Section B, Line 3 Facility , 1
Facility , 1 - MERCY HOSPITAL ROGERS. THE CHNA HAS ALL THE SECTIONS REFERENCED ABOVE AND INCLUDES AN EXECUTIVE SUMMARY, POTENTIALLY AVAILABLE RESOURCES, EVALUATION OF IMPACT, REFERENCES, AND APPENDICES.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - MERCY HOSPITAL ROGERS. IN CONDUCTING ITS COMMUNITY HEALTH NEEDS ASSESSMENT, MERCY NWA COLLECTED AND ANALYZED A SIGNIFICANT QUANTITY OF PRIMARY AND SECONDARY DATA. PRIMARY DATA WAS COLLECTED, AND COMMUNITY INPUT WAS SOLICITED, BY MEANS OF THE 2021 NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY, WHICH WAS LED BY MERCY. SECONDARY DATA WAS COLLECTED AND ANALYZED FROM PUBLICLY AVAILABLE DATA RESOURCES, LISTED BELOW, AND FROM INTERNAL MERCY DATA. NWA INDICATORS WERE COMPARED TO THOSE OF ARKANSAS AND THE UNITED STATES. THE COMMUNITY HEALTH COMMITTEE OF MERCY NWA BOARD OF DIRECTORS GUIDED THE CHNA PROCESS. THE COMMUNITY HEALTH COMMITTEE IS ACCOUNTABLE FOR OVERSEEING COMMUNITY HEALTH AND BENEFIT ACTIVITIES AND ENSURING THESE ACTIVITIES MEET MISSION, COMPLIANCE, AND IRS GUIDELINES. THE COMMITTEE MEETS QUARTERLY AND INCLUDES MEMBERS REPRESENTING NON-PROFIT, GOVERNMENT, ACADEMIC, PUBLIC HEALTH AND BUSINESS SECTORS WITHIN THE COMMUNITY. THE THOUGHTS AND OPINIONS OF PEOPLE WITHIN MERCY'S SERVICE AREA OF NORTHWEST ARKANSAS WERE CENTRAL TO THE HEALTH NEEDS ASSESSMENT PROCESS. INPUT FROM PEOPLE REPRESENTING BROAD INTERESTS OF THE COMMUNITY WAS SOLICITED THROUGH A ROBUST SURVEY PROCESS GUIDED BY A MERCY-LED COMMUNITY COALITION AND BY SEEKING INPUT FROM THE COMMUNITY HEALTH COMMITTEE OF THE BOARD AND THE BENTON COUNTY HEALTH DEPARTMENT. NORTHWEST ARKANSAS IS HOME TO HISPANIC AND MARSHALLESE MINORITY POPULATIONS THAT INCLUDE MEMBERS WHO ARE LOW-INCOME, MEDICALLY UNDERSERVED, AND EXPERIENCE SIGNIFICANT HEALTH DISPARITIES. INPUT FROM THESE GROUPS WAS SOUGHT BY INTENTIONALLY SEEKING OUT THEIR PARTICIPATION IN THE SURVEY AND BY SOLICITING INPUT FROM ORGANIZATIONS REPRESENTING THESE GROUPS. THE FOLLOWING GROUPS TOOK PART IN SOME PHASE OF THE WORK THAT GENERATED NORTHWEST ARKANSAS COMMUNITY HEALTH NEEDS ASSESSMENT: (THE NORTHWEST ARKANSAS COMMUNITY CONSISTS OF: BENTON COUNTY, AR; CARROLL COUNTY, AR; MADISON COUNTY, AR; AND WASHINGTON COUNTY, AR.) -MERCY COWORKERS WHO SERVED ON TEAMS AND DEVELOPED PROGRAMS TO RESPOND TO IDENTIFIED NEEDS. - ARKANSAS CHILDREN'S NORTHWEST, ARKANSAS DEPARTMENT OF HEALTH, BENTON, MADISON, AND WASHINGTON COUNTY HEALTH UNITS, COMMUNITY CLINIC NORTHWEST ARKANSAS, HARK AT THE EXCELLERATE FOUNDATION, MARSHALLESE CONSULATE AND COVID-19 TASK FORCE, NWA COUNCIL HEALTH CARE TRANSFORMATION DIVISION, OZARK GUIDANCE CENTER, UNIVERSITY OF ARKANSAS, UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES, VA MEDICAL CENTER, WASHINGTON REGIONAL MEDICAL CENTER, AND WHOLE HEALTH INSTITUTE. MERCY CONVENED A COMMUNITY COALITION OF 17 NORTHWEST ARKANSAS HEALTH CARE AND SOCIAL SERVICE ORGANIZATIONS TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH SURVEY IN 2021. THE SURVEY WAS DEVELOPED TO BUILD ON THE 2018 NWA COMMUNITY HEALTH SURVEY AND TO INCORPORATE INPUT AND SPECIFIC NEEDS OF THE COALITION PARTNERS. THE FINAL SURVEY WAS MADE UP OF 30 QUESTIONS FOCUSED ON HEALTH ISSUES AND NEEDS MOST IMPORTANT TO THE RESPONDENTS, WELLNESS, MENTAL HEALTH, BARRIERS TO CARE, COVID-19 VACCINATION, CHILDHOOD IMMUNIZATIONS, AND THE NWA COVID-19 RESPONSE. THE SURVEY WAS TRANSLATED INTO SPANISH AND MARSHALLESE BY CERTIFIED MEDICAL INTERPRETERS. THE NORTHWEST ARKANSAS COUNCIL HOSTED THE SURVEY ON THEIR WEBSITE FROM JULY TO SEPTEMBER 2021 IN THE THREE LANGUAGES. THE NWA COUNCIL PROMOTED THE SURVEY ON SOCIAL MEDIA, AND EACH PARTNER ORGANIZATION DISTRIBUTED THE SURVEY ELECTRONICALLY TO THEIR CO-WORKERS, PATIENTS, CLIENTS, AND COMMUNITY MEMBERS BY EMAIL AND THROUGH SOCIAL MEDIA. FLYERS AND BUSINESS CARDS WITH QR CODES FOR THE SURVEY IN EACH LANGUAGE WERE PRODUCED AND DISTRIBUTED BY COALITION PARTNERS IN THE COMMUNITY AND AT COMMUNITY EVENTS. SURVEYS WERE ALSO MADE AVAILABLE IN PAPER FORMAT FOR PARTICIPANTS WHO PREFERRED TO COMPLETE IT MANUALLY OR DID NOT HAVE COMPUTER ACCESS. INTENTIONAL EFFORTS WERE MADE TO INCLUDE AND OVERSAMPLE HISPANIC AND MARSHALLESE COMMUNITY MEMBERS BY ATTENDING COMMUNITY EVENTS, REACHING PARTICIPANTS AT WORKPLACES, USING CULTURALLY SPECIFIC SOCIAL MEDIA OUTLETS, AND UTILIZING HISPANIC AND MARSHALLESE COMMUNITY HEALTH WORKERS. 2,231 RESPONSES WERE INCLUDED IN THE FINAL ANALYTIC SAMPLE. 53% OF RESPONDENTS WERE FROM BENTON COUNTY, 39% FROM WASHINGTON COUNTY, 5% FROM CARROLL COUNTY, AND 3% FROM MADISON COUNTY. 1,647 (74%) OF RESPONDENTS WERE WHITE, 194 (9%) WERE HISPANIC, 123 (6%) WERE MARSHALLESE OR OTHER PACIFIC ISLANDER. AMERICAN INDIAN/ALASKA NATIVE, BLACK/AFRICAN AMERICAN, ASIAN, AND OTHER RACES MADE UP THE REMAINDER OF RESPONDENTS. OF THE 2,231 SURVEY RESPONDENTS FROM THE REGION, ALL INDICATED THEY LIVED IN ONE OF THE FOUR COUNTIES IN THE NORTHWEST ARKANSAS COMMUNITY. RESPONDENTS WERE ASKED TO RANK PERCEIVED COMMUNITY NEEDS, AND THE TOP 8 THAT EMERGED WERE: 1. ACCESS TO AFFORDABLE HEALTH CARE 2. AFFORDABLE HOUSING 3. MENTAL OR BEHAVIORAL HEALTH 4. COVID-19 5. DIABETES 6. FOOD INSECURITY 7. HEART DISEASE 8. OBESITY AND OVERWEIGHT

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - MERCY HOSPITAL ROGERS. THE CHNA WAS NOT CONDUCTED WITH ANOTHER HOSPITAL FACILITY. MERCY HOSPITAL ROGERS PARTICIPATED IN THE NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY PORTION OF THE CHNA.

Schedule H, Part V, Section B, Line 6b Facility , 1
Facility , 1 - MERCY HOSPITAL ROGERS. THE CHNA ITSELF WAS NOT CONDUCTED WITH ANOTHER ORGANIZATION. THE OTHER ORGANIZATIONS WHO PARTICIPATED IN THE NORTHWEST ARKANSAS COMMUNITY HEALTH SURVEY WERE: ARKANSAS COALITION OF MARSHALLESE, ARKANSAS DEPARTMENT OF HEALTH, BENTON, MADISON, AND WASHINGTON COUNTY HEALTH UNITS, COMMUNITY CLINIC NORTHWEST ARKANSAS, HARK AT THE EXCELLERATE FOUNDATION, MARSHALLESE CONSULATE AND COVID-19 TASK FORCE, , NWA COUNCIL HEALTH CARE TRANSFORMATION DIVISION, OZARK GUIDANCE CENTER, UNIVERSITY OF ARKANSAS, UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES NORTHWEST, AND WHOLE HEALTH INSTITUTE.

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - MERCY HOSPITAL ROGERS. IN CONJUNCTION WITH THE CHNA, THE MERCY HOSPITAL ROGERS'S BOARD ADOPTED AN IMPLEMENTATION STRATEGY IN FY22 RELATED TO THE 2021 CHNA. MERCY HOSPITAL ROGERS IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY FOCUSING PROGRAMMING, SERVICES AND EDUCATION OR AWARENESS AROUND: (1) ACCESS TO CARE (2) BEHAVIORAL HEALTH (3) DIABETES/OBESITY/NUTRITION (4) FOOD INSECURITY 1. ACCESS TO CARE FOR AT-RISK PERSONS. A COMMUNITY HEALTH WORKER PROGRAM HAS BEEN OPERATIONAL FOR OVER 3 YEARS. OUR CHWS PROVIDED RESOURCES AND ASSISTANCE TO 861 PATIENTS AND COMMUNITY MEMBERS, INCLUDING FINANCIAL ASSISTANCE, INSURANCE AND COMMUNITY RESOURCES. MERCY IS IN ITS SEVENTH YEAR OF OFFERING AN INTERNAL MEDICINE RESIDENCY PROGRAM IN PARTNERSHIP WITH UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES TO INCREASE THE NUMBER OF PRACTICING PRIMARY CARE PHYSICIANS IN THE AREA. THE PROGRAM CURRENTLY HAS 34 RESIDENTS ENROLLED. A PARTNERSHIP WITH THREE CHILDREN'S ADVOCACY CENTERS PROVIDES COORDINATION, COLLABORATION AND OVERSIGHT OF SEXUAL ASSAULT NURSE EXAMINERS PERFORMING FORENSIC EXAMINATIONS TO VICTIMS OF ABUSE. THE SANE COORDINATOR OVERSAW A TOTAL OF 353 MEDICAL EXAMS PERFORMED BY SANE NURSES AT FOUR COMMUNITY LOCATIONS. A NEW MEDICATION ASSISTANCE PARTNERSHIP WITH A LOCAL PHARMACY BEGAN IN NOVEMBER 2021 AND HAS ASSISTED 16 PATIENTS WITH 56 PRESCRIPTIONS. 2. BEHAVIORAL HEALTH. INTERNSHIP PROGRAM WHICH PREVIOUSLY PROVIDED CHARITABLE THERAPY SERVICES TO UNINSURED AND UNDERINSURED CLIENTS BY INTERNS CLOSED AT THE END OF TAX YEAR 2020. MERCY CONTINUES TO OFFER FINANCIAL ASSISTANCE TO ALL PATIENTS IN NEED OF SERVICES WHO MEET FINANCIAL ASSISTANCE GUIDELINES. 3. DIABETES. MERCY HAS MAINTAINED A CDC FULLY RECOGNIZED DIABETES PREVENTION PROGRAM FOR FIVE FULL YEARS. 300 PARTICIPANTS HAVE ENROLLED AND COMPLETED AT LEAST 4 CLASS SESSIONS SINCE THE PROGRAM BEGAN WITH 15% ATTENDING FREE OR AT REDUCED COST. AVERAGE WEIGHT LOSS OF PARTICIPANTS COMPLETING AT LEAST THE FIRST 6 MONTHS OF THE PROGRAM WAS 3.7%, AND 58% OF PARTICIPANTS REDUCED THEIR HBA1C OR FASTING GLUCOSE LEVELS TO NORMAL. MERCY CONTINUES TO PROVIDE DIABETES SELF-MANAGEMENT EDUCATION CLASSES. 4. FOOD INSECURITY. MERCY HOSPITAL ROGERS IS GOING TO WORK TO DECREASE FOOD INSECURITY AMONG PERSONS AT RISK IN NORTHWEST ARKANSAS. MERCY COWORKERS OPENED THE FIRST LITTLE FREE PANTRY IN 2016 TO PROVIDE FOOD AND OTHER ESSENTIALS TO THE COMMUNITY. OTHER HEALTH ISSUES IDENTIFIED IN THE CHNA PROCESS (AFFORDABLE HOUSING, COVID-19 AND HEART DISEASE) WERE NOT CHOSEN AS PRIORITY FOCUS AREAS FOR DEVELOPMENT OF THE CURRENT COMMUNITY HEALTH IMPROVEMENT PLAN DUE TO MERCY'S CURRENT LACK OF RESOURCES AVAILABLE TO ADDRESS THESE NEEDS AND THE INTENTION TO FOCUS ON THE THREE PRIORITIZED HEALTH NEEDS.

Schedule H, Part V, Section B, Line 20 Facility , 1
Facility , 1 - MERCY HOSPITAL ROGERS. OTHER AREAS FROM A NOTICE PERSPECTIVE: FAP IS POSTED IN ALL REGISTRATION AREAS, FULL POLICY AND PLAIN LANGUAGE DOCUMENT POSTED ON WEBSITE, PLAIN LANGUAGE DOCUMENT IS AVAILABLE WHEN REQUESTED, THERE IS A NOTICE ON STATEMENT, AND ALL PATIENTS GET THREE STATEMENTS BEFORE THEY CAN GO TO A COLLECTION AGENCY.

Schedule H, Part VI, Line 7
STATE FILING OF COMMUNITY BENEFIT REPORT: N/A

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED BY ITS ULTIMATE PARENT ENTITY, MERCY HEALTH (EIN: 43-1423050).

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) ARE $351,128,823. INCLUDED IN THIS AMOUNT WAS BAD DEBT EXPENSE (CHARGES) OF $30,829,832. EXPENSES FOR THE PURPOSE OF CALCULATING LINE 7, COLUMN (F) ARE $320,298,991.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE, AT COST, BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENT ACCOUNTS WAS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE RATIO OF COST TO CHARGES USED WAS BASED ON DETAILED COST ACCOUNT, WHERE AVAILABLE. WHERE COST ACCOUNTING IS NOT AVAILABLE, COST REPORT COST TO CHARGE RATIOS WERE UTILIZED.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE FILING ORGANIZATION DETERMINED THAT THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS $0. ALTHOUGH THE CHARITY CARE POLICY REQUIRES THE PARTICIPATION OF THE PATIENT REQUESTING ASSISTANCE, WE HAVE A PROCESS UNDER PRESUMPTIVE CHARITY TO ADDRESS ACCOUNTS FOR PATIENTS WHO DO NOT PROVIDE THE INFORMATION. WE BELIEVE THAT OUR CHARITY POLICY IS COMPREHENSIVE ENOUGH TO CAPTURE ALMOST ALL PATIENTS WHO QUALIFY FOR CHARITY CARE.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
IN MAY 2014, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) AND INTERNATIONAL ACCOUNTING STANDARDS BOARD ISSUED ACCOUNTING STANDARDS UPDATE (ASU) 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606). THE HEALTH SYSTEM ADOPTED ASU 2014-09 ON JULY 1, 2018 USING A FULL RETROSPECTIVE BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS IS TREATED A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS PATIENT SERVICE REVENUE. AS SUCH, BAD DEBT EXPENSE IS NOT REFERENCED IN MERCY HEALTH AND SUBSIDIARIES AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS TRACKED FOR FORM 990 REPORTING AS FOLLOWS: PATIENT ACCOUNTS RECEIVABLE THAT ARE DEEMED UNCOLLECTIBLE, INCLUDING THOSE PLACED WITH COLLECTION AGENCIES, ARE INITIALLY CHARGED AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IN ACCORDANCE WITH COLLECTION POLICIES OF THE HEALTH SYSTEM AND, IN CERTAIN CASES, ARE RECLASSIFIED TO CHARITY CARE IF DEEMED TO OTHERWISE MEET THE HEALTH SYSTEM'S CHARITY CARE POLICY. THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES BASED UPON THE PAYOR COMPOSITION AND AGING OF RECEIVABLES WITH CONSIDERATION OF THE HISTORICAL PAYMENT AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE RECEIVABLES TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HEALTH SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
IT IS THE POSITION OF MERCY THAT 100% OF ANY SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. THIS AMOUNT REPRESENTS COST OF PROVIDING SERVICES THAT REMAIN UNCOMPENSATED TO THE PROVIDER. THE UNREIMBURSED COSTS OF MEDICARE IS CALCULATED BY THE GROSS CHARGES NET OF THE COST TO CHARGE RATIO LESS ANY PAYMENTS, DEDUCTIONS OR REIMBURSEMENTS USING THE ANNUAL MEDICARE COST REPORT (CMS FORM 2552-96).

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
MERCY'S COLLECTION POLICY PROVIDES THAT MERCY WILL PERFORM A REASONABLE COMMUNICATION AND/OR REVIEW OF PATIENT ACCOUNTS AS IT RELATES TO ANY SERVICE PROVIDED AT OUR FACILITIES BEFORE TURNING THE ACCOUNT TO BAD DEBT OR TAKING LEGAL ACTION FOR NONPAYMENT. MERCY ACTIVELY SCRUBS ACCOUNTS FOR PAYOR PLAN COVERAGE, INCLUDING MEDICAID. IN THE EVENT AN ACCOUNT IS TURNED TO COLLECTIONS AND IS IDENTIFIED IN NEED OF FINANCIAL ASSISTANCE DUE TO CIRCUMSTANCE CHANGES, OR IS NOW REQUESTING ASSISTANCE, THE ACCOUNTS ARE RETURNED BY THE AGENCY AND CONSIDERED FOR CHARITY IF THE PATIENT PROVIDES THE REQUESTED INFORMATION. IF THE PATIENT FAILS TO RETURN THE INFORMATION, THE ACCOUNT WILL QUALIFY FOR COLLECTIONS. MERCY UTILIZES THE EXPERIAN TOOL TO ENHANCE THE ABILITY TO DETERMINE THE CHARITY QUALIFICATION PRIOR TO TURNING TO BAD DEBT, A PROCESS KNOWN AS PRESUMPTIVE CHARITY FOR ALL COMMUNITIES EXCEPT JOPLIN, MAUDE NORTON, CARTHAGE AND SOUTHEAST KANSAS. THIS PRESUMPTIVE SCREENING PROCESS DETAILS EVALUATIONS THAT TAKE PLACE PRIOR TO PATIENT BILLING AND ADDITIONALLY PRIOR TO BAD DEBT PLACEMENT. THE PRESUMPTIVE SCREENING WAS PER ENCOUNTER AND DID NOT PROMOTE ANY LOOK-BACK ADJUSTMENTS. MERCY WILL GRANT CHARITY IN SITUATIONS WHERE THERE HAS BEEN AN INABILITY TO OBTAIN INFORMATION FROM PATIENTS OR THE INFORMATION PROVIDED IS NOT COMPLETE ENOUGH TO MAKE A CHARITY DETERMINATION WHEN A PATIENT HAS SUBMITTED AN APPLICATION. MERCY WILL PURSUE APPROPRIATE MEANS IN THE COLLECTION OF DELINQUENT ACCOUNTS FROM PATIENTS WITH AN ESTABLISHED ABILITY TO PAY OR AN UNWILLINGNESS TO COOPERATE IN VALIDATING ELIGIBILITY FOR FINANCIAL ASSISTANCE. THESE APPROPRIATE MEANS MAY INCLUDE LEGAL ACTION CONSISTENT WITH MERCY MISSION AND VALUES AFTER SENDING 3 MONTHLY STATEMENTS WITH THE FINAL INCLUDING NOTIFICATION; IF NO RESOLUTION THEY WILL BE TURNED TO COLLECTIONS. ADDITIONALLY, THEY MAY INCLUDE LIENS UPON REAL PROPERTY AND REASONABLE WAGE GARNISHMENTS. LEGAL ACTIONS WILL GENERALLY NOT INCLUDE BANK GARNISHMENTS, REPOSSESSION OF ASSETS OR FORECLOSURES TO ENSURE SATISFACTION OF A LIEN. MERCY HAS POLICIES AND PROCEDURES ESTABLISHED TO ADDRESS THE INITIATION OF LEGAL ACTION AND ANNUALLY REVIEW COMPLIANCE WITH POLICIES BUT ENSURE 120 DAYS OF BILLING AND COLLECTIONS OCCUR PRIOR TO ANY EXTRAORDINARY COLLECTIONS ARE PURSUED.

Schedule H, Part V, Section B, Line 16a FAP website
- MERCY HOSPITAL ROGERS: Line 16a URL: https://www.mercy.net/patients-visitors/billing/financial-assistance/;

Schedule H, Part V, Section B, Line 16b FAP Application website
- MERCY HOSPITAL ROGERS: Line 16b URL: https://www.mercy.net/patients-visitors/billing/financial-assistance/;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- MERCY HOSPITAL ROGERS: Line 16c URL: https://www.mercy.net/patients-visitors/billing/financial-assistance/;

Schedule H, Part VI, Line 4 Community information
THE PRIMARY SERVICE AREA FOR MERCY HOSPITAL ROGERS INCLUDES 70 ZIP CODES ACROSS THE BORDER OF ARKANSAS AND MISSOURI. THE FOLLOWING INFORMATION IS DERIVED FROM THE ADVISORY BOARD DEMOGRAPHICS AND 2021-2022 AHA ANALYTICS. THE AREA'S POPULATION IS 562,382. THE MEDIAN HOUSEHOLD INCOME IS $57,000. 36.3% OF THE POPULATION IS 45 AND OLDER. 87% OF THE POPULATION IS A HIGH SCHOOL GRAD OR GREATER AND THE MEDIAN AGE IS 40. 15.7% OF THE HOUSEHOLDS ARE ON MEDICARE, 25.2% ON MEDICAID, AND 10.6% UNINSURED.

Schedule H, Part VI, Line 2 Needs assessment
MERCY HOSPITAL NORTHWEST ARKANSAS COMPLETED A COMPREHENSIVE AND THOROUGH COMMUNITY HEALTH NEEDS ASSESSMENT IN 2021 AND BELIEVES THE ASSESSMENT PROCESS IS COMPREHENSIVE ENOUGH TO SUBSTANTIALLY CAPTURE THE COMMUNITY'S HEALTH RELATED NEEDS. THEREFORE, NO ADDITIONAL NEEDS ASSESSMENTS WERE UNDERTAKEN. THE NEEDS ASSESSMENT PROCESS INCLUDES MEASUREMENT OF A WIDE VARIETY OF DEMOGRAPHIC AND PUBLIC HEALTH INDICATORS, INCLUDING THOSE MEASURING SOCIAL DETERMINANTS OF HEALTH AND THOSE FOCUSED PARTICULARLY ON UNDERSERVED AND VULNERABLE POPULATIONS. HOSPITAL UTILIZATION DATA IS ALSO COLLECTED. THE PROCESS INCLUDED A COMMUNITY-WIDE ELECTRONIC HEALTH NEEDS SURVEY, AND A HEALTH SURVEY FOCUSED SPECIFICALLY ON UNINSURED PATIENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION STRATEGY ARE OVERSEEN AND MONITORED BY A COMMUNITY HEALTH COMMITTEE OF THE HOSPITAL BOARD WHOSE MEMBERS INCLUDE LOCAL GOVERNMENT AND PUBLIC HEALTH OFFICIALS, DIRECTORS OF SEVERAL AREA NONPROFIT ORGANIZATIONS, AND REPRESENTATIVES OF THE BUSINESS COMMUNITY. THE SUBCOMMITTEE MEETS QUARTERLY, ASSISTS IN IDENTIFYING NEW NEEDS OR CONCERNS WHICH MAY HAVE RISEN, REVIEWS THE IMPLEMENTATION STRATEGY, REVISING PROGRAMS AND STRATEGIES AS NECESSARY TO MEET THE EVOLVING NEEDS OF THE COMMUNITY.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
MERCY 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 THROUGH SEVERAL MEANS. IF AT ANY TIME A PATIENT EXPRESSES HARDSHIP AND INABILITY TO PAY, THE ACCOUNT IS PLACED FOR REVIEW. IN ADDITION, PATIENTS HAVE SIGNAGE ABOUT THE POLICY AT THE ACCESS POINTS, AND ALL STAFF WORKING WITH THE PATIENT AT POINT OF SERVICE, SCHEDULING, CUSTOMER SERVICE, AND EVEN THROUGH THE MEDICAID ELIGIBILITY SCREENING HAVE THE MEANS TO SEND THE ACCOUNT FOR REVIEW. THERE IS THE PLAIN LANGUAGE SUMMARY THAT IS BEING PROVIDED TO ALL WHOM EXPRESS HARDSHIP, IN ADDITION TO THE WEB ADDRESS PROVIDING THE APPLICATION, POLICIES, AND EVEN HOW UNINSURED ACCOUNTS ARE HANDLED. LASTLY, THE STATEMENTS MESSAGE TO THE PATIENT THAT MERCY DOES HAVE A FINANCIAL ASSISTANCE PROGRAM AND TO CALL TO SEE IF THEY ARE ELIGIBLE. MERCY STAFFS INTERNAL RESOURCES CERTIFIED TO ASSIST PATIENTS WITH MEDICAID APPLICATIONS AS WELL.

Schedule H, Part VI, Line 5 Promotion of community health
MERCY HOSPITAL ROGERS, IN ACCORDANCE WITH ITS MISSION AND VALUES, PROVIDES QUALITY AND COMPASSIONATE HEALTH CARE TO PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, DISABILITY, AGE OR ABILITY TO PAY. MERCY VIEWS ITS HEALTH CARE SERVICES AS A MINISTRY, WHETHER CARE IS PROVIDED IN THE ACUTE CARE, AMBULATORY, OR HOME-HEALTH ENVIRONMENT. MERCY IS GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY LEADERS AND REPRESENTATIVES OF THE COMMUNITY. THE MAJORITY OF THE BOARD MEMBERS RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES, INDEPENDENT CONTRACTORS, OR FAMILY MEMBERS OF EMPLOYEES OR INDEPENDENT CONTRACTORS. ALL BOARD MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY AND ANY POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED AND RESOLVED. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE REINVESTED IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH INITIATIVES WHICH SUPPORT THE HOSPITAL'S MISSION TO DELIVER COMPASSIONATE CARE AND EXCEPTIONAL HEALTH SERVICES TO ITS COMMUNITY. MERCY IS COMMITTED TO PROMOTING THE HEALTH OF NORTHWEST ARKANSAS AND THE SURROUNDING AREA BY SERVING AS A COMMUNITY HEALTH LEADER AND A VISIBLE PARTNER IN COMMUNITY ACTIVITIES. MERCY PARTICIPATED IN COMMUNITY HEALTH FAIRS AND SCREENINGS, PROVIDED FIRST AID SERVICES AND SPONSORS HEALTH-RELATED RUNS AND WALKS. MERCY PROVIDED A COMMUNITY COVID-19 TEST SITE AND WAS AN ACTIVE PARTICIPANT IN COMMUNITY COVID-19 VACCINE EVENTS AND OUTREACH TO UNDERSERVED COMMUNITY MEMBERS. MERCY IS ALSO DEEPLY COMMITTED TO THE EDUCATION AND TRAINING OF FUTURE HEALTH CARE PROFESSIONALS, PROVIDING TRAINING OPPORTUNITIES FOR STUDENTS IN MEDICINE, NURSING, PHYSICAL THERAPY, IMAGING, NUTRITION, RESPIRATORY THERAPY, LABORATORY, PHARMACY, AND PARAMEDIC PROGRAMS. MERCY COWORKERS WERE ACTIVELY INVOLVED IN VOLUNTEER PROJECTS TO BENEFIT THE LOCAL COMMUNITY. THESE INCLUDED FOOD AND CLOTHING DRIVES, ASSEMBLING SNACK PACKS FOR LOW INCOME CHILDREN, AND PROVIDING CHRISTMAS GIFTS FOR NEEDY FAMILIES.

Schedule H, Part VI, Line 6 Affiliated health care system
"THE FILING ORGANIZATION IS PART OF MERCY HEALTH (""MERCY""). MERCY IS A MISSOURI NON-PROFIT CORPORATION WITH ITS HEADQUARTERS (""MINISTRY OFFICE"") IN ST. LOUIS, MISSOURI. MERCY PROVIDES HEALTH CARE SERVICES IN FOUR STATES - ARKANSAS, KANSAS, MISSOURI, AND OKLAHOMA - AND HAS OUTREACH MINISTRIES LOCATED IN ARKANSAS, LOUISIANA, MISSISSIPPI, AND TEXAS. MERCY'S MISSION IS ""AS THE SISTERS OF MERCY BEFORE US, WE BRING TO LIFE THE HEALING MINISTRY OF JESUS THROUGH OUR COMPASSIONATE CARE AND EXCEPTIONAL SERVICE.""AS OF JUNE 30, 2022, MERCY FACILITIES INCLUDED 30 ACUTE CARE HOSPITALS, 5 HEART HOSPITALS, 5 REHAB HOSPITALS, 2 CHILDREN'S HOSPITALS, 2 ORTHOPEDIC HOSPITALS, AND 1 VIRTUAL CARE COMMAND CENTER. FOR THE FISCAL YEAR ENDED JUNE 30, 2022, MERCY HAD MORE THAN 10.4 MILLION CLINIC AND OUTPATIENT VISITS, APPROXIMATELY 2,300 EMPLOYED PHYSICIANS, AND APPROXIMATELY 42,000 FULL-TIME EQUIVALENT EMPLOYEES, MAKING MERCY THE SIXTH LARGEST CATHOLIC HEALTH SYSTEM IN THE UNITED STATES. MERCY IS SPONSORED BY MERCY HEALTH MINISTRY, WHICH IS GOVERNED BY MEMBERS THAT INCLUDE SISTERS OF MERCY. MANY SERVICES THAT ARE ESSENTIAL TO FULFILLING MERCY'S MISSION ARE CENTRALIZED AT THE MINISTRY OFFICE. SUCH CENTRALIZED SERVICES INCLUDE: FINANCE (INCLUDING TREASURY, FINANCIAL ACCOUNTING AND REPORTING, REVENUE MANAGEMENT, INTERNAL AUDIT, ACCOUNTS PAYABLE AND PAYROLL OPERATIONS, ANALYTICS AND DECISION SUPPORT); ENVIRONMENTAL SERVICES SUPPORT; CLINICAL INTEGRATION; CARE MANAGEMENT; CLINICAL PERFORMANCE ACCELERATION; CLINICAL ENGINEERING; CLINICAL QUALITY MANAGEMENT; COMPLIANCE; GRANTS AND RESEARCH SERVICES; LEGAL AND COMPLIANCE COUNSEL; MARKETING AND COMMUNICATIONS; PLANNING, DESIGN AND CONSTRUCTION; PRODUCT DEVELOPMENT INFORMATICS; REAL ESTATE; SUPPLY CHAIN MANAGEMENT; MANAGED CARE STRATEGY SUPPORT; HUMAN RESOURCES (INCLUDING COMPENSATION, BENEFITS AND RECRUITING); MISSION SERVICES AND ETHICS; PHILANTHROPY SUPPORT; INFORMATION TECHNOLOGY; AND, COMMUNITY RELATIONS. THE CENTRALIZATION OF SUCH SUPPORT SERVICES ENABLES MERCY TO ENSURE THAT EACH OF ITS COMMUNITIES, WHETHER LARGE OR SMALL, HAS THE SERVICES IT NEEDS."