Community Benefit Insight - Tax-exempt hospital

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The Medical Center At Clinton County Inc

The Medical Center Of Albany

723 Burkesville Road
Albany, KY 42602

Bed count	42	Medicare provider number	180106	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 811312058

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

1.99%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 292,963 1.97 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 2,615 0.02 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 660,752 4.45 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 10616380 including grants of $ 0) (Revenue $ 10456358)
OUTPATIENT SERVICES: THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY (MCA) IS RECOGNIZED BY MEDICARE AS AN ACUTE CARE HOSPITAL. THE HOSPITAL SERVES THE COMMUNITY BY PROVIDING CERTAIN OUTPATIENT SERVICES, INCLUDING AN EMERGENCY DEPARTMENT, BY OR UNDER THE SUPERVISION OF PHYSICIANS, DIAGNOSTIC AND THERAPEUTIC SERVICES FOR MEDICAL DIAGNOSIS, TREATMENT, CARE, OR REHABILITATION OF INJURED, DISABLED, OR SICK PERSONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

4B (Expenses $ 2130421 including grants of $ 0) (Revenue $ 2098309)
INPATIENT SERVICES: MCA IS A 42-BED ACUTE CARE HOSPITAL ENGAGED IN PROVIDING INPATIENT SERVICES, BY OR UNDER THE SUPERVISION OF PHYSICIANS, DIAGNOSTIC, AND THERAPEUTIC SERVICES FOR MEDICAL DIAGNOSIS, TREATMENT, CARE, OR REHABILITATION OF INJURED, DISABLED, OR SICK PERSONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT ---------------- THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY (MCA) CONTRACTED WITH THE COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK) IN THE FALL OF 2020 TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE HOSPITAL. THE ASSESSMENT PROCESS INCLUDED COLLECTING SECONDARY DATA RELATED TO THE HEALTH OF THE COMMUNITY. SOCIAL AND ECONOMIC DATA AS WELL AS HEALTH OUTCOMES AND PROVIDERS DATA WERE COLLECTED FROM SECONDARY SOURCES TO HELP PROVIDE DEMOGRAPHIC CONTEXT FOR THE COMMUNITY. IN ADDITION, CEDIK COMPILED HOSPITAL UTILIZATION DATA TO BETTER UNDERSTAND WHO WAS USING THE FACILITY AND FOR WHAT SERVICES. FINALLY, WITH THE ASSISTANCE OF THE STEERING COMMITTEE, INPUT FROM THE COMMUNITY WAS COLLECTED THROUGH KEY INFORMATION INTERVIEWS AND SURVEYS. TO FORM A STEERING COMMITTEE, CEDIK PROVIDED A LIST OF COMMUNITY LEADERS, AGENCIES AND ORGANIZATIONS TO ASSIST MCA IN THE RECRUITMENT OF MEMBERS THAT WOULD FACILITATE BROAD COMMUNITY INPUT. THESE COMMITTEE MEMBERS REPRESENT ORGANIZATIONS AND AGENCIES THAT SERVE THE CLINTON COUNTY POPULATION IN A VARIETY OF AREAS THAT RELATE TO A POPULATIONS HEALTH. BY VOLUNTEERING THEIR TIME, THE COMMITTEE MEMBERS ENABLED THE HOSPITAL TO ACQUIRE INPUT FROM RESIDENTS THAT ARE OFTEN NOT ENGAGED IN CONVERSATIONS ABOUT THEIR HEALTH NEEDS. THE STEERING COMMITTEE PROVIDED BOTH AN EXPERT VIEW OF THE NEEDS THEY SEE WHILE WORKING WITH THE PEOPLE AND CLIENTS THEY SERVE AND IN EXTENSIVE DISTRIBUTION OF THE COMMUNITY SURVEY. IN JANUARY 2021, ELEVEN MEMBERS OF THE CLINTON COUNTY HEALTH COALITION PARTICIPATED IN A FOCUS GROUP FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE COALITION MEMBERSHIP INCLUDES REPRESENTATION FROM THE HEALTH DEPARTMENT, BEHAVIORAL HEALTH, PUBLIC SCHOOLS, FAMILY RESOURCE CENTERS, COOPERATIVE EXTENSION AND COMMUNITY BASED SERVICES. THE COALITION MEMBERS BRING KNOWLEDGE AND EXPERTISE RELATED TO HEALTH NEEDS OF THE POPULATIONS THEY SERVE. IN ADDITION, A TOTAL OF EIGHT KEY INFORMANT INTERVIEWS WITH STEERING COMMITTEE MEMBERS WERE COMPLETED IN THE FALL OF 2020 AND EARLY JANUARY 2021. RESPONSES FROM THE INTERVIEWS HELPED IDENTIFY STRENGTHS OF THE COMMUNITY AND THE HEALTHCARE SYSTEM, CHALLENGES/BARRIERS IN THE BROADER HEALTHCARE SYSTEM AND OPPORTUNITIES FOR IMPROVING THE HEALTH OF THE COMMUNITY.

SCHEDULE H, PART V, SECTION B, LINE 6B
OTHER ORGANIZATION ---------------------- THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WAS PREPARED FOR THE MEDICAL CENTER AT ALBANY, CLINTON COUNTY, KENTUCKY BY THE COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KENTUCKY (CEDIK) AT THE UNIVERSITY OF KENTUCKY. THE CHNA WAS NOT CONDUCTED WITH OTHER HOSPITAL FACILITIES.

SCHEDULE H, PART V, SECTION B, LINE 7A & 10A
AVAILABILITY TO THE PUBLIC ------------------------------------- A COPY OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND STRATEGIC IMPLEMENTATION PLAN CAN BE FOUND AT: HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING NEEDS ----------------- THE CHNA STEERING COMMITTEE MET TO REVIEW FINDINGS FROM THE COMMUNITY SURVEYS, KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND HEALTH DATA. THE PROCESS OF PRIORITY SELECTION CONSIDERED THE FOLLOWING FACTORS: 1) THE ABILITY OF MCA TO EVALUATE AND MEASURE OUTCOMES 2) THE NUMBER OF PEOPLE AFFECTED BY THE ISSUE OR SIZE OF THE ISSUE 3) THE CONSEQUENCES OF NOT ADDRESSING THIS PROBLEM 4) PREVALENCE OF COMMON THEMES 5) THE EXISTENCE OF HOSPITAL PROGRAMS WHICH RESPOND TO THE IDENTIFIED NEED. NEEDS NOT ADDRESSED --------------------- MENTAL HEALTH SERVICES ARE OUTSIDE OF THE RESOURCES THAT MCA IS ABLE TO PROVIDE WITH THE RESOURCES AVAILABLE. MCA WILL CONTINUE TO MAINTAIN EXISTING AND ESTABLISH NEW RELATIONSHIPS WITH ENTITIES PROVIDING BEHAVIORAL HEALTH TREATMENT THAT BENEFIT THE PLACEMENT AND REFERRAL FOR MCA PATIENTS AND FAMILIES. MCA WILL KICK OFF THE IMPLEMENTATION STRATEGY BY INITIATING COLLABORATIVE EFFORTS WITH COMMUNITY LEADERS TO ADDRESS EACH HEALTH PRIORITY IDENTIFIED THROUGH THE ASSESSMENT PROCESS. PERIODIC EVALUATION OF GOALS/OBJECTIVES FOR EACH IDENTIFIED PRIORITY WILL BE CONDUCTED.

SCHEDULE H, PART V, SECTION B, LINE 13B & 13H
"LINE 13B: ELIGIBILITY CRITERIA - INCOME OTHER THAN FPG ---------------------------------------------- BECAUSE THERE MAY BE CIRCUMSTANCES WHERE A PATIENT/GUARANTOR MAY END UP OWING AN AMOUNT THAT IS LARGE IN RELATION TO HIS INCOME, BUT STILL NOT MEET OUR STANDARD FINANCIAL ASSISTANCE (CHARITY CARE) GUIDELINES, AND BECAUSE WE DO NOT WANT TO CREATE WHAT IS COMMONLY KNOWN AS ""MEDICAL INDIGENCY,"" WE WILL ALSO APPLY THE FOLLOWING GUIDELINES TO FINANCIAL ASSISTANCE APPLICATIONS: 1) ONLY PERSONS OR FAMILIES WHO MAKE LESS THAN 20 TIMES (2000%) OF THE SINGLE PERSON FPL ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE. THE PURPOSE OF THIS REQUIREMENT IS TO LIMIT THE INCENTIVE TO NOT PURCHASE HEALTH INSURANCE IF A PERSON CAN AFFORD IT. 2) A SELF-PAY PORTION OF A BILL GREATER THAN 20% OF ANNUAL INCOME QUALIFIES A PERSON FOR CATASTROPHIC FINANCIAL ASSISTANCE. 3) ALSO, THE AMOUNT DUE FROM CATASTROPHIC FINANCIAL ASSISTANCE APPLICANTS IS CAPPED AT 50% OF THEIR DOCUMENTED AND VERIFIED ANNUAL INCOME PLUS THE AMOUNT THE PATIENT'S LIQUID ASSETS EXCEED THEIR IMMEDIATE NEEDS AS PER THE ASSET TEST ABOVE. 4) WE ALLOW PAYMENT OF THIS CAPPED AMOUNT OVER A PERIOD OF UP TO 10 YEARS, WITH UP TO 15 YEARS AVAILABLE WITH THE APPROVAL OF THE DIRECTOR OF COMMONWEALTH FINANCIAL RESOURCES (CFR). 5) THE PAYMENTS ARE TREATED AS LONG-TERM PAY, I.E. THEY REQUIRE A WRITTEN AGREEMENT, AND THE PAYMENTS ARE INTEREST FREE FOR THE REMAINING PORTION OF THE BALANCE DUE. LINE 13H: ELIGIBILITY CRITERIA - OTHER -------------------------------- PERSONS OR FAMILIES THAT QUALIFY FOR MEDICAID, FOOD STAMPS, AND OTHER INDIGENT CARE PROGRAMS THAT CAN BE AND ARE INDEPENDENTLY VERIFIED ARE DEEMED TO MEET THE FINANCIAL ASSISTANCE GUIDELINES, AS WILL ACCOUNTS IDENTIFIED THROUGH TOOLS OR PROGRAMS WHICH PROVIDE REASONABLE ASSURANCE THAT THE ACCOUNT MEETS OUR FINANCIAL ASSISTANCE GUIDELINES. PATIENT ACCOUNTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THE PATIENT HAS HAD MEDICAID WITHIN 60 DAYS BEFORE OR AFTER THE DISCHARGE DATE/DATE OF SERVICE."

SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C
FAP WEBSITE -------------- A COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP CAN BE FOUND AT: HTTPS://MEDCENTERHEALTH.ORG/CFR/BILLING-POLICIES/FINANCIAL-ASSISTANCE/

Supplemental Information

Schedule H (Form 990) Part VI

SCHEDULE H, PART I, LINE 3C
DETERMINING ELIGIBILITY ------------------------------ THE INCOME LIMIT FOR FINANCIAL ASSISTANCE IS 200% OF THE FEDERAL POVERTY LEVEL. DISCOUNTS ARE PROVIDED TO ALL PATIENTS WHO ARE UNINSURED WHOSE INCOME EXCEEDS THE LIMITS TO QUALIFY FOR FINANCIAL ASSISTANCE. SELF-PAY DISCOUNTS ARE NOT LIMITED BASED ON INCOME. THE HOSPITAL ALSO PROVIDES PAYMENT PLANS FOR SELF-PAY PATIENTS. THE ORGANIZATION ALSO USES ASSET LEVELS, UNINSURED, UNDERINSURED, MEDICAID ELIGIBILITY, FOOD STAMP ELIGIBILITY, AND PROVIDES FOR CATASTROPHIC DISCOUNTS. SEE THE NARRATIVES FOR LINES 13B AND 13H FOR MORE DETAIL.

SCHEDULE H, PART I, LINE 6A
COMMUNITY BENEFIT REPORT ------------------------- THE ANNUAL REPORT TO THE COMMUNITY IS MADE AVAILABLE TO THE PUBLIC VIA NEWSPAPER INSERTS, DIRECT MAILINGS, AND IS POSTED ON THE COMMONWEALTH HEALTH CORPORATION'S WEBSITE AT: HTTPS://MEDCENTERHEALTH.ORG/ABOUT-US/

SCHEDULE H, PART I, LINE 7
COSTING METHODOLOGY ---------------------------- THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. THE COSTS RELATED TO MEDICAID PATIENTS WERE ALSO DETERMINED USING A RATIO OF COST TO CHARGE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS.

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE --------------------------- TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990.

SCHEDULE H, PART II
COMMUNITY BUILDING ACTIVITIES ------------------------------ COMMUNITY BUILDING ACTIVITIES INCLUDE PARTICIPATION IN CHAMBER OF COMMERCE AND INDUSTRIAL AUTHORITY.

SCHEDULE H, PART III, LINE 2
BAD DEBT EXPENSE -------------------- THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HOSPITAL'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED MARCH 31, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, LINE 3
BAD DEBTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE --------------------------------------------------------------- THE HOSPITAL HAS A DETAILED FINANCIAL ASSISTANCE POLICY WHICH STATES THAT TO PARTICIPATE IN FINANCIAL ASSISTANCE, CANDIDATES MUST COOPERATE FULLY. IN ADDITION, THE HOSPITAL EDUCATES PATIENTS WITH LIMITED ABILITY TO PAY REGARDING FINANCIAL ASSISTANCE. FOR THESE REASONS, THE HOSPITAL BELIEVES THAT IT ACCURATELY CAPTURES ALL CHARITY CARE DEDUCTIONS PROVIDED ACCORDING TO THE FINANCIAL ASSISTANCE POLICY, AND THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS NEGLIGIBLE.

SCHEDULE H, PART III, LINE 4
BAD DEBT EXPENSE FOOTNOTE --------------------------------- THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THE HOSPITAL ELECTED TO EARLY ADOPT ASU 2011-07 ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE FOR FINANCIAL REPORTING PURPOSES.

SCHEDULE H, PART III, LINE 8
MEDICARE SURPLUS/(SHORTFALL) -------------------------------- COSTS REPORTED ON LINE 6 ARE OBTAINED FROM THE MEDICARE COST REPORT WHICH ARE BASED ON A COST TO CHARGE RATIO.

SCHEDULE H, PART III, LINE 9B
DEBT COLLECTION PRACTICES --------------------------------- MCA PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. BECAUSE MCA DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, REVENUE IS NOT RECORDED FOR SUCH SERVICES. MCA MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF FINANCIAL ASSISTANCE THEY PROVIDE. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THEIR FINANCIAL ASSISTANCE POLICY. OTHER COMPENSATED CARE RELATES PRINCIPALLY TO CONTRACTUAL ALLOWANCES FOR GOVERNMENT PAYERS, DISCOUNTS TAKEN BY COMMERCIAL PAYERS AND BAD DEBTS. BENEFITS FOR THE POOR INCLUDE SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES OR WHO ARE UNINSURED. THIS INCLUDES TRADITIONAL FINANCIAL ASSISTANCE AT STANDARD BILLING RATES AND THE COSTS OF TREATING MEDICAID BENEFICIARIES IN EXCESS OF GOVERNMENT PAYMENTS. MCA DOES NOT PURSUE THE COLLECTION OF AMOUNTS DETERMINED TO BE TRADITIONAL FINANCIAL ASSISTANCE. THEREFORE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUE.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT ------------------------------ MCA IS BUILT UPON THE FOUNDATION OF SERVING OUR COMMUNITY, DAY IN AND DAY OUT, WITH QUALITY DEPENDABLE HEALTHCARE. MCA'S CHNA IS POSTED AT: HTTPS://MEDCENTERHEALTH.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ---------------------------------------------------- UPON REGISTRATION, PATIENTS ARE PROVIDED A PATIENT HANDBOOK WHICH CONTAINS INFORMATION REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, SIGNAGE AND BROCHURES DESCRIBING FINANCIAL ASSISTANCE POLICIES ARE AVAILABLE AT ADMISSIONS AREAS. EACH PATIENT WILL RECEIVE A STATEMENT REFERRED TO AS A FIRST NOTICE. THE FIRST NOTICE STATES THAT IT IS NOT A BILL, BUT IT IS A SUMMARY OF THE PATIENT'S CHARGES. THIS NOTICE AND EACH SUBSEQUENT STATEMENT CONTAINS INFORMATION CONCERNING FINANCIAL ASSISTANCE AS WELL AS CONTACT INFORMATION FOR QUESTIONS.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION ---------------------- THE MEDICAL CENTER AT ALBANY SERVES THE NEEDS OF PATIENTS AND PHYSICIANS OF CLINTON COUNTY, KY AND SURROUNDING COUNTIES.

SCHEDULE H, PART VI, LINE 5
"PROMOTION OF COMMUNITY HEALTH ---------------------------------- AS PART OF COMMONWEALTH HEALTH CORPORATION, THE MEDICAL CENTER AT ALBANY IS PATIENT-FOCUSED, QUALITY-DRIVEN AND MISSION-LED. OUR MISSION IS TO CARE FOR PEOPLE AND IMPROVE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. WE COMBINE STATE-OF-THE-ART TECHNOLOGY, UNSURPASSED PERSONAL CARE, AND THE FINEST HEALTHCARE PROFESSIONALS TO ENSURE EACH VISIT IS THE VERY BEST IT CAN BE. MCA OFFERS FREE STROKE SCREENINGS AT COMMUNITY EVENTS, WORKSITES AND HEALTH FAIRS AND PROVIDES EARLY HEART ATTACK CARE (EHAC) EDUCATION AT LOCAL HEALTH FAIRS. MCA INCREASES COMMUNITY AWARENESS AND KNOWLEDGE OF THE OPIOID EPIDEMIC THROUGH ""THE CHOICE IS YOURS"" ENRICHMENT EVENT HELD FOR HIGH SCHOOL JUNIORS AND SENIORS. MCA PROVIDES CANCER PREVENTION INFORMATION AT LOCAL FESTIVALS AND FAIRS, DISTRIBUTING EDUCATIONAL MATERIALS AND PROMOTIONAL ITEMS PROMOTING AWARENESS AND PREVENTATIVE SCREENINGS."

SCHEDULE H, PART VI, LINE 6
"AFFILIATED HEALTH CARE SYSTEM ------------------------------ THE MEDICAL CENTER AT CLINTON COUNTY D/B/A THE MEDICAL CENTER AT ALBANY (MCA) IS OWNED AND CONTROLLED BY COMMONWEALTH HEALTH CORPORATION, A RELATED 501(C)(3) ORGANIZATION. COMMONWEALTH HEALTH CORPORATION (CHC) IS A HOLDING COMPANY FOR A TOTAL OF TWELVE FOR-PROFIT AND NONPROFIT CORPORATIONS AND PARTNERSHIPS (COLLECTIVELY, THE ""AFFILIATES"") ENGAGED IN VARIOUS ASPECTS OF THE HEALTH CARE INDUSTRY. CHC OWNS AND OPERATES MULTIPLE PHYSICIAN PRACTICES, WHICH ARE ACQUIRED TO ATTRACT AND RETAIN HIGHLY SKILLED PHYSICIANS IN SPECIALTIES THAT SUPPORT THE MISSION OF CHC AND ITS AFFILIATES. IN ADDITION, CHC OPERATES AND PROVIDES VARIOUS CORPORATE SUPPORT SERVICES INCLUDING PATIENT BILLING, COLLECTIONS, ACCOUNTING, MATERIALS MANAGEMENT, ENGINEERING, SECURITY, HUMAN RESOURCES, INFORMATION SYSTEMS, AND ADMINISTRATIVE SUPPORT TO ITS AFFILIATES. CHC HAS ESTABLISHED VARIOUS DIVISIONS FOR ITS OPERATIONS, INCLUDING THE NONPROFIT ORGANIZATIONS DESCRIBED BELOW (IN ADDITION TO THE MEDICAL CENTER AT ALBANY) AND OTHER NONPROFIT AND FOR-PROFIT CORPORATIONS AND PARTNERSHIPS. BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (""THE MEDICAL CENTER""): ----------------- BOWLING GREEN WARREN COUNTY COMMUNITY HOSPITAL CORPORATION (""THE MEDICAL CENTER"") IS A NONPROFIT KENTUCKY CORPORATION THAT OPERATES A 337-BED HOSPITAL FACILITY IN BOWLING GREEN, KENTUCKY UNDER THE NAME ""THE MEDICAL CENTER AT BOWLING GREENSINCE OCTOBER 1996, A 25-BED CRITICAL ACCESS HOSPITAL AND 110-BED NURSING HOME FACILITY IN SCOTTSVILLE, KENTUCKY, UNDER THE NAME ""THE MEDICAL CENTER AT SCOTTSVILLE."" IN ADDITION, SINCE JANUARY 2016, THE CORPORATION HAS OPERATED A 25-BED CRITICAL ACCESS ACUTE CARE HOSPITAL IN HORSE CAVE, KENTUCKY UNDER THE NAME ""THE MEDICAL CENTER AT CAVERNA."" THE THREE FACILITIES ARE PART OF ONE CORPORATION BUT ARE SEPARATELY LICENSED BY THE STATE OF KENTUCKY. THE MEDICAL CENTER IS THE SOLE MEMBER OF MEDICAL CENTER EMS, LLC (EMS), MEDICAL CENTER PHARMACY OF BOWLING GREEN, LLC (RIVERSIDE PHARMACY) AND ENSPIRE QUALITY PARTNERS, LLC (MED CENTER HEALTH PARTNERS). EMS PROVIDES AMBULANCE SERVICES IN WARREN COUNTY, KENTUCKY. RIVERSIDE OFFERS RETAIL PHARMACY SERVICES IN BOWLING GREEN, KY. MED CENTER HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF HEALTHCARE PROVIDERS, WORKING TOGETHER UNDER A PHYSICIAN-LED STRUCTURE TO IMPROVE POPULATION HEALTH, IMPROVE PATIENT EXPERIENCE AND REDUCE THE COST OF HEALTHCARE. THE CORPORATION IS BOTH THE LIMITED PARTNER AND A GENERAL PARTNER IN THE MEDICAL PLAZA PARTNERS, LLP WHICH PROVIDES ON-CAMPUS SPACE FOR HOSPITAL DEPARTMENTS AND OTHER NON-AFFILIATE MEDICAL-RELATED SERVICES. TOGETHER WITH ANOTHER AREA NON-PROFIT ACUTE CARE HOSPITAL CORPORATION, TMC IS AN EQUAL OWNER OF THE BARREN RIVER REGIONAL CANCER CENTER, INC., AN OUTPATIENT RADIATION THERAPY CARE SERVICE LOCATED IN GLASGOW, KENTUCKY. THE MEDICAL CENTER AT SCOTTSVILLE OPERATES TWO RURAL HEALTH CLINICS, ONE IN SCOTTSVILLE, KY AND ONE IN FOUNTAIN RUN, KY. THE MEDICAL CENTER AT CAVERNA OPERATES TWO RURAL HEALTH CLINICS, ONE IN MUNFORDVILLE, KY AND ONE IN HORSE CAVE, KY. COMMONWEALTH HEALTH FREE CLINIC, INC.: -------------------- COMMONWEALTH HEALTH FREE CLINIC, INC. (""CHFC"") WAS ORGANIZED TO OPERATE A CLINIC, WHICH PROVIDES BASIC MEDICAL AND DENTAL DIAGNOSTIC AND TREATMENT SERVICES FOR CHARITABLE PURPOSES FOR THE UNINSURED AND UNDERINSURED OF SOUTH-CENTRAL KENTUCKY AND ALSO SERVES INDIVIDUALS WHO MAY BE COVERED BY SOME FORM OF INSURANCE, BUT WHO ARE UNABLE TO ACCESS A PROVIDER FOR ACUTE OR CHRONIC HEALTHCARE ISSUES. THE CLINIC OFFERS SERVICES INCLUDING NON-EMERGENCY CLINICAL SERVICES, DENTISTRY, COMMUNITY HEALTH EDUCATION AND COUNSELING, DISEASE/CONDITION SPECIFIC EDUCATION AND COUNSELING, AND ACCESS TO PHARMACEUTICALS. COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC: --------------------- COMMONWEALTH REGIONAL SPECIALTY HOSPITAL, INC IS A LONG-TERM ACUTE CARE HOSPITAL THAT OPERATES AS A HOSPITAL WITHIN A HOSPITAL BY LEASING BEDS FROM THE MEDICAL CENTER ON ITS BOWLING GREEN CAMPUS. IT IS AN ACUTE CARE HOSPITAL FOR THOSE PATIENTS REQUIRING AN EXTENDED HOSPITAL STAY (ANTICIPATED LENGTH OF STAY BETWEEN 18-35 DAYS) AND GENERALLY HAVING COMPLEX OR CHRONIC MEDICAL CONDITIONS. THE MEDICAL CENTER AT FRANKLIN, INC.: --------------------- THE MEDICAL CENTER AT FRANKLIN, INC. (MCF) OPERATES A HOSPITAL IN THE COMMUNITY OF FRANKLIN, SIMPSON COUNTY, KENTUCKY. THIS LOCATION IS JUST 20 MILES FROM THE MEDICAL CENTER'S BOWLING GREEN CAMPUS. MCF IS A MEDICARE DESIGNATED CRITICAL ACCESS HOSPITAL OFFERING ACUTE CARE INPATIENT AND OUTPATIENT PROGRAMS IN ITS 25 BED ACUTE CARE FACILITY. THE MEDICAL CENTER AT FRANKLIN, INC. OPERATES A RURAL HEALTH CLINIC IN FRANKLIN, KENTUCKY. COMMONWEALTH HEALTH FOUNDATION: ------------------------ CHC ENDORSED THE ESTABLISHMENT OF COMMONWEALTH HEALTH FOUNDATION (""THE FOUNDATION"") FOR THE PURPOSE OF FOSTERING, SUPPORTING AND INITIATING ACTIVITIES FOR THE AFFILIATED NON-PROFIT 501(C)(3) ORGANIZATIONS. THE FOUNDATION BUILDS RELATIONSHIPS THAT INSPIRE CHARITABLE GIVING IN SUPPORT OF CHC'S MISSION TO CARE FOR PEOPLE AND IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. BLUEGRASS OUTPATIENT CENTER: --------------------------- SINCE 2008, CHC HAS BEEN THE SOLE OWNER OF BLUEGRASS OUTPATIENT CENTER OF BOWLING GREEN, LLC (""BLUEGRASS""). BLUEGRASS PROVIDES COMPREHENSIVE OUTPATIENT REHABILITATION THERAPY SERVICES."

Operating expenses	$ 14,850,250
Total amount spent on community benefits as % of operating expenses	$ 295,578 1.99 %