Community Benefit Insight - Tax-exempt hospital

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North Arkansas Regional Medical Center

North Arkansas Regional Medical Ctr

620 North Main
Harrison, AR 72601

Bed count	174	Medicare provider number	040017	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 710787860

Display data for year:

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

7.91%

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	$ 363,365 0.35 %
Medicaid as % of operating expenses	$ 2,008,183 1.91 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 925,325 0.88 %
Subsidized health services as % of operating expenses	$ 4,789,515 4.56 %
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.	$ 223,976 0.21 %
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	$ 0 0 %
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 $ 78916646 including grants of $ 0) (Revenue $ 92965001)
NARMC PROVIDED OVER 11,282 DAYS OF PATIENT CARE WITH 60.47% BEING PROVIDED TO MEDICARE AND MEDICAID PATIENTS. IN CONNECTION WITH THE PROVIDING OF CARE, NARMC WROTE OFF $201,281,306 OF CHARGES IN THE FORM OF CONTRACTUALS AND CHARITY EQUALING 68.2% OF TOTAL GROSS INCOME.

4B (Expenses $ 968140 including grants of $ 0) (Revenue $ 1484386)
HOSPICE OF THE HILLS MISSION IS TO PROVIDE A SPECIAL KIND OF CARE DESIGNED TO PROVIDE SENSITIVITY AND SUPPORT FOR PEOPLE IN THE FINA PHASE OF A TERMINAL ILLNESS. WE SEEK TO ENABLE PATIENTS TO CARRY ON AN ALERT, PAIN-FREE LIFE AND TO MANAGE OTHER SYMPTOMS SO THAT THEIR LAST DAYS MAY BE SPENT WITH DIGNITY AND QUALITY. WE VIEW THE FAMILY, NOT JUST THE PATIENT AS THE UNIT OF CARE.

4C (Expenses $ 407824 including grants of $ 0) (Revenue $ 140590)
NARMC IS A CO-SPONSOR OF NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, INC. (A NOT-FOR-PROFIT CORPORATION).

Facility Information

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

FORM 990, SCHEDULE H, PART V, SECTION B, LINE 5
DIALOGUES WITH 8 KEY INTERVIEWEES WERE CONDUCTED IN FEBRUARY AND MARCH 2022. INTERVIEWEES WERE DETERMINED BASED ON THEIR SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, OR THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS. INTERVIEWS WERE CONDUCTED VIA TELEPHONE, OR THE INTERVIEWEE ANSWERED THE INTERVIEW QUESTIONS VIA EMAIL; WHICHEVER WAS MORE CONVENIENT FOR THE INTERVIEWEE. ALL INTERVIEWS WERE CONDUCTED BY FORVIS PERSONNEL USING A STANDARD QUESTIONNAIRE. COMMUNITY LEADERS PROVIDED COMMENTS ON THE FOLLOWING ISSUES: 1) HEALTH AND QUALITY OF LIFE FOR RESIDENTS IN THE PRIMARY COMMUNITY, 2) BARRIERS TO IMPROVING HEALTH AND QUALITY OF LIFE FOR RESIDENTS OF THE PRIMARY COMMUNITY, 3) OPINIONS REGARDING THE IMPORTANT HEALTH ISSUES THAT AFFECT COMMUNITY RESIDENTS AND THE TYPES OF SERVICES THAT ARE IMPORTANT FOR ADDRESSING THESE ISSUES, AND 4) DELINEATION OF THE MOST IMPORTANT HEALTH CARE ISSUES OR SERVICES DISCUSSED AND ACTIONS NECESSARY FOR ADDRESSING THOSE ISSUES. INTERVIEW DATA WAS INITIALLY RECORDED IN NARRATIVE FORM. INTERVIEWEES WERE ASSURED THAT PERSONAL IDENTIFIERS SUCH AS NAME OR ORGAINZATIONAL AFFILIATIONS WOULD NOT BE CONNECTED IN ANY WAY TO THE INFORMATION PRESENTED IN THIS REPORT. THIS TECHNIQUE DOES NOT PROVIDE A QUANTITIATIVE ANALYSIS OF THE LEADERS' OPINIONS, BUT REVEALS FOR SOME OF THE FACTORS AFFECTING THE VIEWS AND SENTIMENTS ABOUT OVERALL HEALTH AND QUALITY OF LIFE WITHIN THE COMMUNITY.

FORM 990, SCHEDULE H, PART V, SECTION B, LINE 7A
WWW.NARMC.COM/COMMUNITY-HEALTH-ASSESSMENT

FORM 990, SCHEDULE H, PART V, SECTION B, LINE 11
NARMC OWNS THREE RURAL HEALTH CLINICS: NEWTON COUNTY FAMILY PRACTICE (JASPER, AR), CLAUDE PARRISH COMMUNITY HEALTH CLINIC (LEAD HILL, AR) AND MARSHALL FAMILY PRACTICE (MARSHALL, AR). NARMC ALSO HAS FOUR MANNED AMBULANCE SUBSTATIONS LOCATED IN HARRISON, JASPER, DIAMOND CITY AND MARSHALL. THROUGH THESE RURAL HEALTH CLINICS AND AMBULANCE SUBSTATIONS, WE CONTINUALLY MEET THE NEEDS OF THE COMMUNITIES WE SERVE IN THE RURAL AREAS. NARMC SUPPORTS AND STAFFS THE LOCAL HOSPICE HOUSE, WHICH PROVIDES TERMINALLY ILL PATIENTS AND THEIR FAMILIES WITH AN ALTERNATIVE TO HOSPICE SERVICES IN THEIR HOMES. COST OF SERVICES IS INCLUDED IN THE CHARITY SUBSIDY INFORMATION. NARMC PARTNERS WITH NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, WHICH PROVIDES QUALITY, CERTIFIED HEALTH CARE TRAINING FOR COMMUNITY NEEDS. TRAINING AND EDUCATION INCLUDES CLASSES FOR NURSE ASSISTANTS, HOME HEALTH AIDES, FIRST AID, CPR TRAINING AND CONTINUING HEALTH EDUCATION FOR HEALTHCARE PROFESSIONALS, AS WELL AS, COMMUNITY EDUCATION FOR HEALTH LIVES, WEIGHT LOSS AND SMOKING CESSATION. THESE NEEDS WERE PRIORITIZED AND EVALUATED TO DETERMINE WHICH WERE SIGNIFICANT TO THE COMMUNITY. THE CRITERIA INCLUDED THE NUMBERS OF PERSONS AFFECTED, THE SERIOUSNESS OF THE ISSUE, WHETHER THE HEALTH NEED PARTICULARLY AFFECTED PERSONS LIVING IN POVERTY OR MEMBERS OF AN UNDERSERVED POPULATION AND AVAILABILITY OF COMMUNITY RESOURCES TO ADDRESS THE NEED. - RECRUITMENT OF ADDITIONAL PHYSICIANS & PRACTITIONERS: NARM WILL ACTIVELY RECRUIT PROVIDERS TO PRIMARY CARE PRACTITIONERS IN RURAL PARTS OF THE COMMUNITY, INCLUDING: PEDIATRIC CARE, MID-LEVEL PROVIDERS TO SUPPORT EXISTING PHYSICIAN PRACTICES AND CHRONIC CARE MANAGEMENT, EXPANSION OF FAMLIY PRACTICE AND OBSTETRICAL SERVICES, AND OPENING OF MEDICAL CARE PLAZA WITH ACCESS TO SPECIALTY SERVICES FOR COMPREHENSIVE CARE. NARMC WILL CONTINUE TO EXPAND INFRASTRUCTURE TO SUPPORT HEALTHCARE SERVICES. - MENTAL HEALTH: NARMC WILL EXPAND BEHAVIORAL HEALTH SERVICES AND RESOURCES WITHIN THE COMMUNITY. NAMRC WILL PARTNER WITH COMMUNITY OUTREACH PROGRAMS TO EXPAND SERVICES AND AWARENESS OF BEHAVIORAL HEALTH NEEDS AND SUPPORT EDUCATIONAL PROGRAMS FOR FIRST RESPONDERS AND HEALTH CARE WORKERS. - RURAL OUTREACH: NARMC WILL OFFER APPOINTMENTS WITH SPECIALISTS, SUCH AS PHYSICAL THERAPY, PEDIATRICS AND WOMEN'S HEALTH IN RURAL CLINICS. NARMC WILL SUPPORT PRIMARY CARE IN RURAL SETTINGS WITH ACCESS TO SPECIALTY CARE BY OFFERING ADVANCE TESTING IN RURAL AREAS, EXPANDING URGENT AND AFTER HOURS CARE IN RURAL AREAS AND PARTNERING WITH ORGANZIATIONS TO PROVIDE HIGHER LEVEL OF IMMEDIATE NEED SPECIALTY CARE. - COVID-19 EDUCATION AND OUTREACH: NARMC WILL PARTNER WITH LOCAL AND STATE HEALTH OFFICES TO PROVIDE VACCINATIONS, EXPAND EDUCATION OF COVID-19 VIRUS TREATMENT OPTIONS AND VACCINATION SAFETY, COLLABORATE WITH LOCAL INDUSTRY TO SUPPORT WELLNESS THROUGH COVID-19 PREVENTION STRATEGIES, IDENTIFY AND SUPPORT AT RISK POPULATIONS WITH PREVENTION OF COVID-19 AND VIRAL SPREAD. - HEALTH & WELLNESS EDUCATION: NARMC WILL PROMOTE HEALTH SCREENINGS AND SUPPORT GROUPS TO AID THE COMMUNITY. NARMC WILL PROVIDE EDUCATIONAL OPPORTUNITIES FOR NUTRITIONAL AWARENESS RELATED TO SPECIFIC CONDITIONS. THE HOSPITAL WILL CONTINUE COMMUNITY EDUCATION FOR STROKE AWARENESS AND WILL CONTINUE THE COMMUNITY TRAUMA OUTREACH PROGRAM AND INJURY PREVENTION CLASSES. NARMC PROVIDES AN EDUCATION PROGRAM ON CAR SEAT SAFETY FOR NEWBORNS. NARMC WILL COMBINE EFFORTS WITH THE LOCAL HEALTH DEPARTMENT FOR VACCINATION CLINICS. NARMC HAS FOUNDED THE BOONE COUNTY DIABETES COLLABORATIVE ALONG WITH THE AREA AGENCY ON AGING NORTHWEST ARKANSAS, COMMUNITY HEALTH RESOURCE CENTER, HARRISON CHAMBER OF COMMERCE, BOONE COUNTY HEALTH DEPARTMENT AND NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION. THE MISSION OF THE COLLABORATIVE IS TO PROVIDE HEALTH CARE PROVIDERS, COMMUNITY LEADERS AND PATIENTS FREE DIABETES EDUCATION. THE COLLABORATIVE PARTICIPANTS WORK IN CONJUNCTION TO IDENTIFY PATIENTS WHO NEED HELP IN MANAGING DIABETES. NARMC PROVIDES ONE-ON-ONE EDUCATION WITH A CLINICAL PHARMACIST AND/OR DIETICIAN FOR PATIENTS AS WELL AS QUARTERLY GROUP EDUCATION. NARMC HAS FOUNDED THE COMMUNITY PARAMEDIC PROGRAM IN AN EFFORT TO REDUCE RE-ADMISSION RATES OF THE HOSPITAL AND TO PROMOTE/FACILITATE APPROPRIATE UTILIZATION OF PRIMARY CARE PROVIDERS, THE EMERGENCY DEPARTMENT AND EMS. THE MISSION OF THE PROGRAM IS TO IDENTIFY AT-RISK PATIENTS THROUGH PERSONAL INTERACTION AND EDUCATE THEM ON NAVIGATING THE HEALTHCARE SYSTEM IN ORDER TO BETTER UTILIZE RESOURCES TO THE MUTUAL BENEFIT OF THE PATIENT AND THE HEALTHCARE PROVIDER.

FORM 990, SCHEDULE H, PART V, SECTION B LINE 10A
WWW.NARMC.COM/COMMUNITY-HEALTH-ASSESSMENT

FORM 990, SCHEDULE H, PART V, SECTION B, LINE 16A,B,& C
WWW.NARMC.COM/COPY-OF-CARECREDIT-PAYMENT

Supplemental Information

Schedule H (Form 990) Part VI

FORM 990, SCHEDULE H, PART I, LINE 7
THE COST TO CHARGE RATIO, CALCULATED USING WORKSHEET 2, WAS USED IN COMPLETING LINE 7A AND 7B. LINE 7E, 7F, AND 7G WERE CALCULATED USING ACTUAL COSTS.

FORM 990, SCHEDULE H, PART III, SECTION A, LINES 2 & 3
GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE SYSTEM ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENTS ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. CONSISTENT WITH THE SYSTEMS MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, THE SYSTEM HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURED BALANCES, SUCH AS CO-PAYS AND DEDUCTIBLES. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS THE SYSTEM EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS.

FORM 990, SCHEDULE H, PART III, SECTION A, LINE 4
PLEASE SEE ATTACHED AUDIT REPORT NOTE 1.

FORM 990, SCHEDULE H, PART III, SECTION B, LINE 8
THE AMOUNT REPORTED ON LINE 6 WAS CALCULATED USING THE MEDICARE COST REPORT

FORM 990, SCHEDULE H, PART III, SECTION C, LINE 9B
IN THE CASE OF EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, A PATIENT WHO IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM WILL NOT BE CHARGED MORE THAN AMOUNTS GENERALLY BILLED FOR INDIVIDUALS WHO HAVE INSURANCE COVERAGE. IF NARMC DETERMINES A PATIENT TO BE FAP ELIGIBLE, THEY WILL PROVIDE THE PATIENT WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED AND HOW NARMC DETERMINED THE AMOUNT OWED AS A FAP ELIGIBLE PATIENT, REFUND ANY AMOUNTS PAID IN EXCESS OF THE AMOUNT THE PATIENT IS DETERMINED TO OWE AS A FAP ELIGIBLE PATIENT AND WILL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS (ECAS)

FORM 990, SCHEDULE H, PART V, SECTION A, LINE 1, OTHER
2 HOME HEALTH/HOSPICE 2 SPECIALTY CENTERS

FORM 990, SCHEDULE H, PART VI, LINE 2
NARMC ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY WORKING VERY CLOSELY WITH OTHER HEALTHCARE PROVIDERS AND EDUCATORS IN THE AREA AND PARTICIPATING IN THE SURVEY COMPLETED BY THE HOMETOWN HEALTH COALITION THROUGH THE BOONE COUNTY HEALTH UNIT. THIS DOCUMENT COMPILES DATA FROM SCHOOLS, PHYSICIANS, GOVERNMENT AGENCIES AND THE HOSPITAL TO DETERMINE WHERE OUR COMMUNITY CAN HELP FILL THE VOID IN MEDICAL CARE NEEDS FOR OUR CITIZENS.

FORM 990, SCHEDULE H, PART VI, LINE 4
THE MEDICAL CENTER IS LOCATED IN HARRISON, ARKANSAS (BOONE COUNTY). HARRISON IS APPROXIMATELY AN HOUR AND A HALF EAST OF FAYETTEVILLE, ARKANSAS AND AN HOUR SOUTH OF SPRINGFIELD, MISSOURI (THE CLOSEST METROPOLITAN AREAS). ONE DIVIDED HIGHWAY SERVES THE AREA FROM THE NORTH. MANAGEMENT HAS IDENTIFIED THE COMMUNITY TO INCLUDE ALL OF BOONE AND NEWTON COUNTIES AS WELL AS SIGNIFICANT PORTIONS OF CARROLL, MARION AND SEARCY COUNTIES AND A SMALL PORTION OF POPE COUNTY. BASED ON THE 2015-19 US CENSUS BUREAU ESTIMATES, ABOUT 97,000 PEOPLE LIVE IN THE FIVE COUNTIES INCLUDED IN THE COMMUNITY . THE MEDICAL CENTER IS LOCATED IN HARRISON, ARKANSAS, WHICH IS THE LARGEST TOWN IN THE COMMUNITY WITH A POPULATION OF APPROXIMATELY 13,000 PEOPLE. THE POPULATION OF THE COMMUNITY IS ABOUT 95% WHITE, MAKING IT MUCH MORE RACIALLY HOMOGENOUS THAT EITHER THE STATE OF ARKANSAS OR THE UNITED STATES AS A WHOLE. MOST OF THE REMAINING POPULATION IS HISPANIC OR LATINO WITH APPROXIMATELY ONE-THIRD OF THIS GROUP HAVING LIMITED ENGLISH PROFICIENCY. ACCORDING TO THE US CENSUS BUREAU, ABOUT 23% OF THE COMMUNITY'S POPULATION IS OVER AGE 65, WHICH IS MUCH HIGHER THAN THE STATE OF ARKANSAS (17%) OR THE UNITED STATES (16%) AS A WHOLE. ADDITIONALLY, THE PERCENTAGE OF THE COMMUNITY POPULATION OVER AGE 65 IS EXPECTED TO CONTINUE INCREASING OVER THE NEXT TWO YEARS. THIS AGE GROUP USES MORE HEALTH SERVICES THAN ANY OTHER SO THE MEDICAL CENTER SHOULD PREPARE FOR INCREASED PATIENT VOLUME IN THE NEAR FUTURE. THE AVERAGE HOUSEHOLD INCOME IN THE MEDICAL CENTER'S COMMUNITY IS $56,915 COMPARED TO $66,557 FOR THE STATE OF ARKANSAS AND $88,607 FOR THE UNITED STATES. LOWER THAN AVERAGE HOUSEHOLD INCOME SUGGESTS THAT MANY MEMBERS OF THE COMMUNITY MAY HAVE DIFFICULTY OBTAINING HEALTH CARE, ESPECIALLY PREVENTATIVE CARE.

FORM 990, SCHEDULE H, PART VI, LINE 6
NORTH ARKANSAS MEDICAL SYSTEM IS A PUBLIC BENEFIT CORPORATION TO NORTH ARKANSAS REGIONAL MEDICAL CENTER. IT IS ORGANIZED TO OPERATE FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF AND/OR TO CARRY OUT THE PURPOSES OF THE HOSPITAL. NORTH ARKANSAS MEDICAL SERVICES IS A PUBLIC BENEFIT CORPORATION TO PROMOTE PURPOSES OF THE HOSPITAL. NORTH ARKANSAS MEDICAL FOUNDATION'S MISSION IS TO ENCOURAGE PUBLIC SUPPORT FOR THE ACTIVITIES AND PURPOSE OF NORTH ARKANSAS REGIONAL MEDICAL CENTER.

FORM 990, SCHEDULE H, PART VI, LINE 7
THE STATE OF ARKANSAS DOES NOT REQUIRE NONPROFIT HOSPITALS TO PROVIDE COMMUNITY BENEFIT REPORTS.

FORM 990, SCHEDULE H, PART VI, LINE 3
A PATIENT IS IDENTIFIED AS POSSIBLY NEEDING FINANCIAL ASSISTANCE WHEN THE PATIENT REGISTERS AS A SELF-PAY PATIENT OR HAS A SELF-PAY BALANCE AFTER INSURANCE ON THEIR ACCOUNT. SELF-PAY ACCOUNTS ARE REVIEWED BY THE PATIENT FINANCIALS SERVICES DEPARTMENT. ALL QUALIFYING SELF-PAY ACCOUNTS RECEIVE A DISCOUNT BASED ON THE REIMBURSEMENT PERCENTAGES RECEIVED FROM MEDICARE AND ALL PRIVATE HEALTH INSURANCES PAYING CLAIMS TO THE HOSPITAL BASED UPON THE LOOK BACK PERIOD. CURRENTLY THE SELF PAY DISCOUNT IS 45% OF GROSS CHARGES. ONCE THE PATIENT IS IDENTIFIED AS POSSIBLY NEEDING FINANCIAL ASSISTANCE, THE PATIENT IS SEEN OR CONTACTED BY NARMC'S PATIENT FINANCIAL SERVICES DEPARTMENT TO DETERMINE ELIGIBILITY AND APPLY FOR NARMC'S FINANCIAL ASSISTANCE PROGRAM INCLUDING THOSE WITH MEDICAL CONDITIONS/NEEDS THAT HAVE EXHAUSTED THEIR FINANCIAL RESOURCES, HELP IN APPLYING FOR GOVERNMENTAL ASSISTANCE, HELP IN DETERMINING ELIGIBILITY, APPLY FOR PHARMACEUTICAL ASSISTANCE PROGRAMS OR ANY OTHER PUBLIC ASSISTANCE. PATIENT ELIGIBILITY IS BASED ON A NET HOUSEHOLD INCOME OF 0% TO 138% OF THE FEDERAL POVERTY GUIDELINES IN ORDER TO BE ELIGIBLE FOR A FINANCIAL ASSISTANCE DISCOUNT OF 100%. PATIENT ELIGIBILITY IS BASED ON A NET HOUSEHOLD INCOME OF 138% TO 200% OF FEDERAL POVERTY GUIDELINES IN ORDER TO BE ELIGIBLE FOR A FINANCIAL ASSISTANCE DISCOUNT OF 50%. NARMC TAKES THE FOLLOWING MEASURES TO PUBLICIZE THE FINANCIAL ASSISTANCE PROGRAM TO THE COMMUNITY AND PATIENTS IN THE FOLLOWING WAYS: 1) POST THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND A SUMMARY OF THE POLICY ON THE NARMC WEBSITE AT WWW.NARMC.COM. 2) PROVIDE PAPER COPIES OF THE POLICY, APPLICATION AND SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM UPON REQUEST IN THE PATIENT ACCESS AND PATIENT FINANCIAL SERVICES OFFICES. 3)POST NOTICES ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN THE EMERGENCY DEPARTMENT, PATIENT ACCESS AREAS AND PATIENT FINANCIALS SERVICES OFFICES. 4) DISTRIBUTE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM AND OFFER A FINANCIAL ASSISTANCE APPLICATION TO PATIENTS AT THE TIME OF REGISTRATION OR BEFORE DISCHARGE FROM THE HOSPITAL. 5) INFORM PATIENT ABOUT THE FINANCIAL ASSISTANCE PROGRAM IN PERSON OR DURING CUSTOMER SERVICE INTERACTIONS. 6) PROVIDE A SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM IN THE PATIENT'S MONTHLY BILLING STATEMENT. PATIENTS WILL RECEIVE THEIR FIRST STATEMENT WITHIN 15 DAYS FROM COMPUTATION OF THE FINAL BILL. NARMC WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY WITH ALL BILLING STATEMENTS (MINIUMUM OF THREE STATEMENTS) AND WITH ANY OTHER WRITTEN COMMUNICATIONS REGARDING THE BILL THAT IS PROVIDED TO THE PATIENTS. NARMC SHALL INFORM THE PATIENT ABOUT THE FINANCIAL ASSISTANCE POLICY IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE. NARMC WILL PROVIDE THE PATIENT WITH AT LEAST ONE WRITTEN NOTICE THAT INFORMS THAT PATIENT ABOUT EXTRAORDINARY COLLECTIONS ACTIONS THAT MAY BE TAKEN IF THE FINANCIAL ASSISTANCE APPLICATION IS NOT SUBMITTED OR THE AMOUNT IS NOT PAID IN FULL BY THE DATE SPECIFIED IN THE NOTICE. NARMC SHALL NOT UNDERTAKE EXTRAORDINARY COLLECTION ACTIONS IN LESS THAN 120 DAYS FROM THE DATE OF THE FIRST STATEMENTS. PATIENTS MAY REQUEST FINANCIAL ASSISTANCE UP TO 240 DAYS FROM THE DATE OF THE PATIENT'S FIRST STATEMENT. IF THE PATIENT SUBMITS AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION AFTER 120 DAYS FROM THE FIRST STATEMENT DATE, NARMC SHALL SUSPEND ALL EXTRAORDINARY COLLECTION ACTIONS AND PROVIDE THE PATIENT WITH A WRITTEN NOTICE DESCRIBING THE ADDITIONAL INFORMATION/DOCUMENTATION THAT IS REQUIRED TO COMPLETE THE APPLICATIONS. IF THE PATIENT FAILS TO PROVIDE THE ADDITIONAL INFORMATION REQUESTED BY DATE SPECIFIED IN THE WRITTEN NOTICE, NARMC MAY PROCEED WITH EXTRAORDINARY COLLECTION ACTIONS. COMPLETED FINANCIAL ASSISTANCE APPLICATIONS SUBMITTED WITHIN THE 240 DAY PERIOD SHALL BE REVIEWED BY NARMC. A DETERMINATION SHALL BE MADE AND DOCUMENTED AS TO WHETHER THE PATIENT IS ELIGIBLE AND WRITTEN NOTIFICATION SHALL BE SENT TO THE PATIENT DESCRIBING THE ELIGIBILITY AND BASIS FOR THE DETERMINATION. IF NARMC DETERMINES THE PATIENT TO BE ELIGIBLE, THEY WILL PROVIDE THE PATIENT WITH A BILLING STATEMENT SHOWING THE AMOUNT OWED AND HOW NARMC DETERMINED THE AMOUNT OWED AS A FINANCIAL ASSISTANCE PROGRAM ELIGIBLE PATIENT, REFUND ANY AMOUNTS PAID IN EXCESS OF THE AMOUNT THE PATIENT IS DETERMINED TO OWE AS A FINANCIAL ASSISTANCE PROGRAM PATIENT, AND TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS TAKEN AGAINST THE INDIVIDUAL INCLUDING VACATE JUDGEMENTS, LIFT ANY LIENS OR LEVY AND REMOVE FROM THAT PATIENT'S CREDIT REPORT ANY INFORMATION THAT WAS REPORTED TO A CONSUMER REPORTING AGENCY OR CREDIT BUREAU. NARMC SHALL REFRAIN FROM EXTRAORDINARY COLLECTION ACTIONS UNTIL IT HAS MADE REASONABLE EFFORTS TO DETERMINE FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY, SUSPEND ANY EXTRAORDINARY COLLECTION ACTIONS IF THE PATIENT SUBMITS A FINANCIAL ASSISTANCE PROGRAM APPLICATION UNTIL NARMC DETERMINES FINANCIAL ASSISTANCE PROGRAM ELIGIBILITY. IF THE PATIENT IS ELIGIBLE FOR THE FINANCIAL ASSISTANCE PROGRAM, NARMC WILL ENSURE THE PATIENT DOES NOT PAY MORE THAN THE PATIENT IS REQUIRED TO PAY UNDER THE FINANCIAL ASSISTANCE PROGRAM.

FORM 990, SCHEDULE H, PART VI, LINE 5
NARMC'S BOARD OF DIRECTORS CONSISTS OF COMMUNITY LEADERS WITH GOALS OF PROMOTING COMMUNITY HEALTH. THE HOSPITAL PROVIDES FOUR FREE HEALTH SCREENINGS PER YEAR AND PROVIDES HEALTH CHECKS AT SEVERAL COMMUNITY EVENTS SUCH AS COMMUNITY HEALTH FAIRS, COUNTY FAIRS, RODEOS, LOCAL BUSINESSES, ETC. NARMC PARTNERS WITH AND FINANCIALLY SUPPORTS NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION, WHICH PROVIDES HEALTH EDUCATION TO THE GENERAL POPULATION OF THE COMMUNITY. EMERGENCY SERVICES ARE PROVIDED AT NUMEROUS COMMUNITY EVENTS WITH EITHER PHYSICIANS, PARAMEDICS, EMTS, NURSES, ETC. ADDITIONALLY, NARMC IS VERY INVOLVED IN THE COMMUNITIES IT SERVES BY PROVIDING COMMUNITY HEALTH SUPPORT AND EDUCATION. THE HOSPITAL'S STAFF PARTICIPATES IN A VARIETY OF COMMUNITY SUPPORT ACTIVITIES INCLUDING, BUT NOT LIMITED TO, BUSINESS AFTER HOURS, WORLD'S LARGEST BABY FAIR, THE BUSINESS EXPO AND OZARK EXPO, KHOZ/NARMC HEALTH FAIR, THE KHOZ RADIO STATION MCDONALD'S BREAKFAST CLUB, TKO TELEVISION PROGRAM COMMUNITY CONNECTIONS, KHOZ RADIO STATION COMMUNITY CONTACT AND K26 TV'S 726 COMMUNITY INFORMATION PROGRAMS. THE RURAL HEALTH CLINICS AND RURAL AMBULANCE STATIONS HAVE REPRESENTATIVES ON THE LOCAL CHAMBER OF COMMERCE BOARD OF DIRECTORS, MEMBERS OF KIWANIS, ROTARY, LIONS, EVENING LIONS, FIRST RESPONDERS, VOLUNTEER FIRE DEPARTMENT, ETC. NARMC HAS FOUNDED THE BOONE COUNTY DIABETES COLLABORATIVE ALONG WITH THE AREA AGENCY ON AGING NORTHWEST ARKANSAS, COMMUNITY HEALTH RESOURCE CENTER, HARRISON CHAMBER OF COMMERCE, BOONE COUNTY HEALTH DEPARTMENT AND NORTH ARKANSAS PARTNERSHIP FOR HEALTH EDUCATION. THE MISSION OF THE COLLABORATIVE IS TO PROVIDE HEALTH CARE PROVIDERS, COMMUNITY LEADERS AND PATIENTS FREE DIABETES EDUCATION. THE COLLABORATIVE PARTICIPANTS WORK IN CONJUNCTION TO IDENTIFY PATIENTS WHO NEED HELP IN MANAGING DIABETES. NARMC PROVIDES ONE-ON-ONE EDUCATION WITH A CLINICAL PHARMACIST AND/OR DIETICIAN FOR PATIENTS AS WELL AS QUARTERLY SUPPORT GROUP EDUCATION.

Operating expenses	$ 105,046,552
Total amount spent on community benefits as % of operating expenses	$ 8,310,364 7.91 %