4A (Expenses $ 8434519 including grants of $ 0) (Revenue $ 9582003)
DEWITT HOSPITAL AND NURSING HOME PROVIDES INPATIENT, OUTPATIENT, ACUTE, HOME HEALTH, AND LONG TERM NURSING CARE TO RESIDENTS OF DEWITT, ARKANSAS AND THE SURROUNDING AREA.

FORM 990, SCHEDULE H, PART V, LINE 5
PUBLIC INPUT IS ESSENTIAL IN THE DEVELOPMENT OF A COMMUNITY HEALTH NEEDS ASSESSMENT. TO BEGIN THE PROCESS, THE DEWITT HOSPITAL & NURSING HOME (DHNH) STAFF STEERING COMMITTEE MEMBERS CONVENED WITH MELLIE BRIDEWELL AND LYNN HAWKINS OF THE ARKANSAS RURAL HEALTH PARTNERSHIP TO ASSESS COMMUNITY MEMBER INVOLVEMENT. DUE TO THE SIZE OF THE SERVICE AREA, THE STEERING COMMITTEE CHOSE TO CONDUCT THEIR ASSESSMENT THROUGH A FOCUS GROUP OF COMMUNITY LEADERS AND INDIVIDUALS IN HEALTH-RELATED FIELDS. APPROXIMATELY 40 INDIVIDUALS FROM THE COMMUNITY WERE SELECTED FOR INVITATION TO THE FOCUS GROUP, OR COMMUNITY ADVISORY COMMITTEE, BY THE DEWITT HOSPITAL & NURSING HOME (DHNH) STAFF STEERING COMMITTEE. APPROXIMATELY 35 ACCEPTED THE INVITATION WITH 19 ATTENDING THE FIRST MEETING AND 21 ATTENDING THE SECOND MEETING AND THOSE UNABLE TO ATTEND THE FIRST MEETING WERE BRIEFED. THESE COMMUNITY ADVISORY COMMITTEE MEMBERS MET INITIALLY TO DISCUSS HEALTH STATISTICS AFFECTING THE HOSPITAL SERVICE AREA AND TO INDIVIDUALLY COMPLETE THE 2022 HEALTH NEEDS SURVEY. ADVISORY COMMITTEE MEMBERS ASSISTED IN THE DISTRIBUTING THE SURVEY QR CODE AND FLYERS TO NEIGHBORS, COLLEAGUES, AND FRIENDS PRIOR TO THE SECOND MEETING. SURVEYS WERE ALSO AVAILABLE ELECTRONICALLY ON THE DHNH WEBSITE, THE ARHP WEBSITE, AND VARIOUS SITES THROUGHOUT THE SERVICE AREA. AT THE SECOND COMMITTEE MEETING, MEMBERS WERE PRESENTED WITH THE RESULTS OF THE SURVEYS AND DISCUSSED SOME OF THE QUESTIONS AND RESPONSES AS A GROUP, AND PRIORITIZE COMMUNITY HEALTH CONCERNS. THESE PRIORITIES LED THE STAFF STEERING COMMITTEE TO DEVELOP A MORE DETAILED IMPLEMENTATION PLAN TO ADDRESS THOSE ISSUES AND CREATE COMMUNITY BENEFIT. OVER THE NEXT THREE YEARS, THE ACTION PLANS WILL BE IMPLEMENTED FOR EACH ISSUE, AND THE HOSPITAL STEERING COMMITTEE WILL MEET ANNUALLY WITH THE ADVISORY COMMITTEE TO ASSESS PROGRESS.

FORM 990, SCHEDULE H, PART V, LINE 7A, 10A, 16A, B, & C
WWW.DEWITTHEALTH.ORG/FINANCIAL-ASSISTANCE

FORM 990, SCHEDULE H, PART V, LINE 11
THE TOP THREE ISSUED IDENTIFIED BY THE 2022 CHNA PROCESS WERE: 1. MENTAL & BEHAVIORAL HEALTH OBJECTIVE 1 : INCREASE EFFORTS FOR MENTAL AND BEHAVIORAL HEALTH NAVIGATION, PROGRAMS, AND TRAINING OPPORTUNITIES BY: - INCREASE EFFORTS TO ASSIST LOCAL HEALTHCARE PROVIDER WITH MENTAL AND BEHAVIORAL HEALTH RESOURCSE AND REFERRAL ASSISTANCE. - EXPLORE TELEHELATH OPPORTUNITIES TO ADDRESS MENTAL AND BEHAVIORAL HEALTH NEEDS. OBJECTIVE 2: CONTINUE TO COLLABORATE AND BUILD PARTNERSHIPS TO INCREASE MENTAL AND BEHAVIORAL HEALTH SERVICES AND PROGRAMS IN THE SERVICE AREA BY: - CONTINUE TO WORK WITH ARHP'S MENTAL/BEHAVIORAL HEALTH TASK FORCE - PARTNER WITH OTHER HEALTHCARE ORGANIZATIONS, LOCALLY AND STATEWIDE, TO INCREASE THE CAPACITY TO PROVIDE ADDITIONAL MENTAL HEALTH BEHAVIORAL HEALTH SERVICES. - PARTICIPATE IN ARHP'S OPIOD IMPLEMENTATION PROJECT TO INCREASE MENTAL & BEHAVIORAL HEALTH SERVICES. - PARTNER WITH ARHP TO PROVIDE MENTAL HEALTH FIRST AID TRAINING TO SCHOOLS, COLLEGES, AND COMMUNITY ORGANIZATIONS. 2. CHRONIC DISEASE OBJECTIVE 1: CONTINUE TO PROVIDE ACCESS TO CHRONIC DISEASE MANAGEMENT PROGRAMS AND SERVICES. - PROVIDE MORE EDUCATION TO THTE LOW-INCOME POPOULAITON ON THE IMPORTANCE OF CHRONIC DISEASE SCREEENINGS AND WHERE TO RECEIVE THEM. - EXPLORE STRATEGIES TO INCREASE ACCESS TO SCREENINGS AT THE HOSPITAL AND WITH OTHER PROVIDERS. - PROVIDE SCREENING AND EDUCATIONAL EVENTS THROUGHOUT THE COMMUNITY - GROW THE SWING-BED PROGRAM 3. PATIENT ASSISTANCE & NAVIGATION SERVICES OBJECTIVE 1: INCREASE EFFORTS TO PROVIDE PATIENT AND COMMUNITY ASSISTANCE PROGRAMS - CONTINUE PROVIDING PATIENT NAVIGATION AND ASSISTANCE SERVICES BY UTILIZING THE ARHP COMMUNITY BENEFITS COUNSELORS. - CONTINUE PARTICIPATION IN THE AHRP SOCIAL WORK ROUNDTABLES OBJECTIVE 2: INCREASE EFFORTS TO PROVIDE NAVIGATION SERVICES. - DEVLOP A STRATEGIC OUTREACH PLANTO INCREASE COMMUNITY AWARENESS OF RESOURCES AVAILABLE.

FORM 990, SCHEDULE H, PART V, LINE 16J
PATIENTS ARE INFORMED OF THE CHARITY POLICY WHEN THEY CALL TO MAKE PAYMENT ARRANGEMENTS AND THE APPLICATION IS MAILED TO THE PATIENT.

FORM 990, SCHEDULE H, PART I, LINE 7
THE COST TO CHARGE RATIO (CALCULATED USING WORKSHEET 2) WAS USED FOR LINE 7 AMOUNTS.

FORM 990, SCHEDULE H, PART III, LINE 2
THE HOSPITAL HAS ADOPTED REVENUE RECOGNITION STANDARD ASU 2014-09. THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HOSPITAL DOES NOT EXPECT TO COLLECT ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND AS SUCH ARE RECORDED AS A DEDUCTION FROM GROSS PATIENT REVENUE. THE HOSPITAL INTERNALLY TRACTS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

FORM 990, SCHEDULE H, PART III, LINE 4
ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

FORM 990, SCHEDULE H, PART III, LINE 9B
THE HOSPITAL WILL NOT INITIATE ANY EXTRAORDINARY COLLECTION ACTIONS FOR AT LEAST ONE HUNDRED TWENTY (120) DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT FOR THE CARE AT ISSUE. THE HOSPITAL WILL ACCEPT FAP APPLICATION AT LEAST SIXTY (60) DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. THE HOSPITAL WILL SUSPEND ANY EXTRAORDINARY COLLECTION ACTIVITIES IF AN FAP APPLICATION IS SUBMITTED ANYTIME DURING THE SIXTY (60) DAY APPLICATION PERIOD. FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DISCOUNTED HOSPITAL BILLS, DEWITT HOSPITAL & NURSING HOME MAY OFFER EXTENDED PAYMENT PLANS. IN THESE CASES, THE HOSPITAL WILL NOT SEND UNPAID BILLS TO OUTSIDE COLLECTION AGENCIES AND WILL CEASE ALL COLLECTION EFFORTS.

FORM 990, SCHEDULE H, PART VI, LINE 2
UTILIZES ANNUAL STATISTICAL REPORT WITH DEMOGRAPHIC INFORMATION FROM DHS AS WELL AS REPORTS SHOWING PERCENT OF ACTIVITY OF COMMUNITY BY PAYOR SOURCE.

FORM 990, SCHEDULE H, PART VI, LINE 3
THE HOSPITAL INFORMS PATIENTS UPON ADMISSION, DISCHARGE, AND POSTS NOTICES OF FINANCIAL ASSISTANCE IN CONSPICUOUS AREAS.

FORM 990, SCHEDULE H, PART VI, LINE 4
DEWITT HOSPITAL & NURSING HOME IS A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN DEWITT, ARKANSAS. DEWITT IS A SMALL TOWN, WITH A POPULATION OF ONLY 3,552 ACCORDING TO THE 2000 CENSUS AND SERVES AS THE COUNTY SEAT OF THE COUNTY'S SOUTHERN DISTRICT. THIS SMALL FACILITY SERVES THE AREAS OF ARKANSAS, PRAIRIE, JEFFERSON, DESHA, AND PHILLIPS COUNTIES. THE HOSPITAL IS A NON-PROFIT ORGANIZATION WHICH WAS FOUNDED BY THREE LOCAL COMMUNITY MEMBERS WHO WERE ALSO PRESIDENTS OF THE AREA'S LOCAL BANKS. Arkansas County is a county located in the Arkansas Delta, and has two county seats, one in DeWitt and one in Stuttgart. The health and wellness of the residents of the region bear witness to the deficit of healthcare providers. Chronic disease rates in the region are some of the highest in the country. To make definitive improvements in the health status of south Arkansas Delta residents, a two-handed approach is required. It is not enough to provide programs and services to patients when the healthcare system does not have the infrastructure or capacity to provide the kind of care required to meet the need. Unfortunately, residents of the Delta face staggering challenges that people in other parts of the country simply do not encounter. The Delta is home to abject poverty, high rates of unemployment, and ever climbing rates of people leaving the region for a better life. Outward migration is so severe in the region that seven schools have closed, and two schools consolidated since the 2017-2018 school year. Rural health systems are forced to compete for a handful of qualified healthcare professionals to fill these gaps without the draw of flashy prep schools, grocery stores, and parks that often entice young professionals with families.

FORM 990, SCHEDULE H, PART VI, LINE 5
OPEN MEDICAL STAFF AND COMMUNITY BOARD APPOINTED BY THE MAYOR. AMBULANCE SERVICES ARE PROVIDED AT COMMUNITY EVENTS AT NO CHARGE. THE HOSPITAL ALSO ADMINISTERS FREE BLOOD PRESSURE CHECKS. THE HOSPITAL IS INVOLVED IN CLEAN UP ARKANSAS ACTIVITIES, BLOOD DRIVES, AND HOLDS AN EDUCATIONAL INFORMATION BOOTH AT THE COUNTY FAIR TO BRING HEALTH AWARENESS TO THE GENERAL PUBLIC. DEWITT HOSPITAL AND NURSING HOME IS ACTIVE THROUGHOUT ARKANSAS COUNTY IN SPONSORING HEALTH FAIRS, EDUCATIONAL PROGRAMS, FREE HEALTH SCREENINGS AND OTHER ACTIVITIES TO PROMOTE THE HEALTH OF THE CITIZENS OF ARKANSAS COUNTY. DHNH IS AN ACTIVE MEMBER OF THE ARKANSAS COUNTY HOMETOWN HEALTH INITIATIVE PROJECT, WHICH IS A PROGRAM OF THE ARKANSAS DEPARTMENT OF HEALTH. THE HOMETOWN HEALTH INITIATIVE (HHI) BRINGS TOGETHER A WIDE RANGE OF PEOPLE AND ORGANIZATIONS INCLUDING CONSUMERS, BUSINESS LEADERS, AND HEALTH CARE PROVIDERS OF ALL TYPES, TO DEVELOP AND IMPLEMENT WAYS TO SOLVE HEALTH ISSUES IN EACH COUNTY. THE D-HHIP STRESSES: - COLLABORATION, - COALITION BUILDING, - COMMUNITY HEALTH ASSESSMENTS, - PRIORITIZATION OF HEALTH ISSUES, AND - THE DEVELOPMENT AND IMPLEMENTATION OF COMMUNITY HEALTH STRATEGIES THAT ARE LOCALLY DESIGNED AND SUSTAINED. DEWITT HOSPITAL & NURSING HOME CURRENTLY PARTICIPATES IN SEVERAL HEALTH OUTREACH EFFORTS THROUGH ITS AFFILIATION WITH THE ARKANSAS RURAL HEALTH PARTNERSHIP (ARHP). ARKANSAS RURAL HEALTH PARTNERSHIP IS A 501(C)3 NON-PROFIT, HORIZONTAL HOSPITAL ORGANIZATION COMPRISED OF TWELVE, INDEPENDENTLY OWNED, SOUTH ARKANSAS RURAL HOSPITALS COMMITTED TO WORKING TOGETHER THROUGHOUT THE SOUTH ARKANSAS DELTA REGION TO: IMPROVE THE DELIVERY OF HEALTHCARE SERVICES, INCREASE ACCESS TO HEALTH CARE SERVICES & PROGRAMS, PROVIDE HEALTHCARE PROVIDER EDUCATION OPPORTUNITIES, INCREASE THE UTILIZATION OF TELE HEALTH & TELE MEDICINE TECHNOLOGY, PROMOTE HEALTHY LIFESTYLES, ASSIST COMMUNITY MEMBERS WITH PATIENT ASSISTANCE PROGRAMS, AND REDUCE SERVICE & OPERATIONAL COSTS FOR HOSPITAL MEMBERS THROUGH COLLABORATIVE NEGOTIATION AND PURCHASING.