4A (Expenses $ 59300514 including grants of $ 0) (Revenue $ 66380618)
5,709 PATIENT DAYS OF CARE OF WHICH 225 DAYS WERE NURSERY CARE WERE PROVIDED THROUGH INPATIENT SERVICES IN 2022. THE HOSPITAL PROVIDED 3,124 HOME HEALTH AGENCY VISITS, 71,449 RURAL HEALTH CLINIC VISITS, 7,317 EMERGENCY ROOM VISITS, 43,087 OUTPATIENT VISITS AND 2,156 SURGERIES IN 2022. FOR FURTHER INFORMATION ABOUT PROGRAMS AND SERVICES PLEASE SEE SCHEDULE H PART VI, LINE 2.

PERRY COUNTY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 5: THIS ASSESSMENT HAS EXPLORED THE NEEDS OF THE IDENTIFIED GROUPS BY SPECIFICALLY SEEKING INPUT FROM PERSONS WITH KNOWLEDGE OF THE SPECIFIC HEALTH CONCERNS. INPUT WAS ALSO SOUGHT FROM MEMBERS OF THE COMMUNITY CHARGED PROFESSIONALLY WITH ADVANCING THE HEALTH AND EDUCATION OF THE COMMUNITY AND ALL ITS MEMBERS. THOSE CONSULTED INCLUDE THE HOSPITAL EXECUTIVE STAFF AND AN INTERNAL WORKING GROUP. THE REFERENCE COMMUNITY AND OUTSIDE RESOURCES INCLUDE: COUNTY HEALTH DEPARTMENT, CITY POLICE, COUNTY SHERIFF, SCHOOLS, TASK FORCE, MENTAL HEALTH BOARD, AND OTHERS. A SECOND, HEALTHCARE SPECIFIC SURVEY, WAS THEN DEVELOPED AND CIRCULATED TO OVER 450 HOSPITAL STAFF, VOLUNTEERS, PHYSICIANS, AND DEPARTMENT DIRECTORS. IT WAS ALSO DISTRIBUTED ONLINE FOR TWO WEEKS DURING THE WEEK OF MARCH 20 - APRIL 14, 2019 ALONG WITH PAPER COPIES DISTRIBUTED FOR THOSE WHO DID NOT HAVE ONLINE ACCESS. A TOTAL OF 192 RESPONSES WERE RECEIVED.

PERRY COUNTY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 6B: PCMH WAS A PARTICIPANT IN A COMMUNITY WIDE SURVEY ALONG WITH OTHER SIGNIFICANT COMMUNITY AGENCIES (COUNTY HEALTH DEPARTMENT, CITY POLICE, COUNTY SHERIFF, SCHOOLS, TASK FORCE, MENTAL HEALTH BOARD, AND OTHERS) TO OBTAIN DATA ON INDIVIDUAL PERCEPTIONS OF HEALTH NEEDS. THIS SURVEY IS CONDUCTED EVERY TEN YEARS.

PERRY COUNTY MEMORIAL HOSPITAL
PART V, SECTION B, LINE 11: DEMENTIA AND ALZHEIMER'S DISEASE - PROMOTE AWARENESS BY INCREASING EVIDENCE-BASED COGNITIVE SCREENINGS FOR AT RISK POPULATIONS AND PROVIDING ONGOING COMMUNITY SCREENINGS IN TARGETED POPULATIONS WHILE INCREASING PROVIDER AND CAREGIVER EDUCATION AND SUPPORT. SUBSTANCE ABUSE AND MENTAL HEALTHCARE - INCREASE AWARENESS OF MENTAL HEALTH ISSUES THROUGH PUBLIC OUTREACH AND INCREASE ACCESS TO MENTAL HEALTH SERVICES THROUGH COORDINATION OF PHYSICAL, MENTAL, AND SUBSTANCE ABUSE TREATMENT TO FACILITATE CONSISTENCY AND CONTINUITY IN TREATEMENT. CANCER CARE - BUILD AWARENESS AND PROVIDE EDUCATION RELATED TO PREVENTION STRATEGIES AS WELL AS OFFER CLINICAL SUPPORT FOR PATIENTS IN NEED OF ONCOLOGY SERVICES. MAINTAIN LOCAL MEDICAL ONCOLOGY PROVIDER ACCESS AND BUILD AWARENESS OF LOCAL CANCER TREATMENT OPTIONS.

PART I, LINE 7:
THE HOSPITAL USED A COST-TO-CHARGE RATIO AS CALCULATED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H. THE HOSPITAL USED ACTUAL COSTS AS REPORTED IN THE GENERAL LEDGER SYSTEM TO DETERMINE THE AMOUNTS OF LINES 7E OF PART I OF SCHEDULE H.

PART III, LINE 2:
THE HOSPITAL CALCULATED BAD DEBT EXPENSE AT COST USING THE COST-TO-CHARGE RATIO AS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION EFFORTS HAVE BEEN EXHAUSTED AS OUTLINED IN SCHEDULE H, PART III, LINE 9B. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED. BASED ON THE HOSPITAL'S EXPERIENCE WITH ALL ITS PATIENTS, THEY ESTIMATE THAT IT IS LIKELY THAT UP TO 50% OF THE PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR CHARITY CARE OR OTHER ASSISTANCE BUT CHOSE NOT TO APPLY. THEREFORE, 50% OF THE BAD DEBT EXPENSE WAS INCLUDED ON PART III, LINE 3 AT COST. THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE THAT SPECIFICALLY ADDRESSES BAD DEBTS (NOTE D). THE PROVISION FOR BAD DEBTS REPRESENTS UNCOMPENSATED CARE FOR PATIENTS OF WHICH A MAJORITY ARE UNINSURED OR UNDERINSURED, BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE.

PART III, LINE 9B:
THE HOSPITAL'S CREDIT AND COLLECTION POLICY, PURPOSE, AND PROCEDURES ARE AS FOLLOWS:PURPOSE: ASSIST AND ADVISE PATIENTS ON INSURANCE AND FINANCIAL RESOURCES. PERFORM DUTIES IN CONNECTION WITH CREDIT, COLLECTIONS, AND SOCIAL SERVICES. ARRANGE PAYMENT OF ANY BALANCE NOT COVERED BY INSURANCE. EVALUATE THE CREDIT HISTORY AND DETERMINE PAYMENTS BASED ON THE PATIENT'S ABILITY TO PAY AND THE POLICY OF THE HOSPITAL AS BELOW.ALL EFFORT WILL BE MADE TO COLLECT THE BALANCE AS FOLLOWS:BALANCE UNDER $1,000.00 - PAID WITHIN 3 MONTHS.FOR EACH ADDITIONAL $1,000.00 BALANCE - ADD 3 MONTHS.(EXAMPLE: FOR BALANCES BETWEEN $4,000.00 AND $5,000.00 - PAID WITHIN 12 MONTHS.)ACCOUNTS WITH A BALANCE OF $3.00 AND UNDER WILL NOT BE MAILED A BILLING STATEMENT. THE BALANCE WILL BE CHARGED OFF AS A SMALL BALANCE ADJUSTMENT.STATEMENTS ARE GENERATED ON A WEEKLY BASIS BY RUNNING FIRST TIME STATEMENTS AND CYCLE STATEMENTS 1, 2, 3, OR 4.ACCOUNTS FOLLOW A REGULAR COMPUTER GENERATED BILLING SYSTEM. FIRST TIME STATEMENTS ARE SENT AFTER THE INSURANCE PAYMENT HAS BEEN PROCESSED AND THE ACCOUNT FALLS INTO A BILLING CYCLE. WHEN THAT CYCLE IS PRINTED, A FIRST TIME STATEMENT WILL BE GENERATED. THE FOLLWOING MONTH, A CYCLE STATEMENT IS GENERATED. THE COLLECTION CYCLE ADVANCES AS FOLLOWS: 1, 2, 3, A (FIRST LETTER) AND B (FINAL NOTICE LETTER).AFTER ACCOUNTS WITH A BALANCE OVER $1,000.00 RECEIVE A FIRST TIME STATEMENT, THEY ARE REVIEWED BY THE FINANCIAL COUNSELOR TO DETERMINE IF A COLLECTION PHONE CALL SHOULD BE MADE. FINANCIAL ARRANGEMENTS ARE DISCUSSED AND PAYMENT SCHEDULES ARE AGREED UPON. MONTHLY TERMS CAN BE SET, WHEREBY A DESIGNATED AMOUNT AND DATE OF PAYMENT IS ARRANGED ON A MONTHLY BASIS. ACCOUNTS THAT DO NOT FOLLOW THE DESIGNATED PAYMENT PLAN RECEIVE LETTERS 2, 3, A, AND B. IF THE ACCOUNT IS STILL UNPAID AFTER THE ABOVE PROCEDURES ARE USED, ACCOUNTS ARE WRITTEN OFF AND PREPARED FOR THE COLLECTION AGENCY BY PRINTING THE COLLECTION AGENCY REPORT. REPORTS ARE ALSO PREPARED FOR THE APPROVAL OF THE VICE PRESIDENT OF FINANCE AND THE BUSINESS OFFICE MANAGER. REGULAR WRITE-OFFS ARE DONE ON A MONTHLY BASIS. MEDICARE WRITE OFFS ARE DONE ON A MONTHLY BASIS.ASSISTANCE IS GIVEN TO THE THIRD PARTY AGENCY TO AID IN THE COLLECTION OF ACCOUNTS. THE AGENCY IS NOTIFIED DAILY OF PAYMENTS AND BALANCE DUE ON TURNED ACCOUNTS. WHEN THE AGENCY ADVISES OF SUIT FILING ON ACCOUNTS, AN AFFIDAVIT IS SENT TO OBTAIN PERMISSION. THE AFFIDAVIT IS SIGNED BY THE BUSINESS OFFICE MANAGER AND NOTORIZED PRIOR TO RETURNING TO THE AGENCY. THEY WILL ACT AS OUR REPRESENTATIVE AND SELECT AN ATTORNEY TO REPRESENT THE HOSPITAL IN LEGAL PROCEEDINGS, AND ATTEND ANY COURT PROCEEDINGS ON THE DATE SCHEDULED.WHEN THE COLLECTION AGENCY HAS CEASED ALL COLLECTION EFFORTS AND THE ACCOUNT IS DEEMED UNCOLLECTIBLE, THE COLLECTION AGENCY WILL SEND A RETURN REPORT. AT THAT TIME, ACCOUNTS WILL BE POSTED AS AN ACCOUNT RETURNED FROM THE COLLECTION AGENCY AND CAN BE INCLUDED AS A BAD DEBT ON THE COST REPORT.ACCOUNTS ARE ALSO REVIEWED FOR REFUNDS, CHARGE OFFS, AND PAYROLL DEDUCTION.THE FINANCIAL COUNSELOR SPEAKS WITH PRIVATE PAY PATIENTS IN A/C, ER, AND ON MED/SURG TO SET UP PAYMENT ARRANGEMENTS. A FORM IS SIGNED BY THE PATIENT SETTING UP TERMS WHEN POSSIBLE. IF PATIENT STATES THEY ARE UNABLE TO PAY, THE CHARITY CARE PROGRAM APPLICATION IS GIVEN AND THE PATIENT IS COUNSELED ON CHARITY CARE GUIDELINES.

PART VI, LINE 3:
THE HOSPITAL APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH CHARITY CARE ELIGIBLE AND NON-CHARITY CARE PATIENTS. CHARITY CARE PROGRAM INFORMATION IS SENT OUT WITH WEEKLY STATEMENTS ON PRIVATE PAY ACCOUNTS TO PATIENTS RESIDING IN PERRY COUNTY OR AN ADJACENT COUNTY THAT DOES NOT HAVE A HEALTH CARE FACILITY WITH ACCOUNT BALANCES OVER $1,000.00. PATIENTS ARE ADVISED TO CONTACT THE BUSINESS OFFICE FOR A COMPLETE APPLICATION IF THEY WISH TO APPLY.

PART VI, LINE 4:
PERRY COUNTY IS A RURAL COMMUNITY OF 18,000 PEOPLE. THE GEOGRAPHY IS DENSE FOREST, ROLLING HILLS USED FOR LIVESTOCK FARMING, AND VALLEY AND RIVER BOTTOM-LAND FARMING. AGRICULTURAL WORK NO LONGER DOMINATES THE ECONOMIC LANDSCAPE. LIGHT INDUSTRIAL AND LIGHT MANUFACTURING IS A PREDOMINANT ECONOMIC FORCE. THE ECONOMIC DEMOGRAPHIC IS GENERALLY LOWER TO MIDDLE TO MID-MIDDLE CLASS WEALTH FOR THE WORKING AGED RESIDENTS. RETIREMENT AGED RESIDENTS CONSTITUTE OVER 40% OF THE POPULATION. LOWER SOCIOECONOMIC AND INDIGENT POPULATIONS CONSITUTE LESS THATN 10% OF THE COMMUNITY.

PART VI, LINE 2:
"GENERALLY SPEAKING, THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY THE HOSPITAL IS BASED ON ALL OR A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NONEXISTENCE OF SERVICES, OPPORTUNITIES, SUPPLY, DEMONSTRATED NEED, ""VOICE OF THE CONSUMER"", AND/OR COLLABORATIVE EFFORTS WITH OUTSIDE ENTITIES, GOVERNMENT AGENCIES, AND OTHER HEALTH CARE PROVIDERS THAT WOULD ENABLE THE FILLING OF A NEED OR ENHANCE AND COMPLIMENT AN ALREADY EXISTING SERVICE. DATA IS GATHERED THROUGH BENCHMARKING, MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT, AND THROUGH CONSTANT MONITORING OF STATE AND FEDERAL GUIDELINES. IN ADDITION, NEEDS ASSESSMENTS ARE ON-GOING THROUGH THE VARIOUS PROGRAMS AND SERVICES PROVIDED TO THE COMMUNITY BY THE HOSPITAL AS FOLLOWS: - SPEAK TO COMMUNITY GROUPS ON A VARIETY OF HEALTHCARE TOPICS - SPEAK TO SCHOOL CLASSES ABOUT HEALTHY LIVING AND HEALTHCARE TOPICS - OFFER CLASSES ON CHILDBIRTH (48 HRS/YR BK), AND SIBLINGS (1 HR/MO) - OFFER CPR CLASSES TO THE PUBLIC AND TO AREA BUSINESS FOR THEIR EMPLOYEES - PROVIDE TOURS OF THE HOSPITAL TO STUDENT AND CIVIC GROUPS - COOPERATIVE AGREEMENT WITH THE HEALTH OCCUPATIONS CLASS - CLINICAL SITE FOR PHYSICAL THERAPY, RESPIRATORY, ANESTHESIA, AND RADIOLOGY STUDENTS - PROVIDE A PHYSICAL THERAPIST ASSISTANT, PHYSICAL THERAPIST, AND ATHLETIC TRAINER FOR HIGH SCHOOL SPORTING EVENTS - PROVIDE ATHLETIC TRAINING ONCE A WEEK AT SPORTS PRACTICES - SPONSOR SIX CHAMPIONS FOR LIFE BLOOD DRIVES EACH YEAR - PROVIDE A FREE MEETING ROOM FOR AT LEAST 12 COMMUNITY GROUPS ON A REGULAR BASIS - PROVIDE A BETTER BREATHERS SUPPORT GROUP QUARTERLY - PROVIDE AN ALZHEIMERS SUPPORT GROUP MONTHLY - OFFER BLOOD PRESSURE SCREENINGS AND CHOLESTEROL CHECKS MONTHLY - HOST A FREE WOMEN'S CONFERENCE ANNUALLY - PROVIDE $18,000 IN SCHOLARSHIPS ANNUALLY - OFFER A MEDI-ALERT PROGRAM TO THE AGING POPULATION IN THE COMMUNITY - PARTICIPATE ANNUALLY IN THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE - CONTRIBUTE ANNUALLY TO THE AMERICAN LUNG ASSOCIATION, AMERICAN HEART ASSOCIATION, BOY SCOUTS OF AMERICA, AND GIRL SCOUTS OF AMERICA - SPONSOR THE FIRST AID STATION AT EAST PERRY COMMUNITY FAIR - OFFER SAFE SITTERS CLASSES 3 TIMES A YEAR - OFFER SPORTS PHYSICALS ANNUALLY GIVING BACK THE PROCEEDS TO THE PARTICIPATING SCHOOLS - OFFER MEDICAL AND NON-MEDICAL TRANSPORTATION FOR A SUGGESTED DONATION - CO-SPONSOR THE JR/SR CONFERENCE ANNUALLY - PARTICIPATE IN THE CHAMPS MENTORING PROGRAM - STAFF REPRESENTATION ON NUMEROUS COMMUNITY COMMITTEES - SPONSOR VARIOUS CHAMBER AND COMMUNITY ACTIVITIES (CHAMBER LEADERSHIP DAY, MAYFEST 5K, MAYFEST BOOTH, MAYFEST TOP SPONSOR, CUSTOMER APPRECIATION ON THE SQUARE, CHAMBER WOMEN'S CONFERENCE TOP SPONSOR, TURKEY BURN OFF 5K) - HOST VARIOUS HEALTHCARE RELATED EDUCATIONAL SEMINARS FOR THE PUBLIC - HOST A SPEECH/PHYSICAL/OCCUPATIONAL SCREENING ANNUALLY TO AREA CHILDREN AGES 3 TO 5 YEARS OLD - PERRY CO ESTATES SENIOR HOUSING OFFERED TO LOW-INCOME SENIORS - DONATE PROMOTIONAL ITEMS TO NUMEROUS ORGANIZATIONS/GROUPS (I.E. HAND SANITIZER TO SCHOOLS DURING THE H1N1 FLU SEASON, FIRST AID ITEMS TO SCHOOLS) - PROVIDE CAR SEAT SAFETY CHECKS - PROVIDE FREE SPEECH SCREENINGS ANNUALLY - PROVIDE FREE EDUCATIONAL SEMINARS REGARDING SPEECH AND HEARING - PROVIDE FREE HEARING SCREENINGS AS NEEDED - AMBULANCE PROVIDED STANDBY AT 30 EVENTS FREE OF CHARGE - OFFER COGNITIVE STIMULATION THERAPY PROGRAM FOR ALZHEIMERS PATIENTS - PARTICIPATE IN THE BACKPACK BONANZA FOR UNDERPRIVILEGED CHILDREN - HOST AN ANNUAL SKEET SHOOT TO RAISE FUNDS FOR CHILDREN WITH CHRONIC ILLNESSES ($9,000.00 - 10,000.00 ANNUALLY) - SPONSOR TEEN COUNCIL'S EFFORTS ON HUNGER/RECYCLING AT EAST PERRY FAIR - SPONSORED 60 CHILDREN WITH FIREPUP PROGRAM WITH PERRYVILLE FIRE DEPARTMENT - SPONSOR EAST PERRY FAIR ANNUALLY - POST MESSAGES ON DIGITAL SIGN FOR VARIOUS COMMUNITY ORGANIZATIONS FREE OF CHARGE (TEXTING AND JR/SR CONF) - SPONSOR WATER TENT AT CENTER FOR LIFE 5K AND RYAN BEHRLE 5K - PERRY PARK CENTER SPONSORSHIP (YOUTH BASKETBALL, YOUTH TRACK, PLAY DAY AT THE PARK, DISC GOLF TOURNAMENT) - CO-SPONSOR THE PROCTOR AND GAMBLE BOOTH AT THREE EVENTS THROUGHOUT THE YEAR PROVIDING PROMOTIONAL ITEMS TO ALL WHO STOP AT THE BOOTH - SPONSOR AND PARTICIPATE IN COMMUNITY-WIDE SURVEY"