4A (Expenses $ 333726119 including grants of $ 1811781) (Revenue $ 386083106)
SOUTHEASTHEALTH, THE REGION'S PREMIER HEALTHCARE SYSTEM IN SOUTHEAST MISSOURI, PROVIDES OUR PATIENTS WITH EXCELLENT CARE OF THE HIGHEST CLINICAL QUALITY, CLOSE TO HOME. WITHIN OUR NETWORK ARE MORE THAN 50 CARE LOCATIONS IN 14 COMMUNITIES, INCLUDING HOSPITALS, PRIMARY AND SPECIALTY CARE CLINICS, EXTENDING CARE FOR PATIENTS IN A FOUR-STATE AREA. SOUTHEASTHEALTH CAPE GIRARDEAU HOSPITAL IS A 263 LICENSED BED HOSPITAL AND IS ONE OF THE LARGEST GENERAL ACUTE CARE HOSPITALS BETWEEN ST. LOUIS AND MEMPHIS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

A, 1 - SOUTHEAST HEALTH - SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT: EFFORTS WERE MADE TO INCLUDE AT-RISK, TARGETED POPULATIONS AND PRINCIPLE SPECIALTY AREAS THAT ARE SERVED BY THE HOSPITAL AND PRESENT WITHIN THE COMMUNITY, SUCH AS THE MEDICALLY UNDERSERVED, LOW INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS. TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE COMMUNITY, A FOCUS GROUP AND ONLINE SURVEYS WERE CONDUCTED AS PRIMARY RESEARCH. FOCUS GROUP: A GROUP SURVEY IN THE FORM OF A FOCUS GROUP WAS CONDUCTED. A FOCUS GROUP IS DEFINED AS PEOPLE WHO POSSESS CERTAIN SIMILAR CHARACTERISTICS THAT ARE ASSEMBLED AS A GROUP TO PARTICIPATE IN A FOCUSED DISCUSSION TO HELP UNDERSTAND THE TOPIC OF INTEREST. THE QUESTIONS ASKED AT THE FOCUS GROUP ARE LISTED BELOW. A LIST OF ORGANIZATIONS THE PARTICIPANTS REPRESENTED IS ALSO PROVIDED BELOW. DATA WAS COLLECTED FROM THE FOCUS GROUP PRIMARILY THROUGH NOTE-TAKING. THE QUESTIONS ASKED IN THE FOCUS GROUP ARE LISTED BELOW: 1. HOW WOULD YOU DESCRIBE THE HEALTH OF OUR COMMUNITY? 2. WHAT DO YOU THINK AFFECTS PEOPLES HEALTH CARE? 3. WHAT DO YOU PERCEIVE AS THE MOST IMPORTANT PROBLEMS FACING THE COMMUNITY IN THE HEALTH CARE SERVICES AREA, INCLUDING THE FUTURE OF COMMUNITY HEALTH SERVICES? HOW SHOULD THEY BE SOLVED? 4. WHAT IS YOUR PERCEPTION OF THE LOCAL PHYSICIANS IN THE COMMUNITY IN TERMS OF NUMBERS, QUALITY OF CARE, SPECIALTIES, AND SO ON? 5. WHAT IS YOUR PERCEPTION OF OTHER COMMUNITY HEALTH CARE SERVICES: HOW THEY FUNCTION, WHETHER THEY ARE ADEQUATE, OF HIGH QUALITY? 6. TO WHAT EXTENT DOES THE COMMUNITY PARTICIPATE IN COMMUNITY COALITIONS AND PARTNERSHIPS (E.G., FOOD POLICY COUNCIL, TOBACCO-FREE PARTNERSHIP, NEIGHBORHOOD SAFETY COALITION, ETC.) TO ADDRESS CHRONIC DISEASES AND ASSOCIATED RISK FACTORS? 7. TO WHAT EXTENT DOES THE COMMUNITY PARTICIPATE IN THE PUBLIC POLICY PROCESS TO HIGHLIGHT THE NEED FOR COMMUNITY CHANGES TO PREVENT AND REDUCE CHRONIC DISEASE RISK FACTORS (E.G., POOR NUTRITION, PHYSICAL INACTIVITY, TOBACCO USE AND EXPOSURE)? THE INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE SERVICE AREA INCLUDED INVOLVING PEOPLE FROM THE FOLLOWING ORGANIZATIONS WHEN PRIMARY RESEARCH WAS CONDUCTED: -COMMUNITY CARING COUNCIL -SOUTHEAST MISSOURI STATE UNIVERSITY -MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES -CROSS TRAILS MEDICAL CENTER -JACKSON R-2 SCHOOL DISTRICT -CITY OF CAPE GIRARDEAU PARKS AND RECREATION -EPIC COALITION (EARLY PREVENTION IMPACTS COMMUNITY) -SAINT FRANCIS MEDICAL CENTER -CAPE GIRARDEAU COUNTY PUBLIC HEALTH CENTER -FIRST MIDWEST BANK SURVEY: AN ONLINE SURVEY WAS DISTRIBUTED TO MEMBERS OF THE HEALTHY COMMUNITIES COALITION IN CAPE GIRARDEAU COUNTY. NINE COMPLETED RESPONSES WERE RECEIVED, REPRESENTING THE PERSPECTIVES OF INDIVIDUALS AND/OR AGENCIES INVOLVED WITH HEALTHCARE IN MULTIPLE ROLES. RESPONDENTS ADDRESSED QUESTIONS RELATED TO: UNMET NEEDS IN THE COMMUNITY, CHALLENGES FACING LOCAL HEALTHCARE RESOURCES, INCLUDING SOUTHEASTHEALTH, AND OPPORTUNITIES FOR SOUTHEASTHEALTH TO BETTER SERVE THE COMMUNITY.

A, 1 - SOUTHEAST HEALTH - SCHEDULE H, PART V, SECTION B, LINE 6A
CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA PROCESS WAS CONDUCTED WITH SOUTHEASTHEALTHS REGIONAL HOSPITAL FACILITIES.

A, 1 - SOUTHEAST HEALTH - SCHEDULE H, PART V, SECTION B, LINE 7D
OTHER METHODS OF AVAILABILITY OF THE CHNA: IN ADDITION TO THE HOSPITALS WEBSITE (SEHEALTH.ORG), THE RESULTS WERE SHARED WITH THE CAPE GIRARDEAU COUNTY HEALTHY COMMUNITIES COALITION AND THE STODDARD COUNTY HEALTHY COALITION GROUP.

A, 1 - SOUTHEAST HEALTH - SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING SIGNIFICANT NEEDS: THESE WERE THE TOP 6 PRIORITY HEALTH NEEDS (AND ASSOCIATED BEHAVIORAL NEEDS) THAT WERE DETERMINED FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT: -CANCER (SMOKING, COLON CANCER) -OBESITY (DIET AND EXERCISE) -CHRONIC DISEASE *STROKE *HEART DISEASE *DIABETES (DIET AND EXERCISE) *CHRONIC RESPIRATORY DISEASE (SMOKING) -SUBSTANCE ABUSE/MENTAL HEALTH (DRUG AND ALCOHOL, ANXIETY AND DEPRESSION) -HEALTH CARE AFFORDABILITY (UNINSURED/UNDERINSURED) -PRE-CONCEPTUAL AND PERINATAL HEALTH NEEDS BEING ADDRESSED AND HOW: THE HOSPITAL ALREADY HAS PROGRAMS AND SERVICES IN PLACE TO MEET THE NEEDS OF THE CHRONIC DISEASES LISTED ALONG WITH CANCER. THE ORGANIZATION HAS ALSO BEEN WORKING ON LOWERING THE COST OF HEALTHCARE TO MAKE IT MORE AFFORDABLE AND BY PROVIDING MORE SERVICES IN THE REGION TO MAKE HEALTHCARE SERVICES MORE ACCESSIBLE. SUBSTANCE ABUSE AND MENTAL HEALTH WILL BE ADDRESSED WITH THE EXPANSION OF OUTPATIENT CLINICS IN CAPE GIRARDEAU AND DEXTER AS WELL AS OPENING A LARGE COMPREHENSIVE FACILITY IN CAPE GIRARDEAU. PRE-CONCEPTION/PERINATAL HEALTH WILL BE ADDRESSED BY RESIDENTS HAVING GREATER ACCESS TO PRIMARY CARE.

A, 1 - SOUTHEAST HEALTH - SCHEDULE H, PART V, SECTION B, LINE 13H
ADDITIONAL CRITERIA USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE OTHER THAN INCOME AND ASSETS ALREADY SPECIFIED INCLUDE: - ELIGIBILITY FOR MEDICAID

A, 1 - SOUTHEAST HEALTH - SCHEDULE H, PART V, SECTION B, LINES 16A-16C
FAP AVAILABILITY: THE FULL WEBSITE ADDRESS FOR LINES 16A-16C IS AS FOLLOWS: HTTPS://WWW.SEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE

A, 2 - STODDARD COUNTY - SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT: EFFORTS WERE MADE TO INCLUDE AT-RISK, TARGETED POPULATIONS AND PRINCIPLE SPECIALTY AREAS THAT ARE SERVED BY THE HOSPITAL AND PRESENT WITHIN THE COMMUNITY, SUCH AS THE MEDICALLY UNDERSERVED, LOW INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS. TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE COMMUNITY, A FOCUS GROUP AND ONLINE SURVEYS WERE CONDUCTED AS PRIMARY RESEARCH. FOCUS GROUP: A GROUP SURVEY IN THE FORM OF A FOCUS GROUP WAS CONDUCTED. A FOCUS GROUP IS DEFINED AS PEOPLE WHO POSSESS CERTAIN SIMILAR CHARACTERISTICS THAT ARE ASSEMBLED AS A GROUP TO PARTICIPATE IN A FOCUSED DISCUSSION TO HELP UNDERSTAND THE TOPIC OF INTEREST. THE QUESTIONS ASKED AT THE FOCUS GROUP ARE LISTED BELOW. A LIST OF ORGANIZATIONS THE PARTICIPANTS REPRESENTED IS ALSO PROVIDED BELOW. DATA WAS COLLECTED FROM THE FOCUS GROUP PRIMARILY THROUGH NOTE-TAKING. THE QUESTIONS ASKED IN THE FOCUS GROUP ARE LISTED BELOW: 1. HOW WOULD YOU DESCRIBE THE HEALTH OF OUR COMMUNITY? 2. WHAT DO YOU THINK AFFECTS PEOPLES HEALTH CARE? 3. WHAT DO YOU PERCEIVE AS THE MOST IMPORTANT PROBLEMS FACING THE COMMUNITY IN THE HEALTH CARE SERVICES AREA, INCLUDING THE FUTURE OF COMMUNITY HEALTH SERVICES? HOW SHOULD THEY BE SOLVED? 4. WHAT IS YOUR PERCEPTION OF THE LOCAL PHYSICIANS IN THE COMMUNITY IN TERMS OF NUMBERS, QUALITY OF CARE, SPECIALTIES, AND SO ON? 5. WHAT IS YOUR PERCEPTION OF OTHER COMMUNITY HEALTH CARE SERVICES: HOW THEY FUNCTION, WHETHER THEY ARE ADEQUATE, OF HIGH QUALITY? 6. TO WHAT EXTENT DOES THE COMMUNITY PARTICIPATE IN COMMUNITY COALITIONS AND PARTNERSHIPS (E.G., FOOD POLICY COUNCIL, TOBACCO-FREE PARTNERSHIP, NEIGHBORHOOD SAFETY COALITION, ETC.) TO ADDRESS CHRONIC DISEASES AND ASSOCIATED RISK FACTORS? 7. TO WHAT EXTENT DOES THE COMMUNITY PARTICIPATE IN THE PUBLIC POLICY PROCESS TO HIGHLIGHT THE NEED FOR COMMUNITY CHANGES TO PREVENT AND REDUCE CHRONIC DISEASE RISK FACTORS (E.G., POOR NUTRITION, PHYSICAL INACTIVITY, TOBACCO USE AND EXPOSURE)? THE INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE SERVICE AREA INCLUDED INVOLVING PEOPLE FROM THE FOLLOWING ORGANIZATIONS WHEN PRIMARY RESEARCH WAS CONDUCTED: -DEXTER CHAMBER OF COMMERCE -STODDARD COUNTY PUBLIC HEALTH CENTER -REGIONAL HEALTHCARE FOUNDATION -STODDARD COUNTY AMBULANCE DISTRICT -STODDARD COUNTY 911 SERVICES -STODDARD COUNTY PUBLIC ADMINISTRATION OFFICE -STODDARD COUNTY COMMISSIONER AND CLERK SURVEY: AN ONLINE SURVEY WAS DISTRIBUTED TO MEMBERS OF THE HEALTHY COMMUNITIES COALITION IN CAPE GIRARDEAU COUNTY. NINE COMPLETED RESPONSES WERE RECEIVED, REPRESENTING THE PERSPECTIVES OF INDIVIDUALS AND/OR AGENCIES INVOLVED WITH HEALTHCARE IN MULTIPLE ROLES. RESPONDENTS ADDRESSED QUESTIONS RELATED TO: UNMET NEEDS IN THE COMMUNITY, CHALLENGES FACING LOCAL HEALTHCARE RESOURCES, INCLUDING SOUTHEASTHEALTH, AND OPPORTUNITIES FOR SOUTHEASTHEALTH TO BETTER SERVE THE COMMUNITY.

A, 2 - STODDARD COUNTY - SCHEDULE H, PART V, SECTION B, LINE 6A
CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA PROCESS WAS CONDUCTED WITH SOUTHEASTHEALTH AND SOUTHEASTHEALTHS REGIONAL HOSPITAL FACILITIES.

A, 2 - STODDARD COUNTY - SCHEDULE H, PART V, SECTION B, LINE 7D
OTHER METHODS OF AVAILABILITY OF THE CHNA: IN ADDITION TO THE HOSPITALS WEBSITE (SEHEALTH.ORG), THE RESULTS WERE SHARED WITH THE STODDARD COUNTY HEALTHY COALITION GROUP.

A, 2 - STODDARD COUNTY - SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING SIGNIFICANT NEEDS: THESE WERE THE TOP 6 PRIORITY HEALTH NEEDS (AND ASSOCIATED BEHAVIORAL NEEDS) THAT WERE DETERMINED FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT: -CANCER (SMOKING, COLON CANCER) -OBESITY (DIET AND EXERCISE) -CHRONIC DISEASE *STROKE *HEART DISEASE *DIABETES (DIET AND EXERCISE) *CHRONIC RESPIRATORY DISEASE (SMOKING) -SUBSTANCE ABUSE/MENTAL HEALTH (DRUG AND ALCOHOL, ANXIETY AND DEPRESSION) -HEALTH CARE AFFORDABILITY (UNINSURED/UNDERINSURED) -PRE-CONCEPTUAL AND PERINATAL HEALTH NEEDS BEING ADDRESSED AND HOW: THE HOSPITAL ALREADY HAS PROGRAMS AND SERVICES IN PLACE TO MEET THE NEEDS OF THE CHRONIC DISEASES LISTED ALONG WITH CANCER. THE ORGANIZATION HAS ALSO BEEN WORKING ON LOWERING THE COST OF HEALTHCARE TO MAKE IT MORE AFFORDABLE AND BY PROVIDING MORE SERVICES IN THE REGION TO MAKE HEALTHCARE SERVICES MORE ACCESSIBLE. SUBSTANCE ABUSE AND MENTAL HEALTH WILL BE ADDRESSED WITH THE EXPANSION OF OUTPATIENT CLINICS IN CAPE GIRARDEAU AND DEXTER AS WELL AS OPENING A LARGE COMPREHENSIVE FACILITY IN CAPE GIRARDEAU. PRE-CONCEPTION/PERINATAL HEALTH WILL BE ADDRESSED BY RESIDENTS HAVING GREATER ACCESS TO PRIMARY CARE.

A, 2 - STODDARD COUNTY - SCHEDULE H, PART V, SECTION B, LINE 13H
ADDITIONAL CRITERIA USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE OTHER THAN INCOME AND ASSETS ALREADY SPECIFIED INCLUDE: -ELIGIBILITY FOR MEDICAID

A, 2 - STODDARD COUNTY - SCHEDULE H, PART V, SECTION B, LINES 16A-16C
FAP AVAILABILITY: THE FULL WEBSITE ADDRESS FOR LINES 16A-16C IS AS FOLLOWS: HTTPS://WWW.SEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE

A, 3 - REYNOLDS COUNTY - SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT: EFFORTS WERE MADE TO INCLUDE AT-RISK, TARGETED POPULATIONS AND PRINCIPLE SPECIALTY AREAS THAT ARE SERVED BY THE HOSPITAL AND PRESENT WITHIN THE COMMUNITY, SUCH AS THE MEDICALLY UNDERSERVED, LOW INCOME PERSONS, MINORITY GROUPS, AND THOSE WITH CHRONIC DISEASE NEEDS. TO TAKE INTO ACCOUNT INPUT FROM PERSONS REPRESENTING THE COMMUNITY, A FOCUS GROUP AND ONLINE SURVEYS WERE CONDUCTED AS PRIMARY RESEARCH. FOCUS GROUP: A GROUP SURVEY IN THE FORM OF A FOCUS GROUP WAS CONDUCTED. A FOCUS GROUP IS DEFINED AS PEOPLE WHO POSSESS CERTAIN SIMILAR CHARACTERISTICS THAT ARE ASSEMBLED AS A GROUP TO PARTICIPATE IN A FOCUSED DISCUSSION TO HELP UNDERSTAND THE TOPIC OF INTEREST. THE QUESTIONS ASKED AT THE FOCUS GROUP ARE LISTED BELOW. A LIST OF ORGANIZATIONS THE PARTICIPANTS REPRESENTED IS ALSO PROVIDED BELOW. DATA WAS COLLECTED FROM THE FOCUS GROUP PRIMARILY THROUGH NOTE-TAKING. THE QUESTIONS ASKED IN THE FOCUS GROUP ARE LISTED BELOW: 1. HOW WOULD YOU DESCRIBE THE HEALTH OF OUR COMMUNITY? 2. WHAT DO YOU THINK AFFECTS PEOPLES HEALTH CARE? 3. WHAT DO YOU PERCEIVE AS THE MOST IMPORTANT PROBLEMS FACING THE COMMUNITY IN THE HEALTH CARE SERVICES AREA, INCLUDING THE FUTURE OF COMMUNITY HEALTH SERVICES? HOW SHOULD THEY BE SOLVED? 4. WHAT IS YOUR PERCEPTION OF THE LOCAL PHYSICIANS IN THE COMMUNITY IN TERMS OF NUMBERS, QUALITY OF CARE, SPECIALTIES, AND SO ON? 5. WHAT IS YOUR PERCEPTION OF OTHER COMMUNITY HEALTH CARE SERVICES: HOW THEY FUNCTION, WHETHER THEY ARE ADEQUATE, OF HIGH QUALITY? 6. TO WHAT EXTENT DOES THE COMMUNITY PARTICIPATE IN COMMUNITY COALITIONS AND PARTNERSHIPS (E.G., FOOD POLICY COUNCIL, TOBACCO-FREE PARTNERSHIP, NEIGHBORHOOD SAFETY COALITION, ETC.) TO ADDRESS CHRONIC DISEASES AND ASSOCIATED RISK FACTORS? 7. TO WHAT EXTENT DOES THE COMMUNITY PARTICIPATE IN THE PUBLIC POLICY PROCESS TO HIGHLIGHT THE NEED FOR COMMUNITY CHANGES TO PREVENT AND REDUCE CHRONIC DISEASE RISK FACTORS (E.G., POOR NUTRITION, PHYSICAL INACTIVITY, TOBACCO USE AND EXPOSURE)? THE INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE SERVICE AREA INCLUDED INVOLVING PEOPLE FROM THE FOLLOWING ORGANIZATIONS WHEN PRIMARY RESEARCH WAS CONDUCTED: -REYNOLDS COUNTY PUBLIC HEALTH CENTER -ELLINGTION NUTRITION CENTER -SOUTHEAST HEALTH CENTER OF REYNOLDS COUNTY -WHOLE HEALTH OUTREACH -REYNOLDS COUNTY SHERIFF'S OFFICE -ELLINGTON VOLUNTARY FIRE DEPARTMENT SURVEY: AN ONLINE SURVEY WAS DISTRIBUTED TO MEMBERS OF THE HEALTHY COMMUNITIES COALITION IN CAPE GIRARDEAU COUNTY. NINE COMPLETED RESPONSES WERE RECEIVED, REPRESENTING THE PERSPECTIVES OF INDIVIDUALS AND/OR AGENCIES INVOLVED WITH HEALTHCARE IN MULTIPLE ROLES. RESPONDENTS ADDRESSED QUESTIONS RELATED TO: UNMET NEEDS IN THE COMMUNITY, CHALLENGES FACING LOCAL HEALTHCARE RESOURCES, INCLUDING SOUTHEASTHEALTH, AND OPPORTUNITIES FOR SOUTHEASTHEALTH TO BETTER SERVE THE COMMUNITY. INVOLVED WITH HEALTHCARE IN MULTIPLE ROLES. RESPONDENTS ADDRESSED QUESTIONS RELATED TO: UNMET NEEDS IN THE COMMUNITY, CHALLENGES FACING LOCAL HEALTHCARE RESOURCES, INCLUDING SOUTHEASTHEALTH, AND OPPORTUNITIES FOR SOUTHEASTHEALTH TO BETTER SERVE THE COMMUNITY.

A, 3 - REYNOLDS COUNTY - SCHEDULE H, PART V, SECTION B, LINE 6A
CHNA CONDUCTED WITH OTHER HOSPITALS: THE CHNA PROCESS WAS CONDUCTED WITH SOUTHEASTHEALTH AND SOUTHEASTHEALTHS REGIONAL HOSPITAL FACILITIES.

A, 3 - REYNOLDS COUNTY - SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING SIGNIFICANT NEEDS: THESE WERE THE TOP 6 PRIORITY HEALTH NEEDS (AND ASSOCIATED BEHAVIORAL NEEDS) THAT WERE DETERMINED FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT: -CANCER (SMOKING, COLON CANCER) -OBESITY (DIET AND EXERCISE) -CHRONIC DISEASE *STROKE *HEART DISEASE *DIABETES (DIET AND EXERCISE) *CHRONIC RESPIRATORY DISEASE (SMOKING) -SUBSTANCE ABUSE/MENTAL HEALTH (DRUG AND ALCOHOL, ANXIETY AND DEPRESSION) -HEALTH CARE AFFORDABILITY (UNINSURED/UNDERINSURED) -PRE-CONCEPTUAL AND PERINATAL HEALTH NEEDS BEING ADDRESSED AND HOW: THE HOSPITAL ALREADY HAS PROGRAMS AND SERVICES IN PLACE TO MEET THE NEEDS OF THE CHRONIC DISEASES LISTED ALONG WITH CANCER. THE ORGANIZATION HAS ALSO BEEN WORKING ON LOWERING THE COST OF HEALTHCARE TO MAKE IT MORE AFFORDABLE AND BY PROVIDING MORE SERVICES IN THE REGION TO MAKE HEALTHCARE SERVICES MORE ACCESSIBLE. SUBSTANCE ABUSE AND MENTAL HEALTH WILL BE ADDRESSED WITH THE EXPANSION OF OUTPATIENT CLINICS IN CAPE GIRARDEAU AND DEXTER AS WELL AS OPENING A LARGE COMPREHENSIVE FACILITY IN CAPE GIRARDEAU. PRE-CONCEPTION/PERINATAL HEALTH WILL BE ADDRESSED BY RESIDENTS HAVING GREATER ACCESS TO PRIMARY CARE.

A, 3 - REYNOLDS COUNTY - SCHEDULE H, PART V, SECTION B, LINE 13H
ADDITIONAL CRITERIA USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE OTHER THAN INCOME AND ASSETS ALREADY SPECIFIED INCLUDE: -ELIGIBILITY FOR MEDICAID

A, 3 - REYNOLDS COUNTY - SCHEDULE H, PART V, SECTION B, LINES 16A-16C
FAP AVAILABILITY: THE FULL WEBSITE ADDRESS FOR LINES 16A-16C IS AS FOLLOWS: HTTPS://WWW.SEHEALTH.ORG/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR WHICH EQUALS TOTAL OPERATING EXPENSES PER PART IX, LINE 25, OF THE FORM 990 WAS REDUCED BY BAD DEBT EXPENSE OF $46,468,694.

SCHEDULE H, PART I, LINE 7G
SUBSIDIZED SERVICES: THE ORGANIZATION HAS INCLUDED COSTS ASSOCIATED WITH RURAL HEALTH CENTERS (RHC) IN THE CALCULATION OF SUBSIDIZED SERVICES ON LINE 7G, WITH A NET SUBSIDY FROM RHCS OF $4,024,680. SOUTHEASTHEALTH PROVIDES PRIMARY CARE SERVICES TO THE SURROUNDING COMMUNITIES AT THE CENTERS. THESE SERVICES ARE PROVIDED IN RURAL AREAS WHERE THERE WOULD BE A SHORTAGE OF QUALITY MEDICAL CARE WITHOUT THE SERVICES AND CONTINUES TO PROVIDE THESE SERVICES AS A BENEFIT TO THE COMMUNITY DESPITE KNOWING THAT FINANCIAL SHORTFALLS WILL BE SUSTAINED.

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. IRS WORKSHEET 6 USED SPECIFIC COST TO CHARGE RATIO FOR EACH SERVICE.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE: THE BAD DEBT EXPENSE LISTED ON LINE 2 IS THE BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: SOUTHEAST HOSPITAL ESTIMATES THAT APPROXIMATELY 17.4% OF THE PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR CHARITY CARE OR OTHER ASSISTANCE BUT CHOSE NOT TO APPLY. THEREFORE, THE BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS DETERMINED USING 17.4% OF THE AMOUNT REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HEALTH SYSTEM 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 HEALTH SYSTEM 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 HEALTH SYSTEM 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 OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

SCHEDULE H, PART III, SECTION B, LINE 8
COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY.

SCHEDULE H, PART VI, LINE 2
"NEEDS ASSESSMENT: FOLLOWING ARE WAYS IN WHICH SOUTHEAST HOSPITAL AND SOUTHEASTHEALTH CENTER OF STODDARD COUNTY ASSESSED THE NEEDS OF ITS COMMUNITY BEFORE, DURING AND AFTER THE FORMAL CHNA WAS COMPLETED: -DEFINED ""COMMUNITY"" AS OUR PRIMARY SERVICE AREA BASED ON PATIENT ORIGIN DATA -MADE CONTACT AND DISCUSSED CHNA (COMMUNITY HEALTH NEEDS ASSESSMENT) WITH COUNTY HEALTH COALITION -COLLECTED SECONDARY DATA -HELD A FOCUS GROUP TO COLLECT PRIMARY DATA THAT INCLUDED PEOPLE WITH SPECIAL KNOWLEDGE OF HEALTH ISSUES -ASSESSED ALL PRIMARY & SECONDARY DATA FOR THE SERVICE AREA -CREATED A COMPREHENSIVE LIST OF COMMUNITY HEALTH ISSUES, BEHAVIOR AND LIFESTYLE ISSUES CONTRIBUTING TO HEALTH, AND ENVIRONMENTAL & SOCIAL ISSUES RELATED TO HEALTH FOR THE SERVICE AREA -PRIORITIZED THE LIST BASED ON INPUT FROM THE COALITIONS, CONSISTENCY BETWEEN SECONDARY AND PRIMARY DATA, OUR ABILITY TO ADDRESS, AND THE POTENTIAL TO EFFECT CHANGE -CREATED LIST OF PRIORITIZED HEALTH NEEDS AND BEHAVIORS"

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENT ACCOUNT STATEMENTS FOR SOUTHEASTHEALTH INCLUDE A STATEMENT THAT THE PATIENT MAY CONTACT THE ORGANIZATION WITH ANY QUESTIONS OR PAYMENT ISSUES REGARDING THEIR BILL. IF THE PATIENT COMMUNICATES THEIR INABILITY TO MAKE A PAYMENT, THE PATIENT IS INFORMED OF OPTIONS INCLUDING CHARITY CARE AND OTHER ASSISTANCE AND ARE PROVIDED AN EXPLANATION ON HOW TO APPLY FOR ASSISTANCE.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: SOUTHEASTHEALTH PROVIDES A VARIETY OF PROGRAMS DESIGNED TO IMPROVE COMMUNITY HEALTH INCLUDING: WEIGHT LOSS AND WEIGHT MANAGEMENT PROGRAMS, A SMOKING CESSATION CLASS, AND DIABETES MANAGEMENT PROGRAMS. SOUTHEASTHEALTH IS THE ONLY PROVIDER IN THE AREA PARTICIPATING IN THE NURSE/FAMILY PARTNERSHIP PROGRAM WHEREBY NURSES ARE ASSIGNED AS HEALTH COUNSELORS TO TEENAGE MOTHERS AND ADVISE THEM ON NUTRITION, PRE-NATAL CARE AND CHILDREN'S HEALTH ISSUES.

SCHEDULE H, PART VI, LINE 7
STATE FILING OF COMMUNITY BENEFIT REPORT: MISSOURI

SCHEDULE H, PART III, SECTION C, LINE 9B
BILLING, CREDIT AND COLLECTION POLICY: THE BUSINESS OFFICE OF SOUTHEASTHEALTH WILL ASSIST ALL PATIENTS IN THE BILLING OF INSURANCE CLAIMS TO GOVERNMENTAL AGENCIES, COMMERCIAL INSURANCE CARRIERS AND OTHER THIRD PARTIES FOR THE PURPOSE OF INSURING PROMPT RECEIPT OF PATIENT OBLIGATIONS. SELF-PAY PATIENTS (PATIENTS WITHOUT HEALTH CARE INSURANCE) WILL BE COOPERATED WITH FULLY WHILE BEING ENCOURAGED TO SATISFY THEIR FINANCIAL OBLIGATIONS TO SOUTHEASTHEALTH ON A TIMELY BASIS. AN ATMOSPHERE OF MUTUAL UNDERSTANDING BETWEEN THE PATIENTS WE SERVE AND OURSELVES WILL BE MAINTAINED AT ALL TIMES. SOUTHEASTHEALTH WILL BILL PATIENTS OR THIRD PARTIES ONLY FOR SERVICES ACTUALLY PROVIDED TO PATIENTS AND WILL PROVIDE ASSISTANCE TO PATIENTS SEEKING TO UNDERSTAND THE COST RELATIVE TO THEIR CARE. STAFF WILL ALSO ATTEMPT TO RESOLVE QUESTIONS AND OBJECTIONS TO THE SATISFACTION OF THE PATIENT WHILE CONSIDERING THE INSTITUTIONS NEEDS. PROCEDURES 1. SELF-PAY PATIENTS ARE MAILED A STATEMENT FIVE DAYS AFTER BILLING HAS BEEN COMPLETED. 2. PATIENTS WITH INSURANCE ARE MAILED A STATEMENT ONE DAY AFTER INSURANCE PAYMENTS AND ADJUSTMENTS HAVE BEEN APPLIED TO THE ACCOUNT, LEAVING A BALANCE FOR THE PATIENT. 3. SOUTHEASTHEALTH OFFERS PATIENTS SEVERAL DIFFERENT PAYMENT OPTIONS TO SATISFY THEIR ACCOUNT: A. CASH/CHECK FOR THE FULL PAYMENT. B. MASTERCARD/VISA/DISCOVER/AMERICANEXPRESS C. SHORT-TERM MONTHLY INSTALLMENTS: A. BALANCES OF $500 TO $2500 MINIMUM OF $100/MONTH AND RE-EVALUATE IN 12 MONTHS. B. BALANCES OF $2501 TO $5000 MINIMUM OF $250/MONTH AND RE-EVALUATE IN 12 MONTHS. C. BALANCES OF $5001 AND OVER MINIMUM OF $300/MONTH AND RE-EVALUATE IN 12 MONTHS. D. FINANCIAL ASSISTANCE IS AVAILABLE. PATIENT STATEMENTS LIST WHERE TO CALL OR GO ONLINE TO GET THE APPLICATION. 4. THIRTY DAYS AFTER THE FIRST PATIENT STATEMENT IS MAILED, IF THE BALANCE IS NOT PAID IN FULL, THE BALANCE IS REFERRED TO OUR BILLING SERVICE. 5. FIVE DAYS AFTER RECEIPT OF THE BALANCE, THE BILLING SERVICE BEGINS A DILIGENT COURTESY CALL COMPAIGN. 6. FIVE DAYS LATER, THE BILLING SERVICE MAILS THEIR FIRST PATIENT STATEMENT, AND WILL CONTINUE TO MAIL A PATIENT STATEMENT EVERY THIRTY DAYS FOR AN ADDITIONAL TWO MONTHS. 7. IF PAYMENT OR SATISFACTORY PAYMENT ARRANGEMENTS, AS OUTLINED ABOVE, ARE NOT MADE WITHIN FOUR MONTHS FROM THE ORIGINAL PATIENT STATEMENT, THE ACCOUNT WILL PROCEED THROUGH A COLLECTION PROCESS AS FOLLOWS: A. PRIMARY COLLECTION AGENCY: A. DAY 1 PATIENT STATEMENT IS MAILED. B. DAY 10 BEGIN DILIGENT COURTESY CALL CAMPAIGN, CALLS MADE EVERY THREE DAYS. C. STATEMENTS AND COURTESY CALLS CONTINUE FOR SIX MONTHS. D. DAY 180 IF NO PAYMENTS OR PAYMENT ARRANGEMENTS ARE MADE, THEN ACCOUNTS ARE FORWARDED TO A SECONDARY COLLECTION AGENCY. B. SECONDARY COLLECTION AGENCY (REPORTS TO CREDIT BUREAU): A. DAY 1 PATIENT STATEMENT IS MAILED. B. DAY 10 BEGIN DILIGENT COURTESY CALL CAMPAIGN, CALLS MADE EVERY THREE DAYS. C. STATEMENTS AND COURTESY CALLS CONTINUE FOR TWELVE MONTHS. D. DAY 365 IF NO PAYMENTS OR PAYMENT ARRANGEMENTS ARE MADE, THEN ACCOUNTS ARE TURNED BACK OVER TO SOUTHEASTHEALTH FOR FURTHER COLLECTION REVIEW. 8. ANY ACCOUNT THAT BECOMES DELINQUENT MAY BE TURNED OVER TO AN ATTORNEY OR COLLECTION AGENCY. ANY ADDITIONAL COSTS INCURRED IN COLLECTING DELINQUENT BALANCES, SUCH AS ATTORNEY FEES AND COURT COSTS, WILL BE ADDED TO THE COLLECTION BALANCE.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: SOUTHEASTHEALTH HAS A PRIMARY SERVICE AREA CONSISTING OF CAPE GIRARDEAU COUNTY, BOLLINGER COUNTY, SCOTT COUNTY AND STODDARD COUNTY ALL LOCATED IN SOUTHEAST MISSOURI. THE COMMUNITIES ARE DESCRIBED BELOW: -CAPE GIRARDEAU COUNTY IS LOCATED IN SOUTHEAST MISSOURI ALONG THE MISSISSIPPI RIVER *THE POPULATION OF THE COUNTY IS CURRENTLY 76,997 *WHITES COMPRISE 88.7% AND AFRICAN-AMERICANS REPRESENT 7% OF THE TOTAL POPULATION *THE COUNTY HAS A HIGHER PERCENTAGE OF THE YOUNGER POPULATION, AGES 15 - 24 THAN AVERAGE FOR THE STATE OF MISSOURI *88% OF CAPE GIRARDEAU COUNTY RESIDENTS 25 YEARS AND OVER HAVE GRADUATED FROM HIGH SCHOOL, WITH 33% GOING ON TO RECEIVE A POST-SECONDARY DEGREE *THE UNEMPLOYMENT RATE WAS 5.8% IN 2016, WHICH IS SLIGHTLY HIGHER THAN MISSOURI'S 5.0% *CAPE GIRARDEAU COUNTY HAS 17% OF RESIDENTS IN POVERTY, WITH 18% ELIGIBLE FOR FOOD STAMPS, AND 13.2% UNINSURED -BOLLINGER COUNTY IS LOCATED IN SOUTHEAST MISSOURI *HAS A MOSTLY RURAL POPULATION OF 12,403 *WHITES COMPRISE 97.9% OF THE TOTAL POPULATION *THE COUNTY HAS A HIGHER PERCENTAGE OF THE OLDER POPULATION, AGES 45 - 74 THAN DOES THE STATE OF MISSOURI *80% OF BOLLINGER COUNTY RESIDENTS 25 YEARS AND OVER HAVE GRADUATED FROM HIGH SCHOOL, WITH ONLY 15.4% GOING ON TO RECEIVE A POST-SECONDARY DEGREE *THE UNEMPLOYMENT RATE WAS 4.5% IN 2016, WHICH IS SLIGHTLY LOWER THAN MISSOURI'S 5.0% *BOLLINGER COUNTY HAS 20.1% OF RESIDENTS IN POVERTY, WITH 25% ELIGIBLE FOR FOOD STAMPS, AND 18.3% UNINSURED -SCOTT COUNTY IS LOCATED IN SOUTHEAST MISSOURI ALONG THE MISSISSIPPI RIVER *THE POPULATION OF THE COUNTY IS CURRENTLY 40,797 *WHITES COMPRISE 85.7% AND AFRICAN-AMERICANS COMPRISE 11.4% OFTHE TOTAL POPULATION *THE COUNTY HAS A HIGHER PERCENTAGE OF THE YOUNGEST POPULATION, AGES 0 - 14 AND THE OLDER POPULATION, AGES 65 - 74 THAN DOES THE STATE OF MISSOURI *80.5% OF SCOTT COUNTY RESIDENTS 25 YEARS AND OVER HAVE GRADUATED FROM HIGH SCHOOL, WITH 18% GOING ON TO RECEIVE A POST-SECONDARY DEGREE *THE UNEMPLOYMENT RATE WAS 5.8% IN 2016, WHICH IS SLIGHTLY HIGHER THAN MISSOURI'S 5.0% *SCOTT COUNTY HAS 20.9% OF RESIDENTS IN POVERTY, WITH 24% ELIGIBLE FOR FOOD STAMPS, AND 14.6% UNINSURED -STODDARD COUNTY IS LOCATED IN SOUTHEAST MISSOURI *HAS A MOSTLY RURAL POPULATION OF 29,504 *WHITES COMPRISE 97.3% OF THE TOTAL POPULATION *THE COUNTY HAS A HIGHER PERCENTAGE OF THE OLDER POPULATION, AGE 65+ THAN DOES THE STATE OF MISSOURI *NEARLY 80% OF STODDARD COUNTY RESIDENTS 25 YEARS AND OVER HAVE GRADUATED FROM HIGH SCHOOL, WITH 20% GOING ON TO RECEIVE A POST-SECONDARY DEGREE *THE UNEMPLOYMENT RATE WAS 7.4% IN 2016, WHICH IS CONSIDERABLY HIGHER THAN MISSOURI'S 5.0% *STODDARD COUNTY HAS 19% OF RESIDENTS IN POVERTY, WITH 27% ELIGIBLE FOR FOOD STAMPS, AND 16.9% UNINSURED

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: SOUTHEAST HOSPITAL, D/B/A SOUTHEASTHEALTH (THE HEALTH SYSTEM), PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE AND PHYSICIAN SERVICES TO PATIENTS IN THE CAPE GIRARDEAU AND THE SURROUNDING SOUTHEAST MISSOURI AREA. SOUTHEAST HOSPITAL IS LOCATED IN CAPE GIRARDEAU, MISSOURI, AND HAS MULTIPLE CAMPUSES AND FACILITIES, SUCH AS HEALTHPOINT FITNESS, SOUTHEAST HOME HEALTH, SOUTHEAST HOSPICE, SOUTHEAST MEDICAL PLAZA, SOUTHEAST CANCER CENTER AND VARIOUS OUTPATIENT CLINICS. SOUTHEASTHEALTH OF RIPLEY COUNTY, D/B/A SOUTHEASTHEALTH CENTER OF RIPLEY COUNTY, AND STODDARD COUNTY ARE COLLECTIVELY REFERRED TO AS SOUTHEASTHEALTH REGIONAL SYSTEM. THE SOUTHEASTHEALTH REGIONAL SYSTEM EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT, EMERGENCY CARE, PHYSICIAN SERVICES AND RETAIL PHARMACY OPERATIONS IN DEXTER, MISSOURI; DONIPHAN, MISSOURI; AND THEIR SURROUNDING AREAS. SOUTHEASTHEALTH SERVIR, OPERATED BY SOUTHEASTHEALTH HOSPITAL, PROVIDES SOFTWARE SUPPORT FOR THE HOSPITAL'S REVENUE CYCLE.