4A (Expenses $ 52735434 including grants of $ 50088) (Revenue $ 59580895)
ACUTE CARE HOSPITAL OPERATIONS INCLUDING 1,514 INPATIENT ADMISSIONS, 43,911 OUTPATIENT VISITS AND 14,602 EMERGENCY DEPARMENT VISITS. ADDITIONALLY, CLINIC VISITS TOTALING 21,408 FROM THE FOLLOWING: TAOS SURGICAL SERVICES - 6,040; WOMEN'S HEALTH INSTITUTE - 7,074; HIGH ROAD DERMATOLOGY - 5,071; PRIMARY CARE - 3,223.

SCHEDULE H, PART V, SECTION B, LINE 5
FEDERAL REGULATIONS SURROUNDING CHNA REQUIRE LOCAL INPUT FROM REPRESENTATIVES OF PARTICULAR DEMOGRAPHIC SECTORS. FOR THIS REASON, HOLY CROSS HOSPITAL DEVELOPED A STANDARD PROCESS OF GATHERING COMMUNITY INPUT. WE DEPLOYED A CHNA ROUND 1 SURVEY TO OUR LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITALS DESIRE TO REPRESENT THE REGIONS GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. WE RECEIVED COMMUNITY INPUT FROM 33 LOCAL EXPERT ADVISORS. SURVEY RESPONSES STARTED JANUARY 26, 2016 AND ENDED WITH THE LAST RESPONSE ON FEBRUARY 11, 2016. INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW TAOS COUNTY RELATES TO ITS PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS (PRIORITY POPULATIONS) NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THESE GROUPS. LOCAL OPINIONS OF THE NEEDS OF PRIORITY POPULATIONS, WHILE PRESENTED IN ITS ENTIRETY IN THE APPENDIX, WAS ABSTRACTED IN THE FOLLOWING TAKE-AWAY BULLETED COMMENTS: - THERE IS A LACK OF RESOURCES FOR CHILDREN FROM LOW INCOME FAMILIES -THE NATIVE AMERICAN AND HISPANIC POPULATIONS HAVE UNIQUE NEEDS AND ARE LARGELY UNINSURED - SUPPORT FOR THE HOMELESS IS NEEDED WHEN THE ANALYSIS WAS COMPLETE, WE PUT THE INFORMATION AND SUMMARY CONCLUSIONS BEFORE OUR LOCAL EXPERT ADVISORS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL COMMENTS OF NEED, AND NEW NEEDS DID EMERGE FROM THIS EXCHANGE. CONSULTATION WITH 32 LOCAL EXPERTS OCCURRED AGAIN VIA AN INTERNET-BASED SURVEY (EXPLAINED BELOW) BEGINNING MARCH 7, 2016 AND ENDING MARCH 28, 2016. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A WISDOM OF CROWDS METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. IN THE HCH PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, THE VAST MAJORITY OF COMMENTS AGREED WITH OUR FINDINGS. WE DEVELOPED A SUMMARY OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA SETS. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE POTENTIAL SIGNIFICANT NEED CANDIDATES, INCLUDING THE OPPORTUNITY TO AGAIN PRESENT ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. A RANK ORDER OF PRIORITIES EMERGED, WITH SOME NEEDS RECEIVING NONE OR VIRTUALLY NO SUPPORT, AND OTHER NEEDS RECEIVING IDENTICAL POINT ALLOCATIONS. WE DICHOTOMIZED THE RANK ORDER OF PRIORITIZED NEEDS INTO TWO GROUPS: SIGNIFICANT AND OTHER IDENTIFIED NEEDS. OUR CRITERIA FOR IDENTIFYING AND PRIORITIZING SIGNIFICANT NEEDS WERE BASED ON A DESCENDING FREQUENCY RANK ORDER OF THE NEEDS BASED ON TOTAL POINTS CAST BY THE LOCAL EXPERTS, FURTHER RANKED BY A DESCENDING FREQUENCY COUNT OF THE NUMBER OF LOCAL EXPERTS CASTING ANY POINTS FOR THE NEED. BY OUR DEFINITION, A SIGNIFICANT NEED HAD TO INCLUDE ALL RANK ORDERED NEEDS UNTIL AT LEAST FIFTY PERCENT (50%) OF ALL POINTS WERE INCLUDED AND TO THE EXTENT POSSIBLE, REPRESENTED POINTS ALLOCATED BY A MAJORITY OF VOTING LOCAL EXPERTS. THE DETERMINATION OF THE BREAK POINT, SIGNIFICANT AS OPPOSED TO OTHER, WAS A QUALITATIVE INTERPRETATION BY QHR AND THE HCH EXECUTIVE TEAM WHERE A REASONABLE BREAK POINT IN RANK ORDER OCCURRED.

SCHEDULE H, PART V, SECTION B, LINE 7A
direct url to CHNA: http://taoshospital.org/uploads/files/Holy_Cross_Hospital_-_Community_Heal th_Need_Assesment_-_2016.pdf

SCHEDULE H, PART V, SECTION B, LINE 7D
IN ADDITION TO PUBLISHING THE CHNA ON OUR WEBSITE AND PROVIDING HARD COPIES FOR THE PUBLIC'S REVIEW IN OUR ADMINISTRATIVE OFFICES, WE DELIVERED PRINTED COPIES OF THE CHNA TO TWO LOCAL LIBRARIES, WHERE THEY ARE MADE AVAILABLE TO THE PUBLIC VIA THE REFERENCE DEPARTMENT. ALSO, WE DISSEMINATED THE INFORMATION IN LARGE POSTER BOARD FORMAT VIA THE TAOS CARES HEALTH COUNCIL AND IN ONE COMMUNITY LISTENING SESSION IN AN OUTLYING RURAL AREA.

SCHEDULE H, PART V, SECTION B, LINE 10A
DIRECT URL TO IMPLEMENTATION STRATEGY: http://taoshospital.org/uploads/files/Holy_Cross_Hospital_-_Community_Heal th_Need_Assesment_-_2016.pdf THE IMPLEMENTATION STRATEGY IS FOUND WITHIN THE CHNA DOCUMENT AND BEGINS ON PAGE 39.

SCHEDULE H, PART V, SECTION B, LINE 11
WE USED THE PRIORITY RANKING OF AREA HEALTH NEEDS BY THE LOCAL EXPERT ADVISORS TO ORGANIZE THE SEARCH FOR LOCALLY AVAILABLE RESOURCES AS WELL AS THE RESPONSE TO THE NEEDS BY HCH. THE FOLLOWING LIST: - IDENTIFIES THE RANK ORDER OF EACH IDENTIFIED SIGNIFICANT NEED - PRESENTS THE FACTORS CONSIDERED IN DEVELOPING THE RANKING - ESTABLISHES A PROBLEM STATEMENT TO SPECIFY THE PROBLEM INDICATED BY USE OF THE SIGNIFICANT NEED TERM - IDENTIFIES HCH CURRENT EFFORTS RESPONDING TO THE NEED INCLUDING ANY WRITTEN COMMENTS RECEIVED REGARDING PRIOR HCH IMPLEMENTATION ACTIONS -ESTABLISHES THE IMPLEMENTATION STRATEGY PROGRAMS AND RESOURCES HCH WILL DEVOTE TO ATTEMPT TO ACHIEVE IMPROVEMENTS -DOCUMENTS THE LEADING INDICATORS HCH WILL USE TO MEASURE PROGRESS -PRESENTS THE LAGGING INDICATORS HCH BELIEVES THE LEADING INDICATORS WILL INFLUENCE IN A POSITIVE FASHION, AND -PRESENTS THE LOCALLY AVAILABLE RESOURCES NOTED DURING THE DEVELOPMENT OF THIS REPORT AS BELIEVED TO BE CURRENTLY AVAILABLE TO RESPOND TO THIS NEED. IN GENERAL, HCH IS THE MAJOR HOSPITAL IN THE SERVICE AREA. HOLY CROSS HOSPITAL IS A 29-BED, ACUTE CARE RURAL HOSPITAL LOCATED IN TAOS, NEW MEXICO. THE NEXT CLOSEST FACILITIES ARE OUTSIDE THE SERVICE AREA AND INCLUDE: - PRESBYTERIAN ESPANOLA HOSPITAL IN ESPANOLA, NM, 45 MILES (57 MINUTES) - LOS ALAMOS MEDICAL CENTER IN LOS ALAMOS, NM, 65 MILES (81 MINUTES) -CHRISTUS ST. Vincent REGIONAL MEDICAL CENTER IN SANTA FE, NM, 71 MILES (89 MINUTES) ALL DATA ITEMS ANALYZED TO DETERMINE SIGNIFICANT NEEDS ARE LAGGING INDICATORS, MEASURES PRESENTING RESULTS AFTER A PERIOD OF TIME, CHARACTERIZING HISTORICAL PERFORMANCE. LAGGING INDICATORS TELL YOU NOTHING ABOUT HOW THE OUTCOMES WERE ACHIEVED. IN CONTRAST, THE HCH IMPLEMENTATION STRATEGY USES LEADING INDICATORS. LEADING INDICATORS ANTICIPATE CHANGE IN THE LAGGING INDICATOR. LEADING INDICATORS FOCUS ON SHORT-TERM PERFORMANCE, AND IF ACCURATELY SELECTED, ANTICIPATE THE BROADER ACHIEVEMENT OF DESIRED CHANGE IN THE LAGGING INDICATOR. IN THE QHR APPLICATION, LEADING INDICATORS ALSO MUST BE WITHIN THE ABILITY OF THE HOSPITAL TO INFLUENCE AND MEASURE. WITHIN THE CHNA DOCUMENT, EACH SIGNIFICANT NEED IDENTIFIED THAT HAS AN IMPLEMENTATION STRATEGY HAS ITS OWN SECTION THAT INCLUDES PUBLIC COMMENTS, AN ASSESSMENT OF SERVICES, PROGRAMS AND RESOURCES AVAILABLE TO RESPOND TO THE NEED, AND AN ACTION PLAN.

SCHEDULE H, PART V, SECTION B, LINE 16a
Direct URL for the Financial Assistance Policy: https://holycrossmedicalcenter.org/wp-content/uploads/2018/08/2017_-_Finan cial_Assistance_Policy_-_English_-_Taos_Health_Systems.pdf

SCHEDULE H, PART V, SECTION B, LINE 16b
direct url for fap application form: https://holycrossmedicalcenter.org/wpcontent/uploads/2018/08/FAP_Applicati on.pdf

SCHEDULE H, PART V, SECTION B, LINE 16c
direct url for plain language summary: https://holycrossmedicalcenter.org/wp-content/uploads/2018/08/FINANCIAL_AS SISTANCE_Summary.pdf

SCHEDULE H, PART V, SECTION B, LINE 16i&j
TRANSLATION OF FAP INTO PRIMARY LANGAUGE SPOKEN BY LEP POPULATIONS: Holy Cross Hospital, HAS TRANSLATED THE FAP INTO SPANISH and has provided the policy in paper and on their website. Holy Cross Hospital WOULD CONSIDER TRANSLATING INTO ANOTHER LANGUAGE WHEN IT IS KNOWN THAT PATIENTS WILL NEED THE TRANSLATION AND ARE NOT SERVED BY THE CURRENT FORMS AND STATEMENTS. Holy cross Hospital USES DEMOGRAPHIC DATA FROM THEIR SYSTEM AND THE COUNTIES TO DETERMINE IF A PATIENT POPULATION EXISTS THAT IS OVER 1,000 INDIVIDUALS THAT DO NOT SPEAK ENGLISH OR SPANISH.

SCHEDULE H, PART V, SECTION B, LINE 22d
"PERSONS QUALIFYING FOR THE FINANCIAL ASSISTANCE PROGRAM WILL BE CHARGED NOT MORE THAN THE ""AMOUNTS GENERALLY BILLED"" (AGB) OTHER PAYERS. AMOUNTS GENERALLY BILLED IS CALCULATED USING THE ""LOOK BACK"" METHOD. AMOUNTS GENERALLY BILLED, REPRESENTS EFFECTIVELY, WHAT THE HOSPITAL COLLECTS IN PAYMENTS FROM INSURANCE COMPANIES, MEDICARE AND MEDICAID (INCLUDING PATIENT OUT-OF-POCKET AMOUNTS)."

SCHEDULE H, Part I, Line 7
THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A. THE COST-TO-CHARGE RATIO WAS DERIVED FROM Worksheet 2, RATIO OF PATIENT CARE COST-TO-CHARGES. THE INFORMATION FOR LINES 7E, 7F AND 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS. THE INFORMATION FOR LINE 7G USED A COST-TO-CHARGE RATIO DERIVED FROM THE ORGANIZATION'S COST REPORT.

SCHEDULE H, Part I, Line 7, Column (f)
total bad debt expense removed from the denominator prior to the percentage calculation = $3,580,017

SCHEDULE H, PART III, Section A, LINE 2
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 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 A, LINE 3
THE AMOUNT OF BAD DEBT EXPENSE ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS CALCULATED BASED ON EXPERIENCE AND COMMUNITY/INDUSTRY KNOWLEDGE APPLIED TO VARIOUS FINANCIAL CLASSES. THE LARGEST FINANCIAL CLASS WAS SELF-PAY, WHICH WAS ESTIMATED AT 60% THAT MAY HAVE BEEN ELIGIBLE IF PAPERWORK WOULD HAVE BEEN COMPLETED AND SUBMITTED.

SCHEDULE H, PART III, Section A, LINE 4
THE FOOTNOTE THAT DESCRIBES THE BAD DEBT EXPENSE FOR THE ORGANIZATION IS LOCATED ON PAGES 9-10 OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, Section B, LINE 8
ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE HOSPITALS MUST TREAT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE GOVERNMENT SETS NON NEGOTIABLE MEDICARE RATES WHICH ARE SOMETIMES OUT OF LINE WITH THE TRUE COST TO TREAT MEDICARE PATIENTS. BY TREATING MEDICARE ELIGIBLE PATIENTS, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. THE DATA USED TO EVALUATE THE MEDICARE SHORTFALL WAS OBTAINED FROM THE FY2018 MEDICARE COST REPORT.

SCHEDULE H, PART III, Section C, LINE 9b
HOLY CROSS HOSPITAL WILL CONTINUALLY NOTIFY THE PATIENT WITH OPEN SELF-PAY ACCOUNTS OF THE FINANCIAL ASSISTANCE POLICY AVAILABILITY FOR A 120 DAY PERIOD. THIS IS KNOWN AS THE FINANCIAL ASSISTANCE POLICY NOTIFICATION PERIOD. HOLY CROSS HOSPITAL WILL PROVIDE THE PATIENT WRITTEN NOTIFICATION 30 DAYS PRIOR TO THE END OF THE FINANCIAL ASSISTANCE NOTIFICATION PERIOD. ADDITIONALLY, HOLY CROSS HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITY UNTIL SUFFICIENT TIME AND NOTIFICATION PERIODS HAVE PASSED (AT LEAST 120 DAYS).

SCHEDULE H, PART VI, LINE 2
IN ADDITION TO OUR 2016 CHNA, TAOS HEALTH SYSTEMS, HOLY CROSS HOSPITAL, PARTICIPATES IN A STUDY GROUP IN PARTNERSHIP WITH TOWN AND COUNTY OFFICIALS. THESE SESSIONS ARE OPEN TO THE PUBLIC AND DESIGNED TO ADDRESS COMMUNITY CONCERNS IN AN OPEN FORUM. ALSO, TAOS HEALTH SYSTEMS, DBA HOLY CROSS HOSPITAL, ACTS AS FISCAL AGENT FOR THE TAOS CARES HEALTH COUNCIL, WHICH CONVENES COMMUNITY MEMBERS AND PARTNER AGENCIES MONTHLY IN ORDER TO: 1) DISSEMINATE HEALTH INFORMATION, INCLUDING CHNA DATA, TO COMMUNITY; 2) GATHER COMMUNITY INPUT; 3) BRING HEALTH CARE ENTITIES TOGETHER; 4) STRENGTHEN COMMUNITY SERVICES; 5) ASSIST COMMUNITIES WITH HEALTH AND HEALTHCARE GOALS; 6) EDUCATE COMMUNITY AND HEALTH CARE PROVIDERS. THE INFORMATION OBTAINED FROM THE MONTHLY STUDY GROUPS, OPEN PUBLIC SESSIONS AND TAOS CARESHEALTH COUNCIL IS USED IN CONJUNCTION WITH INTERNAL ASSESSMENTS TO UPDATE THE IMPLEMENTATION STRATEGY FROM THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT.

SCHEDULE H, PART VI, LINE 3
WHEN AN ACCOUNT IS FINAL BILLED AND IDENTIFIED AS SELF-PAY, A LETTER IS SENT TO THE PATIENT REQUESTING EITHER PAYMENT OR THE PATIENT CONTACT THE HOSPITAL TO DISCUSS FINANCIAL ASSISTANCE. PAYMENT PLANS MAY BE ARRANGED OR AN APPLICATION FOR CHARITY CARE MAY BE COMPLETED. FOR SELF-PAY ACCOUNTS LESS THAN $1,000, NO CALLS ARE MADE TO THE PATIENT AND COLLECTION EFFORTS ARE THE SAME FOR ALL ACCOUNTS UNLESS THE PATIENT IS MAKING PAYMENTS OR HAD INDICATED THAT THEY WILL APPLY FOR FINANCIAL ASSISTANCE. FOR SELF-PAY ACCOUNTS BETWEEN $1,000 AND $5,000, THE PATIENT WILL BE CONTACTED AT LEAST 3 TIMES BY TELEPHONE TO ENCOURAGE THEM TO DISCUSS THEIR BILL AND APPLY FOR ASSISTANCE. PATIENTS AGREEING TO APPLY FOR CHARITY CARE WILL BE GIVE APPLICATIONS AND ASSISTED IN COMPLETING THE FORMS IF NECESSARY. WHEN AN APPLICATION IS RECEIVED THE FOLLOWING STEPS WILL BE TAKEN: - IF THE ACCOUNT IS MORE THAN 120 DAYS OLD ALL EXTRAORDINARY COLLECTION ACTIVITY WILL BE SUSPENDED APPLICATION INFORMATION WILL BE REVIEWED FOR A DISPOSITION WITHIN 5 BUSINESS DAYS. IF THE APPLICATION IS APPROVED, THE FOLLOWING STEPS WILL BE TAKEN: - BILLING STATEMENT SHOWING THE AMOUNT OF FINANCIAL ASSISTANCE GIVEN, ANY REMAINING BALANCES OWED WILL BE SENT TO THE PATIENT - REFUND ANY EXCESS PAYMENTS MADE BY INDIVIDUAL IF THE APPLICATION IS RECEIVED INCOMPLETE, THE FOLLOWING ACTION WILL BE TAKEN: - PROVIDE INDIVIDUAL WITH WRITTEN NOTICE OF ADDITIONAL INFORMATION NEEDED WITH COMPLETION DEADLINE - ONE NOTICE THAT EXTRAORDINARY COLLECTIONS WILL PROCEED IF APPLICATION IS NOT COMPLETED OR CLAIM IS NOT PAID WITHIN 30 DAYS FROM ABOVE COMPLETION DEADLINE OR LAST DAY OF APPLICATION PERIOD (240 DAYS) IF THE APPLICATION IS DENIED, PATIENTS WILL BE SENT A LETTER INFORMING THEM OF THE REASON FOR DENIAL. HOLY CROSS HOSPITAL WILL CONTINUALLY NOTIFY THE PATIENT WITH OPEN SELFPAY ACCOUNTS OF THE FINANCIAL ASSISTANCE POLICY AVAILABILITY FOR A 120 DAYS PERIOD. THIS IS KNOWN AS THE FINANCIAL ASSISTANCE POLICY NOTIFICATION PERIOD. HOLY CROSS HOSPITAL WILL PROVIDE THE PATIENT WRITTEN NOTIFICATION 30 DAYS PRIOR TO THE END OF THE FINANCIAL ASSISTANCE NOTIFICATION PERIOD (AT 90 DAYS). HOLY CROSS HOSPITAL WILL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITY UNTIL SUFFICIENT TIME AND NOTIFICATION PERIODS HAVE PASSED (AT LEAST 120 DAYS). PATIENTS WILL BE BILLED FULL CHARGES LESS 20% UNINSURED DISCOUNT IF THEY DO NOT APPLY FOR FINANCIAL ASSISTANCE. FOR ACCOUNTS LESS THAN $2,000, INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. FOR ACCOUNTS GREATER THAN $2,000, WE WILL ACCEPT ALL APPLICATIONS AND CALL THE PATIENT WEEKLY FOR 3 WEEKS TO OBTAIN THE MISSING INFORMATION. AFTER 3 WEEKS, WE WILL MAIL THE APPLICATION TO THE PATIENT EXPLAINING THAT WE WERE UNABLE TO PROCESS AND FOR THEM TO BRING THE APPLICATION BACK TO THS WHEN IT IS COMPLETE. ON SELF-PAY ACCOUNTS OVER $5,000, THE PATIENT WILL BE CALLED AS SOON AS THE ACCOUNT IS IDENTIFIED. THE PATIENT WILL ALSO BE CALLED PRIOR TO EACH ADDITIONAL COLLECTION LETTER BEING SENT. AFTER ALL APPROPRIATE COLLECTIONS LETTERS HAVE BEEN SENT AND TELEPHONE CALLS HAVE BEEN MADE AND THE PATIENT HAS NOT MADE AN ATTEMPT TO MAKE SUITABLE ARRANGEMENTS, THE ACCOUNT WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY.

SCHEDULE H, PART VI, LINE 4
TAOS HEALTH SYSTEM SERVES APPROXIMATELY 51,000 RESIDENTS OF TAOS, COLFAX, AND NORTHERN RIO ARRIBA COUNTIES, A DIVERSE CULTURAL COMMUNITY WITH A POVERTY RATE OF 23.4% IN A RURAL FRONTIER AREA OF 15 PEOPLE PER SQUARE MILE IN MORE THAN 2,500 SQUARE MILES. THE POPULATION OF TAOS COUNTY IS 56.4% HISPANIC OR LATINO, 7.6% NATIVE AMERICAN AND 35.4% WHITE NON-HISPANIC. IN TAOS COUNTY, 22.1% OF OUR COLLECTIVE POPULATION IS 65 OR OVER, COMPARED TO 15.1% NATIONWIDE, SO WE SEE DISPROPORTIONATELY HIGH ONSET IN CHRONIC DISEASES. THE PROPORTION OF TAOS COUNTY CHILDREN IN IMPOVERISHED OR LOW INCOME FAMILIES REMAINS ONE OF THE HIGHEST IN THE STATE AND THE NATION, WITH MORE THAN 43% OF ALL TAOS COUNTY CHILDREN UNDER 18 LIVING IN POVERTY.

SCHEDULE H, PART VI, LINE 5
THS CONTAINS HOLY CROSS HOSPITAL, TAOS WOMEN'S HEALTH INSTITUTE, TAOS SURGICAL SPECIALTISTS, HIGH ROAD DERMATOLOGY, TAOS PRIMARY CARE, AND THE CENTER FOR PHYSICAL HEALTH. WE PROVIDE ACUTE HOSPITAL CARE, SURGERY CARE, AND REHABILITATIVE SPORTS MEDICINE AND PHYSICAL THERAPY SERVICES AS WELL AS A WOMEN'S HEALTH CLINIC, A PEDIATRIC CLINIC AND A SURGICAL SPECIALTIES CLINIC TO ENSURE THAT THE COMMUNITY'S NEED FOR CARE IS MET. OUR SYSTEM EMPLOYS 9 PHYSICIANS AND 11 ADVANCE PRACTICE CLINICIANS IN GENERAL SURGERY, UROLOGY, OB/GYN, DERMATOLOGY, PRIMARY CARE, PEDIATRICS, AND EMERGENCY MEDICINE. IN ADDITION, PROVIDERS OF OTHER SPECIALTIES INCLUDING, BUT NOT LIMITED TO, INTERNAL MEDICINE, CARDIOLOGY, ORTHOPEDICS, ENT, WOUND CARE, ANTI-COAGULATION, AND PODIATRY PROVIDE SERVICES WITHIN OUR ORGANIZATION. OUR EMERGENCY DEPARTMENT, OPERATING ROOMS, LABORATORY, AND RADIOLOGY DEPARTMENTS ARE FULLY STAFFED AND TECHNOLOGICALLY EQUIPPED. THS ALSO PROVIDES A NUMBER OF GRANT AND HOSPITAL FUNDED COMMUNITY BENEFIT PROGRAMS THAT SERVE A WIDE ARRAY OF AREA RESIDENTS AT NO OR LOW COST. THESE INCLUDE: - MEDICAID ENROLLMENT PROVIDES COMMUNITY HEALTH WORKERS, INCLUDING BILINGUAL CHW'S, WHO CURRENTLY ASSIST UNINSURED PEOPLE TO ACCESS TO CENTENNIAL CARE AS WELL AS OUTREACH. - HEALTH EXCHANGE ENROLLMENT PROVIDES OUTREACH AND ENROLLMENT BY CERTIFIED HEALTHCARE GUIDES IN THE HEALTH INSURANCE EXCHANGE. - DIABETES MANAGEMENT PROVIDES DISEASE MANAGEMENT STRATEGIES FOR PREDIABETICS AND PEOPLE LIVING WITH TYPE I AND II DIABETES. - NUTRITION COUNSELING PROVIDES MULTIFACETED COUNSELING FOR PATIENTS FACING CHRONIC DISEASE AND OBESITY. - PRESCRIPTION ASSISTANCE PROVIDES EMERGENCY AND ONGOING ASSISTANCE FOR PATIENTS UNABLE TO PAY FOR THEIR MEDICATIONS. - MEDICATION THERAPY MANAGEMENT IMPROVES MEDICATION SAFETY AND EFFECTIVENESS FOR ANYONE ON PRESCRIPTION MEDICATIONS. - TAOS ALIVE IS A COALITION TARGETED AT PREVENTING YOUTH SUBSTANCE ABUSE VIA ENVIRONMENTAL STRATEGIES SUCH AS MEDIA AWARENESS CAMPAIGNS AND LOCAL POLICY CHANGE. - UNDERAGE DRINKING PREVENTION PROVIDES ALCOHOL LITERACY EDUCATION TO TAOS COUNTY ELEMENTARY, MIDDLE, AND HIGH SCHOOL STUDENTS ALONG WITH MEDIA LITERACY CAMPS DURING THE SUMMER. - OVERDOSE PREVENTION PROVIDES PREVENTION STRATEGIES TO COMMUNITY MEMBERS AT-RISK FOR OPIATE OVERDOSE. - CANCER SUPPORT SERVICES PROVIDES SERVICES FOR PATIENTS AND FAMILIES LIVING WITH CANCER. - SANE (SEXUAL ASSAULT NURSE EXAMINER) SERVES VICTIMS OF SEXUAL ASSAULT WITH CONFIDENTIAL EXAMS AND REFERRALS. - FIRST STEPS HOME VISITING PROVIDES SUPPORT AND REFERRALS FOR FIRST-TIME FAMILIES WITH CHILDREN AGES 0-3. - TAOS LOVES KIDS PARENTING CLASSES PROVIDE TRAINING FOR CAREGIVERS OF CHILDREN AGES 0- 5. - KIDS FIRST! SUPPORTS THE MENTAL AND PHYSICAL HEALTH OF PENASCO VALLEY FAMILIES OF CHILDREN 0-10. - THE ANTI-COAGULATION CLINIC MONITORS AND ADJUSTS DRUG THERAPY FOR PEOPLE WHO SUFFER CARDIOVASCULAR DISEASE AND ARE AT RISK FOR BLOOD CLOTS. - DISASTER PREPAREDNESS WORKS WITH COMMUNITY PARTNERS AND HOSPITAL STAFF TO PREPARE THE HEALTHCARE SYSTEM COMMUNITY FOR COUNTY-WIDE PUBLIC HEALTH EMERGENCIES OF ALL TYPES.

SCHEDULE H, PART VI, LINE 7
COMMUNITY BENEFIT REPORTS ARE FILED IN THE STATE OF NEW MEXICO