4A (Expenses $ 13098769 including grants of $ 0) (Revenue $ 13722135)
Union County General Hospital is a 25-bed acute care hospital located in Clayton, New Mexico. The Hospital provides services to individuals from Northeastern New Mexico, Southeastern Colorado, Western Panhandle of Oklahoma, and the Western Panhandle of Texas. These services include inpatient, swingbed, various outpatient services, emergency patient care and a rural health clinic. There were a total of 249 admissions and 10,132 patient visits at the Hospital as well as 7,422 patient visits at the Union County Health Center RHC and 293 patient visits at the Des Moines Health Center during fiscal year ending 6/30/2022.(Continued on Schedule O)The Hospital provides health care services to patients who meet certain criteria under its charity care policy without charge or at amounts less that established rates. Since the Hospital does not pursue collection of these amounts, they are not reported as patient service revenue. Charges for charity care provided during June 30, 2022 totaled $191,673 and the estimated cost of providing these services was $135,129 calculated by multiplying the ratio of costs to gross charges for the Hospital by the gross uncompensated charges associated with providing charity care.

Union County General Hospital
Part V, Section B, Line 5: UCGH provided CHC Consulting with a list of persons with special knowledge of public health in Union County, including public health representatives, not-for-profit organization professionals, charities and other individuals who focus specifically on underrepresented groups. With respect to individuals providing input, it was noted in the CHNA that 81.8% of those providing input are members of a medically underserved, low-income or minority population in the community, or individuals or organizations serving or representing the interests of such populations. 9.1% of those providing input work for a state, local, tribal or regional government public health department with knowledge, information or expertise relevant to the health needs of the community. 9.1% of those providing input are community leaders.

Union County General Hospital
Part V, Section B, Line 11: The most recently conducted CHNA was completed in 2021 and identified six significant needs in the community. The CHNA team and hospital leadership prioritized those needs using a structured matrix to rank the community health needs based on three characteristics: size and prevalence of the issue, effectiveness of interventions and the hospital's capacity to address the need.The final list of prioritized needs, in descending order, is listed below:1) Access to Consistent, Local Primary Care Providers2) Access to Dental Care Services and Providers3) Access to Specialty Care Services and Providers4) Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy Lifestyles5) Access to Mental and Behavioral Health Care Services and Providers6) Access to Affordable Care and Reducing Health Disparities Among Specific PopulationsPriority 1: Access to Consistent, Local Primary Care ProvidersObjective: Increase access to local primary care services and providers.1a. UCGH recruited an additional Family Practice Nurse Practitioner. 1b. UCGH has opened the School Base Clinic in Des Moines and has turned it into a Rural Health Clinic as well as a School Base Clinic. UCGH has added walk-in hours to their operating hours in the Union County Health Center, Clayton, NM. These hours are on Wednesday, Thursday, and Friday from 5:00p.m. to 7:00p.m. Due to Covid-19 the Hospital has been providing telehealth visits for patients through the RHC. 1c. Union County General Hospital will continue to promote its primary care provider services in order to increase awareness of service offerings in the community. This will be done via the local newspaper, local radio stations, social media outlets, the hospital's website.1d. Union County General Hospital will continue to schedule follow up appointments with patients' primary care provider upon discharge.Priority 2: Access to Dental Care Services and ProvidersObjective: Increase local access to dental health care services.2a. UCGH is currently recruiting dental and dental hygienist providers to the community to increase access to local dental care services. Union County currently has no dental services available. 2b. Due to COVID 19 the dental office and dental providers were put on hold. UCGH is still making this a priority once restrictions are lifted in the state of New Mexico.Priority 3: Access to Specialty Care Services and ProvidersObjective: Increase access to additional specialist services and providers in the community.3a. The hospital has a general surgeon who provides rotating coverage to the community once to twice a month.3b. Union County General Hospital will continue to host a mobile MRI van in the hospital parking lot once a week and assist with scheduling.3c. Union County General Hospital will continue to host a mobile Mammography van in the hospital parking lot 10-12 times per year (as scheduling needs require), and also assist with patient awareness.3d. The hospital will continue to staff a Nuclear Medicine Tech, who will come in as needed for nuclear medicine studies.3e. UCGH provides telemedicine programs in collaboration with the University of New Mexico (UNM) for emergency pediatrics and neurology/neurosurgery services for Strokes.3f. The hospital is currently evaluating rotating specialist coverage.3g. Union County General Hospital will continue to schedule follow up appointments with patients' providers upon discharge, when necessary.3h. Union County General Hospital will continue to market its specialty services to the community to increase awareness of its service offerings.3i. Union County General Hospital has created a specialty clinic in the hospital that will provide services the patients cannot currently receive in Union County.Priority 4: Prevention, Education and Services to Address High Mortality Rates, Chronic Diseases, Preventable Conditions and Unhealthy LifestylesObjective: Increase healthy lifestyle education and prevention resources at the hospital and in the community.4a. Union County General Hospital will continue to provide CPR training for hospital staff and other health care givers in the community.4b. The hospital will continue to incentivize employees and their families to participate in regular physical activity through a discounted membership at a local gym and recreation facilities, and the golf course.4c. UCGH will continue to participate in the county-wide health fairs, and additional hospital-based health fairs each year, to provide blood pressure screenings, lab tests, as well as many different areas of health and wellness education.4d. UCGH will continue to host open house events that include booths for varying community services to share information, educational sessions by providers, blood pressure screenings, lab tests, radiology services, mammography, diabetes finger stick tests, sleep medicine, and the testing of motor skills for physical therapy. Information will be provided in both English and Spanish when possible. 4e. UCGH will continue to maintain its status as a Level 4 Trauma Center through the provision of community education surrounding trauma 1-2 times per year (ex: firework safety, no texting and driving).4f. UCGH will continue to provide free flu shots to the community for the donation of 2 non-perishable food items for donation to community food drive.4g. Many representatives from the hospital serve as members of community organizations, including the Chamber of Commerce, the Rotary Club, the Union County Health Network, and the Local Emergency Planning Committee.4h. The hospital will continue to work with local Emergency Management Services (EMS) to provide trauma education on a regular basis for hospital and EMS staff.4i. UCGH will continue their partnership with the Sexual Assault Prevention program in the community.4j. Union County General Hospital will continue marketing social media, print advertisement and website enhancements to increase professionalism and community awareness of hospital service offerings.4k. Union County General Hospital will explore engaging local employers through the provision of drug screens, TB tests, flu vaccinations and bone scans for staff.4l. Union County General Hospital will continue to participate in the Emergency Planning Committee in the community, which is a collaborative approach that includes nursing, providers and other hospital allied staff, EMS, Flight Crews, the Fire Department, Police staff and the County Emergency Manager.4m. Union County General Hospital will continue to provide education in the lobby of the facility and clinic on a variety of health topics each month.4n. Union County General Hospital was unable to do some of these items due to COVID 19; but plan to start back up just as soon as we can, but we will need to do so while keeping patients and community members safe.Priority 5: Access to Mental and Behavioral Health Care Services and ProvidersObjective: Increase local access to mental and behavioral health care services. 5a. UCGH is currently looking into monetary grants to bring more mental and behavioral health care services to the community. 5b. UCGH is looking into telehealth services for mental and behavioral health care for the community. Priority 6: Access to Affordable Care and Reducing Health Disparities Among Specific PopulationsObjective: Increase local access to affordable health care and reducing health disparities among specific populations.6a. UCGH has trained and certified a few employees to help our patients apply for Medicaid and other low-income state benefits. 6b. UCGH has trained and certified a few employees to help our patients apply for Market Place Insurance that is based on patient's income. 6c. UCGH has trained a few employees to help our patients apply for Medicare. 6d. UCGH advertises through various venues when it is open enrollment for Medicare and the Market Place Insurance.

Union County General Hospital
"Part V, Section B, Line 13h: Presumptive Eligibility for Financial AssistanceThe hospital may use Discovery Healthcare Consultant Group and other publicly available information to determine, consistent with applicable legal requirements, estimated household size and income amounts for the basis of determining financial assistance eligibility when a patient does not provide a financial assistance application or supporting documentation.Expired patients, with no surviving spouse, may be deemed to have no income for purposes of calculation of yearly household income. Documentation of income is not required for expired patients; however, documentation of estate assets may be required. The surviving spouse of an expired patient may apply for financial assistance.The hospital may choose to grant financial assistance based solely upon the initial determination. Any patients who are on state assistance, are unemployed, disabled, transient or incompetent may be valid ""prima facie"" candidates. In such cases, the hospital may not complete full verification or documentation of any request.Patients whose outstanding balance, after payment by all third parties, is at or above 10% of their yearly household income are eligible to receive services at a discounted amount."

Part I, Line 3c:
"Presumptive Eligibility for Financial AssistanceThe hospital may use Discovery Healthcare Consultant Group and other publicly available information to determine, consistent with applicable legal requirements, estimated household size and income amounts for the basis of determining financial assistance eligibility when a patient does not provide a financial assistance application or supporting documentation.Expired patients, with no surviving spouse, may be deemed to have no income for purposes of calculation of yearly household income. Documentation of income is not required for expired patients; however, documentation of estate assets may be required. The surviving spouse of an expired patient may apply for financial assistance.The hospital may choose to grant financial assistance based solely upon the initial determination. Any patients who are on state assistance, are unemployed, disabled, transient or incompetent may be valid ""prima facie"" candidates. In such cases, the hospital may not complete full verification or documentation of any request.Patients whose outstanding balance, after payment by all third parties, is at or above 10% of their yearly household income are eligible to receive services at a discounted amount."

Part I, Line 7:
Charity care expense was converted to cost on line 7a based on an overall cost-to-charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost report. The cost for subsidized health services reported on line 7g was determined using the cost-to-charge ratio derived from worksheet 2.

Part I, Line 7, Column (f):
The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 1,374,176.

Part III, Line 2:
Management reviews patient receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision.

Part III, Line 3:
The amount of bad debt estimated to be attributable to patients under the Organization's charity care policy is 27.5%. This was determined by using the percentage of the population in the service area that is under the federal poverty guideline established for charity care.

Part III, Line 4:
The footnote to the Organization's financial statements can be found on page 12 of the attached audited financial statements.

Part III, Line 8:
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. Both the total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services.

Part III, Line 9b:
When a patient has indicated or demonstrated an inability to pay, an appropriate Hospital representative provides the patient with a financial assistance application. Applications must be completed in their entirety before financial assistance can be considered. Patients who qualify for financial assistance from a government program should be referred to the appropriate agency prior to consideration for charity/indigent care. An application for financial assistance from an outside agency should be obtained prior to charity care approval. From the discharge date, monthly statements are sent with information on financial assistance. After the 3rd statement is sent a Patient Financial Consultant works with the patient until deemed uncollectible. Accounts are sent to collections after 180-days from the date of service or date insurance paid. Patients have an additional 120-days to submit an application for financial assistance.

Part VI, Line 2:
The Hospital assesses the health care needs of the community through public meetings, board meetings, quality assurance meetings, and emergency room call backs.

Part VI, Line 3:
Patients are educated about financial assistance upon admission to the hospital and at discharge. Financial assistance information is displayed in waiting rooms, emergency rooms, and other areas of the hospital.Applying for financial assistance can be initiated by a patient requesting assistance in person, over the phone at 575-374-2585, through the mail at 300 Wilson St, Clayton, NM 88415, by email at andrea.naranjo@ucgh.net or via the hospital's website www.ucgh.net. Additionally, the hospital can initiate a financial assistance application on behalf of the patient.UCHG has certified its own employee so that patients can apply for Medicaid and other government assistance onsite because there is not a Medicaid office in the county. Patients are notified of this through Facebook, the newspaper, and when the organization sees the need for financial assistance.

Part VI, Line 5:
Our Board of Directors is mostly comprised of individuals from the community. The board provides a perspective on the needs of the community. The Hospital extends medical privileges to area physicians. Surplus funds are reinvested into facility and equipment upgrades and free programs throughout the year.During fiscal year 2022 Union County General Hospital did participate in the annual county-wide health fair. A blood draw was done at a discounted rate in April 2022. They also sponsored many different booths with different health needs and health education.

Part VI, Line 4:
Union County General Hospital (UCGH) is a 25-bed acute care hospital located in Clayton, New Mexico. As the key hospital for the region, UCGH offers a wide array of services which includes primary care, emergency care, inpatient care, therapy services, surgical services, swing bed care, a full medical staff and state-of-the-art equipment. UCGH provides the highest quality health care services possible to the residents of Union County and surrounding areas. The defined service area of UCGH is Union County in New Mexico. The population of Union County is expected to decrease from 4,021 in 2022 to 4,011 in 2027 by 0.2%. This is 1.2% less growth than the 1.4% expected growth for the state of New Mexico which is 2,192,707 in 2022 to 2,159,693 in 2027. As of 2022, the racial/ethnic breakout of Union County was 25.9% White Non-Hispanic, 1.6% Black, 39.5% Hispanic, 0.2% Asian, and 32.8% all others. By 2027, the White Non-Hispanic population is expected to decrease by 0.3% while the Black population is not expected to change. The Hispanic population is expected to decrease by 0.2%, the Asian population is not expected to change and all others are expected to decrease by 0.2% in Union County. Union County has a slightly older median age of 42.9 years than New Mexico at 38.5 years.The median household income in Union County and the state is expected to slightly increase over the next five years (2022-2027). Union County has a lower median household income at $40,947 than New Mexico at $56,735. Union County has a higher percentage of families living below poverty at 27.5% as compared to the state at 22.4%. With respect to education, Union County has a lower percentage of residents with a bachelor or advanced degree (12.6%) than the state (29.0%). The closest hospital is Coon Memorial Hospital located 48 miles from Union County General Hospital in Dalhart, TX. The hospital provides general inpatient and outpatient medical and surgical care.The largest industries are public administration, health care and social assistance, and retail trade.