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Van Wert County Hospital Association

Van Wert County Hospital

1250 S Washington St
Van Wert, OH 45891

Bed count	120	Medicare provider number	360071	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 344429514

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

2.99%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 0 0 %
Medicaid as % of operating expenses	$ 2,575,872 2.95 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 18,649 0.02 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 15,916 0.02 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 1,212,702 1.39 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 76150804 including grants of $ 0) (Revenue $ 76693558)
INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

SCHEDULE H, PART V, SECTION B, LINE 5
IN CONDUCTING ITS MOST RECENT CHNA, VAN WERT COUNTY HOSPITAL ASSOCIATION OBTAINED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH VIA INTERVIEWS AND SURVEYS OF COMMUNITY LEADERS, REPRESENTATIVES, AND MEMBERS.

PART V, SECTION B, LINE 6B
VAN WERT COUNTY HOSPITAL ASSOCIATION'S CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS: VAN WERT COUNTY GENERAL HEALTH DISTRICT CRESTVIEW LOCAL SCHOOLS LINCOLNVIEW LOCAL SCHOOLS VAN WERT CITY SCHOOLS WESTWOOD BEHAVIORAL HEALTH CENTER VAN WERT HEALTH NORTHWESTERN OHIO COMMUNITY ACTION COMMISSION FAMILY HEALTH CARE OF NORTHWEST OHIO VAN WERT COUNTY FAMILY & CHILDREN FIRST VAN WERT COUNTY COUNCIL ON AGING YWCA OF VAN WERT COUNTY VAN WERT COUNTY DEPARTMENT OF JOB & FAMILY SERVICES UNITED WAY OF VAN WERT COUNTY MAIN STREET VAN WERT VAN WERT COUNTY ECONOMIC DEVELOPMENT TRI COUNTY ADAMHS BOARD

SCHEDULE H, PART V, SECTION B, LINE 11
THE THREE PRIORITY HEALTH NEEDS THAT WILL BE ADDRESSED IN THE 2022-2024 IMPLEMENTATION STRATEGY ARE: - PRIORITY AREA 1: NUTRITION & PHYSICAL ACTIVITY - PRIORITY AREA 2: ACCESS TO CARE - PRIORITY AREA 3: MENTAL HEALTH & ADDICTION PRIORITY AREA 1: NUTRITION & PHYSICAL ACTIVITY STRATEGY 1: INCREASE YOUTH FRUIT CONSUMPTION. (SHIP INDICATOR HB3: YOUTH FRUIT CONSUMPTION). STRATEGY 2: INCREASE YOUTH VEGETABLE CONSUMPTION. (SHIP INDICATOR HB4: YOUTH VEGETABLE CONSUMPTION) STRATEGY 3: INCREASE PHYSICAL ACTIVITY OF CHILDREN. (SHIP INDICATOR HB5: CHILD PHYSICAL ACTIVITY) ACTION STEP(S): - ANNUAL PARTNERSHIP FOR THE MARKET AT THE WASS FARMERS' MARKET TO INCREASE ACCESS TO FRESH PRODUCE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + BACK TO SCHOOL EVENT + PLACE BIKE RACKS AND WATER STATIONS THROUGHOUT THE COMMUNITY WHERE THERE ARE CURRENTLY NONE (EX. DOWNTOWN AREA) + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN. PRIORITY AREA 2: ACCESS TO CARE STRATEGY 1: INCREASE HEALTH INSURANCE COVERAGE FOR UNINSURANCE ADULTS. (SHIP INDICATOR AC1: UNINSURED ADULTS) STRATEGY 2: INCREASE HEALTH INSURANCE COVERAGE FOR UNINSURED CHILDREN. (SHIP INDICATOR AC2: UNINSURED CHILDREN) ACTION STEP(S): - INCREASE AWARENESS OF SOCIAL SERVICES. - IMPLEMENT INITIATIVE TO DRIVE COMMUNITY WIDE NETWORKING AMONG ORGANIZATIONS AND PROVIDERS IN VAN WERT HEALTH SERVICE AREA. - WORK WITH HEALTH COLLABORATIVE TO BUILD CULTURAL COMPETENCY FOR SPANISH SPEAKING POPULATION. - BUILD NETWORK OF PROVIDERS THAT SERVE SPANISH SPEAKING POPULATION. - INCREASE ELIGIBILITY SOCIAL ASSISTANCE PROGRAMS OF THE HISPANIC/SPANISH SPEAKING POPULATION. STRATEGY 3: DECREASE NUMBER OF PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS. (SHIP INDICATOR AC3: PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS) STRATEGY 4: DECREASE NUMBER OF MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS. (SHIP INDICATOR AC4: MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS) ACTION STEP(S): - PROVIDE UP TO 6 RENEWABLE HIGH SCHOOL SCHOLARSHIPS FOR THOSE PURSUING STUDIES IN HEALTH AND HUMAN SERVICES. - PROVIDE MEDICAL SCHOLARSHIPS. - CONDUCT ONGOING PHYSICIAN RECRUITMENT AND PARTNERSHIPS TO PROVIDE LOCAL ACCESS TO SPECIALTIES. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. STRATEGY 5: DECREASE UNMET NEED FOR MENTAL HEALTH CARE FOR YOUTH DEPRESSION. (SHIP INDICATOR AC5: YOUTH DEPRESSION TREATMENT FOR UNMET NEED) STRATEGY 6: DECREASE UNMET NEED FOR MENTAL HEALTH CARE FOR MENTAL HEALTH CARE FOR ADULTS. (SHIP INDICATOR AC6: ADULT MENTAL HEALTH CARE UNMET NEED) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - INCREASE NUMBER OF ADULTS TRAINED IN YOUTH MENTAL HEALTH FIRST AID. PRIORITY AREA 3: MENTAL HEALTH & ADDICTION STRATEGY 1: DECREASE YOUTH DEPRESSION. (SHIP INDICATOR MHA1: YOUTH DEPRESSION) STRATEGY 2: DECREASE ADULT DEPRESSION. (SHIP INDICATOR MHA2: ADULT DEPRESSION) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN - PROVIDE YOUTH MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY AND SCHOOLS. - PROVIDE MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY. STRATEGY 3: DECREASE YOUTH SUICIDE DEATHS. (SHIP INDICATOR MHA3: YOUTH SUICIDE DEATHS) STRATEGY 4: DECREASE ADULT SUICIDE DEATHS. (SHIP INDICATOR MHA4: ADULT SUICIDE DEATHS) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN - PROVIDE YOUTH MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY AND SCHOOLS. - PROVIDE MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY. STRATEGY 5: DECREASE YOUTH ALCOHOL USE. (SHIP INDICATOR MHA5: YOUTH ALCOHOL USE) STRATEGY 6: DECREASE YOUTH MARIJUANA USE. (SHIP INDICATOR MHA6: YOUTH MARIJUANA USE) STRATEGY 7: DECREASE UNINTENTIONAL DRUG OVERDOSE DEATHS. (SHIP INDICATOR MHA7: UNINTENTIONAL DRUG OVERDOSE DEATHS) ACTION STEP(S): - INCREASE AWARENESS AND UTILIZATION OF GETLOCALHELPNOW APP. - INCREASE INTEGRATED MENTAL HEALTH SERVICES IN SCHOOLS. - UPDATE TREATMENT REFERRAL PATHWAYS FOR LOCAL PHYSICIANS AND ORGANIZATIONS. - INVESTIGATE EMR INTEGRATION BETWEEN MENTAL HEALTH AND HEALTHCARE. - COMMUNITY WELLNESS EDUCATION AND RESOURCES FOR FAMILIES THAT INCLUDE: + KIDS' HEALTH FAIRS AT AREA SCHOOLS + IT'S A GIRL THING EVENT + A HEALTHY LIVING SOCIAL MEDIA CAMPAIGN - PROVIDE YOUTH MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY AND SCHOOLS. - PROVIDE MENTAL HEALTH FIRST AID COURSES IN THE COMMUNITY. TAKING EXISTING ORGANIZATIONAL AND COMMUNITY-BASED RESOURCES INTO CONSIDERATION, VAN WERT COUNTY HOSPITAL ASSOCIATION IS CHOOSING NOT TO ADDRESS CHRONIC DISEASES, TOBACCO AND NICOTINE USE, AND VARIOUS COMMUNITY CONDITIONS/SOCIAL DETERMINANTS OF HEALTH AS IDENTIFIED IN THE CHNA. HOWEVER, HEALTH NEEDS SUCH AS VARIOUS CHRONIC DISEASES ARE INDIRECTLY ADDRESSED BY ACTION STEPS FOR THE 3 PRIORITY FACTORS FOCUSED ON BY THE HOSPITAL. WE ARE ALSO CHOOSING NOT TO ADDRESS COVID-19, MATERNAL AND INFANT HEALTH ISSUES, PREVENTATIVE PRACTICES, AND HIV/AIDS TESTING BECAUSE THOSE HEALTH NEEDS WERE PRIORITIZED EXTREMELY LOW BY THE COMMUNITY IN ALL PRIMARY DATA COLLECTION METHODS. VAN WERT COUNTY HOSPITAL ASSOCIATION CANNOT ADDRESS ALL THE HEALTH NEEDS IN THE COMMUNITY AND MUST FOCUS ON AREAS WHERE WE HAVE THE GREATEST POTENTIAL FOR IMPACT AND THAT ALSO ALIGN WITH OUR MISSION AND PREVENT DUPLICATION OF EFFORT. COMMUNITY PARTNERSHIPS MAY SUPPORT OTHER INITIATIVES THAT THE HOSPITAL CANNOT INDEPENDENTLY LEAD IN ORDER TO ADDRESS THE OTHER HEALTH NEEDS IDENTIFIED IN THE 2021 CHNA.

PART V, SECTION B, LINE 13H
VAN WERT HEALTH UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PATIENTS WITH A HOUSEHOLD INCOME LESS THAN 100% OF FPG WHO ARE INELIGIBLE FOR MEDICAID QUALIFY FOR THE HCAP (HEALTH CARE ASSURANCE PROGRAM) WHICH IS A STATE AND FEDERAL PROGRAM ADMINISTERED BY THE OHIO DEPARTMENT OF HEALTH. VAN WERT HEALTH'S HOPE PROGRAM OFFERS FINANCIAL ASSISTANCE TO PATIENT WHO ARE ABOVE 100% OF THE FPG. THOSE WHOSE INCOMES ARE LESS THAN 200% FPG QUALIFY FOR A 60% DISCOUNT WHILE THOSE WHOSE INCOMES ARE LESS THAN 300% OF THE FPG ARE OFFERED A 40% DISCOUNT. HOPE DISCOUNTS ARE ABOVE AND BEYOND 501R DISCOUNTS FOR SELF-PAY PATIENTS.

PART V, SECTION B, LINE 16J
EVERY PATIENT STATEMENT SENT BY THE ORGANIZATION INCLUDES INFORMATION ABOUT FA / FAP ALONG WITH A FULL APPLICATION FOR THE FAP.

SCHEDULE H, PART V, LINE 7A:
HTTPS://WWW.VANWERTHEALTH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-IMPROVEMEN T

SCHEDULE H, PART V, LINE 10A
HTTPS://WWW.VANWERTHEALTH.ORG/COMMUNITY-HEALTH/COMMUNITY-HEALTH-IMPROVEMEN T

SCHEDULE H, PART V, LINE 16A, B & C
HTTPS://WWW.VANWERTHEALTH.ORG/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C
VAN WERT HEALTH UTILIZES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PATIENTS WITH A HOUSEHOLD INCOME LESS THAN 100% OF FPG WHO ARE INELIGIBLE FOR MEDICAID QUALIFY FOR THE HCAP (HEALTH CARE ASSURANCE PROGRAM) WHICH IS A STATE AND FEDERAL PROGRAM ADMINISTERE BY THE OHIO DEPARTMENT OF HEALTH. VAN WERT HEALTH'S HOPE PROGRAM OFFERS FINANCIAL ASSISTANCE TO PATIENT WHO ARE ABOVE 100% OF THE FPG. THOSE WHOSE INCOMES ARE LESS THAN 200% FPG QUALIFY FOR A 60% DISCOUNT WHILE THOSE WHOSE INCOMES ARE LESS THAN 300% OF THE FPG ARE OFFERED A 40% DISCOUNT. HOPE DISCOUNTS ARE ABOVE AND BEYOND 501R DISCOUNTS FOR SELF-PAY PATIENTS.VAN WERT HEALTH ALSO USES THE FOLLOWING CRITERIA IN ADDITION TO FPG TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY: MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS.

PART I, LINE 7
THE COSTING METHODOLOGY USED IN REPORTING BAD DEBT DATA IS A COST TO CHARGE RATIO METHODOLOGY. THE ORGANIZATION DOES NOT CLAIM BAD DEBT EXPENSE AS A COMMUNITY BENEFIT.

PART I, LN 7 COL(F)
$5,433,353 IN BAD DEBT EXPENSE WAS EXCLUDED FROM FORM 990, PART IX TOTAL EXPENSES IN COMPUTING THE PERCENTAGES REPORTED IN COLUMN F.

PART III, LINE 2
BAD DEBT IS ACCOUNTED FOR AFTER ALL DISCOUNTS FOR 501R AND FINANCIAL ASSISTANCE ARE APPLIED. VAN WERT HEALTH UTILIZES A RESERVE MODEL FOR ACTIVE A/R TO ESTIMATE BAD DEBT EXPENSE, THIS MODEL IS ADJUSTED MONTHLY TO ACCOUNT FOR FLUCTUATIONS IN THE A/R AGE AND BALANCES. AFTER 4 STATEMENTS CYCLES OVER 120 DAYS ANY REMAINING SELF-PAY BALANCE IS SUBMITTED TO A COLLECTION AGENCY. AT THIS POINT THE WRITE-OFF WOULD BE EXPENSED AND THE RESERVE MODEL ON THE A/R WOULD REFLECT AN OFFSETTING CREDIT TO EXPENSE FOR ANY AMOUNT THAT HAD BEEN PREVIOUSLY RESERVED.

PART III, LINE 3
THE COSTING METHODOLOGY USED IN REPORTING BAD DEBT DATA IS A COST TO CHARGE RATIO METHODOLOGY. VAN WERT HEALTH DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP), THEREFORE NO PORTION OF BAD DEBT ATTRIBUTABLE TO FAP-ELIGIBLE INDIVIDUALS IS CONSIDERED A COMMUNITY BENEFIT.

PART III, LINE 4
SEE FOOTNOTE 1, PAGE 13 UNDER 'PATIENT SERVICE REVENUE' IN THE NOTES TO CONSOLIDATED FINANCIAL STATEMENTS.

PART III, LINE 8
THE ORGANIZATION DOES NOT CONSIDER THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT.

PART III, LINE 9B
FOLLOWING THE GUIDELINES AND PROCESSES AS INDICATED IN QUESTION 3, PATIENT EDUCATION REGARDING ELIGIBILITY FOR ASSISTANCE, THE ORGANIZATION APPROPRIATELY IDENTIFIES ACCOUNTS AS TO THE TYPE OF ASSISTANCE QUALIFIED FOR. THE AMOUNTS ELIGIBLE FOR ASSISTANCE ARE WRITTEN OFF TO THE APPROPRIATE PROGRAM AND COLLECTION ACTIVITY CEASES IN REGARD TO THOSE AMOUN TS. THE GOAL OF THE ORGANIZATION'S POLICIES IS TO INDENTIY ACCOUNTS ELIGIBLE FOR ASSISTANCE AND BRING THE ACCOUNT TO AN APPROPRIATE CONCLUSION AS EARLY IN THE BILLING CYCLE AS POSSIBLE.

PART VI, LINE 2
THE ORGANIZATION USES A VARIETY OF METHODS TO ASSESS HEALTH CARE NEEDS. DATA PROVIDED BY THE STATE OF OHIO IS USED TO DETERMINE EPIDEMIOLOGY'S RELATED TO CHRONIC CONDITIONS AND CANCER REGISTRIES PROVIDING PREVALENCE. INTERNAL DATA IS ALSO USED AS WELL AS INPUT FROM OTHER PROVIDERS. THE HOSPITAL ALSO USES PATIENT ORIGIN DATA PROVIDED BY THE OHIO HOSPITAL ASSOCIATION TO DETERMINE CURRENT TREATMENT PATTERNS AND DIAGNOSIS FOR CURRENT RESIDENTS BEING TREATED BY VAN WERT HEALTH AND OTHER SURROUNDING PROVIDERS. THE HOSPITAL ALSO SPONSORS A NUMBER OF HEALTH FAIRS/ASSESSMENTS TO BOTH ADULT AND PEDIATRIC POPULATIONS OF VAN WERT THAT ARE ALSO EXAMINED FOR FREQUENCY AND NEEDS. A NUMBER OF STAFF AS WELL AS BOARD OF TRUSTEES MEMBERS ALSO SERVED ON COMMUNITY HEALTH PROVIDER BOARDS AND PROVIDE INPUT TO THE PLANNING PROCESS. THE HOSPITAL PARTICIPATED IN A COMMUNITY-WIDE HEALTH CARE NEEDS ASSESSMENT PROJECT WITH COLLABORATING AGENCIES WITHIN THE AREA. AS A RESULT OF THIS EFFORT, NUTRITION AND PHYSICAL ACTIVITY, ACCESS TO CARE, MENTAL HEALTH AND ADDICTION ARE THE NEEDS IDENTIFIED BY THE COALITION THAT WILL BE THE FOCUS OF THE HEALTH IMPROVEMENT PLAN DEVELOPED BY THE COALITION. THE HOSPITAL IS ALSO SUBSCRIBED TO A NUMBER OF BENCHMARKING ORGANIZATIONS THAT PROVIDE BEST OF INDUSTRY APPLICATIONS TO ASSESS METHODOLOGIES FOR TREATING OUR RESIDENTS.

PART VI, LINE 3
PATIENT EDUCATION REGARDING THEIR ELIGIBILITY FOR ASSISTANCE BEGINS AT THE PATIENT ACCESS TO CARE AREAS. INFORMATIONAL SIGNAGE IS POSTED IN ALL PATIENT ACCESS AREAS IDENTIFYING FINANCIAL ASSISTANCE PROGRAMS AND INSTRUCTIONS ON HOW TO SEEK OUT THESE PROGRAMS. SIMILAR INFORMATION IS ALSO FOUND IN PATIENT INFORMATIONAL BROCHURES PROVIDED TO PATIENTS PRIOR TO THE RENDERING OF CARE BASED UPON THE TYPE OF CARE BEING PROVIDED. ALSO, AVAILABLE AT ALL PATIENT ACCESS POINTS ARE THE PATIENT FINANCIAL ASSISTANCE BROCHURES. PATIENT REGISTRATION STAFF AT ALL PATIENT ACCESS POINTS ARE TRAINED IN THE PATIENT FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT THE HOSPITAL. THEY BECOME A VALUABLE RESOURCE TO PATIENTS DIRECTING THEM TO THE PROGRAMS THEY MAY QUALIFY FOR AND THE PROCESS WITH WHICH TO SEEK THE APPROPRIATE ASSISTANCE. THE HOSPITAL UTILIZES THE HOSPITAL WEBSITE AS AN ON-LINE AND TECHNOLOGICALLY CURRENT SOURCE OF FINANCIAL ASSISTANCE INFORMATION FOR PATIENTS THAT PREFER FINDING EDUCATIONAL INFORMATION IN THIS FORMAT. FINANCIAL ASSISTANCE PROGRAMS, POLICIES, ELIGIBILITY CRITERIA, AND ON-LINE APPLICATIONS FOR THE VARIOUS PROGRAMS ARE AVAILABLE. PATIENT BILLING STATEMENTS PROVIDE ANOTHER AVENUE FOR EDUCATING PATIENTS AS TO FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AND HOW TO CONTACT THE HOSPITAL TO DETERMINE ELIGIBILITY. THIS INFORMATION IS LOCATED ON THE BACK OF EACH BILLING STATEMENT RECEIVED BY THE PATIENT. THE EXISTENCE OF A FINANCIAL COUNSELOR IN THE PATIENT FINANCIAL SERVICES DEPARTMENT IS ANOTHER MECHANISM UTILIZED IN EDUCATING PATIENTS REGARDING FINANCIAL ASSISTANCE AVAILABLE FOR HOSPITAL SERVICES. ALL UNINSURED OR SELF-PAY POTENTIAL ACCOUNTS ARE IDENTIFIED TO THE FINANCIAL COUNSELOR UPON PATIENT REGISTRATION. PATIENTS MAY BE CONTACTED UPON COMPLETION OF SERVICES. ALL PATIENTS THAT WERE NOT CONTACTED UPON COMPLETION OF SERVICES RECEIVE A FINANCIAL ASSISTANCE APPLICATION THROUGH THE MAIL THAT INCLUDES INFORMATION REGARDING ALL FINANCIAL ASSISTANCE PROGRAMS. THE COUNSELOR PROVIDES FOLLOW-UP AND ASSISTANCE TO IDENTIFY THE PATIENT WITH THE APPROPRIATE FINANCIAL ASSISTANCE PROGRAM.

PART VI, LINE 4
VAN WERT COUNTY HOSPITAL ASSOCIATION DBA VAN WERT HEALTH IS LOCATED IN THE RURAL COUNTY OF VAN WERT, OHIO THAT BORDERS THE INDIANA STATE LINE ALONG ALLEN COUNTY INDIANA. OUR PRIMARY SERVICE AREA COMPRISES VAN WERT AND SOME PORTIONS OF PAULDING, PUTNAM AND MERCER COUNTIES. NUMERICALLY THIS BREAKS DOWN TO APPROXIMATELY 50,000 RESIDENTS IN OUR PRIMARY MARKET AREA. THE HOSPITAL IS LOCATED WITHIN THE CITY OF VAN WERT, WHICH POSSESSES A POPULATION OF 10,700. OUR POPULATION IS PREDOMINANTLY WHITE (93.7%) WITH HISPANIC (3.5%). A MIX OF MINORITIES COMPRISE THE REMAINDER. VAN WERT IS RURAL IN NATURE WITH EMPLOYMENT NOT ONLY IN AGRICULTURAL SERVICES BUT ALSO IN THE MANUFACTURING AND SERVICE SECTOR. THE UNEMPLOYMENT RATE IN VAN WERT COUNTY HAS BEEN STEADILY DROPPING FROM A HIGH OF > 15% IN 2008-2010 TO A CURRENT LEVEL AROUND 3%. HOWEVER, 11.4% OF THE POPULATION IS CONSIDERED TO BE LIVING IN POVERTY AND CONTRIBUTES TO INCREASING NUMBERS OF CITIZENS COVERED UNDER THE MEDICAID PROGRAM AND QUALIFYING FOR THE HOSPITAL'S CHARITY CARE PROGRAM AS WELL AS INCREASING BAD DEBT. LIKE MANY MIDWEST COMMUNITIES THE REGION HAS EXPERIENCED AN AGING POPULATION WITH 19.0% OVER 65 AND 27.8% 45 -64 ESTIMATED FOR 2018 BY THE OHIO OFFICE FOR RESEARCH.

PART VI, LINE 5
"THE VAN WERT COUNTY HOSPITAL ASSOCIATION BOARD OF TRUSTEES IS COMPRISED OF VOLUNTEERS FROM OUR COMMUNITY. THE MAJORITY OF THESE MEMBERS LIVE AND WORK WITHIN THE COMMUNITY AND ARE INVOLVED WITH OTHER NON-PROFIT AGENCIES. SENIOR LEADERSHIP ALSO LIVES IN THE PRIMARY SERVICE AREA. THIS ""SPIRIT"" OF COMMUNITY BASED HEALTHCARE RESIDES IN OUR BOARD OF TRUSTEES AND IS FURTHER EVIDENCED BY OUR OPEN MEDICAL STAFF. THE ACCOMMODATION OF SPECIALTY SERVICES NOT CURRENTLY PRESENT IN OUR AREA BEING PROVIDED THROUGH A SPECIALTY CLINIC OF THE HOSPITAL WHICH INCLUDE NEUROLOGY, NEUROSURGERY, IMMUNOLOGY, AND ENT SERVICES. THE HOSPITAL ASSOCIATED PERSONNEL ALSO SIT ON OTHER COMMUNITY BASED GOVERNANCE BOARDS (UNITED WAY, AMERICAN RED CROSS, CHAMBER OF COMMERCE, WRIGHT STATE UNIVERSITY REGIONAL CAMPUS, PUBLIC ACCESS TELEVISION, AMERICAN CANCER SOCIETY & VAN WERT ECONOMIC DEVELOPMENT TO NAME A FEW) THROUGH PHYSICIAN RECRUITMENT WE HAVE BROUGHT IN A NUMBER OF NEW SPECIALTIES INCLUDING OBSTETRICS, PULMONOLOGY/CRITICAL CARE AND ADDITIONAL LAPAROSCOPIC SURGICAL PROCEDURES. WE ALSO PROVIDE A LOAN FORGIVENESS PROGRAM FOR RESIDENTS INTERESTED IN BECOMING PHYSICIANS AND RETURNING TO OUR AREA. OUR WELLNESS CENTER PROVIDES HEALTH, EDUCATION, AND SOCIAL PROGRAMS FOR TARGETED POPULATIONS. WE HAVE JOINED A REGIONAL STROKE NETWORK AS WELL AS PARTICIPATING IN A NUMBER OF PATIENT AND EDUCATIONAL SUPPORT GROUPS (BETTER BREATHERS, STROKE SUPPORT GROUP, BETTER PARENTING). THE HOSPITAL ALSO PARTICIPATES IN HEALTH PROFESSIONS EDUCATIONAL PROGRAMS. A NUMBER OF OUR PHYSICIANS PROVIDE TRAINING FOR SENIOR MEDICAL STUDENTS THROUGH THE LIMA AREA HEALTH EDUCATION COMMITTEE. A NUMBER OF NURSING EDUCATIONAL PROGRAM USE OUR HOSPITAL TO DO THEIR CLINICAL ROTATIONS. OUR REHAB SERVICES DEPARTMENT ROUTINELY HOSTS STUDENTS FROM THE UNIVERSITY OF FINDLAY, HUNTINGTON COLLEGE, RHODES STATE COLLEGE, UNIVERSITY OF ST. FRANCIS, THE OHIO STATE UNIVERSITY, THE UNIVERSITY OF CINCINNATI, THE UNIVERSITY OF DAYTON, TRINE UNIVERSITY, UTMC AND WESTERN MICHIGAN WHO ARE PURSUING CAREERS IN THERAPY. THE HOSPITAL ON AVERAGE SPENDS IN EXCESS OF 1 MILLION DOLLARS IN NEW DIAGNOSTIC TECHNOLOGIES AND OTHER HEALTH RELATED EQUIPMENT TO BETTER DIAGNOSE AND TREAT OUR CLIENTS. THE HOSPITAL IS CURRENTLY UNDERGOING A NEARLY FORTY MILLION DOLLAR EXPANSION IN ORDER TO BETTER MEET THE NEEDS OF OUR COMMUNITY. THE EXPANSION PROVIDES ALL NEW INPATIENT SPACE FOR ACUTE CARE AND OBSTETRICS. IT WILL ALSO HOUSE A BRAND-NEW SURGICAL SERVICES AREA WITH INCREASED CAPACITY, PRIVATE PRE/POST-OP ROOMS AND CAPACITY FOR ROBOTIC SURGERY. THIS WILL ALLOW PATIENTS WHO ROUTINELY LEAVE THE AREA FOR PORTIONS OF THEIR CARE TO OBTAIN THEIR CARE LOCALLY. VAN WERT HEALTH SUPPORTS NUMEROUS ORGANIZATIONS VIA SPONSORSHIP THROUGHOUT THE COMMUNITY SOME OF THESE INCLUDE THE YWCA SILVER SNEAKERS PROGRAM, THE COMMUNITY FARMER'S MARKET, LIVE HEALTH VAN WERT & THE COUNTY HEALTH COLLABORATIVE, DARE, JUNIOR ACHIEVEMENT, COUNCIL ON AGING, CAMP CLAY, SAFETY COUNCIL WELLNESS AND THE NISWONGER PERFORMING ARTS CONCERT SERIES. VAN WERT HEALTH PROVIDES NUMEROUS SPONSORSHIPS FOR LOCAL SCHOOLS. VAN WERT HEALTH PRESENTS OR PARTICIPATES IN NUMEROUS HEALTH FAIRS THROUGHOUT THE YEAR INCLUDING THE ANNUAL CHILDREN'S HEALTH FAIR, ANNUAL WOMEN'S HEALTH EVENT, ANNUAL CAR SEAT CLINIC AND AN ANNUAL VETERAN'S DAY EVENT. VAN WERT HEALTH STAFF PRESENT AT VARIOUS EVENTS AND SPEAKERS BUREAUS THROUGHOUT THE YEAR INCLUDING THE SILVER SNEAKERS PROGRAM, THE SAFETY COUNCIL AND VARIOUS CAREER FAIRS FOR YOUNG STUDENTS ON THE BENEFITS OF A CAREER IN HEALTH CARE. SUPPORT FOR THE LOCAL BUSINESS DEVELOPMENT COALITION TO PROMOTE GROWTH IN THE OVERALL VAN WERT COMMUNITY."

Operating expenses	$ 87,347,732
Total amount spent on community benefits as % of operating expenses	$ 2,610,437 2.99 %