Community Benefit Insight - Tax-exempt hospital

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City Hospital Association

East Liverpool City Hospital

425 West Fifth Street
East Liverpool, OH 43920

Bed count	144	Medicare provider number	360096	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 340714583

Display data for year:

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

2.27%

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	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 1,520,731 2.25 %
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.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 8,625 0.01 %
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	$ 1,802,345 2.67 %
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	$ 775,008 43.00 %

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 $ 47597176 including grants of $ 8625) (Revenue $ 78523765)
THE ORGANIZATION PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE ORGANIZATION, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO AFFORD ESSENTIAL MEDICAL SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THE ORGANIZATION'S COMMITMENT TO SERVE ALL MEMBERS OF THE ORGANIZATIONS COMMUNITY WITH FREE CARE AND/OR SUBSIDIZED CARE, CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COSTS, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY HAVE BEEN CONSIDERED WHERE THE NEED AND AN INDIVIDUAL'S INABILITY TO PAY EXIST. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THE ORGANIZATION PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS BELOW COST. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE ORGANIZATION CONSIDERS THESE AMOUNTS AS UNCOMPENSATED CARE IN MEETING ITS MISSION IN THE ENTIRE COMMUNITY. THE ORGANIZATION IS LOCATED IN EAST LIVERPOOL, OHIO AND SERVICES THE SURROUNDING COMMUNITIES; STAFFING 120 BEDS FOR ACUTE CARE, INTENSIVE CARE AND SKILLED NURSING IN THE MEDICALLY UNDESERVED AREA. DURING 2019, THE ORGANIZATION PROVIDED NUMEROUS BENEFITS TO THE SURROUNDING COMMUNITY, INCLUDING FINANCIAL SUPPORT THROUGH THE COMMUNITY BENEFIT INITIATIVE PROGRAM. COMMUNITY EDUCATION AND WELLNESS PROGRAMS - THE ORGANIZATION OFFERED THE FOLLOWING TO THE COMMUNITY FREE OR AT A NOMINAL CHARGE: HEALTH FAIRS, CPR CLASSES, CHILDBIRTH CLASSES, GARFIELD ELEMENTARY WELLNESS PROGRAM, COVER THE UNINSURED, PROGRAM HEARTSAVER FIRST AID CLASSES, ADVANCE CARDIAC LIFE SUPPORT, HEALTHCARE PROVIDER RECERTIFICATION, BREAST FEEDING SUPPORT, PASTORAL OUTREACH PROGRAMS, DIABETES EDUCATION, SMOKING CESSATION CLASSES, BASICS IN BABYSITTING CLASSES, AUTISM SUPPORT GROUP, CONDUCTED HOSPITAL TOURS FOR AREA SCHOOLS AND COMMUNITY GROUPS, SERVED AS AN OBSERVATION SITE FOR THE HIGH SCHOOL FOR HEALTH PROFESSIONS DEVELOPED BY THE PUBLIC SCHOOLS, HOSTED SEVERAL SHADOW STUDENTS FROM AREA SCHOOLS, SERVED AS HOST SITE FOR OHIO HIGHER EDUCATION TELECOMMUNICATION SYSTEM, OPERATED A PHYSICIAN REFERRAL LINE FREE TO THE COMMUNITY, HOSTED PROGRAMS FOR STUDENT NURSES AND RADIOLOGY TECHNICIANS IN TRAINING, PROVIDED FOOD TO NEEDY FAMILIES FOR THANKSGIVING, AND GIFTS TO NEEDY CHILDREN FOR CHRISTMAS TO THE SALVATION ARMY DAY OF CARING, DAY OF GIVING PROGRAM - MONEY AND FOOD DRIVE

4B (Expenses $ 675822 including grants of $ 0) (Revenue $ 0)
THE PODIATRY PROGRAM STARTED JULY 2018. THERE ARE FOUR IN THEIR FIRST YEAR, FOUR IN THEIR SECOND YEAR AND FOUR IN THEIR THIRD YEAR FOR THE 2021-2022 YEAR.

Facility Information

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

EAST LIVERPOOL CITY HOSPITAL
PART V, SECTION B, LINE 5: PRIMARY QUALITATIVE DATA TO REFLECT INPUT FROM THE BROAD COMMUNITY AND VULNERABLE POPULATIONS WAS COLLECTED THROUGH 377 WRITTEN COMMUNITY SURVEYS COMPLETED BY INDIVIDUALS REPRESENTING DIVERSE CONSTITUENT GROUPS WITH THIS DATA GATHERED AND ANALYZED BY HCNO; AND 34 STAKEHOLDER AND FOCUS GROUP INTERVIEWS, REFLECTING INPUT FROM 115 PARTICIPANTS WITH THIS DATA GATHERED AND ANALYZED BY THE PARTNERS' WORKGROUP.COMMUNITY LEADERS AND KEY STAKEHOLDERS WERE IDENTIFIED BY THE PARTNERS AS EXPERTS IN A PARTICULAR FIELD RELATED TO THEIR BACKGROUND EXPERIENCE OR PROFESSIONAL POSITION; AND/OR THOSE WHO UNDERSTAND THE NEEDS OF A PARTICULAR COMMUNITY/GEOGRAPHIC REGION OR UNDER-REPRESENTED GROUP, INCLUDING THE MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS DEFINED IN THE CHNA.COMMUNITY PARTICIPANTS REPRESENTED IN THE FOCUS GROUP AND STAKEHOLDER INTERVIEWS INCLUDED: - SCHOOL DISTRICTS AND YOUTH SERVICES - HOSPITAL CASE MANAGERS - JUVENILE JUSTICE SYSTEM - LOCAL GOVERNMENT OFFICIALS/ COUNTY COMMISSIONERS - COMMUNITY RESOURCE CENTERS - HEALTH AND HUMAN SERVICE PROVIDERS - FOOD PANTRIES - MENTAL HEALTH AND RECOVERY SERVICE PROVIDERS - SENIOR SERVICES & HOME HEALTH PROVIDERS - FAITH-BASED ORGANIZATIONS PROVIDING ASSISTANCE - HISPANIC COMMUNITY MEMBERS & SERVICE PROVIDERS

EAST LIVERPOOL CITY HOSPITAL
PART V, SECTION B, LINE 6A: THE 2019 COLUMBIANA COUNTY HEALTH PARTNERS' COLLABORATIVE WORKGROUP IS COMPOSED OF THE FOLLOWING HOSPITALS: AKRON CHILDREN'S HOSPITAL, SALEM REGIONAL MEDICAL CENTER AND EAST LIVERPOOL CITY HOSPITAL.

EAST LIVERPOOL CITY HOSPITAL
PART V, SECTION B, LINE 6B: THE 2019 COLUMBIANA COUNTY HEALTH PARTNERS' COLLABORATIVE WORKGROUP IS COMPOSED OF THE FOLLOWING NON-HOSPITAL ORGANIZATIONS: EAST LIVERPOOL CITY HEALTH DEPARTMENT, COLUMBIANA COUNTY EDUCATION SERVICE CENTER, COLUMBIANA COUNTY GENERAL HEALTH DISTRICT, FAMILY AND CHILDREN FIRST COUNCIL, COLUMBIANA COUNTY MENTAL HEALTH AND RECOVERY SERVICES BOARD, SALEM CITY HEALTH DEPARTMENT, COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY, COORDINATED ACTION FOR SCHOOL HEALTH (CASH) COALITION AND THE OHIO STATE UNIVERSITY- EXTENSION.

EAST LIVERPOOL CITY HOSPITAL
PART V, SECTION B, LINE 11: PROGRESS IN MEETING THE PRIORITIES IDENTIFIED IN ELCH'S 2019-2022 IMPLEMENTATION PLAN WILL BE MONITORED VIA MEASURABLE INDICATORS THAT ARE EVALUATED ON A MINIMUM OF AN ANNUAL BASIS BY ELCH'S SENIOR LEADERSHIP TEAM, INCLUDING QUARTERLY COMMUNITY HEALTH MEETINGS WITH THE INVOLVEMENT OF SENIOR LEADERSHIP. IN ADDITION, ELCH WILL BE COLLABORATING ON THE IMPLEMENTATION OF THE COLUMBIANA COUNTY HEALTH IMPROVEMENT PLAN (CHIP), SO THAT POPULATION HEALTH IMPROVEMENT INITIATIVES AND RESOURCES CAN BE COORDINATED AND INTEGRATED THROUGHOUT THE COUNTY. THE CHIP STEERING COMMITTEE, OF WHICH ELCH IS A KEY MEMBER, WILL MEET AT LEAST SEMI-ANNUALLY FOR THE FIRST YEAR OF THE CHIP'S IMPLEMENTATION AND DEPENDING ON THE PROGRESS, MAY MEET ANNUALLY AFTER THAT TO EVALUATE AND REPORT OUTCOMES. ACTION STEPS, ACCOUNTABLE PERSON/ORGANIZATION, AND TIMELINES WILL BE REVIEWED AT THE END OF EACH YEAR BY THE STEERING COMMITTEE; WITH REVISIONS MADE TO THE CHIP ACCORDINGLY. BEYOND OUTCOME EVALUATION, PROCESS EVALUATION WILL ALSO BE USED ON AN ONGOING BASIS TO FOCUS ON HOW WELL ACTION STEPS ARE BEING IMPLEMENTED.

SCHEDULE H, PART V, LINE 7A
HTTP://WWW.ELCH.ORG/ABOUT-US/COMMUNITY-HEALTH/

Supplemental Information

Schedule H (Form 990) Part VI

PART III, LINE 2:
THE AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS.

PART III, LINE 3:
THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS ESTIMATED TO BE 43% OF THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE.

PART III, LINE 4:
THE COMPANY'S PATIENT ACCOUNTS RECEIVABLE IS REDUCED BY ALLOWANCES FOR CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE COMPANY ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCES FOR BOTH CONTRACTUAL ADJUSTMENTS AND DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THESE ALLOWANCES. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE COMPANY RECORDS A PROVISION FOR DOUBTFUL 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 EXPECTED RATES (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 8:
THE HOSPITAL CONTENDS THAT THE ENTIRE AMOUNT OF THE MEDICARE SURPLUS SHOULD ALSO BE CONSIDERED AS A COMMUNITY BENEFIT. THE REASON FOR THIS IS THAT THE MEDICARE RATES ARE SET UNILATERALLY BY THE FEDERAL GOVERNMENT AND THE HOSPITAL AGREES TO SERVICE THESE PATIENTS AT THESE RATES AS PART OF OUR MISSION AND SERVICE TO THE COMMUNITY.THE COST INCLUDED ON LINE 6 COMES FROM THE MEDICARE COST REPORT WHICH THE FEDERAL GOVERNMENT HAS SET UP AS THEIR WAY TO CAPTURE AND SEGREGATE THE COSTS OF SERVICES PROVIDED TO MEDICARE PATIENTS.

PART III, LINE 9B:
THE HOSPITAL PRACTICE IS THAT UPON VERIFICATION THAT A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, THE HOSPITAL DISCONTINUES COLLECTION EFFORTS AND MAKES THE APPROPRIATE ADJUSTMENT TO THE PATIENT'S ACCOUNT BASED UPON THE PATIENT'S INDIVIDUAL CIRCUMSTANCES.

PART VI, LINE 2:
ONGOING EFFORTS AND EVALUATION OF MANAGEMENT, STAFF, PHYSICIANS WITH FEEDBACK FROM PATIENTS AND COMMUNITY. DEMOGRAPHIC RESEARCH AND STUDIES ALSO UTILIZED TO DETERMINE TYPE AND QUANTITY OF SERVICES NEEDED BY SPECIALTY TO BEST SERVE OUR COMMUNITY.

PART VI, LINE 3:
INFORMATION REGARDING FINANCIAL ASSISTANCE AND CHARITY CARE IS MADE AVAILABLE AT TIME OF REGISTRATION, ON THE HOSPITAL'S WEBSITE, AND ON PATIENT STATEMENTS. APPLICATIONS ARE ALSO MADE AVAILABLE TO PATIENTS AT TIME OF REGISTRATION IF APPROPRIATE.IN ORDER TO ENSURE THAT PATIENTS ARE AWARE OF THE EXISTENCE OF THE FINANCIAL ASSISTANCE POLICY, THE HOSPITAL WIDELY DISSEMINATES THE EXISTENCE AND TERMS OF THIS POLICY THROUGHOUT ITS SERVICE AREA. IN ADDITION TO OTHER APPROPRIATE EFFORTS TO INFORM THE COMMUNITY ABOUT THE POLICY IN A WAY TARGETED TO REACH COMMUNITY MEMBERS MOST LIKELY TO NEED FINANCIAL ASSISTANCE, THE FOLLOWING ACTIONS ARE TAKEN:A. WRITTEN NOTICE TO ALL PATIENTSEACH PATIENT WHO IS SEEN, WHETHER ADMITTED OR NOT, SHALL RECEIVE THE PLAIN LANGUAGE SUMMARY. THE NOTICE SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.B. POSTING OF NOTICESTHE FINANCIAL ASSISTANCE POLICY SHALL BE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS THAT ARE VISIBLE TO THE PATIENTS IN THE FOLLOWING AREAS: (1) EMERGENCY DEPARTMENT; (2) BILLING OFFICE; (3) ADMISSIONS OFFICE; AND (4) OTHER OUTPATIENT SETTINGS. THE NOTICE SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.C. NOTICE TO ACCOMPANY BILLING STATEMENTSEVERY POST DISCHARGE STATEMENT SHALL INCLUDE A COPY OF THE NOTICE. EACH BILL THAT IS SENT TO A PATIENT WHO HAS NOT PROVIDED PROOF OF COVERAGE BY A THIRD PARTY AT THE TIME CARE IS PROVIDED OR UPON DISCHARGE MUST INCLUDE A STATEMENT OF CHARGES FOR SERVICES RENDERED BY THE HOSPITAL. THESE NOTICES SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.D. AVAILABILITY OF FINANCIAL ASSISTANCE DOCUMENTSTHE HOSPITAL SHALL POST A COPY OF THIS POLICY, THE PLAIN LANGUAGE SUMMARY AND THE FINANCIAL ASSISTANCE APPLICATION ON ITS WEBSITE AND MAKE ALL SUCH DOCUMENTS AVAILABLE FOR FREE DOWNLOAD. SUCH DOCUMENTS SHALL BE AVAILABLE IN THE EMERGENCY ROOM AND ADMISSIONS OFFICE AND BY MAIL UPON REQUEST. THE DOCUMENTS SHALL BE PROVIDED IN NON-ENGLISH LANGUAGES SPOKEN BY A SUBSTANTIAL NUMBER OF THE PATIENTS SERVED BY THE HOSPITAL.E. ACCESSIBILITY TO LIMITED ENGLISH PROFICIENT INDIVIDUALSTHE HOSPITAL SHALL MAKE TRANSLATIONS OF THIS POLICY, THE PLAIN LANGUAGE SUMMARY, AND THE FINANCIAL ASSISTANCE APPLICATION AVAILABLE IN ANY LANGUAGE THAT IS THE PRIMARY LANGUAGE OF THE LESSER OF ONE THOUSAND (1,000) INDIVIDUALS OR FIVE PERCENT (5%) OF THE POPULATION OF THE COMMUNITIES SERVED BY THE HOSPITAL.

PART VI, LINE 5:
EAST LIVERPOOL CITY HOSPITAL HAS AN OPEN MEDICAL STAFF, A COMMUNITY BOARD OF TRUSTEES AND IS EXTREMELY GENEROUS WITH FUNDING COMMUNITY CHARITIES AND DONATING EMPLOYEE TIME TO SERVE THE GENERAL POPULATION OF THE AREA SERVED. THIS INCLUDES PARTICIPATING IN COMMUNITY HEALTH FAIRS, SCHOOL PROGRAMS, AND FREE PUBLIC SPEAKING REGARDING TOPICS RECOGNIZED AS IMPLEMENTATION PRIORITIES IN THE 2019 CHNA. ELCH OFFERS FREE SMOKING CESSATION, DIABETES EDUCATION, AND HEALTH NUTRITION TO ALL COMMUNITY MEMBERS.

PART VI, LINE 6:
AFFILIATED HEALTH CARE SYSTEMCITY HOSPITAL ASSOCIATION IS A SUBSIDIARY OF PRIME HEALTHCARE FOUNDATION, INC. (PHF). PHF AND ITS SUBSIDIARIES ARE THEIR OWN HEALTH SYSTEM MANAGED BY PRIME HEALTHCARE MANAGEMENT, INC.PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORTTHIS IS NOT APPLICABLE TO CITY HOSPITAL ASSOCIATION.

PART VI, LINE 4:
COLUMBIANA COUNTY, OHIO COLUMBIANA COUNTY IS LOCATED IN NORTHEASTERN OHIO AND IS ONE OF OHIO'S 32 APPALACHIAN COUNTIES. IT IS BORDERED ON THE NORTH BY MAHONING COUNTY; ON THE EAST BY PENNSYLVANIA; ON THE SOUTH BY THE OHIO RIVER AND WEST VIRGINIA; AND ON THE WEST BY JEFFERSON, CARROLL AND STARK COUNTIES. OVER HALF OF THE COUNTY'S TOTAL POPULATION OF 105,686 LIVES IN UNINCORPORATED RURAL AREAS, WITH VILLAGES AND TOWNS SOME DISTANCE APART.THE COUNTY HAS TWO MAJOR GEOGRAPHIC CONCENTRATIONS OF DEVELOPMENT AND POPULATION. THE NORTHERN CORRIDOR BETWEEN THE CITIES OF SALEM AND EAST PALESTINE, (INCLUDING THE VILLAGES OF WASHINGTONVILLE, LEETONIA, COLUMBIANA AND NEW WATERFORD AND THE FOUR TOWNSHIPS OF PERRY, SALEM, FAIRFIELD AND UNITY); EXTEND ALONG A 20-MILE DISTANCE BORDERING MAHONING COUNTY TO THE NORTH, AND CONTAIN ALMOST 48% OF THE COUNTY'S POPULATION. THE SOUTHERN CORRIDOR EXTENDS FOR ABOUT 10 MILES FROM THE VILLAGE OF WELLSVILLE TO EAST LIVERPOOL, (INCLUDING ST. CLAIR TOWNSHIP) AND CONTAINS 11% OF THE COUNTY'S TOTAL POPULATION.EAST LIVERPOOL CITY HOSPITAL IS THE ONLY HOSPITAL WITHIN 20 MILES OF THE CITY. THE HOSPITAL SERVES PATIENTS WITHIN A 10 TO 15-MILE RADIUS INCLUDING PATIENTS FROM NEIGHBORING PENNSYLVANIA AND WEST VIRGINIA. MOST RESIDENTS HAVE LIVED HERE ALL THEIR LIVES AND THE COMMUNITY IS COMPRISED OF A SIGNIFICANT BIAS OF SENIOR CITIZENS.

Operating expenses	$ 67,462,482
Total amount spent on community benefits as % of operating expenses	$ 1,529,356 2.27 %