4A (Expenses $ 163452463 including grants of $ 103751) (Revenue $ 169780524)
THE PRIMARY EXEMPT PURPOSE OF MERCY HOSPITALS WEST IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. MERCY HOSPITALS WEST ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. TOTAL CHARITY CARE PROVIDED IN 2013 WAS $6,309,157 SERVING 8,088 INDIVIDUALS.

Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment
"(1) A - MERCY HEALTH - WEST HOSPITAL: ALL OF THE INDIVIDUALS LISTED BELOW WERE IDENTIFIED FOR PARTICIPATION BECAUSE THEY POSSESSED CURRENT DATA OR INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL. THE STAFF AND OFFICIALS WHO, BY VIRTUE OF THEIR OFFICE OR POSITION, ARE CONSIDERED TO HAVE EXPERTISE IN PUBLIC HEALTH ARE INDICATED BY AN ASTERISK (*) AFTER THEIR NAME. INDIVIDUALS CONTACTED: JUDY BENNINGTON*, ADMINISTRATOR, ADAMS COUNTY HEALTH DEPARTMENT MARY ANN MIARS-PEERCY, EXECUTIVE DIRECTOR, UNITED WAY OF SCIOTO COUNTY ALVIN NORRIS, EXECUTIVE DIRECTOR, ADAMS-BROWN COUNTIES ECONOMIC OPPORTUNITIES INC HAROLD VERMILLION*, HEALTH COMMISSIONER, BROWN COUNTY HEALTH DEPARTMENT COLLEEN CHAMBERLAIN, ASSOCIATE DIRECTOR, BROWN COUNTY ALCOHOL, DRUG ADDICTION, MENTAL HEALTH SERVICES BOARD DEBRA GORDON, AREA DIRECTOR, UNITED WAY OF GREATER CINCINNATI JACKIE PHILLIPS*, HEALTH COMMISSIONER, MIDDLETOWN CITY HEALTH DEPARTMENT MIKE SANDERS, EXECUTIVE DIRECTOR, MIDDLETOWN AREA UNITED WAY JEFFERY DIVER, EXECUTIVE DIRECTOR, BUTLER COUNTY SUPPORTS TO ENCOURAGE LOW-INCOME FAMILIES JOHN GUIDUGLI, PRESIDENT AND CHIEF EXECUTIVE OFFICER, HAMILTON COMMUNITY FOUNDATION DUANE GORDON, EXECUTIVE DIRECTOR, MIDDLETOWN COMMUNITY FOUNDATION KAREN SCHERRA, CHIEF OPERATING OFFICER, CLERMONT COUNTY MENTAL HEALTH AND RECOVERY BOARD BILLIE KUNTZ, EXECUTIVE DIRECTOR, CLERMONT COUNTY COMMUNITY SERVICES LISA JACKSON, VP MARKETING, DEVELOPMENT, HEALTHSOURCE OF OHIO TIM INGRAM*, HEALTH COMMISSIONER, HAMILTON COUNTY PUBLIC HEALTH ERIK STEWART, VICE PRESIDENT OF SYSTEM PERFORMANCE, HAMILTON COUNTY MENTAL HEALTH AND RECOVERY SERVICES BOARD BARBARA TERRY, VICE PRESIDENT COMMUNITY IMPACT, COMMUNITY/CHARITY UNITED WAY OF GREATER CINCINNATI WILL PARR, AGENCY DIRECTOR, CINCINNATI/HAMILTON COMMUNITY ACTION SHILOH TURNER, VICE PRESIDENT OF PROGRAMS, GREATER CINCINNATI FOUNDATION H.A. MUSSER, PRESIDENT AND CHIEF EXECUTIVE OFFICER, SANTA MARIA COMMUNITY SERVICES DR. JIM VANZANT*, HEALTH COMMISSIONER, HIGHLAND COUNTY HEALTH DEPARTMENT JUNI FREY, EXECUTIVE DIRECTOR, PAINT VALLEY ALCOHOL, DRUG ADDICTION, MENTAL HEALTH SERVICES BOARD DUANE STANSBURY*, HEALTH COMMISSIONER, WARREN COUNTY COMBINED HEALTH DISTRICT BRENT LAWYER, EXECUTIVE DIRECTOR, MENTAL HEALTH AND RETARDATION SERVICES OF WARREN AND CLINTON COUNTIES KAREN HILL, DIRECTOR, AGING SERVICES, WARREN COUNTY COMMUNITY SERVICES INC. JULIA RUPP, CHIEF OPERATING OFFICER, COMMUNITY MENTAL HEALTH CENTER KAREN SNYDER, DIRECTOR, DEARBORN COUNTY UNITED WAY MARK NEFF, COORDINATOR, DEARBORN COUNTY COMMUNITY FOUNDATION DAVID WELSH, M.D.*, COUNTY HEALTH OFFICER, RIPLEY COUNTY HEALTH DEPARTMENT SALLY MORRIS, EXECUTIVE DIRECTOR, RIPLEY COUNTY COMMUNITY FOUNDATION JOHN JOY, DEAN, SOUTHERN STATE COMMUNITY COLLEGE ERIC RADEMACHER, PHD, CO-DIRECTOR UNIVERSITY OF CINCINNATI, INSTITUTE FOR POLICY RESEARCH JOHN TAFARO, PRESIDENT CHATFIELD COLLEGE DIRECT SERVICE PROVIDER GROUP LEVEL ASSESSMENTS: BECKY BASFORD, CERTIFIED NURSE PRACTITIONER, ADAMS COUNTY REGIONAL MEDICAL CENTER (ACRMC) KRYS HESS, FOOD SERVICE SUPERVISOR, ADAMS COUNTY OHIO VALLEY SCHOOL DISTRICT (ACOVSD) CAROL MOTZA*, BOARD MEMBER, HEALTH DEPARTMENT BRIAN MCCORD, SPORTS MEDICINE MANAGER, ADAMS COUNTY REGIONAL MEDICAL CENTER (ACRMC) WILL WEST, WAL-MART FARRAH JAQUEZ, ASSISTANT PROFESSOR, UNIVERSITY OF CINCINNATI (UC) SHAY BEIGHLE, TEACHER, NORTH ADAMS HIGH SCHOOL HOLLY JOHNSON, DIRECTOR, ADAMS COUNTY ECONOMIC DEVELOPMENT COUNCIL (ACEDC) MIKE CLINTON KAREN BALLENGEE, TREASURER, MANCHESTER LOCAL SCHOOL DISTRICT (MLSD) ALVIS GEORGE, MANCHESTER LOCAL SCHOOL DISTRICT (MLSD) DANE CLARK, ASSEMBLY AND TEST MANAGER/BOARD OF TRUSTEES, GENERAL ELECTRIC (GE)/ADAMS COUNTY REGIONAL MEDICAL CENTER JOYCE PORTER, DIRECTOR OF HUMAN RESOURCES AND RISK MANAGEMENT, ADAMS COUNTY REGIONAL MEDICAL CENTER (ACRMC) CHARLIE BESS, VOLUN""TEEN"" COORDINATOR/BOARD MEMBER, ADAMS COUNTY REGIONAL MEDICAL CENTER (ACRMC)/ADAMS COUNTY/OHIO VALLEY SCHOOL DISTRICT (ACOVSD) DELORA BLYMAIL, WORKFORCE CONNECTIONS OF ADAMS AND BROWN COUNTIES STEVE DUNKIN, EXECUTIVE DIRECTOR, BROWN COUNTY ALCOHOL, DRUG ADDICTION, MENTAL HEALTH BOARD MARY FRANCIS, DIRECTOR, ASSISTANCE FOR SUBSTANCE ABUSE PREVENTION CENTER ERIN HOLSTED, MSW, LICENSED SOCIAL WORKER, WESTERN BROWN SCHOOL BASED HEALTH CENTER JOAN PHILLIPS, CHIEF EXECUTIVE OFFICE, BROWN COUNTY HOSPITAL VENITA MILBURN, BROWN COUNTY HOSPITAL SUE BASTA, PHD, RN; CONTINUING EDUCATION HEALTH PROMOTION PROGRAMS, HEALTH-UC/UNIVERSITY OF CINCINNATI AREA HEALTH EDUCATION CENTER RAMONA APPLEGATE, ADAMS BROWN EARLY HEAD START/ADAMS/BROWN COUNTY ECONOMIC OPPORTUNITIES, INC. BONITA HAAS, BSW, LICENSED SOCIAL WORKER; ASSISTANT DIRECTOR, ADAMS BROWN HIGH SCHOOL/EARLY HEAD START/HELP ME GROW/ADAMS/BROWN COUNTY ECONOMIC OPPORTUNITIES, INC. JOAN GARRETT, PRE-K DIRECTOR, BOARD MEMBER, BROWN COUNTY EDUCATIONAL SERVICE CENTER DAYNE MICHAEL, SUPERVISOR, BROWN COUNTY EDUCATIONAL SERVICE CENTER MARGARET CLARK, JUDGE PROBATE JUVENILE COURT RANDY ALLMAN, DIRECTOR REGIONAL SERVICES, BROWN COUNTY RECOVERY SERVICES (TALBERT HOUSE) DAVID SHARP, DIRECTOR OF JOB/FAMILY SERVICES, BROWN COUNTY RECOVERY SERVICES TAMMIE KELLER, BUSINESS MANAGER, BROWN COUNTY BOARD OF DEVELOPMENTAL DISABILITIES LINDA ONDRE, COORDINATOR, FAMILY CHILDREN FIRST COUNCIL ANGIE DEVILBLISS, FACULTY SECRETARY, SOUTHERN STATE COMMUNITY COLLEGE HEATHER WELLS, MSW, LICENSED SOCIAL WORKER/ COORDINATOR, BUTLER COUNTY FAMILY CHILDREN FIRST COUNCIL BILL STALER, CHIEF EXECUTIVE OFFICER LIFESPAN MARC BELLIJARIO, CHIEF EXECUTIVE OFFICER, PRIMARY HEALTH SOLUTIONS YVETTE DORSEY-BENSON*, DIRECTOR, MIDDLETOWN HEALTH DEPARTMENT PROJECT CARRIE COREEN, BUTLER 211 ANGIE DUNCAN, DIRECTOR BUTLER COUNTY SUCCESS DAVID FOSTER, SUPPORT SERVICES DIRECTOR, FAIRFIELD CITY SCHOOLS NINA ROSE, SENIOR HIGH STUDENTS AGAINST DRUNK DRIVING SPONSOR, FAIRFIELD CITY SCHOOLS SUSIE SHERIDAN, PRACTICE MANAGER, PRIMARY HEALTH SOLUTIONS STEPHANIE JOHNSON, SCHOOL NURSE, TALAWANDA SCHOOL DISTRICT, BOARD, BUTLER COUNTY HEALTH DEPARTMENT AND OXFORD COLLEGE CORNER FREE CLINIC LINDA KIMBLE, EXECUTIVE DIRECTOR, SERVE CITY CARI WYNNE, SUPERVISOR, EDUCATIONAL SERVICE CENTER - SUCCESS CARLA GROSSMAN, COUNSELOR, MERCY CLERMONT MENTAL HEALTH BILLIE ELLIOT, LIFEPOINT SOLUTIONS DEB SPRADLIN, DIRECTOR OF BEHAVIORAL HEALTH SERVICES, SISTERS OF MERCY CLERMONT MARTY LAMBERT*, HEALTH COMMISSIONER, CLERMONT COUNTY HEALTH DISTRICT JULIANNE NESBIT*, ASSISTANT HEALTH COMMISSIONER, CLERMONT COUNTY HEALTH DISTRICT KAREN BALON, LPN; HEALTH MANAGER, CHILD FOCUS, INC. PEGGY HALEY, DIRECTOR MERCY CLERMONT OUTREACH LAURA METZLER, DIRECTOR OF COMMUNITY/VOLUNTEER IMPROVEMENT, AMERICAN CANCER SOCIETY MARTY GROVE, DIRECTOR OF NURSING CLINICAL SERVICES - EDUCATION, MERCY CLERMONT CHARLOTTE GOERING, MERCY CLERMONT ANN LANE, OFFICE MANAGER EMERGENCY ROOM, MERCY CLERMONT IRENE BEHLING, DIRECTOR OF MISSION INTEGRATION, MERCY CLERMONT CAROL MUHLENKAMP, DIRECTOR OF PATIENT CARE SERVICES, NURSING - DEARBORN COUNTY HOSPITAL (DCH) STEPHANIE CRAIG, DIRECTOR OF EDUCATION AND RISK MANAGEMENT, EDUCATION/RISK ASSESSMENT DEARBORN COUNTY HOSPITAL MAYOR DONNIE HASTINGS, MAYOR, CITY OF AURORA TOM TALBOT, CHIEF EXECUTIVE OFFICE, COMMUNITY MENTAL HEALTH CENTER, INC. BILL CUNNINGHAM, MAYOR OF LAWRENCEBURG KARL GALEY, SUPERINTENDENT, LAWRENCEBURG SCHOOLS CECELIA SCUDDER, NURSING ADMINISTRATION, DEARBORN COUNTY HOSPITAL ARN EDWARDS, LIFETIME RESOURCES LOIS FRANKLIN*, PUBLIC HEALTH NURSE, DEARBORN COUNTY HEALTH DEPARTMENT (DCHD) DEBBIE FEHLING*, RN, HEALTH EDUCATOR, DEARBORN COUNTY HEALTH DEPARTMENT (DCHD) BRENDA COLEMAN, VICE CHAIRPERSON ON BOARD, HEALTH CARE ACCESS NOW NANCY CARTER*, RDH, MPH ASSISTANT DENTAL DIRECTOR, CINCINNATI HEALTH DEPARTMENT SALLY STEWART, CHIEF EXECUTIVE OFFICER, CROSSROAD HEALTH CENTER BILL EBELHAR, DIRECTOR OF OUTPATIENT COUNSELING, CENTERPOINT HEALTH RANDY ALLMAN, PROGRAM DIRECTOR, TALBERT HOUSE SEAN KELLEY, DIRECTOR OF EXTERNAL RELATIONS, THE HEALTH COLLABORATIVE MARY DAY, MANAGING LTC OMBUDSMAN, PRO SENIORS, INC. SHANA TRENT, PRACTICE MANAGER, THE HEALTHCARE CONNECTION SAUNDRA REGAN, PHD, RESEARCH SCIENTIST, UNIVERSITY OF CINCINNATI FAMILY RESIDENCY JUDITH WARREN, EXECUTIVE DIRECTOR, HEALTH CARE ACCESS NOW ANN BARNUM, OFFICER - SUBSTANCE USE DISORDERS, HEALTH FOUNDATION OF GREATER CINCINNATI SENIOR PROGRAM STEPHANIE MARSHALL, PROJECT MANAGER, HEALTH CARE ACCESS NOW TIM INGRAM*, HEALTH COMMISSIONER, HAMILTON COUNTY PUBLIC HEALTH TERRESA ADAMS, COMMUNITY SPECIALIST, CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER DOLORES LINDSAY, CHIEF EXECUTIVE OFFICER, THE HEALTHCARE CONNECTION - RESPONSE CONTINUES AT SCHEDULE H PART VI -;"

Schedule H, Part V Sec B, Line 4, Other Hospital Facilities included in Needs Assessment
(1) A - MERCY HEALTH - WEST HOSPITAL: ADAMS COUNTY REGIONAL MEDICAL CENTER ATRIUM MEDICAL CENTER DEARBORN COUNTY HOSPITAL FORT HAMILTON HOSPITAL LINDNER CENTER OF HOPE MARGARET MARY COMMUNITY HOSPITAL MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRIHEALTH UC HEALTH MERCY HEALTH - ANDERSON HOSPITAL MERCY HEALTH - JEWISH HOSPITAL MERCY HEALTH - CLERMONT HOSPITAL MERCY HEALTH - FAIRFIELD HOSPITAL ;

Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment
(1) A - MERCY HEALTH - WEST HOSPITAL: ACCESS TO DENTAL HEALTH SERVICES WAS IDENTIFIED AS A PRIORITY IN THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY MERCY HEALTH - WEST HOSPITAL. WHILE THIS IS A LEGITIMATE COMMUNITY CONCERN, MERCY HEALTH - WEST HOSPITAL HAS CHOSEN TO NOT FOCUS THEIR EFFORTS ON THIS NEED. NEITHER ACCESS TO NOR PROVISION OF DENTAL CARE IS A CORE COMPETENCY OF THE HOSPITAL AND SHOULD BE CONSIDERED TO BE OUTSIDE THE HOSPITAL'S SPHERE OF COMMUNITY INFLUENCE. OUR COMMUNITY BENEFIT RESOURCES WOULD BE FAR BETTER DEPLOYED BY FOCUSING ON THE REMAINING FOUR PRIORITY AREAS. FURTHER, THIS NEED IS CURRENTLY BEING ADDRESSED BY THE CINCYSMILES FOUNDATION, FORMERLY KNOWN AS THE GREATER CINCINNATI ORAL HEALTH COUNCIL, WHOSE PRIMARY FOCUS IS CREATING ACCESS TO DENTAL CARE FOR NEEDY POPULATIONS. THIS ORGANIZATION IMPLEMENTS INNOVATIVE PUBLIC PROGRAMS INCLUDING: OPTIONS/ DONATED DENTAL SERVICES SCHOOL- BASED DENTAL DISEASE PREVENTION PROGRAM THE DENTAL ROAD CREW, A STATE-OF-THE-ART DENTAL OFFICE ON WHEELS HEAD START - EARLY CHILDHOOD INITIATIVE LINCOLN HEIGHTS DENTAL CENTER - THIS 8-CHAIR DENTAL FACILITY PROVIDES COMPREHENSIVE DENTAL CARE TO 3,500 LOW INCOME CHILDREN AND ADULTS FROM HAMILTON, BUTLER AND WARREN COUNTIES. THIS IS ONE OF THE FEW PLACES THE WORKING POOR CAN GO TO GET QUALITY DENTAL CARE AT FEES BASED ON THEIR INCOME LEVEL. THE CENTER SERVES 8-10 PEOPLE WITH DENTAL EMERGENCIES EVERY DAY IN ADDITION TO SCHEDULED APPOINTMENTS. IT IS ASSOCIATED WITH THE HEALTHCARE CONNECTION, A FEDERALLY FUNDED HEALTH CLINIC WITH A 20-YEAR HISTORY OF SERVING LOW INCOME VALLEY RESIDENTS. MERCY HEALTH WEST HOSPITAL IS PROVIDING ASSISTANCE IN THE FORM OF RENT SUBSIDIES TO THE CROSSROADS HEALTH CENTER TO ALLOW THEM TO MAINTAIN THEIR SERVICES ON THE WESTERN HILLS CAMPUS. IN ADDITION TO MEDICAL SERVICES FOR INDIGENT PATIENTS, BASIC DENTAL SERVICES ARE OFFERED. ;

Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined
(1) A - MERCY HEALTH - WEST HOSPITAL: THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY CARE OR OTHER MEDICALLY NECESSARY CARE IS BASED UPON FEDERAL POVERTY LEVELS STATED IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.;

Schedule H, Part I, Line 6a, Community benefit report prepared by related organization
CATHOLIC HEALTH PARTNERS

Schedule H, Part I, Line 7, Costing Methodology used to calculate financial assistance
COST OF CHARITY CARE WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS DETERMINED USING THE HOSPITAL COST ACCOUNTING SYSTEM AND INCLUDED BOTH INPATIENTS AND OUTPATIENTS FOR TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PLANS. FOR SUBSIDIZED SERVICES THE HOSPITAL'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO THE SPECIFIC SERVICE EXCLUDING TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PATIENTS. COSTS FOR CHARITY AND BAD DEBT ACCOUNTS ARE DEDUCTED USING A RATIO OF COST TO CHARGE SPECIFIC TO THAT SUBSIDIZED SERVICE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS.

Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation
0

Schedule H, Part II, Community Building Activities
MERCY HOSPITALS WEST (MHW) PROVIDES COMMUNITY SUPPORT BY ASSISTING IN DISASTER PREPAREDNESS. PREPARING FOR DISASTER IS AN IMPORTANT ROLE FOR THE HOSPITAL TO ASSURE THE SAFETY AND HEALTH OF COMMUNITY RESIDENTS IN THE EVENT OF A NATURAL DISASTER, INDUSTRIAL ACCIDENT OR OTHER LARGE SCALE EMERGENCY. THE CHILDREN'S CENTER/DAY CARE SUBSIDIZED PROGRAM FOR THE POOR HELPS RESIDENTS MAINTAIN EMPLOYMENT BY PROVIDING LOW COST /HIGH QUALITY DAY CARE FOR THEIR CHILDREN. MHW SUPPORTS THE EVERY CHILD SUCCEEDS COMMUNITY PROGRAM BY PROVIDING SPACE TO OPERATE THE PROGRAM. MHW MAKES DONATIONS TO COMMUNITY GROUPS.

Schedule H, Part III, Line 2, Bad debt expense - methodology used to estimate amount
THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON THE HOSPITAL'S HISTORICAL COLLECTION EXPERIENCE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED ON PAST COLLECTION EXPERIENCE. THE HOSPITAL'S CONCENTRATION OF CREDIT RISK RELATED TO NET PATIENT ACCOUNTS IS LIMITED DUE TO THE DIVERSITY OF PATIENTS AND PAYORS. NET PATIENT ACCOUNTS CONSIST OF AMOUNTS DUE FROM GOVERNMENTAL PROGRAMS (PRIMARILY MEDICARE AND MEDICAID), PRIVATE INSURANCE COMPANIES, MANAGED CARE PROGRAMS AND PATIENTS THEMSELVES. NET PATIENT SERVICE REVENUE FOR SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE IS RECOGNIZED BASED ON CONTRACTUAL RATES FOR SERVICES RENDERED. THE HOSPITAL RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). AMOUNTS RECOGNIZED ARE SUBJECT TO ADJUSTMENT UPON REVIEW BY THIRD-PARTY PAYORS. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE WHEN SERVICES ARE PROVIDED. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED. THUS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. ANY DISCOUNTS APPLIED TO SELF-PAY PATIENTS WOULD BE DEEMED EITHER CHARITY OR A CONTRACTUAL ADJUSTMENT. BAD DEBT WOULD BE BASED ON THE BALANCE AFTER THE CHARITY OR CONTRACTUAL ADJUSTMENT THAT IS DEEMED UNCOLLECTABLE FOLLOWING A REASONABLE COLLECTION EFFORT.

Schedule H, Part III, Line 3, Bad Debt Expense Methodology
"THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DOES NOT PERMIT THE COST OF PATIENTS WHO ARE UNCOOPERATIVE OR UNABLE TO BE LOCATED TO BE RECLASSIFIED FROM BAD DEBT TO FINANCIAL ASSISTANCE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES AN APPLICATION AND SUPPORTING DOCUMENTATION. THEREFORE, ZERO DOLLARS ARE BEING REPORTED ON PART III, LINE 3 AS AMOUNTS INCLUDED IN BAD DEBT THAT COULD BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY (""CHA GUIDELINES"") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE BAD DEBT EXPENSE AS COMMUNITY BENEFIT."

Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote
THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THE HOSPITAL ELECTED TO EARLY ADOPT ASU 2011-07. ACCORDINGLY, BAD DEBT EXPENSE IS REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE. NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, B. SIGNIFICANT ACCOUNTING POLICIES, NET PATIENT ACCOUNTS AND NET PATIENT SERVICE REVENUE (PAGE 11) STATES NET PATIENT ACCOUNTS ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED UPON THE HISTORICAL COLLECTION EXPERIENCE OF EACH REGIONAL AFFILIATE ADJUSTED FOR CURRENT ENVIRONMENTAL RISKS AND TRENDS FOR EACH MAJOR PAYOR SOURCE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS IN THE PERIOD OF SERVICE BASED UPON PAST COLLECTION EXPERIENCE.

Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs
"THE HOSPITAL FOLLOWS THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES POLICY DOCUMENT, COMMUNITY BENEFIT PROGRAM, A REVISED RESOURCE FOR SOCIAL ACCOUNTABILITY (""CHA GUIDELINES"") FOR DETERMINING COMMUNITY BENEFIT. THE CHA GUIDELINES RECOMMEND THAT HOSPITALS NOT INCLUDE MEDICARE LOSSES AS COMMUNITY BENEFIT. THE HOSPITAL'S COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE MEDICARE AMOUNTS IN PART III."

Schedule H, Part III, Line 9b, Collection practices for patients eligible for financial assistance
PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE NOT SENT TO A COLLECTION AGENCY. THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAYS AND AFTER, AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT REFUSE TO DO SO; WHEN PATIENTS REFUSE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL.

SCHEDULE H, PART V, SECTION B, LINE 3, 1: COMMUNITY SERVED BY NEEDS ASSESSMENT RESPONSE CONTINUED
ABDA TALL, INTERPRETER/PATIENT ADVOCATE, THE HEALTHCARE CONNECTION LINCOLN HEIGHTS YOLANDA MAYWEATHER, INTERPRETER/PATIENT ADVOCATE, THE HEALTHCARE CONNECTION JOE CURRY, EXECUTIVE DIRECTOR, EVERYBODY RIDES METRO KIM SULLIVAN, CHIEF EXECUTIVE OFFICER/PRESIDENT, SINCERE HOME HEALTH CARE TIM SULLIVAN, SINCERE HOME HEALTH CARE RAY WATSON, COMMUNITY INVESTMENT PROGRAM OFFICER, THE GREATER CINCINNATI FOUNDATION MICHELLE DUFF, CASEWORKER, BIG BROTHERS BIG SISTERS KAREN MCDONALD-MYERS, EXECUTIVE DIRECTOR, BIG BROTHERS BIG SISTERS RITA EASDAY, SUPERINTENDENT, HILLSBORO CITY SCHOOLS TONY LONG, SUPERINTENDENT, SOUTHERN OHIO EDUCATIONAL SERVICES CENTER DANIELLE RATCLIFF, FCFC COORDINATOR, FAMILY AND CHILDREN FIRST JUNI FREY, EXECUTIVE DIRECTOR, PAINT VALLEY ALCOHOL, DRUG ADDICTION, MENTAL HEALTH DANA BERRYMAN, PARENT REPRESENTATIVE BONNIE CUMBERLAND, PARENT REPRESENTATIVE HEATHER GIBSON, PROJECT DIRECTOR, HELP ME GROW SHENA WEADE, DIRECTOR OF EARLY CHILDHOOD PROGRAMS, HIGHLAND COUNTY COMMUNITY ACTION ORGANIZATION/HEADSTART/EARLY HEAD START AMANDA ROBBINS, PARENT REPRESENTATIVE, HELP ME GROW MELODY ELLIOTT, DIRECTOR, FRS TRANSPORTATION JEHONA PREZA, COMMUNITY OUTREACH, MOLINA HEALTHCARE SUSAN ROADES, CASE MANAGER/SOCIAL SERVICE SUPERVISOR, HIGHLAND COUNTY JOB AND FAMILY SERVICES LISA HIGLEY, HEALTH CHEK/PREGNANCY RELATED SERVICES, HIGHLAND COUNTY JOB AND FAMILY SERVICES AMY WATSON, NURSE, JAC-CEN-DEL NURSE TONYA GEORGE, OFFICE MANAGER, HEALTH CENTERED CHIROPRACTIC PAT THOMAS*, HEALTH DEPARTMENT DIRECTOR, RIPLEY COUNTY HEALTH DEPARTMENT VICKY POWELL*, PUBLIC HEALTH NURSE, RIPLEY COUNTY HEALTH DEPARTMENT GAYLA VONDERHEIDE, DIRECTOR OF HEALTH SERVICES, BATESVILLE COMMUNITY SCHOOL APPIE THOMPSON, RN, MILAN COMMUNITY SCHOOLS TONY CZACK, MANAGER, ANYTIME FITNESS GERALYN LITZINGER, MANAGER OF OCCUPATIONAL HEALTH SERVICES, MARGARET MARY COMMUNITY HOSPITAL CINDY BLESSING, WELLNESS COORDINATOR/CHOICES DIRECTOR, CITY OF BATESVILLE BRENDA WETZLER, BOARD SECRETARY OSGOOD COMMUNITY FOUNDATION LAURA ROLF, COMMUNITY DEVELOPMENT DIRECTOR, BIG BROTHERS/BIG SISTERS OF GREATER CINCINNATI TRISH HUNTER, DIRECTOR OF SUPPORT SERVICES, MARGARET MARY COMMUNITY HOSPITAL KATHY COOLEY, RD, DIETITIAN, MARGARET MARY COMMUNITY HOSPITAL BONNIE PLOEGER, DIRECTOR OF INPATIENT CARE, MARGARET MARY COMMUNITY HOSPITAL KATHY NEWELL, CARDIOLOGY DIRECTOR, MARGARET MARY COMMUNITY HOSPITAL KEVIN KNEKELEN, NEACE LUKEN ANGELA HURLEY, WELLNESS DIRECTOR, SOUTHERN INDIANA YMCA AMY ERTEL, SCHOOL NURSE, SAINT LOUIS SCHOOL ANGIE JOHNSON, EXECUTIVE DIRECTOR, SOUTHERN INDIANA YMCA LINDA TUTTLE, MANAGER OF SOCIAL SERVICES DEPARTMENT, MARGARET MARY COMMUNITY HOSPITAL DELLA MENCHHOFER, OSGOOD COMMUNITY FOUNDATION DENISE ROARK, SCHOOL NURSE, MILAN ELEMENTARY DEBBIE BLANK, REPORTER, THE HERALD-TRIBUNE JEAN DORGAN, ABUSE RAPE CRISIS SHELTER JERRI LANGWORTHY, VOLUNTEER RESOURCE CENTER DIRECTOR/COMMUNITY BUILDING, WARREN COUNTY UNITED WAY KATHY MICHELICH, EDUCATOR AND DIRECTOR, OHIO STATE UNIVERSITY EXTENSION SUE MILLER, FAMILY SERVICES DIRECTOR, WARREN COUNTY COMMUNITY SERVICES SHARON MOELLER, SCHOOL NURSE/SAFETY OFFICER, WARREN COUNTY CAREER CENTER MARILYN SINGLETON, SITE MANAGER, TRIHEALTH SANDY SMOOT, COORDINATOR, FAMILY & CHILDREN FIRST COUNCIL DUANE STANSBURY*, HEALTH COMMISSIONER, HEALTH DISTRICT (HEALTH DEPARTMENT) JUDY WEBB, DIRECTOR, ELDERLY SERVICES PROGRAM, WARREN COUNTY COMMUNITY SERVICES THE FOCUS GROUP PARTICIPANTS, LISTED ABOVE, INCLUDED REPRESENTATIVES OF COMMUNITY, CONSUMER, AND EDUCATIONAL ORGANIZATIONS AS WELL AS SERVICE AND HEALTH PROVIDERS. THE STAKEHOLDER INTERVIEWS AND THE FOCUS GROUP PARTICIPANTS IDENTIFIED COMMUNITY NEEDS. FOR THE PRIORITIZING OF COMMUNITY HEALTH NEEDS, THE HOSPITAL CONVENED A ONE-TIME COMMITTEE AND INVITED COMMUNITY LEADERS FROM THE HOSPITAL'S SERVICE AREA TO PARTICIPATE IN DISCUSSING, EVALUATING, SCORING, AND PRIORITIZING THE HEALTH NEEDS IDENTIFIED THROUGH BOTH THE HCAN REPORT AND THE SUPPLEMENTAL DATA PROVIDED BY THE HOSPITAL. THE FOLLOWING COMMUNITY FORUMS WERE OPEN TO THE GENERAL PUBLIC. THEY WERE ALSO PROMOTED TO INTERVIEWEES AND FOCUS GROUP PARTICIPANTS AND THEIR ORGANIZATIONS, INCLUDING REPRESENTATIVES WHO WORK DAILY WITH LOW-INCOME RESIDENTS, PEOPLE WITH CHRONIC DISEASES, THE ELDERLY, YOUNG PEOPLE, DISABLED POPULATIONS, PEOPLE WITH MENTAL HEALTH AND/OR SUBSTANCE ABUSE, AND MINORITY POPULATIONS. AT EACH FORUM, CDS CONTAINING HCAN'S REPORT WERE GIVEN AWAY FOR PUBLIC DISSEMINATION. THE FORUMS WERE ORGANIZED BY HCAN AND THE ACTION RESEARCH CENTER, AND THE HOSPITAL WAS NOT PRIVY TO THEIR COMMUNICATIONS PLAN. NOT ALL PARTICIPANTS IN COMMUNITY FORUMS PROVIDED THEIR TITLES AND AFFILIATIONS. COMMUNITY FORUMS DESCRIPTION PREPARED ON JULY 2, 2012 BY ACTION RESEARCH CENTER TEAM MEMBERS AND HCAN STAFF & CONSULTANTS IN ORDER TO DISSEMINATE RESULTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND BEGIN THE CONVERSATION ABOUT NEXT STEPS, FIVE COMMUNITY FORUMS WERE ORGANIZED BY HCAN AND THE UNIVERSITY OF CINCINNATI ACTION RESEARCH CENTER. THE FORUMS WERE HELD AT ACCESSIBLE SITES ACROSS THE NINE COUNTY REGION: FORUM 1: ADAMS, BROWN, AND HIGHLAND COUNTIES, JUNE 11, 2012 LOCATION: BROWN COUNTY FAIRGROUNDS IN GEORGETOWN, OH 16 ATTENDEES: JIM SETTLES, RIPLEY; ROSE MERKOWITZ, WILMINGTON; JIM MERKOWITZ, WASHINGTON COURT HOUSE; STEVE DUNKIN, GEORGETOWN; DENISE NEU, GEORGETOWN; SHARON ASHLEY, BLUE CREEK; SAUNDRA STEVENS, WEST UNION; SHERRY STOUT, WINCHESTER; ELIZABETH PENDELL, PEEBLES; NANCY DARBY, WEST UNION; KATHY JELLEY, GEORGETOWN; PENNY CONDO, GEORGETOWN; AMY HABIG, HILLSBORO; CHERYL WILLIAMS, GEORGETOWN; BRIAN PECK, GEORGETOWN; AND MARY BAILEY, GEORGETOWN. FORUM 2: DEARBORN AND RIPLEY COUNTIES, JUNE 12, 2012 LOCATION: SOUTHEAST INDIANA YMCA IN BATESVILLE, IN 24 ATTENDEES: VICKY POWELL, BATESVILLE; TOM TALBOT, GREENDALE; KIM INSCHO, MMCH; FRANK GOODPASTER, OSGOOD; PAULA GOODPASTER, VERSAILLES; KIM LINKEL, BATESVILLE; LUREE KETCHAM, LAWRENCEBURG; RUTH WRIGHT, LAWRENCEBURG; JENNIFER MEHLON, BATESVILLE; DIANE RAVER, BATESVILLE; ASHLEY MORRIS, BATESVILLE; GERALYN LITZINGER, BATESVILLE; STEPHANIE CRAIG, LAWRENCEBURG; ANGIE JOHNSON, BATESVILLE; CONNIE DEBURGER, VERSAILLES; RAE LYNN DEANGELIS, LAWRENCEBURG; PAULA BRUNER, LAWRENCEBURG; JANE YORN, BATESVILLE; LISA WERNER, BATESVILLE; LAURA ROLF, LAWRENCEBURG; KATHY NEWELL, BATESVILLE; RICK FLEDDERMAN, RIPLEY; KATHY COOLEY, RIPLEY; AND RHONDA SAVAGE, BATESVILLE. FORUM 3: BUTLER AND WARREN COUNTIES, JUNE 25, 2012 LOCATION: MIAMI UNIVERSITY VOICE OF AMERICA LEARNING CENTER IN WEST CHESTER, OH 18 ATTENDEES: JENNIFER KRUGER, CITY OF HAMILTON; TERRY PURDUE, HAMILTON; JOYCE KACHELRIES, HAMILTON; JANE BARNES, HAMILTON; MIKE OBERDOESK, CINCINNATI; SHERRY SCHILLING, OXFORD; DAWN FAHNER, OXFORD; SUSAN LIPNICKEY, OXFORD; MARC BELLISARO, HAMILTON; HEATHER WELLS, HAMILTON; KAREN HILL, LEBANON; JUDY WEBB, LEBANON; SANDY SMOOT, LEBANON; SHARON KLEIN, OXFORD; PAT VAN OFLEN, FAIRFIELD; LYNN OSWALD, MASON; BRAD FARR, WEST CHESTER; AND BRENT LAWYER, LEBANON. FORUM 4: CLERMONT AND HAMILTON COUNTIES, JUNE 26, 2012 LOCATION: UNION TOWNSHIP CIVIC CENTER IN EASTGATE AREA 7 ATTENDEES: SUE MOTZ, MERCY HEALTH; HEIDI NYKOLAYKO WOODS, RECOVERY CENTER; GWEN FINEGAN, MERCY HEALTH; WENDY HESS, TRIHEALTH; IRENE BEHLING, MERCY HEALTH; GYASI C. CHISLEY, MERCY HEALTH; AND RUCHI BAWA, UC-CLERMONT. - RESPONSE CONTINUES AT 2: COMMUNITY SERVED BY NEEDS ASSESSMENT RESPONSE CONTINUATION -

SCHEDULE H, PART V, SECTION B, LINE 3, 2: COMMUNITY SERVED BY NEEDS ASSESSMENT RESPONSE CONTINUED
"FORUM 5: HAMILTON COUNTY, JUNE 28, 2012 LOCATION: HEALTH FOUNDATION IN CINCINNATI, OH 20 ATTENDEES: COL OWENS, LEGAL AID SOCIETY; DONNA MARSH, MARSH MEDIA GROUP; ASHAKI WARREN; MONICA ROBERTS, HEALING CENTER CINCINNATI; TONY SAVICKI; MELISSA MAY; JOSH KAUFMANN, PROJECT ACCESS; TONDA FRANCIS, GREATER CINCINNATI HEALTH COUNCIL; LEE ANN LISKA, MERCY HEALTH; RICK STUMPF, UNIVERSITY OF CINCINNATI; DON ROHLING, MERCY HEALTH; MARY BETH MEYER, CENTER FOR RESPITE CARE; JEFF ARMADA, MERCY HEALTH; KATHY LORDO, HAMILTON COUNTY PUBLIC HEALTH; TIM INGRAM, HAMILTON COUNTY HEALTH COMMISSIONER; YOUSUF AHMAD, MERCY HEALTH; JILL GORLEY, ALZHEIMER'S ASSOCIATION; LIANNE HOWARD, CITY OF CINCINNATI; TORI AMES, CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER; LESLIE APPLEGATE, UNIVERSITY OF CINCINNATI. ALTHOUGH THESE FORUMS WERE INITIALLY DESIGNED TO INCLUDE COMMUNITY RESIDENTS, SERVICE PROVIDERS, AND HOSPITAL REPRESENTATIVES, THE MAJORITY OF ATTENDEES WERE SERVICE PROVIDERS AND HOSPITAL REPRESENTATIVES. EACH FORUM WAS HELD FOR 1.5 HOURS. AT EACH FORUM, THE SAME AGENDA WAS FOLLOWED. * WELCOME AND INTRODUCTION * KEY CHNA FINDINGS AND RECOMMENDATIONS (ACROSS NINE COUNTIES AND COUNTY SPECIFIC) * ""IMAGINING THE FUTURE"" EXERCISE (SMALL GROUP COUNTY SPECIFIC DISCUSSIONS ABOUT REPORT RECOMMENDATIONS) * WRAP UP AND NEXT STEPS OVERALL, THE ATTENDEES WERE INTERESTED IN HEARING THE RESULTS - BOTH NINE-COUNTY AND COUNTY-SPECIFIC. THEY WERE ENGAGED IN DISCUSSING NEXT STEPS. ATTENDEES OFFERED SPECIFIC SUGGESTIONS ABOUT HOW BEST TO MOVE FORWARD. BASED ON THE DISCUSSIONS AND INTEREST EXPRESSED BY ATTENDEES, THERE APPEARS TO BE A HIGH LEVEL OF WILLINGNESS AMONG ATTENDEES TO PARTNER WITH HOSPITALS AND OTHER COUNTY STAKEHOLDERS FOR THE DEVELOPMENT OF PRACTICAL COMMUNITY HEALTH IMPROVEMENT INITIATIVES. THE ATTENDEES WERE RATHER PASSIONATE AND READY TO MOBILIZE FOR ACTION PLANNING AND EXECUTION. ATTENDEES WERE INVITED TO INDICATE IF THEY WOULD BE INTERESTED IN FOLLOW-UP FOR FUTURE MEETINGS, ACTION PLANNING AND INFORMATION. THE MAJORITY OF ATTENDEES DID CONSENT FOR FUTURE FOLLOW-UP. THEREFORE, THE HOSPITALS WOULD HAVE A CORE GROUP OF COUNTY RESIDENTS AND PROVIDERS TO WORK WITH IN DEVELOPING THEIR RESPECTIVE COMMUNITY HEALTH IMPROVEMENT PLANS. GENERAL OVERALL THEMES FROM THE GROUP DISCUSSIONS ALL COUNTIES AGREED WITH AND IDENTIFIED THE NEED TO ESTABLISH A COLLABORATIVE HEALTH ADVISORY BOARD THAT INCLUDES CONSUMERS. ADAMS COUNTY WAS THE ONLY COUNTY WHO FELT THEY ALREADY HAD SUCH A BOARD WITH THEIR HEALTH AND WELLNESS COALITION. SOME OF THE COUNTIES DESCRIBED COALITIONS AND BOARDS ALREADY IN EXISTENCE THAT COULD BE EXAMINED AND POSSIBLY CONDENSED OR EXPANDED TO BETTER MEET COMMUNICATION AND RESOURCE NEEDS. ALL COUNTIES IDENTIFIED THE NEED TO MAKE SURE THAT COUNTY AND COMMUNITY RESOURCES ARE NOT ONLY IDENTIFIED, BUT SHARED WIDELY SOCOMMUNITY MEMBERS KNOW WHAT IS AVAILABLE. COORDINATION OF SERVICES (BEYOND MEDICAL HEALTH SERVICES) WAS STRESSED IN ALL FORUMS. SEVERAL GLAS AND FORUMS WERE VENUES OF DISCOVERY, AS PARTICIPANTS BECAME AWARE OF SERVICES IN THEIR COUNTY. ALL COUNTY GROUPS NOTED THE IMPORTANCE OF ASSESSING THE RESOURCES AVAILABLE (AND WHOM THEY SERVE), AS WELL AS COLLABORATING IN SPREADING AWARENESS OF THOSE RESOURCES. THE GROUPS ALSO AGREED THAT IT MADE SENSE TO COORDINATE EFFORTS TO ENSURE THAT THE PEOPLE OF THEIR COUNTIES WOULD HAVE ACCESS TO NEEDED SERVICES. PARTICIPANTS AT THE COMMUNITY FORUMS WERE ANXIOUS TO NETWORK AND WORK COLLABORATIVELY. THEY OFTEN REPRESENTED THE SERVICE PROVIDERS THAT ARE ALREADY STRETCHED THIN IN THEIR RESPECTIVE ROLES. AS THE WARREN COUNTY GROUP PUT IT, ""WHO WILL TAKE THE LEAD IN COORDINATING THESE EFFORTS?"" IN TERMS OF NEXT STEPS, SEVERAL COUNTY GROUPS FELT THAT FURTHER ASSESSMENT OF NEEDS OF VULNERABLE POPULATIONS WAS WARRANTED. FOR EXAMPLE, ADAMS COUNTY ATTENDEES IDENTIFIED THAT MORE INFORMATION ON CHILDREN AND THE ELDERLY WAS NEEDED. OTHER COUNTY GROUPS ALSO VOICED THAT CONTINUED IN-DEPTH NEEDS ASSESSMENTS WERE IMPORTANT TO DETERMINE NEEDS AND PRIORITIZATION. ONE GROUP, HOWEVER, SAID THAT IT'S TIME TO TAKE ACTION, RATHER THAN CONTINUING TO CONDUCT MORE ASSESSMENTS. ACCESS TO CARE DISCUSSIONS RAISED ISSUES OF TRANSPORTATION WITH SOME SUGGESTIONS FOR MOBILE HEALTH CARE (RIPLEY), ACCESS TO TRANSPORTATION (DEARBORN) AND REVISED HOURS OR WALK IN CLINICS, IN THE WARREN COUNTY SMALL GROUP DISCUSSION, ATTENDEES REITERATED THAT TRANSPORTATION IS A CHALLENGE WITHIN THEIR COUNTY. THEY STATED THAT THEY MUST TAKE ACTION TO ADDRESS TRANSPORTATION SINCE THEY HAVE KNOWN IT'S A PROBLEM AND CONTINUES TO BE A PROBLEM ACCORDING TO THE RESULTS OF THIS CHNA. THE LACK OF SPECIFIC TYPES OF PROVIDERS WAS NOTED IN MANY COUNTIES, ESPECIALLY OUTSIDE THE I-275 LOOP. PRIMARY CARE, DENTAL, MENTAL HEALTH AND SUBSTANCE ABUSE PRACTITIONERS ARE LACKING IN SEVERAL OF THE COUNTIES. SOME SUGGESTIONS WERE MADE FOR INCENTIVIZING PRACTITIONERS TO NOT ONLY WORK IN OUTLYING AREAS (CLERMONT), BUT TO AGREE TO CARE FOR THE UNDERINSURED AND UNINSURED (HAMILTON). PARTICIPANTS WERE AWARE THAT FUNDING IS PART OF THE EQUATION. SOME SUGGESTED THAT LOAN FORGIVENESS AND INTERNSHIPS MIGHT BE INCENTIVES FOR RECRUITMENT. PARTNERING WITH BUSINESS AND COMMUNITY LEADERS WAS BROUGHT UP BOTH IN DIRECT COLLABORATION AND IN GRANTS/ FUNDING FOR NEEDED PROGRAMS."

Schedule H, Part VI, Line 2, Needs assessment.
THE HOSPITAL USES EXISTING COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS SUCH AS THE UNITED WAY OF GREATER CINCINNATI REPORT (THE STATE OF THE COMMUNITY - A REPORT ON THE SOCIO-ECONOMIC HEALTH OF THE GREATER CINCINNATI REGION) AND THE GREATER CINCINNATI HEALTH COUNCIL REPORT (INDICATORS OF HEALTHY COMMUNITIES). THE HOSPITAL ALSO USES DATA PROVIDED BY THE OHIO HOSPITAL ASSOCIATION. THE HOSPITAL ALSO UTILIZES HOSPITAL PERSONNEL AND PHYSICIANS WHO HAVE IDENTIFIED COMMUNITY NEEDS BASED ON ADMISSION/DISCHARGE AND OTHER HOSPITAL DATA. BASED ON THIS DATA AND INFORMATION, THE HOSPITAL ASSESSES AND CONTINUALLY RESPONDS TO CHANGING COMMUNITY NEEDS THROUGH THE SERVICES OFFERED. THE HOSPITAL RECOGNIZES THE HEALTH OF THE COMMUNITY IS INFLUENCED BY SOCIAL, ECONOMIC, AND ENVIRONMENTAL FACTORS, NOT JUST BY DISEASE AND ILLNESS. OUR COMMUNITY BENEFIT INCLUDES BOTH QUALITATIVE AND QUANTITATIVE DATA; DEMOGRAPHICS INCLUDING RACE, AGE, AND ETHNICITY; SOCIOECONOMIC DATA INCLUDING INCOME, EDUCATION, AND HEALTH INSURANCE RATES; PRIMARY CARE AND CHRONIC DISEASE NEEDS OF UNINSURED PERSONS; AND DATA ON HEALTH DISPARITIES IN HEALTH OUTCOMES AMONG MINORITY GROUPS. THE HOSPITAL INCORPORATES PLANNING FOR COMMUNITY BENEFITS AS PART OF ITS ANNUAL BUSINESS AND STRATEGIC PLANNING PROCESSES. TO HELP FACILITATE THIS PLANNING PROCESS, THE HOSPITAL UTILIZES QUANTITATIVE PRIMARY MARKET RESEARCH AND THE ANALYSIS OF HEALTH CARE UTILIZATION DATA BASES. IN ADDITION, SERVICE USE IS FORECAST UTILIZING LICENSED POPULATION BASED SOFTWARE. THE HOSPITAL HAS DEDICATED STAFF TO ASSIST IN THE COMMUNITY BENEFIT PLANNING, REPORTING, MONITORING AND IMPLEMENTATION OF COMMUNITY BENEFIT PROGRAMS AND SERVICES. THIS STAFF DEDICATED TO COMMUNITY BENEFIT EFFORTS OF THE HOSPITAL MEETS WITH THE REGIONAL COMMUNITY BENEFIT PLANNING COMMITTEE ON A MONTHLY BASIS AND WORKS CLOSELY WITH HEALTH AND HUMAN SERVICE ORGANIZATIONS IN THE AREA, PARTNERING WITH SOME TO PROVIDE SERVICES AND TO AVOID DUPLICATION. COMMUNITY BENEFIT ACTIVITIES AND PROGRAM EFFECTIVENESS ARE REPORTED TO THE REGIONAL BOARD BY THE HUMAN RESOURCE, MISSION AND COMMUNITY OUTREACH COMMITTEE OF THE REGIONAL BOARD.

Schedule H, Part VI, Line 3, Patient education of eligibility for assistance.
MERCY HOSPITALS WEST (MHW) POSTS ITS CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY DEPARTMENTS AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. MHW PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS AS PART OF THE INTAKE PROCESS AND WITH DISCHARGE MATERIALS. ADDITIONALLY, A COPY OF THE POLICY OR A SUMMARY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IS INCLUDED IN PATIENT BILLS. MHW DISCUSSES WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, WHERE APPLICABLE. THE HOSPITAL ELIGIBILITY LINK PROGRAM (HELP) IS A FREE REFERRAL SERVICE PROVIDED BY MHW. THE PURPOSE OF HELP IS TO ASSIST PATIENTS IN OBTAINING MEDICAL BENEFITS THROUGH FEDERAL, STATE, AND HOSPITAL PROGRAMS. HELP REPRESENTATIVES WILL PROVIDE THE FOLLOWING SERVICES AT NO COST TO THE PATIENT: * EXPLORE ELIGIBILITY UNDER PUBLIC ASSISTANCE PROGRAMS * FILE APPLICATIONS ON PATIENT'S BEHALF * SCHEDULE AND ATTEND APPOINTMENTS * PROVIDE TRANSPORTATION WHEN NECESSARY * PROVIDE MEDICAL DOCUMENTATION TO SOCIAL SECURITY ADMINISTRATION FOR DISABILITY CLAIMS. THROUGH HELP, PATIENTS AND THEIR COUNSELORS LOOK AT WHAT OPTIONS ARE AVAILABLE. MHW UNDERSTANDS THAT NOT EVERYONE CAN PAY FOR HEALTHCARE SERVICES. HELP IS HERE TO OFFER OPTIONS AND ASSISTANCE FOR THOSE WHO ARE UNINSURED OR UNDERINSURED. HELP IS AN EXTENSION OF MHW'S MISSION TO IMPROVE THE HEALTH OF OUR COMMUNITY WITH EMPHASIS ON THE POOR AND UNDERSERVED. MEETING THE NEEDS OF THOSE WITH LIMITED RESOURCES HAS ALWAYS BEEN THE HEART OF OUR MISSION. MHW IS PROUD TO MAKE OUR FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO THE PUBLIC THROUGH OUR WEBSITE, WHICH CAN BE FOUND AT E-MERCY.COM. OTHER PATIENT EDUCATION INFORMATION THAT IS PROVIDED FOR ELIGIBILITY OF ASSISTANCE IS AS FOLLOWS: * A BILINGUAL REPRESENTATIVE IS AVAILABLE IN OUR OB CLINIC AT FAIRFIELD. TWO BILINGUAL REPRESENTATIVES ARE AVAILABLE IN OUR CUSTOMER SERVICE DEPARTMENT. * STAFF TRAINING ON HOSPITAL CARE ASSURANCE PROGRAM (HCAP) AND HOSPITAL FINANCIAL ASSISTANCE (HFA) WAS PROVIDED IN 2009 BY A PRIVATE AUDITING COMPANY. TRAINING INCLUDED A MANUAL AND IN-DEPTH INFORMATION REGARDING THE PREPARATION OF THE COST REPORT LOGS, ACCURATE COMPLETION OF THE HCAP APPLICATION AS WELL AS AN OVERVIEW OF THE FAQ'S PROVIDED BY THE OHIO HOSPITAL ASSOCIATION. * STAFF TRAINING PROVIDED BY SOCIAL SECURITY ADMINISTRATION TO ASSIST PATIENTS IN OBTAINING DISABILITY BENEFITS. * FINANCIAL ASSISTANCE COUNSELORS WORK WITH CASE MANAGERS TO EXPEDITE THE TRANSFER OF PATIENTS TO EXTENDED CARE FACILITIES. * FEDERAL POVERTY GUIDELINES ARE POSTED ON OUR WEBSITE AS WELL AS A COPY OF OUR CHARITY APPLICATION. * ALL THIRD PARTIES THAT WORK ON BEHALF OF THE ORGANIZATION TO COLLECT FEES (SUCH AS COLLECTION AGENCIES AND LAW FIRMS) ARE REQUIRED TO FOLLOW THE HOSPITAL'S POLICIES REGARDING PATIENT NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE. * CONSISTENT REVIEW OF SELF PAY PATIENTS FOR RETROACTIVE MEDICAID COVERAGE. * SERVICES PROVIDED BY VENDOR TO REACH OUT TO PATIENTS IN BAD DEBT TO SCREEN FOR HCAP ELIGIBILITY.

Schedule H, Part VI, Line 4, Community information.
MERCY HEALTH - WEST HOSPITAL (MHW) SERVES A ONE-COUNTY GEOGRAPHIC AREA FEATURING HAMILTON COUNTY. THE POPULATION OF MHW'S PRIMARY SERVICE AREA IS APPROXIMATELY 444,600. OUR COMMUNITY IS CHANGING AND WE ALSO SERVE A GROWING UNINSURED AND UNDERINSURED POPULATION. THERE ARE EIGHT HOSPITALS IN THE COMMUNITY OF WHICH ALL EIGHT ARE NOT-FOR-PROFIT HOSPITALS. MHW QUALIFIES FOR A DISPROPORTIONATE SHARE PAYMENT ON THEIR MEDICARE COST REPORT DUE TO THE LARGER THAN NORMAL SHARE OF MEDICAID PATIENT VOLUME SERVED BY THE HOSPITAL. THE DEMOGRAPHIC AREA SERVED BY MHW SERVES A POPULATION THAT INCLUDES APPROXIMATELY 4.9% NON-ENGLISH SPEAKING PEOPLE. APPROXIMATELY 12.5% OF RESIDENTS ARE IN HOUSEHOLDS BELOW THE FEDERAL POVERTY GUIDELINES. THE AVERAGE FAMILY HOUSEHOLD INCOME OF THE COMMUNITY SERVED BY THE HOSPITAL IS ROUGHLY $62,206. THE LARGEST ETHNIC GROUP IN THE COMMUNITY SERVED BY THE HOSPITAL IS GERMAN, WITH APPROXIMATELY 31% OF THE POPULATION BEING OF GERMAN DESCENT. THE OCCUPATION CLASSIFICATION IN THE COMMUNITY CONSISTS OF 20% BLUE COLLAR, 61% WHITE COLLAR AND 19% SERVICE & FARM WORKERS. THE PERCENTAGE OF THE POPULATION IN THE COMMUNITY OVER 65 YEARS OLD IS ABOUT 18%. THROUGH THE COMMUNITY NEEDS ASSESSMENT PROCESS, CANCER, MENTAL HEALTH (INCLUDING SUBSTANCE ABUSE), DENTAL HEALTH, HEART DISEASE AND DIABETES WERE MAJOR HEALTH PROBLEMS IDENTIFIED IN THIS SERVICE AREA. EACH OF THESE MAY BE PREVENTABLE THROUGH PROPER CARE AND MAINTAINING CONTROL OF THE ILLNESS/DISEASE AS WELL AS LEADING HEALTHIER LIVES. MHW WORKS CLOSELY WITH LOCAL COMMUNITY AGENCIES AND HEALTH DEPARTMENTS TO ADDRESS HEALTH PROBLEMS AND MINIMIZE THE EFFECTS ON THOSE WHO SUFFER. IN 2013, MHW HAD 99,080 ADMISSIONS, 88,051 OUTPATIENT VISITS, AND 98,721 EMERGENCY ROOM VISITS.

Schedule H, Part VI, Line 5, Promotion of community health
THE HOSPITAL OPERATES AN EMERGENCY ROOM OPEN TO ALL PERSONS REGARDLESS OF ABILITY TO PAY. IN ADDITION TO PROVIDING EMERGENCY SERVICES, THE HOSPITAL PROVIDES MINOR EMERGENCY AND URGENT CARE SERVICES TO ALL REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PARTICIPATES IN MEDICAID, MEDICARE, CHAMPUS, AND/OR OTHER GOVERNMENT SPONSORED HEALTH PROGRAMS. THROUGH THE HEALTH PARTNERSHIP PROGRAM AND THE MERCY CLINIC, THE HOSPITAL CONNECTS POOR AND LOW INCOME RESIDENTS WITH PRIMARY CARE PHYSICIANS IN THE COMMUNITY WHO VOLUNTEER THEIR SERVICES TO PROVIDE PRIMARY AND URGENT CARE SERVICES. THE HOSPITAL ALSO PROVIDES PHARMACEUTICAL SUPPORT FOR THESE POOR AND LOW INCOME RESIDENTS. THE HOSPITAL ALSO COLLABORATES WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS SUCH AS LINCOLN HEIGHTS HEALTH CENTER AND HEALTH SOURCE OF OHIO AS WELL AS COMMUNITY AGENCIES SUCH AS HEALTH CARE ACCESS NOW TO FURTHER ASSIST THE POOR AND MEDICALLY UNDERSERVED FIND A MEDICAL HOME IN THE COMMUNITY. MEDICAL SUPPLIES AND EQUIPMENT ARE DONATED TO LOCAL AGENCIES AS WELL AS TO AGENCIES WHICH SERVE OTHER COUNTRIES. THE HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED IN THE AREA. THE MAJORITY OF THE GOVERNING BODY CONSISTS OF INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY SERVED BY THE HOSPITAL. THE HOSPITAL SERVES AS A CLINICAL EXPERIENCE SITE FOR SURGICAL RESIDENTS AS WELL AS OTHER HEALTH CARE PROFESSIONALS, SUCH AS NURSES, RESPIRATORY THERAPISTS, PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS AND OTHERS. COMMUNITY GROUPS AND INDIVIDUALS ARE VERY SUPPORTIVE OF THE HOSPITAL AS IS EVIDENCED BY THE LARGE NUMBER OF VOLUNTEERS. THE HOSPITAL RECEIVES GUIDANCE AND INPUT FROM ITS COMMUNITY ADVISORY COUNCIL.

Schedule H, Part VI, Line 6, Affiliated health care system
THE HOSPITAL IS ONE OF THE COMMUNITY HOSPITALS THAT ARE PART OF MERCY HEALTH PARTNERS OF SOUTHWEST OHIO (MHP-SWO). ALL ARE ACUTE CARE HOSPITALS AND OHIO NON-PROFIT CORPORATIONS. THE HOSPITALS ARE SPONSORED BY THE SISTERS OF MERCY AND THE FRANCISCAN SISTERS OF THE POOR AND HAVE BEEN PART OF THE COMMUNITY SINCE THEY WERE FOUNDED IN THE FOLLOWING YEARS: THE JEWISH HOSPITAL 1850 LICENSED BEDS: 209 MERCY HOSPITAL MT. AIRY 1971 LICENSED BEDS: 548 MERCY HOSPITAL CLERMONT 1973 LICENSED BEDS: 148 MERCY HOSPITAL FAIRFIELD 1978 LICENSED BEDS: 209 MERCY HOSPITAL WESTERN HILLS 1982 LICENSED BEDS: 261 MERCY HOSPITAL ANDERSON 1984 LICENSED BEDS: 226 MERCY HEALTH - WEST HOSPITAL 2013 LICENSED BEDS: 250 EACH OF THE HOSPITALS WORK INDIVIDUALLY AND COLLECTIVELY TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS. IN ADDITION, MERCY FRANCISCAN AT ST. JOHN AND MERCY FRANCISCAN AT ST. RAPHAEL ARE TWO SOCIAL SERVICE AGENCIES THAT PROVIDE SHELTER, FOOD, EDUCATION, CLOTHES, AND HEALTH SERVICES TO CLIENTS IN ECONOMICALLY DEPRESSED NEIGHBORHOODS IN INNER CITY CINCINNATI AND HAMILTON. MHP-SWO IS THE SOLE SPONSOR FOR THESE AGENCIES. IN ADDITION, MHP-SWO INCLUDES SENIOR HEALTH AND HOUSING COMMUNITIES IN CINCINNATI, OHIO, HAMILTON, OHIO, LOUISVILLE KENTUCKY AND NEW ALBANY, INDIANA. THESE SENIOR HEALTH AND HOUSING FACILITIES PROVIDE COMMUNITY BENEFIT SERVICES FOR THEIR RESIDENTS AND THE COMMUNITIES THEY SERVE. MERCY HEALTH PARTNERS OF SOUTHWEST OHIO COMMUNITY BENEFIT FOR 2013 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2013 COMMUNITY BENEFIT: $104.5 MILLION BENEFITS TO THE BROADER COMMUNITY: $10.7 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID: $49.0 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY: $37.5 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR: $7.3 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 9.7 PERCENT MERCY HEALTH PARTNERS OF SOUTHWEST OHIO IS A MEMBER OF CATHOLIC HEALTH PARTNERS (CHP). CHP IS THE LARGEST HEALTH SYSTEM IN OHIO, THE STATE'S FOURTH LARGEST EMPLOYER AND ONE OF THE LARGEST CATHOLIC HEALTH SYSTEMS IN THE UNITED STATES. CHP IS SPONSORED BY PARTNERS IN CATHOLIC HEALTH MINISTRIES (PCHM). PCHM IS A PUBLIC JURIDIC PERSON OF THE ROMAN CATHOLIC CHURCH. CHP CONTINUES THE HEALTHCARE MINISTRIES BEGUN BY ITS FOUNDERS IN URBAN AND RURAL AREAS ACROSS OHIO, PENNSYLVANIA AND KENTUCKY MORE THAN 150 YEARS AGO. CHP PROVIDES INTEGRATED HEALTH SERVICES VIA ACUTE CARE HOSPITALS, PHYSICIAN PRACTICES, LONG-TERM CARE RESIDENCES, HOUSING SITES FOR THE ELDERLY, HOME HEALTH AGENCIES, HOSPICE PROGRAMS, OUTREACH SERVICES AND WELLNESS CENTERS. CHP HOSPITALS INCLUDE CRITICAL ACCESS FACILITIES THAT OFFER ESSENTIAL HEALTH SERVICES THAT OTHERWISE WOULD NOT BE AVAILABLE IN MANY COMMUNITIES. CHP'S MISSION CALLS IT TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES WITH SPECIAL EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. IN ADDITION TO PROVIDING PROGRAMS AND SERVICES DESIGNED TO ENHANCE THE HEALTH OF ENTIRE COMMUNITIES, CHP CARES FOR EVERYONE WHO COMES TO ITS FACILITIES, REGARDLESS OF THEIR ABILITY TO PAY. CHP'S HOME OFFICE IN CINCINNATI, OHIO PROVIDES SERVICES AND SUPPORT TO THE ENTIRE SYSTEM. ITS GOVERNANCE PRACTICES HAVE BEEN NATIONALLY RECOGNIZED FOR QUALITY. SYSTEM LEADERSHIP PROVIDES STRATEGIC VISION AND MANAGEMENT OVERSIGHT IN SUPPORT OF THE MINISTRY BY DIRECTING RESOURCES, PROVIDING ACCESS TO LOWER COST DEBT FINANCING, IMPROVING CLINICAL OUTCOMES AND REDUCING OPERATING COSTS. SYSTEM-WIDE COMMUNITY BENEFIT FOR 2013 PER THE AUDIT FOOTNOTE IS AS FOLLOWS: TOTAL 2013 COMMUNITY BENEFIT: $374.7 MILLION BENEFITS TO THE BROADER COMMUNITY: $73.5 MILLION UNREIMBURSED CARE FOR THOSE WHO ARE POOR AND QUALIFY FOR MEDICAID: $150.9 MILLION COST OF CARE FOR THOSE WHO COULD NOT AFFORD TO PAY: $122.0 MILLION SUPPORT FOR OTHER PROGRAMS FOR THOSE WHO ARE POOR: $28.3 MILLION COMMUNITY BENEFIT AS PERCENT OF TOTAL EXPENSE: 9.8 PERCENT