4A (Expenses $ 19203755 including grants of $ 0) (Revenue $ 24382464)
NEUROSCIENCES SERVICES: NEUROSCIENCES SERVICES AT BLANCHARD VALLEY REGIONAL HEALTH CENTER (BVRHC) INCLUDE: SPINAL SURGERY, CRANIAL SURGERY, PERIPHERAL NERVE SURGERY, PAIN MANAGEMENT SURGERY, AND MANY OTHER PROCEDURES. ALSO, BVRHC PROVIDES SERVICES THAT DIAGNOSE, TREAT, AND MANAGE DISORDERS OF THE BRAIN AND NERVOUS SYSTEM. WE WORK DIRECTLY WITH OUR PATIENTS TO CREATE A HEALTH CARE PLAN TO FIT THEIR NEEDS. OUR CONTINUING GOAL IS TO PROVIDE SUPERIOR OUTCOMES BY UTILIZING THE LATEST SURGICAL TECHNIQUES AND EVIDENCE-BASED MEDICINE GUIDELINES TO ACHIEVE CLINICAL EXCELLENCE. EXCELLENCE.

4B (Expenses $ 32727566 including grants of $ 0) (Revenue $ 41553263)
CARDIOVASCULAR SERVICES: BLANCHARD VALLEY HEARTCARE CENTER OFFERS A COMPLETE RANGE OF SERVICES FOR COMPREHENSIVE CARDIAC CARE. SERVICES FOR DIAGNOSIS AND TREATMENT INCLUDE CORONARY ARTERY BYPASS SURGERY, VALVE REPLACEMENTS, CARDIAC AND PULMONARY REHABILITATION, AND DIAGNOSTIC TESTING INCLUDING EKGS, STRESS TESTS, HOLTER MONITORING, AND ECHOCARDIOGRAMS. THE CARDIAC AND PULMONARY REHAB PROGRAMS ARE NATIONALLY CERTIFIED BY THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACPR). IN ADDITION, EDUCATION IS PROVIDED TO PATIENTS AND THEIR FAMILY, AS WELL AS COMMUNITY MEMBERS, ON A VARIETY OF HEART-RELATED TOPICS THROUGHOUT THE YEAR. THE EMERGENCY DEPARTMENTS AT BLANCHARD VALLEY HOSPITAL AND BLUFFTON HOSPITAL ADHERE TO THE NATIONAL GOLD STANDARD OF HEARTCARE THAT INCLUDES THE ADMINISTRATION OF CLOT BUSTERS AND OTHER DRUG THERAPY. ALL EMERGENCY DEPARTMENT PHYSICIANS AND NURSES HAVE RECEVIED EXTENSIVE EDUCATION IN CRITICAL CARDIAC CARE, WHICH INCLUDES ADVANCED CARDIAC LIFE SUPPORT. THANKS TO TEAMWORK, THE BVH EMERGENCY DEPARTMENT AND THE BLANCHARD VALLEY HEARTCARE CENTER CONSISTENTLY BEAT THE 90-MINUTE NATIONAL BENCHMARK FOR DOOR TO BALLOON TIME, ESTABLISHED BY THE AMERICAN COLLEGE OF CARDIOLOGY (ACC). IN 2021, OUR MEDIAN DOOR TO BALLOON TIME WAS 53 MINUTES.

4C (Expenses $ 16990078 including grants of $ 0) (Revenue $ 21571821)
ORTHOPEDIC SERVICES: ORTHOPEDIC SERVICES AT BLANCHARD VALLEY REGIONAL HEALTH CENTER INCLUDE: HIP FRACTURE REPAIR AND REPLACEMENT, KNEE SURGERY, TOTAL KNEE REPLACEMENT, JOINT REPLACEMENT, AND MANY OTHER PROCEDURES. JOINT REPLACEMENTS ARE PERFORMED WITH SOME OF THE MOST ADVANCED TECHNOLOGY IN THE U.S., INCLUDING MINIMALLY INVASIVE AND GENDER-SPECIFIC PROCEDURES. THE ORTHOPEDIC PROGRAM WAS DEVELOPED THROUGH THE COLLABORATION OF BLANCHARD VALLEY REGIONAL HEALTH CENTER'S SPECIALTY ORTHOPEDIC SURGEONS AND HOSPITAL ASSOCIATES. THE SURGEONS AND OTHER HOSPITAL ASSOCIATES WORK DIRECTLY WITH PATIENTS TO CREATE A HEALTH CARE PLAN TO FIT THEIR NEEDS.

4D (Expenses $ 167797558 including grants of $ 0) (Revenue $ 269833250)
MANAGEMENT, WOULD CARE, AND DIALYSIS.

PART V, LINE 3 - BLANCHARD VALLEY HOSPITAL & BLUFFTON HOSPITAL
A.) A DEFINITION OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY THE DEFINITION OF THE COMMUNITY FOR THE COMMUNITY HEALTH ASSESSMENT WAS HANCOCK COUNTY, OHIO. THE COMMUNITY THAT IS SERVED BY THE HOSPITAL FACILITY IS DEFINED AS RESIDENTS AND COMMUNITY MEMBERS THAT LIVE WITHIN HANCOCK COUNTY AS WELL AS RESIDENTS AND COMMUNITY MEMBERS THAT UTILIZE SERVICES PROVIDED BY BLANCHARD VALLEY HOSPITAL AND BLUFFTON HOSPITAL. B.) DEMOGRAPHICS OF THE COMMUNITY HANCOCK COUNTY, OHIO IS HOME TO 74,920 RESIDENTS. APPROXIMATELY 78% OF RESIDENTS WERE ADULTS OVER THE AGE OF 18, (SOURCE: CENSUS, 2020). THE MAJORITY (88%) OF THE POPULATION WERE CAUCASIAN. HISPANICS (6%), AFRICAN AMERICANS (2%), ASIAN (2%) AND TWO OR MORE RACES (2%) COMPRISE THE REST OF THE POPULATION (SOURCE: CENSUS, 2020). THE MEDIAN HOUSEHOLD INCOME IN HANCOCK COUNTY (IN 2020 INFLATION-ADJUSTED DOLLARS) IS $61,473. NINE PERCENT OF ALL HANCOCK COUNTY RESIDENTS HAD AN INCOME BELOW THE POVERTY LEVEL IN 2020 (SOURCE: CENSUS, 2020 SMALL AREA INCOME AND POVERTY ESTIMATES). EIGHT PERCENT OF HANCOCK COUNTY RESIDENTS WERE UNINSURED. C.)EXISTING HEALTH CARE FACILITIES AND RESOURCES WITHIN THE COMMUNITY THAT ARE AVAILABLE TO RESPOND TO THE HEALTH NEEDS OF THE COMMUNITY THESE ARE THE ORGANIZATIONS WHO PARTICIPATED IN THE HEALTH ASSESSMENT AND STRATEGIC PLANNING PROCESS: BLANCHARD VALLEY HEALTH SYSTEM, CITY OF FINDLAY PARKS & RECREATION, FINDLAY CITY SCHOOLS, FINDLAY-HANCOCK COUNTY COMMUNITY FOUNDATION, FINDLAY YMCA, HANCOCK COUNTY ADAMHS BOARD/COMMUNITY PARTNERSHIP, HANCOCK COUNTY FAMILY & CHILDREN FIRST COUNCIL, HANCOCK COUNTY SCHOOLS AND EDUCATIONAL SERVICES CENTER, HANCOCK PUBLIC HEALTH, HHWP COMMUNITY ACTION COMMISSION, THE OHIO STATE UNIVERSITY EXTENSION OFFICE, UNITED WAY OF HANCOCK COUNTY, AND 50 NORTH. D) HOW DATA WAS OBTAINED ADULT SURVEY ADULTS AGES 19 AND OVER LIVING IN HANCOCK COUNTY WERE USED AS THE SAMPLING FRAME FOR THE ADULT SURVEY. THERE WERE 57,957 PERSONS AGES 19 AND OVER LIVING IN HANCOCK COUNTY. THE INVESTIGATORS CONDUCTED A POWER ANALYSIS TO DETERMINE WHAT SAMPLE SIZE WAS NEEDED TO ENSURE A 95% CONFIDENCE LEVEL WITH A CORRESPONDING MARGIN OF ERROR OF 6% (I.E., WE CAN BE 95% SURE THAT THE TRUE POPULATION RESPONSES ARE WITHIN A 6% MARGIN OF ERROR OF THE SURVEY FINDINGS.) A SAMPLE SIZE OF AT LEAST 266 ADULTS WAS NEEDED TO ENSURE THIS LEVEL OF CONFIDENCE. THE RANDOM SAMPLE OF MAILING ADDRESSES OF ADULTS FROM HANCOCK COUNTY WAS OBTAINED FROM MELISSA DATA CORPORATION IN RANCHO SANTA MARGARITA, CALIFORNIA. PRIOR TO MAILING THE SURVEY TO ADULTS, THE PROJECT TEAM MAILED AN ADVANCE LETTER TO 2,000 ADULTS IN HANCOCK COUNTY. THIS ADVANCE LETTER WAS PERSONALIZED; PRINTED ON BE HEALTHY NOW HANCOCK COUNTY COALITION STATIONERY; AND SIGNED BY WILLIAM KOSE, VICE PRESIDENT-SPECIAL PROJECTS, BLANCHARD VALLEY HEALTH SYSTEM AND KARIM BAROUDI, HANCOCK COUNTY HEALTH COMMISSIONER. THE LETTER INTRODUCED THE COUNTY HEALTH ASSESSMENT PROJECT AND INFORMED THE READERS THAT THEY MAY BE RANDOMLY SELECTED TO RECEIVE THE SURVEY. THE LETTER ALSO EXPLAINED THAT THE RESPONDENTS' CONFIDENTIALITY WOULD BE PROTECTED AND ENCOURAGED THE READERS TO COMPLETE AND RETURN THE SURVEY PROMPTLY IF THEY WERE SELECTED. SIX WEEKS FOLLOWING THE ADVANCE LETTER, A MAILING PROCEDURE WAS IMPLEMENTED TO MAXIMIZE THE SURVEY RETURN RATE. THE INITIAL MAILING INCLUDED A PERSONALIZED HAND SIGNED COVER LETTER (ON BE HEALTHY NOW HANCOCK COUNTY COALITION STATIONERY) DESCRIBING THE PURPOSE OF THE STUDY, A QUESTIONNAIRE PRINTED ON WHITE PAPER, A SELF- ADDRESSED STAMPED RETURN ENVELOPE, AND A $2 INCENTIVE. SURVEYS RETURNED AS UNDELIVERABLE WERE NOT REPLACED WITH ANOTHER POTENTIAL RESPONDENT. THE RESPONSE RATE FOR THE MAILING WAS 11% (N=213: CI=? 6.70). THIS RETURN RATE AND SAMPLE SIZE MEANS THAT THE RESPONSES IN THE HEALTH ASSESSMENT SHOULD BE REPRESENTATIVE OF THE ENTIRE COUNTY.

E.) THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY
The health needs of Hancock County that were examined by the needs assessment include but are not limited to: health status perceptions, health care coverage, health care access and utilization, cardiovascular health, cancer, diabetes, asthma and other respiratory disease, weight status, tobacco use, alcohol consumption, drug use, women's health, men's health, preventive medicine and environmental health, sexual behavior and pregnancy outcomes, quality of life, social context and safety, mental health and suicide, oral health, youth weight control, youth tobacco use, youth alcohol consumption, youth drug use, youth sexual behavior and teen pregnancy outcomes, youth mental health and suicide, youth safety, youth violence issues, child health and functional status, child health insurance, access, and medical home, early childhood, middle childhood, family functioning, neighborhood and community context, and parent health. There were 26 key leaders from the community that represented public health, law enforcement, churches, local officials, social service agencies and other various community members in attendance at the public release of the community health needs assessment. At the event, participants participated in focus groups and priorities were chosen for Hancock County to focus on. F.) Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups Lack of health care coverage, tobacco use, prescription drug abuse, lack of female health screenings, and lack of routine dental care were all prevalent issues among those Hancock County adults with incomes less than $25,000. The chronic disease prevalence among Hancock County adults with incomes less than $25,000 were: high blood pressure (62%), high blood cholesterol (58%), diabetes (25%), and asthma (17%). High blood pressure, diabetes, obesity, and asthma had a higher prevalence among those adults with incomes less than $25,000. Eight percent of Hancock County adults were uninsured at the time of the survey. Hancock County adults who were uninsured reported that the reason they were without health care coverage was that they lost or changed employers, they could not afford to pay the insurance premiums, their spouse or parent lost their job or changed employers, or their employer does not/stopped offering coverage. The majority (88%) of the population were Caucasian. Hispanics (6%), African Americans (2%), Asian (2%) and two or more races (2%) comprise the rest of the population (Source: Census, 2020). G.) The process for identifying and prioritizing community health needs and services to meet the community health needs There were 26 key leaders from the community that represented public health, law enforcement, churches, local officials, social service agencies and other various community members in attendance at the public release of the community health needs assessment. At the event, participants participated in focus groups and priorities were chosen for Hancock County to focus on. H.) The process for consulting with persons representing the community's interests Local community agencies were invited to participate in the health assessment process, including choosing questions for the surveys, providing local data, reviewing draft reports and planning the community event, release of the data and setting priorities. The needs of the population, especially those who are medically underserved, low-income, minority populations and populations with chronic disease needs, were taken into account through the sample methodology that surveyed these populations. In addition, the organizations that serve these populations participated in the health assessment and community planning process, such as United Way of Hancock County, Cultural Connections of Hancock County, 50 North, etc. The participants included: A (PH) indicates they work in the Public Health field. Karim Baroudi, Hancock Public Health (PH) Kimberly Bash, Findlay-Hancock County Community Foundation Dr. Jasmin Bradley, LGBTQ+ Spectrum of Findlay Gary Bright, Hancock Public Health Carolyn Copus, 50 North Angela DeBoskey, United Way of Hancock County Taylor Coote, United Way of Hancock County Dr. William Kose, Blanchard Valley Health System Myron Lewis, Blanchard Valley Health System Amy Miranda, Hancock County Job and Family Services Erin Rodabaugh Gallegos, HHWP Community Action Commission Chad Masters, Hancock Public Health Stacy Shaw, Children's Mentoring Connection Christina Muryn, Mayor City of Findlay Precia Stuby, Hancock County ADAMHS Board Zachary Thomas, Hancock County ADAMHS Board Brian Treece, Findlay-Hancock County Community Foundation Roxanne Williams, Blanchard Valley Health

PART V, LINE 5 - BLANCHARD VALLEY HOSPITAL & BLUFFTON HOSPITAL
HANCOCK COUNTY CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO, A NON-PROFIT HOSPITAL ASSOCIATION, LOCATED IN TOLEDO, OHIO, TO COORDINATE AND MANAGE THE HEALTH ASSESSMENT PROCESS. THE HOSPITAL COUNCIL HAS BEEN COMPLETING COMPREHENSIVE HEALTH ASSESSMENTS SINCE 1999. THE PROJECT COORDINATOR CONDUCTED A SERIES OF MEETINGS WITH THE PLANNING COMMITTEE FROM HANCOCK COUNTY. DURING THESE MEETINGS, BANKS OF POTENTIAL SURVEY QUESTIONS FROM THE BRFSS, YRBSS, AND NSCH SURVEYS WERE REVIEWED AND DISCUSSED. BASED ON INPUT FROM THE HANCOCK COUNTY PLANNING COMMITTEE, THE PROJECT COORDINATOR COMPOSED DRAFTS OF SURVEYS CONTAINING 112 ITEMS FOR THE ADULT SURVEY. LOCAL COMMUNITY AGENCIES WERE INVITED TO PARTICIPATE IN THE HEALTH ASSESSMENT PROCESS, INCLUDING CHOOSING QUESTIONS FOR THE SURVEYS, PROVIDING LOCAL DATA, REVIEWING DRAFT REPORTS AND PLANNING THE COMMUNITY EVENT, RELEASE OF THE DATA AND SETTING PRIORITIES. THE NEEDS OF THE POPULATION, ESPECIALLY THOSE WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS AND POPULATIONS WITH CHRONIC DISEASE NEEDS, WERE TAKEN INTO ACCOUNT THROUGH THE SAMPLE METHODOLOGY THAT SURVEYED THESE POPULATIONS. IN ADDITION, THE ORGANIZATIONS THAT SERVE THESE POPULATIONS PARTICIPATED IN THE HEALTH ASSESSMENT AND COMMUNITY PLANNING PROCESS, SUCH AS UNITED WAY OF HANCOCK COUNTY, 50 NORTH, ETC. THE PARTICIPANTS INCLUDED: A (PH) AFTER THEIR NAME INDICATES THEY WORK IN THE PUBLIC HEALTH FIELD. Karim Baroudi, Hancock Public Health (PH) Kimberly Bash, Findlay-Hancock County Community Foundation Dr. Jasmin Bradley, LGBTQ+ Spectrum of Findlay Gary Bright, Hancock Public Health Carolyn Copus, 50 North Angela DeBoskey, United Way of Hancock County Taylor Coote, United Way of Hancock County Dr. William Kose, Blanchard Valley Health System Myron Lewis, Blanchard Valley Health System Amy Miranda, Hancock County Job and Family Services Erin Rodabaugh Gallegos, HHWP Community Action Commission Chad Masters, Hancock Public Health Stacy Shaw, Children's Mentoring Connection Christina Muryn, Mayor City of Findlay Precia Stuby, Hancock County ADAMHS Board Zachary Thomas, Hancock County ADAMHS Board Brian Treece, Findlay-Hancock County Community Foundation Roxanne Williams, Blanchard Valley Health PART V, SECTION B, LINE 6A - BLANCHARD VALLEY HOSPITAL & BLUFFTON HOSPITAL PART V, SECTION B, LINE 6B - BLANCHARD VALLEY HOSPITAL & BLUFFTON HOSPITAL THESE ARE THE ORGANIZATIONS WHO PARTICIPATED IN THE HEALTH ASSESSMENT AND STRATEGIC PLANNING PROCESS: BLANCHARD VALLEY HEALTH SYSTEM, CITY OF FINDLAY PARKS & RECREATION, FINDLAY CITY SCHOOLS, FINDLAY-HANCOCK COUNTY COMMUNITY FOUNDATION, FINDLAY YMCA, HANCOCK COUNTY ADAMHS BOARD/COMMUNITY PARTNERSHIP, HANCOCK COUNTY FAMILY & CHILDREN FIRST COUNCIL, HANCOCK COUNTY SCHOOLS AND EDUCATIONAL SERVICES CENTER, HANCOCK PUBLIC HEALTH, HHWP COMMUNITY ACTION COMMISSION, THE OHIO STATE UNIVERSITY EXTENSION OFFICE, UNITED WAY OF HANCOCK COUNTY, AND 50 NORTH. PART V, SECTION B, LINE 7D THE ASSESSMENT IS AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTPS://WWW.BVHEALTHSYSTEM.ORG/ ALSO, PRINTED COPIES WERE GIVEN TO ALL KEY LEADERS AT COMMUNITY EVENT.

PART V, SECTION B, LINE 11 - BLANCHARD VALLEY HOSPITAL & BLUFFTON HOSPITAL
Resource restrictions do not allow the hospital to address all of the needs identified through the health assessment. Of the priority needs identified by the community planning process, the hospital is not directly addressing the issues of youth violence, mental health and addiction. This is because many community agencies across Hancock County are addressing these issues. THE IMPLEMENTATION STRATEGY WILL DELINIATE THE WAYS ALL ISSUES ARE BEING ADDRESSED AND BY WHICH ORGANIZATIONS.

SCHEDULE H, PART III, SECTION A, LINE 2
OUR BAD DEBT EXPENSE IS COMPRISED OF FOUR COMPONENTS. FIRST, ACCOUNTS THAT HAVE BEEN TRANSFERRED TO COLLECTION AGENCIES ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. SECOND, CHANGES IN OUR ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON CHANGES IN OUR ACCOUNTS RECEIVABLE AGING BUCKETS ARE RECORDED AS AN INCREASE OR DECREASE TO BAD DEBT EXPENSE. THIRD, ANY ACCOUNTS NOT COLLECTIBLE DUE TO BANKRUPTCIES OR DEATHS (ESTATES NOT SUFFICIENT) ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. FINALLY, ANY RECOVERIES THAT ARE RECEIVED FROM COLLECTION AGENCIES ARE RECORDED AS A DECREASE TO BAD DEBT EXPENSE. THESE FOUR COMPONENTS ARE THE NET BAD DEBT EXPENSE AMOUNTS THAT ARE PRESENTED IN OUR FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION A, LINE 3
THE ASSUMPTION IS THAT OUR CHARITY CARE PROGRAMS CAPTURE A LARGE PERCENTAGE OF THOSE WHO QUALIFY. HOWEVER, THERE IS A SUBSECTION OF PATIENTS WHO ARE PROVIDED THE INFORMATION FOR CHARITY CARE BUT CHOOSE NOT TO PROVIDE THE NECESSARY DOCUMENTS. THERE IS A LARGE PORTION OF BAD DEBT THAT FROM INDIVIDUALS THAT HAVE INSURANCE, AND THESE INDIVIDUALS WORK IN WHITE/BLUE COLLAR JOBS BUT CHOOSE NOT TO PAY THEIR BILLS. THUS, THE ASSUMPTION THAT IS USED IS THAT TWO OUT OF EVERY THREE BAD DEBT ACCOUNTS ARE FOR SUCH INDIVIDUALS. THEREFORE, THE REMAINING ONE OUT OF EVERY THREE BAD DEBT ACCOUNTS WOULD POTENTIALLY QUALIFY FOR CHARITY CARE.

SCHEDULE H, PART III, SECTION A, LINE 4
WE DO NOT HAVE A BAD DEBT FOOTNOTE. OUR BAD DEBT EXPENSE IS COMPRISED OF FOUR COMPONENTS. FIRST, ACCOUNTS THAT HAVE BEEN TRANSFERRED TO COLLECTION AGENCIES ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. SECOND, CHANGES IN OUR ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON CHANGES IN OUR ACCOUNTS RECEIVABLE AGING BUCKETS ARE RECORDED AS AN INCREASE OR DECREASE TO BAD DEBT EXPENSE. THIRD, ANY ACCOUNTS NOT COLLECTIBLE DUE TO BANKRUPTCIES OR DEATHS (ESTATES NOT SUFFICIENT) ARE RECORDED AS AN INCREASE TO BAD DEBT EXPENSE. FINALLY, ANY RECOVERIES THAT ARE RECEIVED FROM COLLECTION AGENCIES ARE RECORDED AS A DECREASE TO BAD DEBT EXPENSE. THESE FOUR COMPONENTS ARE THE NET BAD DEBT EXPENSE AMOUNTS THAT ARE PRESENTED IN OUR FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION B, LINE 8
WE FEEL THAT ALL OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT. WE PERFORM SERVICES FOR MEDICARE PATIENTS AND CONSCIOUSLY KNOW THAT THE COSTS TO PERFORM SUCH SERVICES ARE HIGHER THAN THE REIMBURSEMENT WE RECEIVE. THUS, WE FEEL THAT THIS IS A BENEFIT TO THE COMMUNITY BY BEING A CONVENIENT AND REPUTABLE SOURCE WITHIN THE COMMUNITY TO RECEIVE SUCH SERVICES. THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS OUR 2021 MEDICARE COST REPORTS AND OUR 2021 PSR REPORTS.

SCHEDULE H, PART III, SECTION C, LINE 9B
BVRHC HAS ESTABLISHED A FINANCIAL ASSISTANCE POLICY (FAP) THAT HAS BILLING AND COLLECTION PRACTICES FOR PATIENT PAYMENT OBLIGATIONS THAT ARE FAIR, CONSISTENT, AND COMPLIANT WITH STATE AND FEDERAL REGULATIONS. BVRHC WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS (ECA) AGAINST AN INDIVIDUAL TO COLLECT PAYMENT UNLESS IT HAS MADE REASONABLE EFFORTS TO DETERMINE THE ELIGIBILITY UNDER THE FAP. BVRHC WILL WORK WITH ALL PATIENTS TO ESTABLISH SUITABLE PAYMENT ARRANGEMENTS SUCH AS PAYMENT IN FULL, SHORT TERM PAYMENT PLANS, AND LONG TERM LOAN PROGRAMS. BVRHC WILL NOT INITIATE ANY ECA AGAINST AN INDIVIDUAL UNTIL THE PATIENT'S FAP ELIGIBILITY HAS BEEN DETERMINED AND THE INTERNAL COLLECTION PROCESSES HAVE BEEN COMPLETED. THE INTERNAL COLLECTION PROCESSES CONSIST OF MAILING STATEMENTS, MAKING PHONE CALLS, AND SENDING LETTERS. COLLECTION PROCEDURES GENERALLY BEGIN AFTER 120 DAYS AND AFTER ALL EFFORTS HAVE BEEN EXHAUSTED PER THE INTERNAL COLLECTION PROCESSES.

SCHEDULE H, PART VI, LINE 2
BLANCHARD VALLEY REGIONAL HEALTH CENTER (BVRHC) HAS A LONG-STANDING COMMITMENT TO THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THROUGH PARTICIPATION IN AND SPONSORSHIP OF HEALTH FAIRS, HEALTH SCREENINGS, AWARENESS CAMPAIGNS, AND EDUCATIONAL EVENTS; AS WELL AS ACTIVE AND ONGOING DIALOGUE WITH THE FINDLAY CITY AND HANCOCK COUNTY HEALTH DEPARTMENTS, BVRHC SEEKS NOT ONLY TO ASSESS THE NEEDS OF LOCAL COMMUNITIES, BUT ALSO TO ENCOURAGE COMMUNITY MEMBERS OF ALL AGES TO TAKE CHARGE OF THEIR HEALTH CARE NEEDS. WE CONFER WITH THE LOCAL CITY AND COUNTY SCHOOLS, AND COOPERATE WITH AGENCIES IN THE COMMUNITY THAT MAY, FROM TIME TO TIME, CONDUCT HEALTH ASSESSMENTS. THE BLUFFTON HOSPITAL COLLABORATES WITH THE LOCAL SCHOOLS TO PROVIDE A SCHOOL NURSE PROGRAM THAT NOT ONLY EVALUATES THE POPULATION FOR HEALTH ISSUES, BUT PROVIDES EDUCATION AS WELL. BVRHC PERIODICALLY CONDUCTS PHYSICIAN NEEDS ASSESSMENTS. OUR MULTIPLE BOARDS AND COMMITTEES ARE FORMED WITH MEMBERS AND PHYSICIANS WHO LIVE WITHIN THE COMMUNITY. WE ALSO MONITOR DISEASES AND CONDITIONS THAT PRESENT IN OUR EMERGENCY DEPARTMENT AT CAUGHMAN HEALTH CENTER.

SCHEDULE H, PART VI, LINE 7
OHIO

SCHEDULE H, PART VI, LINE 3
BLANCHARD VALLEY REGIONAL HEALTH CENTER EDUCATES PATIENTS ABOUT OUR OPTIONS FOR FINANCIAL ASSISTANCE IN SEVERAL WAYS. THE FINANCIAL ASSISTANCE GUIDELINES ARE ON THE BACK OF EACH STATEMENT. WHEN PATIENTS ARE CALLED OR CALL THE BUSINESS OFFICE, ASSOCIATES IN THE CREDIT AND COLLECTION DEPARTMENT PRE-SCREEN PATIENTS TO DETERMINE IF THEY MAY BE ELIGIBLE FOR ANY TYPE OF FINANCIAL ASSISTANCE. IF THE PATIENT IS DETERMINED TO POTENTIALLY BE ELIGIBLE, WE DISCUSS WITH THE PATIENT THEIR OPTIONS FOR OBTAINING FINANCIAL ASSISTANCE. WE THEN SEND AN APPLICATION TO THE PATIENTS VIA MAIL. THE PROCESS IS ALSO DEFINED AND OUR APPLICATION AVAILABLE ON OUR WEBSITE. IN ADDITION, IF WE HAVE AN OUTPATIENT OR INPATIENT THAT MAY QUALIFY, WE TALK TO THOSE PATIENTS AND EVEN ASSIST WITH COMPLETING THE APPLICATION. APPLICATIONS ARE THEN PROCESSED AND A LETTER OR AWARD OR DENIAL IS SENT TO THE PATIENT. THEY ARE INSTRUCTED TO CALL THE FINANCIAL ADVOCATES IF THEY HAVE FURTHER QUESTIONS OR CONCERNS. NOTE: ALL POINTS OF SERVICE ARE EQUIPPED TO DISCUSS AND DISTRIBUTE THE FINANCIAL ASSISTANCE APPLICATION.

SCHEDULE H, PART VI, LINE 4
BLANCHARD VALLEY HEALTH SYSTEM SERVES AN EIGHT-COUNTY AREA THAT INCLUDES HANCOCK, ALLEN, PUTNAM, HENRY, WOOD, SENECA, WYANDOT, AND HARDIN COUNTIES. HANCOCK (OUR PRIMARY SERVICE AREA) AND SENECA COUNTIES CAN BE DESCRIBED AS MICROPOLITAN; ALLEN AND WOOD COUNTIES AS METROPOLITAN; AND THE SURROUNDING FOUR COUNTIES AS RURAL. FINDLAY HAS BEEN RANKED AS THE TOP MICROPOLITAN COMMUNITY FOR THE PAST 5 YEARS BY SITE SELECTION MAGAZINE (2015-2019). THE POPULATION OF HANCOCK COUNTY IS APPROXIMATELY 76,000, WITH FINDLAY COMPRISING ABOUT HALF OF THAT TOTAL. MEDIAN INCOME IS MODERATE; RANGING FROM $40,000 TO $60,000 DEPENDING ON LOCATION. FINDLAY SUPPORTS A UNIVERSITY, AS WELL AS SEVERAL LARGE CORPORATIONS INCLUDING COOPER TIRE, MARATHON PETROLEUM AND WHIRLPOOL. THE SURROUNDING AREAS ARE HEAVILY AGRICULTURAL.

SCHEDULE H, PART VI, LINE 5
BY REACHING OUT TO THE COMMUNITY THOUGH HEALTH FAIRS, SERVING ON THE BOARDS OF LOCAL ORGANIZATIONS, AND PROVIDING HEALTH EDUCATION, WE ARE GIVEN THE OPPORTUNITY TO FURTHER THE KNOWLEDGE OF THE COMMUNITY ABOUT THE IMPORTANCE OF WELLNESS. WE ARE ALSO PRESENTED WITH THE OPPORTUNITY TO INTERACT WITH OUR COMMUNITY AND LISTEN TO AND IDENTIFY THEIR NEEDS. OUR HOSPITALS ARE MAJOR SPONSORS OF AND PARTICIPATE IN MANY COMMUNITY HEALTH FAIRS THAT PROVIDE FREE OR LOW-COST HEALTH SCREENS, EDUCATIONAL MATERIALS ON VARIOUS HEALTH TOPICS, AND OVERALL HELP TO INCREASE AWARENESS THROUGHOUT THE COMMUNITY OF HEALTHIER LIFESTYLES AND OF LOCAL RESOURCES FOR HEALTH AND HEALTHCARE SERVICES AND PRODUCTS. THE ORGANIZATION ALSO CONTRIBUTES MONETARILY TO LOCAL CHARITIES SUCH AS UNITED WAY, MARCH OF DIMES AND THE AMERICAN CANCER SOCIETY.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM CAUGHMAN HEALTH CENTER PROVIDES HEALTH CARE TO HANCOCK COUNTY FAMILIES, REGARDLESS OF THEIR ABILITY TO PAY. FAMILY PRACTICE, PEDIATRIC, OB/GYN, AND PREVENTATIVE SERVICES ARE OFFERED AT CAUGHMAN. CAUGHMAN ALSO PARTICIPATES IN A PROGRAM THAT CONNECTS PATIENTS WITH PHARMACEUTICAL COMPANIES' INDIGENT CARE PROGRAMS TO PROVIDE MEDICATIONS AT NO CHARGE TO PATIENTS. A LICENSED INDEPENDENT SOCIAL WORKER IS EMPLOYED AT CAUGHMAN, AND SHE FACILITATES CLASSES FOR TEEN MOMS, PROVIDES COUNSELING TO PATIENTS, MAKES HOME VISITS FOR PATIENTS, AND PROVIDES ADDITIONAL SUPPORT FOR PATIENTS. BLANCHARD VALLEY REGIONAL HEALTH CENTER, ALONG WITH ITS AFFILIATES, PROVIDES UNRESTRICTED ACCESS TO CARE THROUGH THE ABOVE MENTIONED CAUGHMAN HEALTH CENTER, PHYSICIAN'S PLUS URGENT CARE FACILITY, AND ALL OF THEIR RELATED MEDICAL PRACTICES. WE ARE A SPONSORING AND PARTICIPATING MEMBER OF THE NORTHWEST OHIO FLOOD MITIGATION PARTNERSHIP WHICH IS WORKING TOWARDS RESOLVING THE FLOODING ISSUES IN OUR COMMUNITY.