4A (Expenses $ 24444392 including grants of $ 1387) (Revenue $ 25750807)
WE CONTINUE TO PROVIDE QUALITY HEALTH CARE TO MCCURTAIN COUNTY, OKLAHOMA AND ITS SURROUNDING AREAS. THE HOSPITAL CONTINUES TO OPERATE AND MAINTAIN THE FOLLOWING CLINICS: MCCURTAIN MEMORIAL SURGICAL SERVICES CLINIC OPENED JUNE 2019, MCCURTAIN NORTH URGENT CARE CLINIC OPENED 7/1/2019, BOOKER T WASHINGTON FREE CARE CLINIC OPENED 10/2019, AND THE MCCURTAIN FAMILY CLINIC OPENED 10/14/2019. THE VALLIANT URGENT CARE CLINIC WAS RECENTLY OPENED IN FEBRUARY 2021. BY PROVIDING CLINICS IN THE SURROUNDING AREAS THE HOSPITAL SEEKS TO PROVIDE HEALTHCARE ACCESS TO LOCAL COMMUNITY WHICH IS IN A MEDICALLY UNDERSERVED REGION.

4B (Expenses $ 27250 including grants of $ 0) (Revenue $ 0)
THE HOSPITAL ENDEAVORS TO FULFILL ITS MISSION OF COMMUNITY SERVICE BY PROVIDING CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER OUR CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN OUR ESTABLISHED RATES. WE MAINTAIN RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE WE PROVIDE.

4C (Expenses $ 2253 including grants of $ 0) (Revenue $ 8931)
TO PROMOTE GENERAL HEALTH AND WELLNESS WITHIN THE COMMUNITY THE HOSPITAL PROVIDES A WELLNESS CENTER OPEN TO THE PUBLIC WITH REDUCED MEMBERSHIP RATES FOR SENIORS. THE HOSPITAL ALSO MAINTAINS AN OUTDOOR WELL-LIGHTED WALKING TRACK OPEN TO THE PUBLIC 24 HOURS A DAY.

SCHEDULE H, PART V, SECTION B, LINE 5
INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY: Community input was gathered through a single community meeting in a hybrid format. Local community members had the opportunity to meet in person at McCurtain Memorial Hospital or meet virtually via Zoom. The meeting was held on May 31, 2022. COMMUNITY MEMBERS IN ATTENDANCE AT THIS MEETING INCLUDED: -MCCURTAIN MEMORIAL HOSPITAL -MCCURTAIN COUNTY HEALTH DEPARTMENT -OKLAHOMA STATE DEPT OF HEALTH -MCCURTAIN COUNTY COOPERATIVE EXTENSION -MCCURTAIN COUNTY HEALTH COALITION -OKLAHOMA STATE DEPT OF MENTAL HEALTH & SUBSTANCE ABUSE SERVICES -IDABEL CHAMBER OF COMMERCE -BRIGHTER HEIGHTS OKLAHOMA -EASTER OK STATE COLLEGE -OKLAHOMA STATE UNIVERSITY A SURVEY WAS ALSO CONDUCTED IN MAY 2022 TO GAUGE HOSPITAL USAGE, SATISFACTION AND ADDITIONAL COMMUNITY HEALTH NEEDS. A TOTAL OF 297 SURVEYS WERE COMPLETED.

SCHEDULE H, PART V, SECTION B, LINE 11
NEEDS ADDRESSED AND NOT ADDRESSED: THE FOLLOWING NEEDS WERE IDENTIFIED IN THE CHNA COMPLETED IN 2022.THE HOSPITAL HAS CHOSEN TO FOCUS ON FIVE IDENTIFIED NEEDS AND REGRETS THAT A LACK OF HOSPITAL RESOURCES PREVENTS US FROM SPECIFICALLY ADDRESSING ALL OF THE NEEDS IDENTIFIED IN THE COMMUNITY MEETING. THE NEEDS THAT WILL NOT BE ADDRESSED ARE THE FOLLOWING: - INPATIENT MENTAL HEALTH - ADDITIONAL WOMEN'S HEALTH/OBGYN C ARE - TRANSPORTATION - SUBSTANCE ABUSE ASSISTANCE - HOUSING & HOMELESSNESS - EDUCATION ON FOOD INSECURITY AND AVAILABILITY THE FIVE NEEDS IDENTIFIED THAT THE HOSPITAL HAS THE RESOURCES TO ADDRESS ARE SIMILAR TO THE NEEDS IDENTIFIED IN THE 2019 CHNA. SPECIALTY SERVICES THE HOSPITAL PLANS TO PARTNER WITH OU HEALTH DOCTORS TO PROVIDE SPECIALTY CONSULTS IN NEPHROLOGY, CARDIOLOGY, INFECTIOUS DISEASE, PULMONOLOGY AND NEUROLOGY. THIS WILL REDUCE TRAVEL TIME FOR PATIENTS WHO NEED THESE SERVICES IN THE COMMUNITY. SERVICES FOR AGING POPULATION THE HOSPITAL IS DEVELOPING A STEPDOWN/SWING BED PROGRAM TO FOCUS ON AGING PATIENTS WHO NEED MORE SPECIALIZED CARE THAN WOULD BE PROVIDED AT AN ASSISTED LIVING FACILITY. THIS PROGRAM HAS BEEN DESIGNED TO ADDRESS CLINICAL OBSTACLES THROUGH NURSING, THERAPY, AND REHABILITATION. CONTINUITY OF CARE THE HOSPITAL HAS PARTNERED WITH THE 340B PROGRAM TO PROVIDE COST-EFFECTIVE DRUGS AND MEDICINE TO UNINSURED/UNDER-INSURED PATIENTS. ADDITIONALLY, THE SWINGBED PROGRAM WILL ALLOW MORE AGGRESSIVE INPATIENT STEPDOWN THAT WILL GIVE PATIENTS MORE STABILITY BEFORE DISCHARGE. COST OF CARE THE 340B PROGRAM PROVIDE COST SAVING DRUGS TO PATIENTS AND THEIR FAMILIES AND WILL DECREASE THE OVERALL COSTS TO HOSPITAL PATIENTS. HEALTH LITERACY THE HOSPITAL CONTINUES TO PROVIDE EDUCATION TO PATIENTS IN GENERAL WELLNESS AND EARLY DETECTION OF HIGH BLOOD PRESSURE, OBESITY AND OTHER CHRONIC ILLNESSES.

SCHEDULE H, PART V, SECTION B, LINE 6B
CHNA CONDUCTED WITH OTHER FACILITIES: THE CHNA WAS CONDUCTED WITH THE ASSISTANCE OF OKLAHOMA OFFICE OF RURAL HEALTH AND OSU CENTER FOR RURAL HEALTH.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE: ACCOUNTS ARE NOT WRITTEN OFF TO BAD DEBT UNTIL ALL PAYMENTS, DISCOUNTS AND CONTRACTUAL ALLOWANCES ARE APPLIED AND INTERNAL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. WHEN A PAYMENT IS RECEIVED ON AN ACCOUNT PREVIOUSLY WRITTEN OFF TO BAD DEBT, THE PAYMENT REDUCES THE CURRENT YEAR'S BAD DEBT EXPENSE.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE: THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS 24%. THIS IS DETERMINED BY USING THE PERCENTAGE OF THE POPULATION IN THE SERVICE AREA THAT IS UNDER THE FEDERAL POVERTY GUIDELINE ESTABLISHED FOR CHARITY CARE.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT FOOTNOTE: NOT APPLICABLE DUE TO ADOPTION OF ASU 2014-09 TOPIC 606 REVENUE FROM CONTRACTS WITH CUSTOMERS.

SCHEDULE H, PART III, SECTION B, LINE 8
COST METHODOLOGY: TOTAL REVENUE RECEIVED FROM MEDICARE (INCLUDING DSH AND IME) IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT (INCLUDING LSA). BOTH THE TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION PRACTICES: SELF-PAY PATIENTS WILL BE NOTIFIED OF THE FINANCIAL ASSISTANCE PROGRAM UPON REGISTRATION DURING FACE-TO-FACE INTERVIEWS IF POSSIBLE. FIRST TIME BILLING STATEMENTS WILL BE MAILED TO THE RESPONSIBLE PARTY OF ALL PATIENTS WITHIN APPROXIMATELY 15 DAYS OF DISCHARGE. INFORMATION REGARDING MAKING APPLICATION FOR FINANCIAL ASSISTANCE IS INCLUDED IN THE STATEMENT. APPLICANTS ARE NOTIFIED BY MAIL OR PHONE CALL WHEN THEIR APPLICATION IS INCOMPLETE AND ARE GIVEN AN OPPORTUNITY TO PROVIDE THE MISSING DOCUMENTATION OR INFORMATION WITHIN 90 DAYS OF NOTIFICATION. BEFORE FINDING A PATIENT ELIGIBLE FOR ASSISTANCE UNDER THIS POLICY MCCURTAIN MEMORIAL MAY REQUIRE PATIENTS TO APPLY FOR PUBLIC HEALTH COVERAGE PROGRAMS, SUCH AS MEDICAID, FOR WHICH MCCURTAIN MEMORIAL PRESUMES THE PATIENTS ARE ELIGIBLE, AS INSTRUCTED BY THE HOSPITAL'S FINANCIAL SERVICES DEPARTMENT. MCCURTAIN MEMORIAL MAY DENY ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS WHO HAVE BEEN SCREENED FOR A PUBLIC HEALTH COVERAGE PROGRAM AND ARE PRESUMED TO BE ELIGIBLE BUT ARE NOT COOPERATING WITH THE PROCESS TO APPLY FOR THE HEALTH COVERAGE PROGRAM. IF THE INDIVIDUAL DOES NOT PROVIDE THE REQUIRED INFORMATION OR THE APPLICATION IS DENIED, NORMAL COLLECTION PROCEDURES WILL COMMENCE. A PATIENT HAS 120 DAYS TO APPLY FOR FINANCIAL ASSISTANCE FROM THE DATE OF DISCHARGE THE ACCOUNT IS SENT TO AN OUTSIDE COLLECTION AGENCY. MCCURTAIN MEMORIAL, AS WELL AS THIRD PARTIES WORKING ON BEHALF OF MCCURTAIN MEMORIAL, WILL NOT USE EXTRAORDINARY COLLECTIONS EFFORTS WITHIN THE FIRST 120 DAYS POST DISCHARGE. NOR WILL MCCURTAIN MEMORIAL USE EXTRAORDINARY COLLECTION EFFORTS WHILE THE PATIENT OR REPRESENTATIVE IS ACTIVELY IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE. IN THE EVENT THAT A PATIENT OR RESPONSIBLE PARTY APPLIES FOR FINANCIAL ASSISTANCE WITHIN 240 DAYS OF FIRST STATEMENT DATE AND HAS BEEN FOUND TO BE ELIGIBLE, ANY EXTRAORDINARY COLLECTION EFFORTS BY MCCURTAIN MEMORIAL OR THIRD PARTIES WORKING ON BEHALF OF MCCURTAIN WILL CEASE AND RETRACTION WILL BE MADE FOR ANY ADVERSE REPORTING TO CREDIT BUREAUS IN REGARDS TO THE SERVICES FOR WHICH THEY HAVE BEEN APPROVED.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: HOSPITAL ADMINISTRATION CONTINUALLY COMMUNICATES WITH THE BOARD OF TRUSTEES AND SEEKS THEIR INPUT EACH MONTH ON COMMUNITY HEALTH NEEDS AND THE HOSPITAL'S ABILITY TO MEET THOSE NEEDS, EVALUATING INTERNAL AND EXTERNAL ISSUES THAT AFFECT THE ORGANIZATION. THE ADMINISTRATOR'S REPORT EACH MONTH GIVES AN UPDATE FROM PREVIOUSLY DISCUSSED ITEMS TO INCLUDE PROGRESS REPORTS ON HOW THE HOSPITAL IS ADDRESSING OR INTENDS TO ADDRESS EACH NEED IDENTIFIED.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL POSTS ITS CHARITY CARE POLICY SUMMARY WITH FINANCIAL ASSISTANCE CONTACT INFORMATION IN THE FINANCIAL SERVICES OFFICE. FINANCIAL ASSISTANCE GUIDANCE AND INFORMATION IS PROVIDED TO PATIENTS UPON COMPLETION OF MEDICAL EVALUATION AND SCREENING AT WHICH TIME POTENTIALLY ELIGIBLE PATIENTS ARE COUNSELED BY FINANCIAL SERVICES. FINANCIAL ASSISTANCE INFORMATION IS NOT PROVIDED WITH DISCHARGE MATERIALS. FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN FIRST TIME STATEMENTS OF PATIENT BILLS. FINANCIAL SERVICES COUNSELS ALL PATIENTS WHO ARE POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BY PROVIDING GUIDANCE IN APPLYING FOR ASSISTANCE THROUGH FEDERAL, STATE AND COUNTY PROGRAMS. SHOULD A PATIENT NOT QUALIFY FOR ONE OF THESE PROGRAMS AND IS NOT ELIGIBLE FOR NOR ENROLLED IN PRIVATE OR PUBLIC INSURANCE PLANS, THE PATIENT MAY STILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM UPON MEETING THE CRITERIA OUTLINED IN THE POLICY (78-06-20).

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: NOT APPLICABLE

SCHEDULE H, PART VI, LINE 7
STATE FILING OF COMMUNITY BENEFIT REPORT: NO REPORT WAS FILED FOR FY2022

SCHEDULE H, PART I, LINE 7
COST METHODOLOGY FOR COMMUNITY BENEFIT COSTS: THE AMOUNTS REPORTED ON THE TABLE ON PART I, LINE 7 WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM COMPLETING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES FROM THE IRS INSTRUCTIONS. THIS RATIO WAS ALSO USED WHILE COMPLETING WORKSHEET 3 and 6. Worksheet 8 was completed using the hospital's internal income statements.

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $6,162,167 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF PERCENT OF TOTAL EXPENSE IN THIS COLUMN.

SCHEDULE H, PART I, LINE 3C
FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: - ASSET LEVEL - MEDICAL INDIGENCY - INSURANCE STATUS - UNDERINSURANCE STATUS - FAMILY SIZE - NATURE AND EXTENT OF DEBT

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: MCCURTAIN MEMORIAL HOSPITAL IS THE ONLY HOSPITAL LOCATED IN MCCURTAIN COUNTY, WHICH IS THE 3RD LARGEST COUNTY IN THE STATE. THE ENTIRE COUNTY IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA WITH PORTIONS OF THE COUNTY DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS DUE TO THE GEOGRAPHICAL AREA, CENSUS TRACTS, AND/OR A NATIVE AMERICAN TRIBAL POPULATION. ACCORDING TO THE 2021 U.S. CENSUS BUREAU QUICKFACTS(SMALL AREA INCOME AND POVERTY ESTIMATES, SAIPE) ESTIMATES, THE PERCENTAGE OF MCCURTAIN COUNTY INDIVIDUALS (ALL AGES) WHOSE INCOME WAS BELOW POVERTY WAS 21.5%. OF THE ESTIMATED POPULATION FOR 2017-2021, THERE WERE APPROXIMATELY 23.4% OF PERSONS UNDER THE AGE OF 65 YEARS WITHOUT HEALTH INSURANCE COVERAGE, COMPARED TO 16.8% FOR THE SAME CATEGORY IN THE ENTIRE STATE OF OKLAHOMA AND 9.8% FOR THE NATION. APPROXIMATELY 30% OF THE PEOPLE IN MCCURTAIN COUNTY ARE COVERED BY MEDICAID AND THE UNEMPLOYMENT RATE RANKS AS ONE OF THE HIGHEST IN THE STATE. THE PRIMARY SERVICE AREA IS APPROXIMATELY A 35-MILE RADIUS AROUND IDABEL. THE 2020 US CENSUS BUREAU POPULATION ESTIMATES BASE FOR MCCURTAIN COUNTY IS 30,814, WITH AN ESTIMATED 30,884 AT JULY 1, 2021. OF THE 2021 ESTIMATED POPULATION, 18.1% ARE IN THE AGE GROUP 65 AND OLDER AND 25.9% ARE UNDER THE AGE OF 18. THESE COUNTY PERCENTAGES ARE ABOVE THE OKLAHOMA STATE PERCENTAGES FOR THE SAME CATEGORIES, 16.8% AND 22.2% RESPECTIVELY. WITH THE EXCEPTION OF MCCURTAIN MEMORIAL HOSPITAL THERE ARE NO OTHER MAJOR HOSPITALS LOCATED WITHIN THE COUNTY. MCCURTAIN COUNTY HAS MAJOR EMPLOYERS SUCH AS CHOCTAW NATION, INTERNATIONAL PAPER, TYSON FOODS, SETCO, JM HUBER ENGINEERED WOODS, DOMINANCE/PAN PACIFIC PRODUCTS, DARYL THOMASON TRUCKING AND THE MCCURTAIN MEMORIAL HOSPITAL. MCCURTAIN COUNTY'S UNEMPLOYMENT RATE OF 3.6% IS SLIGHTLY ABOVE THE STATE RATE OF 3.2% FOR NOT SEASONALLY ADJUSTED RATES. WITH THE SLOWING OF COVID-19 RELATED CLOSURES AND SERVICE SUSPENSIONS, MCCURTAIN COUNTY HAS EXPERIENCED A DECREASE IN UNEMPLOYMENT RATES.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: MCCURTAIN MEMORIAL HOSPITAL IS A SOLE COMMUNITY PROVIDER WITH A BOARD OF DIRECTORS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. FIVE MEMBERS OF THE BOARD ARE NON-PHYSICIANS AND ONE MEMBER IS A PHYSICIAN AS OF JUNE 30, 2021. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. THE HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE AND MEDICAL EDUCATION. THE HOSPITAL CONTINUOUSLY EVALUATES AND MONITORS QUALITY CONTROL INITIATIVES. THE HOSPITAL'S EMERGENCY ROOM IS AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. CONTINUING EDUCATION CLASSES ARE PROVIDED TO PERSONNEL ON A REGULAR BASIS INCLUDING EKG MONITORING CLASSES, VENOUS THROMBO-EMBOLISM PREVENTION AND PROPHYLAXIS, ACLS, PALS, CPI, CPR, MEDICARE WORKSHOPS, CREDENTIALING UPDATES IN ADDITION TO ALLOWANCES PROVIDED TO EMPLOYED PHYSICIANS AND CRNA FOR CONTINUING MEDICAL EDUCATION WORKSHOPS AND SEMINARS. EMERGENCY SERVICES ARE AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY. MCCURTAIN MEMORIAL HOSPITAL IS AN ACTIVE COMMUNITY MEMBER WITHIN THE COUNTY AND PARTICIPATES IN COMMUNITY EVENTS SUCH AS HEALTH FAIRS, BLOOD DRIVES, SEASONAL FESTIVALS AND PARADES, COUNTY FAIRS, ETC. WITH THE PURPOSE OF EDUCATING PEOPLE OF THE COMMUNITY IN HEALTH, WELLNESS AND DISEASE AND ILLNESS PREVENTION. PAMPHLETS AND OTHER USEFUL INFORMATION ARE PROVIDED AS WELL AS FREE BLOOD PRESSURE CHECKS AND GLUCOSE SCREENINGS. THE WELLNESS CENTER IS AN EXERCISE AREA THAT COMMUNITY MEMBERS CAN SUBSCRIBE TO AND USE THE EXERCISE EQUIPMENT ON A REGULAR BASIS. PERSONNEL ARE AVAILABLE TO ASSIST THEM. THIS PROGRAM IS AVAILABLE TO ALL COMMUNITY MEMBERS AT A LOW COST WITH DISCOUNTED RATES FOR SENIORS AND IS FREE TO EMPLOYEES IN ORDER TO HELP ADVOCATE HEALTHY LIFESTYLES. THE GARDEN MEADOWS WALKING TRAIL LOCATED AT THE HOSPITAL IS OPEN TO THE PUBLIC 24 HOURS A DAY, 7 DAYS A WEEK AT NO CHARGE AND IS INTENDED TO PROMOTE PHYSICAL ACTIVITY FOR HEALTHIER LIFESTYLES.