Community Benefit Insight - Tax-exempt hospital

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Tuality Healthcare

Tuality Healthcare

335 S E 8th Ave
Hillsboro, OR 97123

Bed count	215	Medicare provider number	380021	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 930430029

Display data for year:

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

14.45%

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	$ 7,457,258 2.50 %
Medicaid as % of operating expenses	$ 32,532,859 10.89 %
Costs of other means-tested government programs as % of operating expenses	$ 524,697 0.18 %
Health professions education as % of operating expenses	$ 2,442,641 0.82 %
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.	$ 106,285 0.04 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 97,913 0.03 %
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	$ 325,075 0.11 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

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

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

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

Community Health Needs Assessment Activities: 2021

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

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

Supplemental Information: 2021

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

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

4A (Expenses $ 293483017 including grants of $ 116130) (Revenue $ 288091567)
THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE COST-EFFECTIVE COMPREHENSIVE HIGH QUALITY HEALTH CARE TO MEMBERS OF THE COMMUNITY. TUALITY HEALTHCARE IS A LICENSED 215-BED HOSPITAL AND HEALTH SERVICES PROVIDER OPERATING IN WASHINGTON COUNTY, OREGON. IN ADDITION TO ACUTE CARE HOSPITAL SERVICES, THE COMPANY PROVIDES A WIDE ARRAY OF OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES THROUGHOUT WESTERN WASHINGTON COUNTY. IN FISCAL YEAR 2022, THE ORGANIZATION PROVIDED CARE FOR 31,614 IN-PATIENT ACUTE CARE DAYS, 34,241 EMERGENCY ROOM VISITS, 20,826 URGENT CARE VISITS, AND 20,767 HOME HEALTH VISITS. PLEASE SEE THE COMPANY'S COMMUNITY BENEFIT REPORT (ON THE COMPANY'S WEBSITE AT HTTPS://TUALITY.ORG) FOR A DESCRIPTION OF PROGRAMS AND CHARITY CARE PROVIDED BY TUALITY HEALTHCARE.

Facility Information

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

FACILITY 1, HILLSBORO MEDICAL CENTER - PART V, LINE 5
TO GATHER INPUT FOR THIS NEEDS ASSESSMENT, FOUR TOWN HALLS WERE CONDUCTED (ONE EACH IN CLACKAMAS, MULTNOMAH AND WASHINGTON COUNTIES IN OREGON AND ONE IN CLARK COUNTY IN WASHINGTON). IN ADDITION, 18 COMMUNITY LISTENING SESSIONS WERE HELD ACROSS THE QUAD-COUNTY REGION, WITH MORE THAN 200 PARTICIPANTS. THE TOWN HALL EVENTS WERE DESIGNED TO BRING TOGETHER COMMUNITY LEADERS AND REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, TO PROVIDE FEEDBACK ON EARLY DATA FINDINGS AND ELICIT CONVERSATIONS ABOUT COMMUNITIES FOR OUTREACH IN THE LISTENING SESSIONS. DURING THESE TOWN HALLS, A LIST OF POPULATIONS AND COMMUNITIES WERE TARGETED FOR INCLUSION IN THE SMALLER FOCUS GROUP BASED LISTENING SESSIONS. INDEPENDENT OUTSIDE GROUPS WERE BROUGHT IN TO ANALYIZE THE DATA COLLECTED AT THE TOWN HALLS AND REACH A CONSENSUS ON THE CATEGORIES OF PARTICIPANTS TO BE INCLUDED IN THE SMALLER MEETINGS.

FACILITY 1, HILLSBORO MEDICAL CENTER - PART V, LINE 6A
OTHER HOSPITAL FACILITIES WITH WHICH THE ASSESSMENT WAS CONDUCTED: ADVENTIST MEDICAL CENTER PORTLAND LEGACY EMANUEL MEDICAL CENTER LEGACY GOOD SAMARITAN MEDICAL CENTER LEGACY MOUNT HOOD MEDICAL CENTER LEGACY SALMON CREEK MEDICAL CENTER KAISER FOUNDATION HOSPITAL WESTSIDE KAISER SUNNYSIDE MEDICAL CENTER OREGON HEALTH SCIENCES UNIVERSITY PEACEHEALTH PROVIDENCE MILWAUKIE HOSPITAL PROVIDENCE PORTLAND MEDICAL CENTER PROVIDENCE ST. VINCENT MEDICAL PROVIDENCE WILLAMETTE FALLS MEDICAL CENTER

FACILITY 1, HILLSBORO MEDICAL CENTER - PART V, LINE 6B
ORGANIZATIONS PARTICIPATING IN THE ASSESSMENT: HEALTH SHARE OF OREGON WASHINGTON COUNTY HEALTH DEPARTMENT MULTNOMAH COUNTY HEALTH DEPARTMENT HEALTH, HOUSING & HUMAN SERVICES OF CLACKAMAS COUNTY

FACILITY 1, HILLSBORO MEDICAL CENTER - PART V, LINE 11
IMPLEMENTATION STRATEGY CAN BE FOUND AT HTTPS://TUALITY.ORG/ABOUT/COMMUNITY_BENEFIT_REPORT/ A HOST OF ISSUES IMPACTS THE HEALTH OF COMMUNITIES IN THE QUAD-COUNTY REGION OF CLARK COUNTY, WASHINGTON AND CLACKAMAS, MULTNOMAH AND WASHINGTON COUNTIES IN OREGON, INCLUDING: -DISCRIMINATION AND RACISM: THE REGION IS HOME TO DIVERSE COMMUNITIES WITH THEIR OWN STRENGTHS AND CHALLENGES TO ADDRESS UNIQUE HEALTH NEEDS. MANY COMMUNITIES - LGBTQ+, RURAL, PEOPLE LIVING WITH DISABILITIES, PEOPLE LIVING WITH MENTAL HEALTH CONCERNS, IMMIGRANTS, REFUGEES, AND PEOPLE OF COLOR - FACE GREATER CHALLENGES IN ACCESSING RESOURCES, HEALTH CARE, AND ATTAINING OVERALL WELL-BEING, DUE TO DISCRIMINATION AND RACISM. TUALITY HEALTHCARE SUPPORTS THIS CORE ISSUE BY CONSULTING AND PARTNERING WITH COMMUNITY GROUPS TO ADDRESS RACISM AND PARTICIPATES IN ORGANIZATIONAL EQUITY, DIVERSITY AND INCLUSION WORK. -TRAUMA: TRAUMA WAS IDENTIFIED ACROSS THE REGION AS AN UNDERLYING CORE ISSUE AFFECTING HEALTH AND WELL-BEING OF COMMUNITY MEMBERS. INDIVIDUALS AND GROUPS WHO HAVE EXPERIENCED TRAUMA SEE INCREASED RISK OF DISEASE AND DEATH. THIS IS AN OVERARCHING CORE ISSUE, WHICH MUST BE CONSIDERED IN ALL PROGRAMS TO ADEQUATELY ADDRESS THE OTHER CORE ISSUES. TUALITY HEALTHCARE SUPPORTS THIS CORE ISSUE BY PROVIDING TRAUMA-INFORMED CARE. -BEHAVIORAL HEALTH: MEETING BEHAVIORAL HEALTH NEEDS IS CRITICAL, PARTICULARLY WITH THE HIGH RATES OF DEPRESSION AND SUICIDE IN THE REGION. ACROSS THE REGION ALMOST A QUARTER (24.1%) OF THE POPULATION HAS BEEN DIAGNOSED WITH DEPRESSION. TUALITY HEALTHCARE IS ADDRESSING THIS CORE ISSUE BY IMPLEMENTING UNIVERSAL DEPRESSION SCREENINGS, CONDUCTING OPIOID PREVENTION WORK AND BY RE-OPENING THE GERIPSYCH UNIT IN 2019. -CHRONIC CONDITIONS: CHRONIC DISEASES ARE CONDITIONS THAT LAST ONE YEAR OR MORE AND REQUIRE ONGOING MEDICAL ATTENTION AND/OR LIMIT ACTIVITIES OF DAILY LIVING. RISK FACTORS FOR CHRONIC DISEASE INCLUDE: TOBACCO USE SECONDHAND SMOKE POOR NUTRITION LACK OF PHYSICAL ACTIVITY EXCESSIVE ALCOHOL OTHER SUBSTANCE USE TUALATY HEALTHCARE IS ADDRESSING THIS CORE ISSUE THROUGH NUTRITION AND CHRONIC CONDITION SELF-MANAGEMENT EDUCATION, PARTNERING WITH COMMUNITY- BASED ORGANIZATIONS TO SUPPORT HEALTHY LIFESTYLES, TOBACCO PREVENTION PROGRAMS AND A SIGNIFICANT INVESTMENT IN CARDIAC SERVICES FOR THE COMMUNITY. -ACCESS TO HEALTHCARE: COMMUNITY MEMBERS IDENTIFIED THE NEED FOR BETTER ACCESS TO THE HEALTH CARE SYSTEM, INCLUDING CULTURALLY RESPONSIVE HEALTH CARE, AND SUPPORT FOR NAVIGATING THE HEALTH CARE SYSTEM, INCLUDING A BETTER UNDERSTANDING OF INSURANCE AS KEY AREAS FOR MORE FOCUS. TUALITY HEALTHCARE IS ADDRESSING THIS CORE ISSUE THROUGH FINANCIAL ASSISTANCE PROGRAMS FOR PATIENTS AND EXPANDING PRIMARY CARE CLINICS INCLUDING IMPROVED PATIENT NAVIGATION SERVICES. -CULTURALLY RESPONSIVE CARE: HEALTH CARE THAT IS RESPONSIVE TO THE CULTURAL NEEDS OF PATIENTS IS CRITICAL TO ENSURE THAT ALL COMMUNITY MEMBERS LIVE THEIR FULLEST AND HEALTHIEST LIVES. THE CURRENT HEALTH CARE SYSTEM IS WORKING TO BE RESPONSIVE BUT HAS WORK TO DO TO MEET THE NEEDS OF ALL PATIENTS. SPECIFICALLY, COMMUNITY MEMBERS WANTED MORE PROVIDERS WHO SHARE THEIR CULTURAL BACKGROUND, MORE COMMUNITY HEALTH WORKERS WHO CAN ASSIST PATIENTS IN NAVIGATING THE SYSTEM AND LIVING THEIR HEALTHIEST LIVES, AND INFORMATION PROVIDED IN MORE LANGUAGES THAN ENGLISH AND SPANISH. TUALITY HEALTHCARE IS ADDRESSING THIS CORE ISSUE BY CONDUCTING INTERNAL TRAININGS FOR PROVIDERS, STAFF AND LEADERS. -ISOLATION: ISOLATION IS A KEY DETERMINANT OF HEALTH. IT IS DIFFERENT FROM LONELINESS, THOUGH THEY ARE OFTEN DISCUSSED TOGETHER. IN THIS REPORT, ISOLATION MEANS EITHER GEOGRAPHIC, PHYSICAL, AND/OR SOCIAL ISOLATION. IT PERTAINS TO SOCIAL CONTACTS OR NETWORK THAT CAN INCLUDE FAMILY, FRIENDS, BUT ALSO THE BROADER ENVIRONMENT THROUGH SOCIAL ACTIVITIES. ISOLATION ALSO MEANS BEING GEOGRAPHICALLY ISOLATED (WHERE YOU LIVE IS A LONG WAY FROM OTHER PEOPLE, SERVICES). ISOLATION HAS PARTICULARLY DETRIMENTAL EFFECTS ON LOW-INCOME SENIORS WHO, IN URBAN SETTINGS, TEND TO BE CLUSTERED IN AREAS WITH HIGH PROPORTIONS OF LOW-INCOME OLDER ADULTS. TUALITY HEALTHCARE IS ADDRESSING THIS CORE ISSUE BY PROVIDING HOME HEALTH CARE.

Supplemental Information

Schedule H (Form 990) Part VI

SCHEDULE H, PART I, LINE 7G
TUALITY HEALTHCARE PLAYS HOST TO MANY EDUCATIONAL AND COMMUNITY EVENTS AT THE TUALITY HEALTH AND EDUCATION CENTER. HILLSBORO ROTARY CLUB, WASHINGTON COUNTY COMMUNITY ACTION AND OTHER CIVIC GROUPS HOLD REGULAR EVENTS AT THE CENTER. TUALITY HEALTHCARE'S COMMUNITY EDUCATION DEPARTMENT ALSO HOSTS DOZENS OF EVENTS THAT RANGE FROM CLASSES ON DIABETES, YOGA AND HEALTHY

SCHEDULE H, PART I, LINE 7, COLUMN (F)
ACCOUNTS RECEIVABLE ARE STATED AT UNPAID BALANCES (NET OF CONTRACTUAL ALLOWANCES) AND ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. SUBSTANTIALLY ALL OF THE COMPANY'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO ITS HOSPITALS' PATIENTS. THE COMPANY ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY RESERVING A PERCENTAGE OF ALL SELF-PAY ACCOUNTS RECEIVABLE WITHOUT REGARD TO AGING CATEGORY, BASED ON COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES AND, IF PRESENT, ANTICIPATED CHANGES IN TRENDS. FOR ALL OTHER NON-SELF-PAY PAYER CATEGORIES, THE COMPANY RESERVES 100% OF ALL ACCOUNTS AGING OVER 365 DAYS FROM THE DATE OF DISCHARGE. THE PERCENTAGE USED TO RESERVE FOR ALL SEL-PAY ACCOUNTS IS BASED ON THE COMPANY'S COLLECTION HISTORY. THE COMPANY COLLECTS SUBSTANTIALLY ALL OF ITS THIRD-PARTY INSURED RECEIVABLES, WHICH INCLUDE RECEIVABLES FROM GOVERNMENT AGENCIES. COLLECTIONS ARE IMPACTED BY ECONOMIC ABILITY OF PATIENTS TO PAY AND THE EFFECTIVENESS OF THE COMPANY'S COLLECTION EFFORTS. SIGNIFICANT CHANGES IN PAYER MIX, BUSINESS OFFICE OPERATIONS, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE COMPANY'S COLLECTION OF ACCOUNTS RECEIVABLE AND THE ESTIMATES OF THE COLLECTABILITY OF FUTURE ACCOUNTS RECEIVABLE. THE PROCESS OF ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS REQUIRES THE COMPANY TO ESTIMAT THE COLLECTABILITY OF SELF-PAY ACCOUNTS RECEIVABLE, WHICH IS PRIMARILY BASED ON ITS COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES AND, IF AVAILABLE, ANTICIPATED CHANGES IN COLLECTION TRENDS. THE COMPANY ALSO CONTINUALLY REVIEWS ITS OVERALL RESERVE ADEQUACY BY ANALYZING CURRENT PERIOD NET REVENUE AND ADMISSIONS BY PAYER CLASSIFICATION, AGED ACCOUNTS RECEIVABLE BY PAYER, AND DAYS REVENUE OUTSTANDING. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS DECREASED BY CHARGE-OFFS (NET OF RECOVERIES). ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE COMPANY'S POLICIES.

SCHEDULE H, PART I, LINE 7
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS 5,511,085.

SCHEDULE H, PART II
IN ADDITION TO REFERENCING AND ACCESSING OUR INTERNAL TUALITY FINANCIAL ASSISTANCE PROGRAM (BEFORE, DURING, AND AFTER SERVICES ARE RENDERED), WE ALSO RECOGNIZE OTHER PORTLAND PROVIDERS' (HOSPITALS, PHYSICIAN, AMBULANCE DME, ETC) FINANCIAL ASSISTANCE DETERMINATION (WITH WRITTEN PROOF).

SCHEDULE H, PART III, LINE 2
ACCOUNTS RECEIVABLE ARE STATED AT UNPAID BALANCES (NET OF CONTRACTUAL ALLOWANCES) AND ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. SUBSTANTIALLY ALL OF THE COMPANY'S RECEIVABLES ARE RELATED TO PROVIDING HEALTHCARE SERVICES TO ITS HOSPITALS' PATIENTS. THE COMPANY ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY RESERVING A PERCENTAGE OF ALL SELF-PAY ACCOUNTS RECEIVABLE WITHOUT REGARD TO AGING CATEGORY, BASED ON COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES AND, IF PRESENT, ANTICIPATED CHANGES IN TRENDS. FOR ALL OTHER NON-SELF-PAY PAYER CATEGORIES, THE COMPANY RESERVES 100% OF ALL ACCOUNTS AGING OVER 365 DAYS FROM THE DATE OF DISCHARGE. THE PERCENTAGE USED TO RESERVE FOR ALL SELF-PAY ACCOUNTS IS BASED ON THE COMPANY'S COLLECTION HISTORY. THE COMPANY COLLECTS SUBSTANTIALLY ALL OF ITS THIRD-PARTY INSURED RECEIVABLES, WHICH INCLUDE RECEIVABLES FROM GOVERNMENTAL AGENCIES. COLLECTIONS ARE IMPACTED BY THE ECONOMIC ABILITY OF PATIENTS TO PAY AND THE EFFECTIVENESS OF THE COMPANY'S COLLECTION EFFORTS. SIGNIFICANT CHANGES IN PAYER MIX, BUSINESS OFFICE OPERATIONS, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE COMPANY'S COLLECTION OF ACCOUNTS RECEIVABLE AND THE ESTIMATES OF THE COLLECTABILITY OF FUTURE ACCOUNTS RECEIVABLE. THE PROCESS OF ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS REQUIRES THE COMPANY TO ESTIMATE THE COLLECTABILITY OF SELF-PAY ACCOUNTS RECEIVABLE, WHICH IS PRIMARILY BASED ON ITS COLLECTION HISTORY, ADJUSTED FOR EXPECTED RECOVERIES AND, IF AVAILABLE, ANTICIPATED CHANGES IN COLLECTION TRENDS. THE COMPANY ALSO CONTINUALLY REVIEWS ITS OVERALL RESERVE ADEQUACY BY ANALYZING CURRENT PERIOD NET REVENUE AND ADMISSIONS BY PAYER CLASSIFICATION, AGED ACCOUNTS RECEIVABLE BY PAYER, AND DAYS REVENUE OUTSTANDING. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS DECREASED BY CHARGE-OFFS (NET OF RECOVERIES). ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE COMPANY'S POLICIES.

SCHEDULE H, PART III, LINE 9B
REQUESTS FOR FINANCIAL ASSISTANCE MAY BE MADE AT ANY POINT BEFORE, DURING, OR AFTER THE PROVISION OF CARE. INFORMATION RELATED TO ELIGIBILITY FOR FINANCIAL ASSISTANCE IS LOCATED IN THE LOBBIES OF THE HOSPITAL AND AVAILABLE ON THE TUALITY.ORG WEBSITE. IN ADDITION TO REFERENCING AND ACCESSING OUR INTERNAL TUALITY FINANCIAL ASSISTANCE PROGRAM, WE ALSO RECOGNIZE OTHER PORTLAND PROVIDERS' (HOSPITALS, PHYSICIAN, AMBULANCE, DME, ETC.) FINANCIAL ASSISTANCE DETERMINATION (WITH WRITTEN PROOF).

SCHEDULE H, PART VI, LINE 4
OR

SCHEDULE H, PART VI, LINE 7
OREGON

SCHEDULE H, PART VI
PART VI, LINE 1: PLEASE VIEW OUR COMMUNITY BENEFIT REPORT FOUND IN THE ABOUT US SECTION OF OUR WEBSITE, WWW.TUALITY.ORG, FOR A DESCRIPTION OF PROGRAMS AND CHARITY CARE PROVIDED BY TUALITY HEALTHCARE.

SCHEDULE H, PART VI, LINE 2
"TUALITY HEALTHCARE SERVES A LARGE GEOGRAPHIC AREA OF WESTERN WASHINGTON COUNTY THAT STRETCHES FROM THE SUBURBAN PORTLAND CITIES OF ALOHA AND BEAVERTON TO THE COAST RANGE. THE MARKET INCLUDES THE CITIES OF HILLSBORO AND FOREST GROVE, SITES OF TUALITY'S TWO HOSPITALS, PLUS SMALLER TOWNS SUCH AS CORNELIUS, GASTON, NORTH PLAINS AND BANKS. THIS REGION IS ROUGHLY 250,000 PEOPLE AND IS ONE OF THE FASTEST GROWING AREAS IN OREGON. IN ADDITION, TUALITY IS ONE OF THE REGION'S LARGEST EMPLOYERS WITH A STAFF OF OVER 1,500. TUALITY PROVIDES FINANCIAL, MATERIAL AND MEDICAL ASSISTANCE TO MANY COMMUNITY PARTNERS IN THE REGION. TUALITY HEALTHCARE IS DESIGNATED A ""DISPROPORTIONATE SHARE HOSPITAL"" BY THE CENTERS FOR MEDICAR AND MEDICAID SERVICES, DUE TO THE LARGER THAN NORMAL PERCENTAGE OF CARE WE PROVIDE TO THE LOW INCOME AND INDIGENT POLULATION IN OUR AREA."

SCHEDULE H, PART VI, LINE 3
WHEN IT COMES TO COMMUNITY, EVERYONE HAS A PART TO PLAY. FOR US, IT'S AN HONOR AND A DUTY TO HELP THOSE NEAR US RECEIVE THE BEST MEDICAL CARE POSSIBLE. THAT'S WHY, SINCE OUR BEGINNINGS IN 1918, WE'VE WORKED HARD TO PROVIDE QUALITY, CONVENIENT CARE FOR PEOPLE IN WESTERN WASHINGTON COUNTY. TODAY, WE'RE THE ONLY LOCAL, INDEPENDENT, COMMUNITY-GOVERNED HEALTHCARE SYSTEM IN THE AREA, OFFERING INPATIENT AND OUTPATIENT TREATMENT, SPECIALTY SERVICES, HEALTH EDUCATION AND MORE. OF COURSE, OUR GOAL ISN'T ONLY TO TREAT YOU WHEN YOU'RE SICK, BUT ALSO TO HELP YOU STAY WELL. FOR THAT REASON, YOU'LL OFTEN FIND US AT LOCAL EVENTS AND OTHER PUBLIC PLACES, OFFERING FREE OR LOW-COST HEALTH SCREENINGS AND EDUCATIONAL COURSES. FOR THOSE WHO NEED IT, WE EVEN PROVIDE TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS. MANY OF THESE SERVICES ARE OFFERED AT TUALITY HEALTH EDUCATION CENTER AND OTHER LOCATIONS. WE REALLY ARE YOUR NEIGHBORS MANY OF OUR 1,500 EMPLOYEES LIVE JUST A SHORT DISTANCE FROM WORK. OUR LARGER FACILITIES INCLUDE HILLSBORO MEDICAL CENTER IN HILLSBORO. IN ADDITION, WE HAVE NUMBEROUS OTHER MEDICAL CENTERS AND OUTPATIENT FACILITIES. BY KEEPING UP WITH THE LATEST ADVANCES IN MEDICAL SCIENCE, WE'VE EARNED A STERLING REPUTATION FOR THE QUALITY OF OUR HEART, CANCER, STROKE,AND DIAGNOSTIC IMAGING SERVICES. IN THIS WAY, WE ARE ABLE TO OFFER THE BEST POSSIBLE MEDICAL CARE TO THE TUALATIN VALLEY CITIES AND COMMUNITIES IN WESTERN WASHINGTON COUNTY, SUCH AS ALOHA, BEAVERTON, HILLSBORO, FOREST GROVE, CORNELIUS, AND THE SMALLER COMMUNITIES OF THE COASTAL RANGE FOOTHILLS.

Operating expenses	$ 298,770,315
Total amount spent on community benefits as % of operating expenses	$ 43,161,653 14.45 %