4A (Expenses $ 21754547 including grants of $ 0) (Revenue $ 21559757)
FROM JULY 1, 2016 TO JUNE 30, 2017, THE HOSPITAL PROVIDED INPATIENT SERVICES TO 1,323 PATIENTS ACCUMULATING 8,332 DAYS OF PATIENT CARE. IN ADDITION TO INPATIENT AND SWING BED CARE, THE HOSPITAL PROVIDES 24-HOUR EMERGENCY ROOM SERVICES. DURING THE FISCAL YEAR, THE HOSPITAL HAD EMERGENCY VISITS OF 11,889. THE ELLWOOD CITY HOME HEALTH AGENCY PROGRAM HAD VISITS OF 19,160. DURING THE FISCAL YEAR, SERVICES ARE PROVIDED TO ALL PATIENTS WITHOUT REGARD TO RAVE, COLOR, NATIONAL ORIGIN, ANCESTRY, AGE, RELIGIOUS CREED, OR HANDICAP. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHAGRES FOR-GONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. DURING THE FISCAL YEAR, THE HOSPITAL PROVIDED UNCOMPENSATED AND CHARITY CARE IN THE AMOUNT OF $1,242,000. IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, SERVICES ARE PROVIDED UNDER THE MEDICAID PROGRAM TO FINANCIALLY NEEDY PATIENTS. THE HOSPITAL ALSO CO-SPONSORS THE ELLWOOD CITY MEALS ON WHEELS PROGRAM BY PROVIDING THE PREPARATION OF FOODS FOR ALL MEALS SERVED. THE ELLWOOD CITY HOSPITAL AND THE ELLWOOD CITY HOSPITAL AUXILIARY ALSO PROVIDE A TECH ALERT SYSTEM FOR THE ELDERLY, YEARLY (AS WELL AS THROUGHOUT THE YEAR) INFORMATIONAL FAIRS, SUCH AS PRENATAL CLASSES, SIBLING CLASSES, BABYSITTING CLASSES, NATIONAL SAFETY BELT/SAFETY WEEK, BREAST CANCER AWARENESS WEEK, PROSTATE SCREENINGS, AND GENERAL HEALTH SCREENINGS TO NAME A FEW. THE HOSPITAL AND AUXILIARY ALSO PARTICIPATE WITH VARIOUS LOCAL, CIVIC, AND SCHOOL GROUPS TO PROVIDE OUTREACH SERVICES TO THE TRI-COUNTY AREA. SUCH PROGRAMS INCLUDE KINDERGARTEN TOURS OF THE HOSPITAL, A VOLUNTEER PROGRAM, AND USE OF THE HOSPITAL AS A CLINICAL SITE FOR AREA NURSING STUDENTS. THE HOSPITAL ALSO ENCOURAGES ITS EMPLOYEES TO BECOME INVOLVED WITH VOLUNTEER SERVICES SUCH AS THE UNITED WAY, THE RED CROSS ANNUAL BLOOD DRIVE, AND VARIOUS COMMUNITY PROJECTS. THE ELLWOOD CITY HOSPITAL, IN CORPORATION WITH HIGHMARK BLUE CROSS BLUE SHIELD, OFFERS A LOW COST COVERAGE PROGRAM CALLED SPECIAL CARE AND THE CARING PROGRAM SPECIAL CARE IS DESIGNED FOR INDIVIDUALS AND FAMILIES WITH LOW INCOMES WHO ARE INELIGIBLE FOR GOVERNMENT ASSISTANCE AND THE CARING PROGRAM IS FOR CHILDREN OF LOW INCOME FAMILIES.

ELLWOOD CITY HOSPITAL
PART V, SECTION B, LINE 5: THE PRIMARY INTERVIEW DATA INCLUDED OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL AND INCLUDED THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES. ARNETT CARBIS TOOTHMAN, AN INDEPENDENT ACCOUNTING FIRM, WORKED TOGETHER WITH THE ELLWOOD CITY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTE TO DEVELOP A BROAD LIST OF COMMUNITY LEADERS TO INTERVIEW. THESE COMMUNITY MEMBERS WERE SELECTED BASED ON THEIR INVOLVEMENT WITHIN THE COMMUNITY AND BECAUSE THEY PROVIDED DISTINCTIVE BACKGROUNDS AND A VARIETY OF PERSPECTIVES ON THE STATE OF THE COMMUNITY AND HEALTH CARE. INTERVIEWS WERE CONDUCTED WITH A NUMBER OF DIRECTORS AND STAFF MEMBERS FROM COMMUNITY HEALTH CENTERS, MEMBERS FROM SOCIAL SERVICES ORGANIZATIONS, EDUCATIONAL LEADERS, RELIGIOUS GROUPS, AND ELECTED OFFICIALS. THE SELECTED PARTICIPANTS GIVE AN OVERARCHING VIEWPOINT OF THE COMMUNITY AND THROUGH THESE INTERVIEWS THE HEALTH NEEDS FROM THE PERSPECTIVE OF THE COMMUNITY WERE IDENTIFIED.

ELLWOOD CITY HOSPITAL
PART V, SECTION B, LINE 11: THE ELLWOOD CITY HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY THE ADOPTION AND EXECUTION OF AN IMPLEMENTATION STRATEGY THAT ADDRESSES EACH COMMUNITY HEALTH NEED. THE HOSPITAL PARTICIPATED IN THE DEVELOPMENT OF A COMMUNITY-WIDE PLAN AND IMPLEMENTED THE STRATEGY BY PRIORITIZING THE COMMUNITY HEALTH NEEDS AND THE SERVICES THAT THE HOSPITAL WILL UNDERTAKE TO MEET THE HEALTH NEEDS. IN ADDITION, A BUDGET WAS ADOPTED FOR THE SERVICES THAT WOULD BE PROVIDED BY THE HOSPITAL TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS. A NEED THAT IS NOT BEING ADDRESSED IS DRUG AND ALCOHOL ABUSE. THE HOSPITAL DOES NOT HAVE A DRUG AND ALCOHOL INPATIENT UNIT AND DOES NOT HAVE THE RESOURCES THAT WOULD BE REQUIRED TO EFFECT THE CHANGES THAT ARE NEEDED TO ADEQUATELY ADDRESS THE LACK OF DRUG AND ALCOHOL ABUSE CARE IN ITS SERVICE ARE. HOWEVER, THIS NEED IS BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES OPERATED BY OTHER COMMUNITY PARTNERS WITHIN LAWRENCE COUNTY AND SURROUNDING AREAS. THE HOSPITAL SUPPORTED BRINGING IN A NEW SUBOXONE DRUG ADDICTION TREATMENT CENTER TO THE COMMUNITY. THE HOSPITAL WILL CONTINUE TO EVALUATE AND INTENDS TO ADDRESS IN A FUTURE PLAN.

PART I, LINE 7:
"THE AMOUNTS DERIVED FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WERE CALCULATED USING THE HOSPITAL'S OWN INTERNAL REPORTING SYSTEM IN ACCESSING TOTAL CHARGES FOR EACH CATEGORY WHERE APPLICABLE. THE SYSTEM ADDRESSES ALL PATIENT SEGMENTS. COSTS FOR EACH OF THE AREAS WERE DERIVED USING WORKSHEET 2 FROM SCHEDULE H INSTRUCTIONS, ""RATIO OF PATIENT CARE COST-TO-CHARGES."""

PART III, LINE 4:
"THE BAD DEBT EXPENSE AT COST WAS DETERMINED BASED ON THE HOSPITAL'S REPORTED BAD DEBT EXPENSE AT GROSS AND MULTIPLIED BY THE ""RATIO OF PATIENT CARE COST-TO-CHARGES"" FROM WORKSHEET 2 FROM SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL STATEMENTS STATE THAT MANAGEMENT ALSO PROVIDED FOR BAD DEBTS, WHICH PRIMARILY RELATE TO PATIENT RECEIVABLES FROM INDIVIDUALS, WHICH IT DETERMINES ARE UNCOLLECTABLE. THE HOSPITAL'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE THAT FURTHER DESCRIBES BAD DEBT EXPENSE. BAD DEBT EXPENSE IS ACCOUNTED FOR BY ESTIMATING ON A MONTHLY BASIS THE AMOUNT OF BAD DEBT EXPENSE BASED ON HISTORICAL REIMBURSEMENT FOR OUTSTANDING ACCOUNTS RECEIVABLE BALANCES BY PAYOR AND TAKING INTO ACCOUNT THE AGING OF SUCH RECEIVABLES ALONG WITH ACTUAL ACCOUNTS WRITTEN OFF."

PART III, LINE 8:
MEDICARE ALLOWABLE COSTS OF CARE WERE DERIVED FROM THE MEDICARE COST REPORT WITH REIMBURSEMENT BASED ON THE PROSPECTIVE PAYMENT SYSTEM. OVERHEAD COSTS WERE ALLOCATED BASED ON STATISTICAL ALLOCATIONS TO THE HOSPITAL'S ANCILLARY DEPARTMENTS AFTER DEPARTMENTAL RECLASSES AND ADJUSTMENTS.

PART III, LINE 9B:
THE HOSPITAL'S COLLECTION POLICY DOES CONTAIN PROVISIONS ON THE COLLECTIONS PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE WILL REMAIN A QUALIFYING PATIENT FOR SIX MONTHS FOLLOWING INITIAL QUALIFICATION. THESE PATIENTS ARE TRACKED AND EVALUATED ON ANY SUBSEQUENT STAY THAT MAY OR MAY NOT OCCUR IN THE FOLLOWING SIX MONTHS. THE COLLECTION POLICY ALSO COVERS THOSE PATIENTS WHO ARE UNINSURED AND THE PROCESS IN WHICH THEY CAN RECEIVE FINANCIAL ASSISTANCE IN THE FORM OF DISCOUNTS AND/OR PAYMENT ARRANGEMENTS. IF ACCOUNTS ARE NOT PAID IN FULL OR PAYMENT ARRANGEMENTS ARE NOT FOLLOWED, THEN FOLLOW-UP LETTERS ARE INITIATED AS A FRIENDLY REMINDER. IF THE ACCOUNT BECOMES DELINQUENT, THE ACCOUNT IS CONSIDERED FOR REFERRAL TO BAD DEBT.

PART VI, LINE 2:
THE ORGANIZATION ASSESSED THE HEALTH CARE NEEDS FOR THE COMMUNITIES IT SERVES BY PERFORMING A COMPREHENSIVE PROCESS THAT INCLUDED A COMBINATION OF COMMUNITY FEEDBACK, HOSPITAL STAFF REPRESENTATION, CONTRIBUTING SOCIAL AGENCY LEADERS AND GOVERNMENTAL OFFICIALS, AND SELECTED PRIMARY AND SECONDARY SOURCES OF DATA TO DISTINGUISH AREAS FOR IMPROVEMENT. THE PRIMARY INTERVIEW DATA INCLUDED OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL AND INCLUDED THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES. CONVENTIONAL HEALTH GUIDES AS WELL AS DEMOGRAPHIC, ECONOMIC, SOCIAL, AND ENVIRONMENTAL FACTORS WERE EVALUATED, THE DATA WAS UTILIZED TO ADDRESS THE IDENTIFIED HEALTH NEEDS OF THE SERVICE AREA, TO HELP PRIORITIES, AND TO PROVIDE RECOMMENDATIONS TO THE HOSPITAL ON THE WAYS TO MEET THE COMMUNITY HEALTH NEEDS.

PART VI, LINE 3:
THROUGH THE COMBINATION OF THE HOSPITAL'S PATIENT CREDIT AND COLLECTION POLICY AND THE COMMUNITY CARE GUIDELINES POLICY, GUARANTORS ARE INFORMED AND EDUCATED ABOUT THEIR AVAILABILITY FOR ASSISTANCE PROGRAMS OR CHARITY CARE. THERE ARE PHYSICAL POSTINGS IN THE HOSPITAL FOR PATIENTS TO READ. ALSO WRITTEN ON PATIENT STATEMENTS ARE INSTRUCTIONS REGARDING HOW TO APPLY FOR ASSISTANCE OR CHARITY CARE. ALSO, THE HOSPITAL FINANCIAL ASSISTANCE FORMS ARE ON ITS WEBSITE. THE UNINSURED ARE INFORMED OF THE AVAILABILITY OF A MEDICAL ASSISTANCE APPLICATION AND A CHARITY CARE APPLICATION IF THEY ARE NOT EXPECTING TO QUALIFY FOR MEDICAL ASSISTANCE.

PART VI, LINE 4:
ELLWOOD CITY HOSPITAL IS LOCATED IN RURAL WESTERN PENNSYLVANIA SERVING PRIMARILY LAWRENCE, BUTLER, AND BEAVER COUNTIES. THE LOCAL COMMUNITY USED TO BE A THRIVING STEEL INDUSTRY AREA AND NOW CONSISTS OF AN AGING POPULATION. APPROXIMATELY 56% OF THE HOSPITAL'S PATIENTS ARE MEDICARE RECIPIENTS AND 11% ARE UNINSURED OR MEDICAID RECIPIENTS.

PART VI, LINE 5:
THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF BUSINESS PEOPLE WHO RESIDE IN THE PRIMARY SERVICE AREA WITH AN INTEREST IN THE CONTINUATION OF THE HOSPITAL IN PROVIDING MEDICAL SERVICES TO THE POPULATION. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL DEPARTMENTS. THE HOSPITAL IS ALSO PURSUING ARRANGEMENTS WITH OTHER HOSPITALS FOR ADDITIONAL PHYSICIAN STAFF TO PROVIDE HEALTH SERVICES. RESERVE CAPITAL FUNDS ALONG WITH CONTINUING OPERATIONS ARE BEING USED TO IMPROVE PATIENT CARE THROUGH THE PURCHASE OF UPDATED MEDICAL EQUIPMENT. SERVICES ARE PROVIDED TO ALL PATIENTS WITHOUT REGARD TO RACE, COLOR, NATIONAL ORIGIN, ANCESTRY, AGE, RELIGIOUS CREED, OR HANDICAP. SERVICES ARE PROVIDED UNDER THE MEDICAID PROGRAM TO FINANCIALLY NEEDY PATIENTS. THE HOSPITAL ALSO CO-SPONSORS THE ELLWOOD CITY MEALS ON WHEELS PROGRAM BY PROVIDING THE PREPARATION OF FOODS FOR ALL MEALS SERVED. THE ELLWOOD CITY HOSPITAL AND ELLWOOD CITY HOSPITAL AUXILIARY ALSO PROVIDE A TECH ALERT SYSTEM FOR THE ELDERLY, YEARLY (AS WELL AS THROUGHOUT THE YEAR) INFORMATIONAL FAIRS, SUCH AS NATIONAL SAFETY BELT/SAFETY WEEK, BREAST CANCER AWARENESS WEEK, PROSTATE SCREENINGS, AND GENERAL HEALTH SCREENINGS TO NAME A FEW. THE HOSPITAL AND AUXILIARY ALSO PARTICIPATE WITH VARIOUS LOCAL, CIVIC, AND SCHOOL GROUPS TO PROVIDE OUTREACH SERVICES TO THE TRI-COUNTY AREA. SUCH PROGRAMS INCLUDED KINDERGARTEN TOURS OF THE HOSPITAL, A VOLUNTEER PROGRAM, AND THE USE OF THE HOSPITAL AS A CLINICAL SITE FOR AREA NURSING STUDENTS. THE HOSPITAL ALSO ENCOURAGES ITS EMPLOYEES TO BECOME INVOLVED WITH VOLUNTEER SERVICES SUCH AS THE UNITED WAY, THE RED CROSS ANNUAL BLOOD DRIVE AND VARIOUS COMMUNITY PROJECTS. THE ELLWOOD CITY HOSPITAL, IN COOPERATION WITH HIGHMARK BLUE CROSS BLUE SHIELD, OFFERS A LOW COST COVERAGE PROGRAM CALLED SPECIAL CARE AND THE CARING PROGRAM. SPECIAL CARE IS DESIGNATED FOR INDIVIDUALS AND FAMILIES WITH LOW INCOMES WHO ARE INELIGIBLE FOR GOVERNMENT ASSISTANCE AND THE CARING PROGRAM IS FOR CHILDREN OF LOW-INCOME FAMILIES.