4A (Expenses $ 62776001 including grants of $ 0) (Revenue $ 67644037)
MMC PROVIDES ACUTE CARE SERVICES TO PATIENTS. AN ACUTE CARE SETTING IS AN INSTITUTION OR MEDICAL FACILITY PROVIDING PATIENTS WITH SHORT-TERM TREATMENT FOR AN ACUTE INJURY OR ILLNESS. ACUTE CARE FACILITIES ARE BENEFICIAL TO PATIENTS WITH ACUTE CONDITIONS BECAUSE THEY ARE ABLE TO FOCUS ON GIVING QUICK, EFFICIENT CARE TO THEIR PATIENTS. SEE SCHEDULE O FOR ADDITIONAL DETAILS.

4B (Expenses $ 25751546 including grants of $ 0) (Revenue $ 49510304)
MMC PERFORMS BOTH INPATIENT AND OUTPATIENT SURGERY. THE SURGERY DEPARTMENT UTILIZES THE LATEST IN SURGICAL EQUIPMENT AND TECHNIQUES IN PROVIDING BOTH INPATIENT AND OUTPATIENT CARE. THE SURGICAL TEAM CONSISTS OF SPECIALLY TRAINED NURSES AND ANESTHETISTS, GENERAL AND SPECIALTY SURGEONS AND ANESTHESIOLOGISTS. THE MMC SURGEONS REPRESENT THE AREAS OF GENERAL SURGERY, PERIPHERAL VASCULAR SURGERY, OBSTETRICS AND GYNECOLOGY, OPHTHALMOLOGY, ORAL AND MAXILLOFACIAL SURGERY, ORTHOPEDICS, OTOLARYNGOLOGY, PLASTIC AND RECONSTRUCTIVE SURGERY, AND UROLOGY. SEE SCHEDULE O FOR ADDITIONAL DETAILS.

4C (Expenses $ 24908151 including grants of $ 0) (Revenue $ 39560242)
MMC PROVIDES ONCOLOGY SERVICES AT THE YOLANDA G. BARCO ONCOLOGY INSTITUTE. A COMPREHENSIVE CANCER CARE PROGRAM, APPROVED BY THE AMERICAN COLLEGE OF SURGEONS, IS AVAILABLE IN MEADVILLE WITH THE LATEST TECHNOLOGY AND PHYSICIAN SPECIALISTS AVAILABLE. WE HAVE ACCESS TO RESEARCH AND THE MOST UP-TO-DATE TREATMENT PROTOCOLS. MEADVILLE MEDICAL CENTER IS A MEMBER OF THE ASSOCIATION FOR COMMUNITY CANCER CENTERS. WE BELIEVE THAT CANCER CARE IS BEST DELIVERED IN A COMMUNITY SETTING. SEE SCHEDULE O FOR ADDITIONAL DETAILS.

SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT: THE RESEARCH PROCESS INCLUDED A WIDE BASED SURVEY OF THE POPULATION. THE SURVEY INCLUDED INPUT FROM UNDERREPRESENTED GROUPS IN PUBLIC HOUSING. ELECTRONIC SURVEYS WERE COMPLETED. A GOOD DIVERSITY OF RESPONSE WAS REALIZED.

SCHEDULE H, PART V, SECTION B, LINE 6A
OTHER HOSPITAL FACILITIES: MEADVILLE MEDICAL CENTER'S CHNA WAS CONDUCTED WITH ANOTHER HOSPITAL FACILITY, TITUSVILLE AREA HOSPITAL.

SCHEDULE H, PART V, SECTION B, LINE 6B
OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: THE CHNA REPORT WAS CONDUCTED WITH ALLEGHENY COLLEGE AND VARIOUS LOCAL COMMUNITY PARTNERS.

SCHEDULE H, PART V, SECTION B, LINE 7A
HOSPITAL FACILITY'S WEBSITE: HTTPS://WWW.MMCHS.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.A SPX

SCHEDULE H, PART V, SECTION B, LINE 7B
OTHER WEBSITE: HTTPS://WWW.TITUSVILLEHOSPITAL.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT.ASPX

SCHEDULE H, PART V, SECTION B, LINE 7D
OTHER METHODS OF PROVIDING THE CHNA TO THE PUBLIC: OTHER METHODS IN WHICH MEADVILLE MEDICAL CENTER MADE ITS CHNA WIDELY AVAILABLE TO THE PUBLIC INCLUDED ITS ANNUAL MEETING OF THE CRAWFORD (COUNTY) HEALTH IMPROVEMENT COALITION, TELEVISING THE RESULTS OF THE REPORT ON LOCAL TELEVISION AND BROADCASTING THE RESULTS OF THE REPORT ON LOCAL RADIO STATIONS.

SCHEDULE H, PART V, SECTION B, LINE 10B
THE IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING WEBSITE: HTTPS://WWW.MMCHS.ORG/PATIENT-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.A SPX

SCHEDULE H, PART V, SECTION B, LINE 11
ADDRESSING IDENTIFIED NEEDS: IN RESPONSE TO THE RESULTS OF MEADVILLE MEDICAL CENTERS'S (MMC) MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, THE ORGANIZATION ADOPTED AN IMPLEMENTATION STRATEGY. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN COLLABORATION BETWEEN MEADVILLE MEDICAL CENTER, TITUSVILLE AREA HOSPITAL AND ALLEGHENY COLLEGE LOOKED AT DATA COLLECTED FROM MORE THAN 1,100 ADULT PARTICIPANTS FROM ACROSS CRAWFORD COUNTY. ONLINE SURVEYS SHOWED A NEED TO SUPPORT COMMUNITY MEMBERS IN LEADING A HEALTHIER LIFESTYLE. INTERNAL DATA AND SURVEY DATA ALIGNED TO IDENTIFY LONGER THAN ACCEPTABLE WAIT TIMES FOR CERTAIN HEALTHCARE SERVICES. 7.1% OF RESPONDENTS STATED THEY DID NOT ACCESS MEDICAL CARE WHEN THEY NEEDED IT BECAUSE WAIT TIMES WERE TOO LONG AND WAIT TIMES OF UP TO MANY MONTHS FOR A NEXT AVAILABLE APPOINTMENT IN CERTAIN OFFICES MAKES THIS A PRIORITY FOCUS. COST OF HEALTHCARE, ALONG WITH NATIONWIDE ECONOMIC CONDITIONS, IS A CONCERN. MMC REMAINS A LOW-COST HEALTHCARE PROVIDER IN THE REGION ACCORDING TO THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL. HOWEVER, WITH RISING INSURANCE DEDUCTIBLES, CO-PAYS AND INCREASING LABOR AND SUPPLY COST, MANAGING OPERATIONAL EXPENSES IS A PRIORITY. IN THE 2016 CHNA, 73% OF ALL RESPONDENTS SAID THEY HAD AN ANNUAL CHECKUP IN THE PRIOR YEAR WHILE IN 2022 80% HAVE RECEIVED A CHECK-UP IN THE PRIOR YEAR. DURING THE 2019 CHNA THERE WAS A DECREASE OF 14% AMONG RESPONDENTS WHO STATED THEY HAD A PRIMARY CARE PHYSICIAN. THE GOAL IS TO CONNECT INDIVIDUALS WITH A CONSISTENT CARE PROVIDER, BUT OUR HOPE IS THE MOST RECENT DATA SHOWS THERE HAS BEEN A POSITIVE IMPROVEMENT IN INDIVIDUALS GETTING ROUTINE SCREENINGS. IN THE 2016 CHNA 14% OF RESPONDENTS SAID THEY USED TOBACCO, IN 2019 35% REPORTED SMOKING (CURRENT AND FORMER) AND IN 2022 9.2% REPORTED USING TOBACCO. THIS DECREASE REFLECTS POSITIVE OUTCOMES FROM PRIOR STRATEGIES WHICH WILL CONTINUE INTO THE FUTURE. THE MOST IMPORTANT HEALTH ISSUE IN OUR COMMUNITY, SELECTED BY 63% OF RESPONDENTS, IS MENTAL HEALTH. INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES BY ADDING ADDITIONAL PROVIDERS AND CONNECTING WITH INDIVIDUALS IN REMOTE AREAS OF THE COUNTY IS CRITICAL. PEDIATRIC COUNSELORS AND SUPPORT SERVICES ACROSS THE COUNTY AND IN THE SCHOOLS NEEDS TO BECOME A COMMUNITY-WIDE PRIORITY.

SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C
FAP, FAP APPLICATION, AND PLS WEBSITE: HTTP://WWW.MMCHS.ORG/PATIENT-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTAN CE.ASPX

SCHEDULE H, PART V, SECTION B, LINE 20E
OTHER METHODS OF PUBLICIZING FINANCIAL ASSISTANCE POLICY: THE BILLING INVOICE OFFERS A PHONE NUMBER TO CALL FOR EXPLANATION OF THE FINANCIAL ASSISTANCE POLICY.

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE: TO ARRIVE AT THE PERCENT OF TOTAL EXPENSES, THE DENOMINATOR USED WAS TOTAL OPERATING EXPENSES PER PART IX, LINE 25 OF THE FORM 990.

SCHEDULE H, PART I, LINE 7
COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1, 3, AND 6. OTHER IRS WORKSHEETS USED THE HOSPITAL'S COST ACCOUNTING SYSTEM, WHICH INCLUDED ALL PATIENT SEGMENTS.

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE: THE HOSPITAL HAS ADOPTED THE NEW REVENUE RECOGNITION STANDARD ASU 2014-09. UNDER ASU 2014-09, THE ESTIMATED AMOUNTS DUE FROM PATIENTS FOR WHICH THE HEALTH SYSTEM DOES NOT EXPECT TO BE ENTITLED OR COLLECT FROM THE PATIENTS ARE CONSIDERED IMPLICIT PRICE CONCESSIONS AND EXCLUDED FROM THE HEALTH SYSTEM'S ESTIMATION OF THE TRANSACTION PRICE OR REVENUE RECORDED. BAD DEBT EXPENSE WAS NOT SIGNIFICANT TO THE AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022. HOWEVER, THE HOSPITAL INTERNALLY TRACKS BAD DEBT EXPENSE CONSISTENT WITH HISTORICAL PRACTICES AND THAT AMOUNT HAS BEEN REPORTED ON SCHEDULE H, PART III, SECTION A, LINE 2.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE: BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY FOR LINE 3 WAS DETERMINED USING A MONTHLY AVERAGE OF PATIENTS ATTRIBUTABLE TO CHARITY.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT EXPENSE FOOTNOTE: THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. THEY DO, HOWEVER, CONTAIN A FOOTNOTE THAT DESCRIBES PATIENT ACCOUNTS RECEIVABLE, THAT NOTE CAN BE FOUND ON PAGE 11 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION B, LINE 8
COMMUNITY BENEFIT: SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. COST ACCOUNTING WAS USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION POLICY: FOR UNINSURED PATIENTS ELIGIBLE FOR DISCOUNTS FROM BILLED TO CHARGES, A MEDICAL ASSISTANCE APPLICATION CAN BE COMPLETED. ONCE COMPLETED, IT WILL BE REVIEWED FOR ELIGIBILITY. A CONTRACT FOR PAYMENT CAN BE NEGOTIATED WITH THE FACILITY'S COLLECTIONS PERSONNEL.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: MEADVILLE MEDICAL CENTER COMPLETES A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT ON A REGULAR BASIS TO DETERMINE HEALTH CARE NEEDS. THE MOST RECENT ASSESSMENT WAS COMPLETED IN 2022. MEADVILLE MEDICAL CENTER WORKS WITH MANY COMMUNITY PARTNERS INCLUDING; HEALTH AND HUMAN SERVICE PROVIDERS, EDUCATION, GOVERNMENT, FAITH, LAW ENFORCEMENT, AND OTHER INTERESTED PARTIES IN COMPLETING THE ASSESSMENT OF THE COMMUNITY HEALTH NEEDS.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ELIGIBILITY FOR FINANCIAL ASSISTANCE IS REVIEWED ACCORDING TO THE U.S. GOVERNMENT'S FEDERAL POVERTY GUIDELINES. MEADVILLE MEDICAL CENTER (MMC) OFFERS A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS TO MEET THE NEEDS OF PATIENTS. PROGRAMS APPLY ONLY TO MEADVILLE MEDICAL CENTER HOSPITAL CHARGES. PATIENTS WILL RECEIVE A SEPARATE BILL FROM EACH INDEPENDENT PRACTITIONER, OR GROUPS OF PRACTITIONERS, FOR CARE, TREATMENT, OR SERVICES PROVIDED. THE MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM DOES NOT APPLY TO THESE CHARGES. IN ADDITION TO THE MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAMS, PATIENTS MAY ALSO BE ELIGIBLE FOR PUBLIC PROGRAMS SUCH AS MEDICAID OR MEDICARE. APPLYING FOR SUCH PROGRAMS MAY BE REQUIRED PRIOR TO APPLYING FOR A MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAM. MEADVILLE MEDICAL CENTER WILL ASSIST PATIENTS WITH STATE FUNDED PUBLIC PROGRAMS AND THE ENROLLMENT PROCESS. THE MEADVILLE MEDICAL CENTER FINANCIAL ASSISTANCE PROGRAMS INCLUDE FOUR PROGRAMS: 1. UNINSURED FINANCIAL ASSISTANCE - AVAILABLE TO UNINSURED PATIENTS, OFFERS FREE CARE OR DISCOUNTED CARE BASED ON FAMILY SIZE AND INCOME ACCORDING TO THE ELIGIBILITY CRITERIA. 2. SELF-PAY DISCOUNT - AVAILABLE TO UNINSURED PATIENTS, OFFERS A 40% DISCOUNT, NO APPLICATION NECESSARY, DOES NOT APPLY TO MEDICARE, MEDICAID, BCBS AND OTHER INSURANCE/THIRD PARTY PAYER DEDUCTIBLE AND CO-INSURANCE AMOUNTS. 3. CATASTROPHIC DISCOUNT - AVAILABLE TO UNINSURED AND INSURED PATIENTS, LIMITS THE OUT-OF-POCKET COSTS WHEN MEDICAL DEBTS SPECIFIC TO MEDICAL CARE AT MEADVILLE MEDICAL CENTER EXCEED 25% OF THE PATIENT'S FAMILY GROSS INCOME. 4. PAYMENT PLAN PROGRAM - AVAILABLE TO UNINSURED AND INSURED PATIENTS, ASSISTS PATIENTS WITH THEIR FINANCIAL OBLIGATIONS BY ESTABLISHING PAYMENT ARRANGEMENTS. TO QUALIFY FOR FREE SERVICES (100% FINANCIAL ASSISTANCE) THE PATIENT'S HOUSEHOLD INCOME MUST BE AT OR BELOW 300% OF THE CURRENT FEDERAL POVERTY GUIDELINES.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: MEADVILLE MEDICAL CENTER SERVES ANY PERSON IN NEED OF SERVICE, THE MAJORITY OF WHICH RESIDE IN CENTRAL AND WESTERN CRAWFORD COUNTY IN NORTHWESTERN PENNSYLVANIA, PRIMARILY A RURAL AREA. THE POPULATION OF THE PRIMARILY RURAL SERVICE AREA WAS 83,351. THE AREA HAS A HIGH RATE OF POVERTY, LOWER MEDIAN AND HOUSEHOLD INCOME, AND HIGHER RATE OF MEDICAL ASSISTANCE ELIGIBILITY THAN THE SURROUNDING AREAS AND THE STATE AND NATION AS A WHOLE. THE UNIQUE NEEDS OF THE COMMUNITY ARE CONSIDERED IN ALL PLANNING.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH: MEADVILLE MEDICAL CENTER TAKES THE LEADERSHIP POSITION IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE HEALTH IN THE AREAS WE SERVE. WE ARE AN ACTIVE PARTICIPANT IN THE CRAWFORD (COUNTY) HEALTH IMPROVEMENT COALITION THAT ASSESSES NEEDS IN AN ONGOING BASIS AND INITIATES NEEDED INTERVENTIONS, MOST RECENTLY FREE FLU SHOTS TO ELDERLY AND LOW INCOME PERSONS. MEADVILLE MEDICAL CENTER SUPPORTS FINANCIALLY AND OPERATIONALLY THE MEADVILLE AREA FREE CLINIC WHICH PROVIDES PRIMARY CARE FOR PERSONS WITH NO HEALTH INSURANCE, MEDICARE OR MEDICAL ASSISTANCE. THE FREE CLINIC IS ALSO SUPPORTED BY THE UNITED WAY COMMUNITY FUND DRIVE AND WAS STARTED TO MEET A COMMUNITY NEED AS DETERMINED IN A PRIOR COMMUNITY HEALTH NEEDS ASSESSMENT. SURPLUS FUNDS ARE INVESTED IN REPLACEMENT EQUIPMENT, NEW AND IMPROVED FACILITIES AND SERVICES TO THE COMMUNITY.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: THE PRIMARY PURPOSE OF THE HEALTH SYSTEM IS TO PROVIDE MEDICAL SERVICES TO THE LOCAL AND SURROUNDING COMMUNITIES THROUGH THE OPERATIONS OF THE MEDICAL CENTER, CHS, MPS AND HCC. THE MEDICAL CENTER IS A SOLE COMMUNITY HOSPITAL LOCATED IN MEADVILLE, PENNSYLVANIA, AND PROVIDES PRIMARY ACUTE CARE MEDICAL SERVICES. COMMUNITY HEALTH SERVICES PROVIDES VARIOUS OUTPATIENT SERVICES, SOME OF WHICH ARE FUNDED THROUGH GOVERNMENTAL GRANTS. MEADVILLE PHYSICIANS SERVICES IS COMPRISED OF PHYSICIAN PRACTICES LOCATED WITHIN CRAWFORD COUNTY, PENNSYLVANIA. HOME CARE CONNECTIONS HOLDS THE EQUITY INVESTMENT IN VANTAGE HOLDING COMPANY, LLC AND ORTHOPEDIC ASSOCIATES. THE MEADVILLE MEDICAL CENTER FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH SYSTEM. MEADVILLE HOUSING CORPORATION IS A FOR-PROFIT COMPANY THAT RENTS RESIDENTIAL LIVING ACCOMMODATIONS AT TWO HOUSING SITES, BOTH OF WHICH ARE IN OR NEAR MEADVILLE, PENNSYLVANIA. NEEDS ARE ASSESSED AND PLANNING IS CONDUCTED CENTRALLY WITHIN THE ORGANIZATION WITH THE PARTICIPATION OF AFFILIATES. THE MEADVILLE HEALTH CENTER WAS OPENED TO ADDRESS GROWING NEED FOR MEDICAL CARE FOR PERSONS COVERED BY MEDICAL ASSISTANCE IN CENTRAL CRAWFORD COUNTY. TITUSVILLE AREA HEALTH CENTER, INC. AND AFFILIATES (HEALTH CENTER) CONSISTS OF TITUSVILLE AREA HEALTH CENTER, INC. (PARENT), TITUSVILLE AREA HOSPITAL (HOSPITAL), THE TITUSVILLE AREA HEALTH CENTER FOUNDATION (FOUNDATION) AND TITUSVILLE AREA HEALTH SERVICES, INC. (HEALTH SERVICES). THE HOSPITAL PRIMARILY EARNS REVENUES BY PROVIDING INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA. THE FOUNDATION WAS ESTABLISHED TO RECEIVE, ADMINISTER AND DISTRIBUTE FUNDS AND PROPERTY FOR THE BENEFIT AND SUPPORT OF THE HEALTH CENTER AND AFFILIATES. HEALTH SERVICES OPERATES SEPARATELY FROM THE HOSPITAL OFFERING MULTISPECIALTY FAMILY MEDICINE PEDIATRICS TO PATIENTS IN TITUSVILLE, PENNSYLVANIA, AND THE SURROUNDING AREA.