4A (Expenses $ 6644416 including grants of $ 0) (Revenue $ 4785496)
A WIDE VARIETY OF OUTPATIENT SERVICES WERE PROVIDED TO THE COMMUNITY INCLUDING LAB, RADIOLOGY, SURGICAL, OBSERVATION, BEHAVIORAL HEALTH, AND THERAPEUTIC SERVICES. OVER 23,000 OUTPATIENT VISITS WERE PERFORMED DURING THE YEAR. SERVICES WERE RENDERED REGARDLESS OF THE PATIENT'S ABILITY TO PAY. ALL QUALITY MEASURES REQUIRED BY MEDICARE AND MAJOR INSURANCE CARRIERS WERE MET. 55% OF THE OUTPATIENT VISITS WERE MEDICARE; 43% OF THE OUTPATIENT VISITS WERE MEDICAL ASSISTANCE.

4B (Expenses $ 5881260 including grants of $ 0) (Revenue $ 5250102)
OUR EMERGENCY ROOM PROVIDED OVER 11,000 VISITS DURING THE YEAR. SERVICES WERE RENDERED REGARDLESS OF THE PATIENT'S ABILITY TO PAY. ALL QUALITY MEASURES REQUIRED BY MEDICARE AND MAJOR INSURANCE CARRIERS WERE MET. 22% OF THE VISITS WERE MEDICARE; 42% OF THE VISITS WERE MEDICAL ASSISTANCE.

4C (Expenses $ 2449495 including grants of $ 0) (Revenue $ 7737241)
INPATIENT ACUTE SERVICES WERE PROVIDED TO 569 PATIENTS IN THE COMMUNITY. WASHINGTON HEALTH SYSTEM GREENE PROVIDES A WIDE ARRAY OF MEDICAL AND SURGICAL SERVICES. SPECIALTIES INCLUDE UROLOGY, GASTROENTEROLOGY, ORTHOPEDICS AND GENERAL SURGERY. SERVICES WERE RENDERED REGARDLESS OF A PATIENT'S ABILITY TO PAY. ALL QUALITY MEASURES REQUIRED BY MEDICARE AND MAJOR INSURANCE CARRIERS WERE MET. 67% OF THE INPATIENT CASES WERE MEDICARE; 14% OF THE PATIENT CASES WERE MEDICAL ASSISTANCE.

4D (Expenses $ 18641 including grants of $ 0) (Revenue $ 61624)
OTHER PROGRAM SERVICES INCLUDE ACTIVITIES PERFORMED BY THE HOSPITAL TO DO BUSINESS IN THE COMMUNITY AND PROVIDE VALUABLE COMMUNITY BENEFITS. ACTIVITIES IN THIS CATEGORY INCLUDE RENTAL ACTIVITIES AND OPERATION OF AN EMPLOYEE CAFETERIA.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - Washington Health System Greene. IN ORDER TO TAKE INTO ACCOUNT INPUT FROM THE COMMUNITY THAT THE HOSPITAL SERVES, THE ASSESSMENT INCLUDED A RANDOM COMMUNITY SURVEY AS WELL AS COMMUNITY FEEDBACK MEETINGS AND SURVEYS WITH THE FOLLOWING COMMUNITY GROUPS: PATIENT AND FAMILY CENTERED CARE COMMITTEE OF WASHINGTON HEALTH SYSTEM WASHINGTON PHYSICIAN HOSPITAL ORGANIZATION

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - The Washington Hospital. A hospital located in Washington, PA

Schedule H, Part V, Section B, Line 6a Facility , 2
Facility , 2 - Penn Highlands Mon Valley Hospital. A hospital located in Monongahela, PA

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - Washington Health System Greene. THE NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE REVIEWED AND PRIORITIZED BASED ON MAGNITUDE OF THE NEED, POTENTIAL IMPACT ON THE COMMUNITY HEALTH, COST, ENVIRONMENTAL FACTORS AND PRACTICALITY. AN IMPLEMENTATION PLAN WAS DEVELOPED AND APPROVED BY THE BOARD OF TRUSTEES. THE HOSPITAL WILL FOCUS THE IMPLEMENTATION ON TREATING TWO OF THE TOP NEEDS, REDUCTION OF THE COLORECTAL CANCER DEATH RATE AND REDUCTION OF THE LUNG CANCER DEATH RATE. THE FOLLOWING ARE SOME OF THE HEALTH NEEDS NOT BEING ADDRESSED IN THE INITIAL IMPLEMENTATION STRATEGY: YEARS OF POTENTIAL LIFE LOST DRUG OVERDOSE DEATHS CORONARY HEART DISEASE DEATHS COPD DEATHS BREAST CANCER DEATHS

Schedule H, Part I, Line 7 COLUMN F - BAD DEBT
BAD DEBT EXPENSE IS NOT INCLUDED IN THE EXPENSES IN THE LINE 7 PERCENT OF TOTAL EXPENSES CALCULATION.

Schedule H, Part V, Section B, Line 20 INDICATE EFFORTS MADE BEFORE BEFORE ANY ACTIONS
LINE 20 WAS LEFT BLANK BECAUSE NONE OF THE ACTIONS DESCRIBED IN LINE 19 ARE PERMITTED UNDER OUR POLICY.

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
THE HOSPITAL'S COST-TO-CHARGE RATIOS WERE USED TO CALCULATE ALL AMOUNTS REPORTED ON LINE 7. ALTHOUGH WORKSHEET 2 WAS NOT USED TO CALCULATE THIS RATIO, WE PREPARED A SIMILAR CALCULATION THAT WE FEEL IS MORE DETAILED. SIMILAR TO WORKSHEET 2, WE STARTED WITH OUR OVERALL COST-TO-CHARGE RATIO AND ADJUSTED FOR THE COMMUNITY BENEFITS INCLUDED IN PART I AND THE MEDICAID PROVIDER TAXES WE PAID.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE HOSPITAL FOLLOWS AICPA GUIDANCE IN REPORTING BAD DEBT AS A DEDUCTION FROM NET PATIENT SERVICE REVENUE. ACCOUNTS ARE DEEMED TO BE BAD DEBT AFTER ALL REASONABLE COLLECTION EFFORTS ARE APPLIED. THE HOSPITAL HAS A GENEROUS INTEREST-FREE PAYMENT PLAN POLICY AND DOES NOT CLASSIFY ACCOUNTS ON A PAYMENT PLAN AS BAD DEBT. ANY ACCOUNTS THAT ARE DETERMINED TO BE CHARITY CARE ARE EXCLUDED FROM BAD DEBT TOTALS. ANY DISCOUNT OR SETTLEMENTS PROVIDED TO PATIENTS ARE ALSO EXCLUDED FROM BAD DEBT TOTALS. THE AMOUNT DUE FROM A PATIENT IS WRITTEN OFF TO BAD DEBT ONCE THE ACCOUNT IS DEEMED UNCOLLECTABLE. THE HOSPITAL CONVERTS ALL BAD DEBT ACCOUNTS TO GROSS CHARGES AND APPLIES AN OVERALL COST-TO-CHARGE RATIO TO DETERMINE THE COST OF BAD DEBT REPORTED ON PART III, LINE 2.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
ALTHOUGH WE RECOGNIZE THE POSSIBILITY THAT SOME OF THE BAD DEBT COSTS COULD QUALIFY UNDER OUR CHARITY CARE POLICY, WE HAVE NO REASONABLE WAY TO DETERMINE THOSE AMOUNTS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
"THE AUDITED FINANCIAL STATEMENTS OF THE HOSPITAL DESCRIBES BAD DEBT AS FOLLOWS: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYERS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HEALTH SYSTEM ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HEALTH SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT CARE SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. FOOTNOTES: FOOTNOTE 3, ""PATIENT AND UNINSURED PAYERS"" IS FOUND ON PAGE 19 OF THE AUDITED FINANCIAL STATEMENTS"

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE MEDICARE COSTS ARE CALCULATED USING COST-TO-CHARGE RATIOS THAT HAVE BEEN CALCULATED BASED ON THE DEPARTMENT WHERE THE SERVICES WERE PROVIDED.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
THE HOSPITAL HAS A WRITTEN BAD DEBT POLICY IT FOLLOWS FOR ALL PATIENTS. IF A PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE ACCOUNT IS EXCLUDED FROM THE NORMAL COLLECTION PROCESS. THOSE ACCOUNTS ARE HANDLED UNDER THE SEPARATE CHARITY CARE POLICY. IF AN ACCOUNT IS SET UP ON A PAYMENT PLAN, ONLY THE CURRENT MONTHLY PAYMENT AMOUNT IS PURSUED UNDER THE COLLECTION POLICY.

Schedule H, Part V, Section B, Line 16a FAP website
- Washington Health System Greene: Line 16a URL: https://whs.org/patient-guests/;

Schedule H, Part V, Section B, Line 16b FAP Application website
- Washington Health System Greene: Line 16b URL: https://whs.org/patient-guests/;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- Washington Health System Greene: Line 16c URL: https://whs.org/patient-guests/;

Schedule H, Part VI, Line 2 Needs assessment
THE PRIMARY METHOD THAT THE HOSPITAL USES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES IS THROUGH ASSESSING THE TOTAL NUMBER OF PHYSICIANS PROVIDING MEDICAL SERVICES TO THE AREAS SERVED. THE QUALITATIVE STANDARD DOES NOT FACTOR THE ECONOMIC OR FINANCIAL BENEFITS TO THE HOSPITAL OF ANY RECRUITMENT OF PHYSICIANS IN ADDRESSING THE CONTINUUM OF NEED. THE ASSESSMENT FOCUSES ON COMMUNITY NEED AS A DETERMINING FACTOR IN ASSESSING THE APPROPRIATENESS OF PHYSICIAN RECRUITMENT INITIATIVES. THE APPROACH TO EVALUATING PHYSICIAN NEED IS BASED ON THE FOLLOWING FACTORS: -DEFINING THE DEMOGRAPHIC PROFILE AND PAYOR MIX OF THE HOSPITAL'S SERVICE AREA. -RESEARCHING UNIQUE SERVICE AREA FACTORS THAT MIGHT INFLUENCE THE DEMAND FOR HEALTHCARE SERVICES WITHIN THE AREA. -IDENTIFYING THE TOTAL NUMBER OF PHYSICIANS BY SPECIALTY IN THE DEFINED SERVICE AREA. -DEVELOPING A PROFILE OF THE CURRENT MEDICAL STAFF. -UTILIZING SIX ESTABLISHED PHYSICIAN NEEDS ASSESSMENT MODELS TO IDENTIFY POTENTIAL PHYSICIAN SURPLUSES OR DEFICITS IN EACH MEDICAL SPECIALTY. -EXAMINING RESULTS OF THE MEDICAL STAFF SURVEY AND PHYSICIAN FOCUS INTERVIEWS TO DETERMINE THE PERCEIVED RECRUITMENT NEEDS OF THE HOSPITAL'S EXISTING STAFF PHYSICIANS AND TO IDENTIFY MEDICAL COMMUNITY CONCERNS. -CONDUCT A COMMUNITY SURVEY TO INTEGRATE PERCEIVED SHORTAGES INTO RECOMMENDATIONS. -EVALUATING RESULTS OF THE ABOVE EFFORTS IN THE CONTEXT OF OUR MEDICAL STAFFING AND CONSULTING EXPERIENCE. OTHER WAYS TO ASSESS THE COMMUNITIES' HEALTH NEEDS INCLUDES CONDUCTING VARIOUS HEALTH SCREENINGS, SEMINARS AND EDUCATION SESSIONS HELD FOR THE GENERAL PUBLIC.

Schedule H, Part VI, Line 5 Promotion of community health
WASHINGTON HEALTH SYSTEM GREENE STRIVES TO PROMOTE COMMUNITY HEALTH IN MANY AREAS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF. ALL APPLICANTS WHO MEET THE REQUIREMENTS ARE GRANTED MEDICAL STAFF PRIVILEGES. THE HOSPITAL ACTIVELY RECRUITS PHYSICIANS IN AREAS IDENTIFIED AS HAVING A NEED IN THE COMMUNITY. THE HOSPITAL'S BOARD OF TRUSTEES IS COMPRISED OF COMMUNITY LEADERS WHO RESIDE IN THE COMMUNITIES WE SERVE AND WHOSE INSIGHT AND EXPERIENCE IS INVALUABLE IN PROVIDING DIRECTION TO THE HOSPITAL IN PROMOTING THE COMMUNITY HEALTH. THE HOSPITAL PROVIDES MANY SCREENING AND EDUCATIONAL PROGRAMS IN THE COMMUNITY. THE HOSPITAL PARTICIPATES IN REGIONAL EMERGENCY PREPAREDNESS AND IS ACTIVE IN ENSURING WE CAN RESPOND TO A COMMUNITY EMERGENCY.

Schedule H, Part VI, Line 6 Affiliated health care system
WHS Greene is part of the Washington Health System. The goal of the system is to provide integrated healthcare centered around patients and families. WHS Greene's role is to provide healthcare services in the Greene county area of the system. WHS Greene is the only hospital in this county and provides a full array of inpatient and outpatient services to the community it serves.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
THE HOSPITAL ATTEMPTS TO INFORM ALL UNINSURED PATIENTS OF AVAILABLE PROGRAMS TO ASSIST THEM IN OBTAINING HEALTH CARE SERVICES. INPATIENT: ANY PATIENT ADMITTED TO THE HOSPITAL WITHOUT INSURANCE IS PROVIDED ASSISTANCE IN APPLYING FOR THE STATE MEDICAL ASSISTANCE PROGRAM. A HOSPITAL REPRESENTATIVE WILL EXPLAIN THE STATE PROGRAMS TO THE PATIENT AND ASSIST IN THE PREPARATION OF THE APPLICATION AND GATHERING OF INFORMATION, IF APPLICABLE. IF THE PATIENT DOES NOT QUALIFY FOR ASSISTANCE, THE REPRESENTATIVE INFORMS HIM / HER OF THE HOSPITAL'S CHARITY CARE PROGRAM. OUTPATIENT: CERTAIN OUTPATIENT AREAS (EMERGENCY ROOM, REGISTRATION) HAVE SIGNS THAT LET PATIENTS KNOW THE HOSPITAL HAS A CHARITY CARE PROGRAM. SOME AREAS ALSO HAVE MEDICAL ASSISTANCE APPLICATIONS ON HAND TO GIVE TO PATIENTS. CONSISTENT WITH THE HOSPITAL MISSION, ALL PATIENTS REQUIRING IMMEDIATE CARE ARE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY. ALL PATIENTS: FOR PATIENTS THAT ARE UNINSURED OR UNDER INSURED, A HOSPITAL REPRESENTATIVE IS AVAILABLE TO DISCUSS OPTIONS FOR PAYMENT WITH THE PATIENT. WHEN APPROPRIATE, PAYMENT FOR ELECTIVE SERVICES IS DISCUSSED UPFRONT AND IF THE PATIENT IS ABLE TO PAY, IS COLLECTED IN ADVANCE OF SERVICE. EFFORTS ARE MADE TO COLLECT PATIENT LIABILITIES IN CERTAIN AREAS SUCH AS OPSU AND ADMISSIONS. INSURANCE COPAYS ARE ATTEMPTED TO BE COLLECTED IN THE EMERGENCY DEPARTMENT IN ACCORDANCE WITH EMTALA REGULATIONS. WHEN THERE IS A BALANCE DUE (SELF-PAY OR BALANCE AFTER INSURANCE) AND NO COLLECTION WAS MADE IN ADVANCE OF OR AT THE TIME OF SERVICE, A STATEMENT WILL BE SENT TO PATIENTS PROVIDING A PHONE NUMBER FOR THEM TO CALL AND DISCUSS PAYMENT OPTIONS. IF THE PATIENT DOES NOT CALL OR MAKE PAYMENT, A HOSPITAL REPRESENTATIVE WILL CALL HIM / HER TO DISCUSS THE AMOUNT DUE AND TO DETERMINE IF THEY ARE ELIGIBLE FOR ANY PROGRAMS OR INSURANCES OR TO MAKE PAYMENT ARRANGEMENTS THAT CAN HELP THE PATIENT. AT ANY POINT IN THE CONVERSATION, IF THE PATIENT SAYS HE / SHE CANNOT AFFORD TO PAY THE BILL, THE PATIENT IS OFFERED A CHARITY CARE APPLICATION. ONCE THE CHARITY CARE APPLICATION IS COMPLETE, IF THE PATIENT DOES NOT QUALIFY BUT CONTINUES TO EXPRESS CONCERNS ABOUT BEING ABLE TO PAY HIS / HER BILL, THE ACCOUNT IS REVIEWED FOR THE POSSIBILITY OF A DISCOUNT OR AN AFFORDABLE PAYMENT PLAN. THE HOSPITAL STRIVES TO ACCOMMODATE EVERY PATIENT'S FINANCIAL SITUATION IF POSSIBLE. THE HOSPITAL'S CHARITY CARE PROGRAM PROVIDES FOR FREE OR DISCOUNTED CARE BASED ON FEDERAL POVERTY GUIDELINES (FPG). DEPENDING ON INCOME LEVEL, INDIVIDUALS WITHOUT INSURANCE CAN QUALIFY FOR DISCOUNTS RANGING BETWEEN 60-100%. INDIVIDUALS WITH INSURANCE CAN QUALIFY FOR DISCOUNTS RANGING BETWEEN 10-100%. ALL BILLS FOR PATIENTS WITHOUT INSURANCE COVERAGE ARE DISCOUNTED TO THE AVERAGE OF OUR TOP COMMERCIAL PAYORS. DISCOUNTS RANGE FROM 30% TO 60% DEPENDING ON THE TYPE OF SERVICE PROVIDED.

Schedule H, Part VI, Line 4 Community information
WASHINGTON HEALTH SYSTEM GREENE (WHSG) IS A 23 BED ACUTE CARE GENERAL HOSPITAL LOCATED IN WAYNESBURG, PENNSYLVANIA. THE HOSPITAL SERVES THE SURROUNDING COMMUNITIES WITH A TOTAL PATIENT DRAW OF OVER 35,000 RESIDENTS LIVING IN 18 ZIP CODES. THE SERVICE AREA EXTENDS TO THE WESTERN AND SOUTHERN BORDERS OF PENNSYLVANIA. THERE ARE THREE OTHER GENERAL ACUTE CARE HOSPITALS THAT SERVE PORTIONS OF WHSG'S GEOGRAPHIC AREA. THE GEOGRAPHIC AREA OF SERVICE IS QUITE LARGE AND HAS A SUBSTANTIAL RURAL COMPONENT. SEVERAL AREAS WITHIN WHSG'S SERVICE AREA ARE DESIGNATED AS MEDICALLY UNDERSERVED AND / OR AREAS WITH A HEALTH CARE PROFESSIONAL SHORTAGE. APPROXIMATELY 28% OF THE PATIENTS SERVED ARE MEDICAL ASSISTANCE AND ABOUT 4% ARE UNINSURED. HOUSEHOLD INCOME / ECONOMIC FACTORS CAN HAVE A SIGNIFICANT IMPACT ON THE GENERAL HEALTH OF A SERVICE AREA. LOWER HOUSEHOLD INCOME MAY REFLECT LOWER PRIMARY CARE UTILIZATION AND HIGHER CRITICAL CARE UTILIZATION. VARIOUS STUDIES AND ARTICLES ALSO SUGGEST GREATER RELIANCE ON HOSPITAL EMERGENCY ROOMS FOR NON-EMERGENCY DIAGNOSIS AND TREATMENT IN LOW-INCOME AREAS. THE HOSPITAL'S SERVICE AREA MAY HAVE SOME HOUSEHOLD INCOME RELATED FACTORS THAT WOULD DRIVE AN ADDITIONAL NEED FOR PHYSICIAN SERVICES WITHIN PORTIONS OF THE COMMUNITY. APPROXIMATELY 15% OF THE HOUSEHOLDS WITHIN THE PRIMARY SERVICE AREA ARE AT OR BELOW THE POVERTY LEVEL. A LACK OF AVAILABLE RESOURCES TO THE INDIGENT MAY INCREASE VOLUMES IN THE EMERGENCY ROOM, AS PATIENTS LACKING PRIMARY CARE ACCESS OFTEN SEEK ROUTINE CARE THROUGH EMERGENCY SERVICES.