4A (Expenses $ 55509964 including grants of $ 0) (Revenue $ 66130143)
MCLEOD MEDICAL CENTER - DILLON IS A 79 BED COMMUNITY HOSPITAL LOCATED IN DILLON, SOUTH CAROLINA. MCLEOD MEDICAL CENTER - DILLON OPERATES AS PART OF THE OVERALL MCLEOD HEALTH SYSTEM. SEE ALSO THE COMMUNITY BENEFIT REPORT ON SCHEDULE H.

MCLEOD MEDICAL CENTER DILLON
"PART V, SECTION B, LINE 5: FOR THE 2022 DILLON COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT, (OR ""CHNA""), ONE-ON-ONE INTERVIEWS, QUESTIONNAIRES, AND FORUMS WERE CONDUCTED IN SPRING 2022 AS A MEANS TO GATHER INPUT. HIGHLIGHTS ARE LISTED BELOW (FULL CHNA IS FOUND AT MCLEODHEALTH.ORG).TOP HEALTH CONCERNS REPORTED AMONG COMMUNITY MEMBERS-DRUG ABUSE-HEART DISEASE/STROKE-OBESITY -DIABETESSOURCE: MCLEOD HEALTH 2022 SURVEY TOP HEALTH CONCERNS REPORTED AMONG HEALTH PROFESSIONALS -DIABETES -OBESITY -DRUG ABUSE -SMOKING/TOBACCO USE-VIOLENCESOURCE: MCLEOD HEALTH 2022 SURVEY PRIMARY DIAGNOSIS ADMITTED TO EMERGENCY DEPARTMENT MOST FREQUENT HEALTH NEEDS PRESENTING TO MCLEOD HEALTH DILLON EMERGENCY DEPARTMENT OCTOBER 2020 SEPTEMBER 2021: -COVID-19 -PAIN IN THROAT AND CHEST-SEVERE BACK PAIN -ABDOMINAL AND PELVIC PAIN -OTHER JOINT DISORDER -OTHER AND UNSPECIFIED SOFT TISSUE DISORDERSOURCE: MCLEOD HEALTH CLINICAL OUTCOMESPRIMARY INPATIENT DIAGNOSIS MOST FREQUENT HEALTH NEEDS PRESENTING TO MCLEOD HEALTH DILLON OCTOBER 2020 SEPTEMBER 2021: -COVID-19 -LIVEBORN INFANT -SEPSIS -TYPE 2 DIABETES -BACTERIAL PNEUMONIASOURCE: MCLEOD HEALTH CLINICAL OUTCOMES OPPORTUNITIES & PLAN PRIORITIES MCLEOD HEALTH DILLON WILL COLLABORATE WITH COMMUNITY PARTNERS TO PROVIDE COMMUNITY HEALTH INITIATIVES THAT ARE FOCUSED ON AREAS LISTED BELOW AND FURTHER DESCRIBED WITHIN THE IMPLEMENTATION PLAN. EVIDENCE-BASED PRACTICES WILL BE INSTITUTED TO ADDRESS THE FOLLOWING KEY AREAS BY MCLEOD DILLON: -CHRONIC DISEASES -ACCESS TO CARE -MENTAL HEALTH & SUBSTANCE ABUSE -SEXUAL HEALTHOVERVIEWTHIS COMMUNITY HEALTH NEEDS ASSESSMENT SERVES AS A TOOL TO EVALUATE THE OVERALL HEALTH STATUS, BEHAVIORS AND NEEDS OF DILLON COUNTY. THE MARCH 2010 PASSAGE OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (ACA) INTRODUCED REPORTING REQUIREMENTS FOR PRIVATE, NOT-FOR-PROFIT HOSPITALS. TO MEET THESE NEW FEDERAL REQUIREMENTS, THE INFORMATION GATHERED IN THIS ASSESSMENT IS USED TO GUIDE THE STRATEGIC PLANNING PROCESS IN ADDRESSING HEALTH DISPARITIES. A COMMUNITY HEALTH NEEDS ASSESSMENT GIVES INFORMATION TO HEALTH CARE PROVIDERS TO MAKE DECISIONS AND COMMIT RESOURCES TO AREAS OF GREATEST NEED, MAKING THE GREATEST IMPACT ON COMMUNITY HEALTH STATUS. THIS ASSESSMENT INCORPORATES DATA FROM WITHIN THE COMMUNITY, SUCH AS INDIVIDUALS SERVED AND HEALTH ORGANIZATIONS, AS WELL AS VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA TO DEVELOP A TAILORED PLAN WHICH TARGETS THE NEEDS OF THE COUNTY.METHODS AN ASSESSMENT TEAM COMPRISED OF MCLEOD HEALTH'S COMMUNITY HEALTH AND COMMUNICATION AND PUBLIC INFORMATION STAFF REVIEWED LITERATURE, DATA AND PUBLICATIONS FROM PUBLIC SOURCES. MEMBERS OF THE ASSESSMENT TEAM REPRESENTED EACH OF THE SEVEN ACUTE CARE HOSPITAL FACILITIES WITHIN MCLEOD HEALTH AND WERE ASSIGNED TO COLLECT DATA THAT REPRESENTED INDICATORS OF COMMUNITY HEALTH STATUS OR ITS SOCIOECONOMIC DETERMINANTS. THEREFORE, FOCUS WAS PLACED ON IDENTIFYING LOCALLY APPROPRIATE INDICATORS, BENCHMARKS, AND PERTINENT HEALTH ISSUES. PRE-EXISTING DATABASES CONTAINING LOCAL, STATE AND NATIONAL HEALTH AND BEHAVIOR DATA WERE USED FOR COMPARISONS WHEN POSSIBLE. DATA COLLECTION WAS LIMITED TO THE MOST RECENT PUBLICLY AVAILABLE RESOURCES AND SOME PRIMARY DATA FROM QUALITATIVE AND QUANTITATIVE INVESTIGATION. AS A RESULT, THIS DOCUMENT PORTRAYS A PARTIAL PICTURE OF THE HEALTH STATUS OF THE COMMUNITY SERVED. DATA ANALYSIS INCLUDED DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH DETERMINANT MEASURES.DATA ANALYSIS INCLUDED DEMOGRAPHIC, SOCIOECONOMIC AND HEALTH DETERMINANT MEASURES. WHEN POSSIBLE, DATA ALSO WAS ANALYZED ACCORDING TO AGE, GENDER AND/OR RACE TO OFFER INSIGHT INTO HEALTH DISPARITIES THAT MAY AFFECT SPECIFIC SUBGROUPS IN THE COMMUNITY. A SUMMARY OF COUNTY DATA IS REFLECTED AS A COMPARISON TO STATE AND NATIONAL DATA WHEN AVAILABLE TO INDICATE COMMUNITY HEALTH CONCERNS.HEALTH DETERMINANTS AND DISPARITIES WHAT ARE THE DETERMINANTS OF HEALTH? HEALTH BEHAVIORS HAD THE MAJORITY OVERALL IMPACT ON FUTURE HEALTH OUTCOMES (I.E., SMOKING, DIET, DRUG & ALCOHOL USE, PHYSICAL ACTIVITY, OTHER LIFESTYLE BEHAVIORS) AND ACCOUNT FOR 40% OF CAUSES FOR PREMATURE DEATH. GENETIC PREDISPOSITION IS RESPONSIBLE FOR 30%, SOCIAL AND ENVIRONMENTAL CIRCUMSTANCES 20%, AND HEALTH CARE FOR ONLY 10% (I.E., ACCESS TO PHYSICIAN AND OTHER HEALTH SERVICES) OF HEALTH RISK FOR PREMATURE DEATH.INDIVIDUAL BEHAVIORAL DETERMINANTS (40%) EXAMPLES: -DIET -PHYSICAL ACTIVITY -ALCOHOL, CIGARETTE, AND OTHER DRUG USE -HAND WASHING GENETIC DETERMINANTS (30%) EXAMPLES: -AGE -SEX -HIV STATUS-INHERITED CONDITIONS, SUCH AS SICKLE-CELL ANEMIA, HEMOPHILIA, AND CYSTIC FIBROSIS-CARRYING THE BRCA1 OR BRCA2 GENE, WHICH INCREASES RISK FOR BREAST AND OVARIAN CANCER -FAMILY HISTORY OF HEART DISEASE, CANCER, ETC. SOCIAL AND ENVIRONMENTAL DETERMINANTS (20%) EXAMPLES OF SOCIAL DETERMINANTS: -AVAILABILITY OF RESOURCES TO MEET DAILY NEEDS, SUCH AS EDUCATIONAL AND JOB OPPORTUNITIES, LIVING WAGES, OR HEALTHFUL FOODS -SOCIAL NORMS AND ATTITUDES, SUCH AS DISCRIMINATION -EXPOSURE TO CRIME, VIOLENCE, AND SOCIAL DISORDER, SUCH AS THE PRESENCE OF TRASH -SOCIAL SUPPORT AND SOCIAL INTERACTIONS SOCIOECONOMIC CONDITIONS, SUCH AS CONCENTRATED POVERTY-QUALITY SCHOOLS-TRANSPORTATION OPTIONS-PUBLIC SAFETYEXAMPLES OF ENVIRONMENTAL DETERMINANTS: -QUALITY OF FOOD, WATER, AND AIR -WORKSITES, SCHOOLS, AND RECREATIONAL SETTINGS -HOUSING, HOMES, AND NEIGHBORHOODS -EXPOSURE TO TOXIC SUBSTANCES AND OTHER PHYSICAL HAZARDS-PHYSICAL BARRIERS, ESPECIALLY FOR PEOPLE WITH DISABILITIESHEALTH CARE DETERMINANTS (10%) EXAMPLES: -QUALITY, AFFORDABILITY, AND AVAILABILITY OF SERVICES -LACK OF INSURANCE COVERAGE -LIMITED LANGUAGE ACCESS WHAT ARE HEALTH DISPARITIES?""HEALTH DISPARITY"" REFERS TO A HIGHER BURDEN OF ILLNESS, INJURY, DISABILITY, OR MORTALITY EXPERIENCED BY ONE POPULATION GROUP RELATIVE TO ANOTHER GROUP. HEALTH DISPARITIES CAN INVOLVE THE MEDICAL CARE DIFFERENCES BETWEEN GROUPS IN HEALTH INSURANCE COVERAGE, ACCESS TO CARE, AND QUALITY OF CARE. WHILE DISPARITIES ARE COMMONLY VIEWED THROUGH THE LENS OF RACE AND ETHNICITY, THEY OCCUR ACROSS MANY DIMENSIONS, INCLUDING SOCIOECONOMIC STATUS, AGE, LOCATION, GENDER, AND DISABILITY STATUS. POOR HEALTH STATUS IS OFTEN LINKED WITH PEOPLE WITHOUT HEALTH INSURANCE, THOSE WHO HAVE POOR ACCESS OF CARE (I.E., LIMITED TRANSPORTATION), LOWER SOCIOECONOMIC STATUS, LOWER EDUCATION OBTAINMENT, AND THOSE AMONG RACIAL MINORITY GROUPS. BEYOND THE PROVISION OF HEALTH CARE SERVICES, ELIMINATING HEALTH DISPARITIES WILL NECESSITATE BEHAVIORAL, ENVIRONMENTAL, AND SOCIAL-LEVEL APPROACHES TO ADDRESS ISSUES SUCH AS INSUFFICIENT EDUCATION, INADEQUATE HOUSING, EXPOSURE TO VIOLENCE, AND LIMITED OPPORTUNITIES TO EARN A LIVABLE WAGE. HEALTH DISPARITIES HAVE PERSISTED ACROSS THE NATION AND HAVE BEEN DOCUMENTED FOR MANY DECADES AND, DESPITE OVERALL IMPROVEMENTS IN POPULATION HEALTH OVER TIME, MANY DISPARITIES HAVE PERSISTED AND, IN SOME CASES, WIDENED. MOREOVER, ECONOMIC DOWNTURNS CONTRIBUTED TO A FURTHER WIDENING OF DISPARITIES. THE COMMUNITY HEALTH NEEDS ASSESSMENT ATTEMPTS TO IDENTIFY AND QUANTIFY THE HEALTH DISPARITIES WITHIN A DEFINED COUNTY POPULATION THAT ARE AT DISPROPORTIONATELY HIGHER IN INCIDENCE OF DISEASE, DISABILITY, OR AT RISK OF EXPERIENCING WORSE HEALTH OUTCOMES. WITHIN THESE IDENTIFIED DISPARITIES AND AVAILABILITY OF HEALTH RESOURCES, GAPS CAN BE IDENTIFIED AND PRIORITIZED BASED ON NEED SO THAT HEALTH RESOURCES CAN BE TARGETED. PLANNING INITIATIVES TO ADDRESS COMMUNITY HEALTH NEEDS TAKE IN CONSIDERATION THE EXISTING INITIATIVES, THE AVAILABLE RESOURCES THAT WE ARE AWARE OF, AND WHERE FUTURE IMPROVEMENTS CAN BE ANTICIPATED TO MAKE MEANINGFUL IMPACT ON IMPROVING COMMUNITY HEALTH."

PART V, SECTION B, LINE 5 (CONT.):
"WHAT ARE KEY INITIATIVES TO REDUCE DISPARITIES?IN 2010, THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) ESTABLISHED A VISION OF, ""A NATION FREE OF DISPARITIES IN HEALTH AND HEALTH CARE, AND SET OUT A SERIES OF PRIORITIES, STRATEGIES, ACTIONS, AND GOALS TO ACHIEVE THIS VISION. STATES, LOCAL COMMUNITIES, PRIVATE ORGANIZATIONS, AND PROVIDERS ALSO ARE ENGAGED IN EFFORTS TO REDUCE HEALTH DISPARITIES. FEDERAL, STATE, AND LOCAL AGENCIES AND PROGRAMS WORK ALONG WITH LOCAL HOSPITALS, OFTEN IN COOPERATION, TO PROVIDE ACCESS TO NEEDED HEALTH CARE SERVICES. WITHIN CONSTRAINTS OF LIMITED RESOURCES, EACH OF THESE ENTITIES GENERALLY TARGET POPULATIONS WITH SPECIFIC SERVICES OFFERED WITHIN THE COUNTY. THIS STUDY ATTEMPTS TO INCORPORATE THEIR INPUT INTO DETERMINING THE PRIORITIES AMONG HEALTH DISPARITIES AND LOOK FOR OPPORTUNITIES FOR COLLABORATION. PREVENTATIVE CARE PREVENTATIVE CARE INCLUDES MEDICAL SERVICES SUCH AS SCREENINGS, IMMUNIZATIONS, COUNSELING, AND PREVENTATIVE MEDICATIONS INTENDED TO PREVENT ILLNESS OR DETECT DISEASES EARLY BEFORE SYMPTOMS ARE DEVELOPED. WITH EARLY DETECTION, DISEASES CAN BE TREATED MORE EFFECTIVELY, REDUCING POTENTIAL COMPLICATIONS OF DISEASE OR EVEN DEATH. REGULAR PREVENTATIVE CARE CAN IMPROVE INDIVIDUAL HEALTH AND THE OVERALL HEALTH OF A COMMUNITY. VARIOUS PREVENTATIVE CARE GUIDELINES AND RECOMMENDATIONS ARE PUBLISHED BY DIFFERENT PROFESSIONAL ORGANIZATIONS, BUT MOST HEALTH CARE PROFESSIONALS REFER TO THE RECOMMENDATIONS PUBLISHED BY THE UNITED STATES PREVENTATIVE SERVICES TASK FORCE (USPSTF) AS A RELIABLE, WIDELY ACCEPTED, AND EVIDENCE-BASED GUIDE. THE USPSTF IS AN INDEPENDENT, VOLUNTEER PANEL OF NATIONAL EXPERTS IN PREVENTION AND EVIDENCE-BASED MEDICINE. THEIR RECOMMENDATIONS ARE BASED ON A RIGOROUS REVIEW OF EXISTING PEER-REVIEWED DATA. THE USPSTF ASSIGNS A LETTER GRADE (A, B, C, D, OR I) TO EACH RECOMMENDATION BASED ON THE STRENGTH OF EVIDENCE AND THE BALANCE OF BENEFITS AND POTENTIAL HARMS OF THE PREVENTATIVE SERVICE. GRADE A AND GRADE B PREVENTATIVE SERVICES ARE RECOMMENDED BECAUSE THE USPSTF HAS DETERMINED A HIGH OR MODERATE CERTAINTY THAT THE NET BENEFIT IS MODERATE OR SUBSTANTIAL. USPSTF PREVENTATIVE CARE RECOMMENDATIONS APPLY TO PEOPLE WHO HAVE NO SIGNS OR SYMPTOMS OF A SPECIFIC DISEASE OR CONDITION. USPSTF RECOMMENDATIONS ARE EVIDENCE-BASED GUIDELINES THAT HELP PHYSICIANS IDENTIFY APPROPRIATE PREVENTATIVE SERVICES FOR CERTAIN PATIENT POPULATIONS, BUT PREVENTATIVE CARE SHOULD BE TAILORED FOR EACH PATIENT DEPENDING ON INDIVIDUAL CIRCUMSTANCES. DETERMINING APPROPRIATE PREVENTATIVE SERVICES FOR AN INDIVIDUAL PATIENT REQUIRES A ONE-ON-ONE DISCUSSION BETWEEN THE PHYSICIAN AND PATIENT. A COMPLETE LIST OF USPSTF PREVENTIVE CARE GUIDELINES, INCLUDING A AND B GRADE RECOMMENDATIONS, CAN BE FOUND AT WWW.USPREVENTIVESERVICESTASKFORCE.ORG. COMMUNITY DEFINED FOR THIS ASSESSMENTTHE COMMUNITY FOR THIS CHNA WAS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF MCLEOD DILLON INPATIENT AND OUTPATIENT HOSPITAL DATA. THE STUDY AREA FOR THIS ASSESSMENT IS DEFINED AS DILLON COUNTY WHICH REPRESENTS THE MAJORITY OF PATIENTS SERVED.DEMOGRAPHICS CURRENT POPULATION DEMOGRAPHICS AND CHANGES IN DEMOGRAPHIC COMPOSITION OVER TIME PLAY A DETERMINING ROLE IN THE TYPES OF HEALTH AND SOCIAL SERVICES NEEDED BY COMMUNITIES. TOTAL POPULATION A TOTAL OF 30,473 PEOPLE LIVE IN THE 405.07 SQUARE MILE REPORT AREA DEFINED FOR THIS ASSESSMENT ACCORDING TO THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY 2016-2020 FIVE-YEAR ESTIMATES. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 75 PERSONS PER SQUARE MILE, IS LESS THAN THE NATIONAL AVERAGE POPULATION DENSITY OF 92 PERSONS PER SQUARE MILE.TOTAL POPULATION CHANGE, 2010-2020ACCORDING TO THE UNITED STATES CENSUS BUREAU DECENNIAL CENSUS, BETWEEN 2010 AND 2020 THE POPULATION IN THE REPORT AREA FELL BY 3,770 PERSONS, A CHANGE OF -11.76%. A SIGNIFICANT POSITIVE OR NEGATIVE SHIFT IN TOTAL POPULATION OVER TIME IMPACTS HEALTHCARE PROVIDERS AND THE UTILIZATION OF COMMUNITY RESOURCES.POPULATION WITH LIMITED ENGLISH PROFICIENCY THIS INDICATOR REPORTS THE PERCENTAGE OF THE POPULATION AGE 5 AND OLDER WHO SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME AND SPEAK ENGLISH LESS THAN ""VERY WELL"". THIS INDICATOR IS RELEVANT BECAUSE AN INABILITY TO SPEAK ENGLISH WELL CREATES BARRIERS TO HEALTHCARE ACCESS, PROVIDER COMMUNICATIONS, AND HEALTH LITERACY/EDUCATION. OF THE 28,430 TOTAL POPULATION AGE 5 AND OLDER IN THE REPORT AREA, 288 OR 1.01% HAVE LIMITED ENGLISH PROFICIENCY.INCOME AND ECONOMICSECONOMIC AND SOCIAL INSECURITY OFTEN ARE ASSOCIATED WITH POOR HEALTH. POVERTY, UNEMPLOYMENT, AND LACK OF EDUCATIONAL ACHIEVEMENT AFFECT ACCESS TO CARE AND A COMMUNITY'S ABILITY TO ENGAGE IN HEALTHY BEHAVIORS. WITHOUT A NETWORK OF SUPPORT AND A SAFE COMMUNITY, FAMILIES CANNOT THRIVE. ENSURING ACCESS TO SOCIAL AND ECONOMIC RESOURCES PROVIDES A FOUNDATION FOR A HEALTHY COMMUNITY. INCOME - MEDIAN HOUSEHOLD INCOME THIS INDICATOR REPORTS MEDIAN HOUSEHOLD INCOME BASED ON THE LATEST 5-YEAR AMERICAN COMMUNITY SURVEY ESTIMATES. THIS INCLUDES THE INCOME OF THE HOUSEHOLDER AND ALL OTHER INDIVIDUALS 15 YEARS OLD AND OVER IN THE HOUSEHOLD, WHETHER THEY ARE RELATED TO THE HOUSEHOLDER OR NOT. BECAUSE MANY HOUSEHOLDS CONSIST OF ONLY ONE PERSON, AVERAGE HOUSEHOLD INCOME IS USUALLY LESS THAN AVERAGE FAMILY INCOME. THERE ARE 11,147 HOUSEHOLDS IN THE REPORT AREA, WITH AN AVERAGE INCOME OF $50,278 AND MEDIAN INCOME OF $36,429.POVERTY - POPULATION BELOW 100% FPL POVERTY IS CONSIDERED A KEY DRIVER OF HEALTH STATUS. WITHIN THE REPORT AREA 30.2% OR 9,070 INDIVIDUALS FOR WHOM POVERTY STATUS IS DETERMINED ARE LIVING IN HOUSEHOLDS WITH INCOME BELOW THE FEDERAL POVERTY LEVEL (FPL). THIS INDICATOR IS RELEVANT BECAUSE POVERTY CREATES BARRIERS TO ACCESS INCLUDING HEALTH SERVICES, HEALTHY FOOD, AND OTHER NECESSITIES THAT CONTRIBUTE TO POOR HEALTH STATUS.EDUCATION THIS CATEGORY CONTAINS INDICATORS THAT DESCRIBE THE EDUCATION SYSTEM AND THE EDUCATIONAL OUTCOMES OF REPORT AREA POPULATIONS. EDUCATION METRICS CAN BE USED TO DESCRIBE VARIATION IN POPULATION ACCESS, PROFICIENCY, AND ATTAINMENT THROUGHOUT THE EDUCATION SYSTEM, FROM ACCESS TO PRE-KINDERGARTEN THROUGH ADVANCED DEGREE ATTAINMENT. THESE INDICATORS ARE IMPORTANT BECAUSE EDUCATION IS CLOSELY TIED TO HEALTH OUTCOMES AND ECONOMIC OPPORTUNITY. ATTAINMENT - BACHELOR'S DEGREE OR HIGHER12.95% OF THE POPULATION AGED 25 AND OLDER, OR 2,622 HAVE OBTAINED A BACHELOR'S LEVEL DEGREE OR HIGHER. THIS INDICATOR IS RELEVANT BECAUSE EDUCATIONAL ATTAINMENT HAS BEEN LINKED TO POSITIVE HEALTH OUTCOMES.ATTAINMENT - HIGH SCHOOL GRADUATION RATE THE ADJUSTED COHORT GRADUATION RATE (ACGR) IS A GRADUATION METRIC THAT FOLLOWS A ""COHORT"" OF FIRST-TIME 9TH GRADERS IN A PARTICULAR SCHOOL YEAR AND ADJUST THIS NUMBER BY ADDING ANY STUDENTS WHO TRANSFER INTO THE COHORT AFTER 9TH GRADE AND SUBTRACTING ANY STUDENTS WHO TRANSFER OUT, EMIGRATE TO ANOTHER COUNTRY, OR PASS AWAY. THE ACGR IS THE PERCENTAGE OF THE STUDENTS IN THIS COHORT WHO GRADUATE WITHIN FOUR YEARS. IN THE REPORT AREA, THE ADJUSTED COHORT GRADUATION RATE WAS 84.1% DURING THE MOST RECENTLY REPORTED SCHOOL YEAR. STUDENTS IN THE REPORT AREA PERFORMED WORSE THAN THE STATE, WHICH HAD AN ACGR OF 85.3%.OTHER SOCIAL & ECONOMIC FACTORSECONOMIC AND SOCIAL INSECURITY OFTEN ARE ASSOCIATED WITH POOR HEALTH. POVERTY, UNEMPLOYMENT, AND LACK OF EDUCATIONAL ACHIEVEMENT AFFECT ACCESS TO CARE AND A COMMUNITY'S ABILITY TO ENGAGE IN HEALTHY BEHAVIORS. WITHOUT A NETWORK OF SUPPORT AND A SAFE COMMUNITY, FAMILIES CANNOT THRIVE. ENSURING ACCESS TO SOCIAL AND ECONOMIC RESOURCES PROVIDES A FOUNDATION FOR A HEALTHY COMMUNITY. INSURANCE - UNINSURED POPULATION (ACS) THE LACK OF HEALTH INSURANCE IS CONSIDERED A KEY DRIVER OF HEALTH STATUS. IN THE REPORT AREA 13.08% OF THE TOTAL CIVILIAN NON-INSTITUTIONALIZED POPULATION ARE WITHOUT HEALTH INSURANCE COVERAGE. THE RATE OF UNINSURED PERSONS IN THE REPORT AREA IS GREATER THAN THE STATE AVERAGE OF 10.39%. THIS INDICATOR IS RELEVANT BECAUSE LACK OF INSURANCE IS A PRIMARY BARRIER TO HEALTHCARE ACCESS INCLUDING REGULAR PRIMARY CARE, SPECIALTY CARE, AND OTHER HEALTH SERVICES THAT CONTRIBUTES TO POOR HEALTH STATUS.PHYSICAL ENVIRONMENT A COMMUNITY'S HEALTH ALSO IS AFFECTED BY THE PHYSICAL ENVIRONMENT. A SAFE, CLEAN ENVIRONMENT THAT PROVIDES ACCESS TO HEALTHY FOOD AND RECREATIONAL OPPORTUNITIES IS IMPORTANT TO MAINTAINING AND IMPROVING COMMUNITY HEALTH.AIR AND WATER QUALITY PARTICULATE MATTER 2.5THIS INDICATOR REPORTS THE PERCENTAGE OF DAYS WITH PARTICULATE MATTER 2.5 LEVELS ABOVE THE NATIONAL AMBIENT AIR QUALITY STANDARD (35 MICROGRAMS PER CUBIC METER) PER YEAR, CALCULATED USING DATA COLLECTED BY MONITORING STATIONS AND MODELED TO INCLUDE COUNTIES WHERE NO MONITORING STATIONS OCCUR. THIS INDICATOR IS RELEVANT BECAUSE POOR AIR QUALITY CONTRIBUTES TO RESPIRATORY ISSUES AND OVERALL POOR HEALTH."

FOOD ENVIRONMENT - FOOD DESERT CENSUS TRACTS
"THIS INDICATOR REPORTS THE NUMBER OF NEIGHBORHOODS IN THE REPORT AREA THAT ARE WITHIN FOOD DESERTS. THE USDA FOOD ACCESS RESEARCH ATLAS DEFINES A FOOD DESERT AS ANY NEIGHBORHOOD THAT LACKS HEALTHY FOOD SOURCES DUE TO INCOME LEVEL, DISTANCE TO SUPERMARKETS, OR VEHICLE ACCESS. THE REPORT AREA HAS A POPULATION OF 5,247 LIVING IN FOOD DESERTS AND A TOTAL OF 1 CENSUS TRACT CLASSIFIED AS FOOD DESERTS BY THE USDA.FOOD ENVIRONMENT - GROCERY STORES HEALTHY DIETARY BEHAVIORS ARE SUPPORTED BY ACCESS TO HEALTHY FOODS, AND GROCERY STORES ARE A MAJOR PROVIDER OF THESE FOODS. THERE ARE 7 GROCERY ESTABLISHMENTS IN THE REPORT AREA, A RATE OF 24.74 PER 100,000 POPULATION. GROCERY STORES ARE DEFINED AS SUPERMARKETS AND SMALLER GROCERY STORES PRIMARILY ENGAGED IN RETAILING A GENERAL LINE OF FOOD, SUCH AS CANNED AND FROZEN FOODS; FRESH FRUITS AND VEGETABLES; AND FRESH AND PREPARED MEATS, FISH, AND POULTRY. DELICATESSEN-TYPE ESTABLISHMENTS ARE ALSO INCLUDED. CONVENIENCE STORES AND LARGE GENERAL MERCHANDISE STORES THAT ALSO RETAIL FOOD, SUCH AS SUPERCENTERS AND WAREHOUSE CLUB STORES, ARE EXCLUDED.FOOD ENVIRONMENT - SNAP-AUTHORIZED FOOD STORES THIS INDICATOR REPORTS THE NUMBER OF SNAP-AUTHORIZED FOOD STORES AS A RATE PER 10,000 POPULATION. SNAP-AUTHORIZED STORES INCLUDE GROCERY STORES AS WELL AS SUPERCENTERS, SPECIALTY FOOD STORES, AND CONVENIENCE STORES THAT ARE AUTHORIZED TO ACCEPT SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM) BENEFITS. THE REPORT AREA CONTAINS A TOTAL OF 45 SNAP-AUTHORIZED RETAILERS WITH A RATE OF 14.82.CLINICAL CARE AND PREVENTION A LACK OF ACCESS TO CARE PRESENTS BARRIERS TO GOOD HEALTH. SUPPLY, ACCESSIBILITY OF FACILITIES AND PHYSICIANS, THE RATE OF UNINSURED, FINANCIAL HARDSHIP, TRANSPORTATION BARRIERS, CULTURAL COMPETENCY, AND COVERAGE LIMITATIONS AFFECT ACCESS. RATES OF MORBIDITY, MORTALITY, AND EMERGENCY HOSPITALIZATIONS CAN BE REDUCED IF COMMUNITY RESIDENTS ACCESS SERVICES SUCH AS HEALTH SCREENINGS, ROUTINE TESTS, AND VACCINATIONS. PREVENTION INDICATORS CAN CALL ATTENTION TO A LACK OF ACCESS OR KNOWLEDGE REGARDING ONE OR MORE HEALTH ISSUES AND CAN INFORM PROGRAM INTERVENTIONS.CANCER SCREENING - MAMMOGRAM (MEDICARE) THIS INDICATOR REPORTS THE PERCENTAGE OF FEMALE MEDICARE BENEFICIARIES AGE 35 AND OLDER WHO HAD A MAMMOGRAM IN THE MOST RECENT REPORTING YEAR. THE AMERICAN CANCER SOCIETY RECOMMENDS THAT WOMEN AGE 45 TO 54 SHOULD GET A MAMMOGRAM EVERY YEAR, AND WOMEN AGE 55 AND OLDER SHOULD GET A MAMMOGRAM EVERY OTHER YEAR. IN THE LATEST REPORTING PERIOD THERE WERE 6,371 MEDICARE BENEFICIARIES IN THE REPORT AREA, AND 33% OF FEMALE BENEFICIARIES AGE 35 OR OLDER HAD A MAMMOGRAM IN THE PAST YEAR. THE RATE IN THE REPORT AREA WAS LOWER THAN THE STATE RATE OF 38% DURING THE SAME TIME PERIOD.DIABETES MANAGEMENT - HEMOGLOBIN A1C TEST THIS INDICATOR REPORTS THE PERCENTAGE OF DIABETIC MEDICARE PATIENTS WHO HAVE HAD A HEMOGLOBIN A1C (HA1C) TEST, A BLOOD TEST WHICH MEASURES BLOOD SUGAR LEVELS, ADMINISTERED BY A HEALTH CARE PROFESSIONAL IN THE PAST YEAR. DATA IS OBTAINED FROM THE DARTMOUTH ATLAS DATA - SELECTED PRIMARY CARE ACCESS AND QUALITY MEASURES (2008-2019). THIS INDICATOR IS RELEVANT BECAUSE ENGAGING IN PREVENTIVE BEHAVIORS ALLOWS FOR EARLY DETECTION AND TREATMENT OF HEALTH PROBLEMS. THIS INDICATOR CAN ALSO HIGHLIGHT A LACK OF ACCESS TO PREVENTIVE CARE, A LACK OF HEALTH KNOWLEDGE, INSUFFICIENT PROVIDER OUTREACH, AND/OR SOCIAL BARRIERS PREVENTING UTILIZATION OF SERVICES. AS OF YEAR 2019, 532 OR 90.02% MEDICARE ENROLLEES WITH DIABETES HAVE HAD AN ANNUAL EXAM OUT OF 591 MEDICARE ENROLLEES WITH DIABETES IN THE REPORT AREA. HOSPITALIZATIONS - PREVENTABLE CONDITIONS THIS INDICATOR REPORTS THE PREVENTABLE HOSPITALIZATION RATE AMONG MEDICARE BENEFICIARIES FOR THE LATEST REPORTING PERIOD. PREVENTABLE HOSPITALIZATIONS INCLUDE HOSPITAL ADMISSIONS FOR ONE OR MORE OF THE FOLLOWING CONDITIONS: DIABETES WITH SHORT-TERM COMPLICATIONS, DIABETES WITH LONG-TERM COMPLICATIONS, UNCONTROLLED DIABETES WITHOUT COMPLICATIONS, DIABETES WITH LOWER EXTREMITY AMPUTATION, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, ASTHMA, HYPERTENSION, HEART FAILURE, BACTERIAL PNEUMONIA, OR URINARY TRACT INFECTION. RATES ARE PRESENTED PER 100,000 BENEFICIARIES. IN THE LATEST REPORTING PERIOD THERE WERE 6,371 MEDICARE BENEFICIARIES IN THE REPORT AREA. THE PREVENTABLE HOSPITALIZATION RATE WAS 3,281. THE RATE IN THE REPORT AREA WAS LOWER THAN THE STATE RATE OF 3,115 DURING THE SAME TIME PERIOD.HEALTH BEHAVIORS HEALTH BEHAVIORS SUCH AS POOR DIET, A LACK OF EXERCISE, AND SUBSTANCE ABUSE CONTRIBUTE TO POOR HEALTH STATUS.ALCOHOL - HEAVY ALCOHOL CONSUMPTIONIN THE REPORT AREA, 3,889, OR 17.01% ADULTS SELF-REPORT EXCESSIVE DRINKING IN THE LAST 30 DAYS, WHICH IS LESS THAN THE STATE RATE OF 21.69%. DATA FOR THIS INDICATOR WERE BASED ON SURVEY RESPONSES TO THE 2019 BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) ANNUAL SURVEY AND ARE USED FOR THE 2022 COUNTY HEALTH RANKINGS. EXCESSIVE DRINKING IS DEFINED AS THE PERCENTAGE OF THE POPULATION WHO REPORT AT LEAST ONE BINGE DRINKING EPISODE INVOLVING FIVE OR MORE DRINKS FOR MEN AND FOUR OR MORE FOR WOMEN OVER THE PAST 30 DAYS, OR HEAVY DRINKING INVOLVING MORE THAN TWO DRINKS PER DAY FOR MEN AND MORE THAN ONE PER DAY FOR WOMEN, OVER THE SAME TIME PERIOD. ALCOHOL USE IS A BEHAVIORAL HEALTH ISSUE THAT IS ALSO A RISK FACTOR FOR A NUMBER OF NEGATIVE HEALTH OUTCOMES, INCLUDING: PHYSICAL INJURIES RELATED TO MOTOR VEHICLE ACCIDENTS, STROKE, CHRONIC DISEASES SUCH AS HEART DISEASE AND CANCER, AND MENTAL HEALTH CONDITIONS SUCH AS DEPRESSION AND SUICIDE. THERE ARE A NUMBER OF EVIDENCE-BASED INTERVENTIONS THAT MAY REDUCE EXCESSIVE/BINGE DRINKING; EXAMPLES INCLUDE RAISING TAXES ON ALCOHOLIC BEVERAGES, RESTRICTING ACCESS TO ALCOHOL BY LIMITING DAYS AND HOURS OF RETAIL SALES, AND SCREENING AND COUNSELING FOR ALCOHOL ABUSE (CENTERS FOR DISEASE CONTROL AND PREVENTION, PREVENTING EXCESSIVE ALCOHOL USE, 2020). PHYSICAL INACTIVITY WITHIN THE REPORT AREA, 6,694 OR 29.5% OF ADULTS AGE 20 AND OLDER WHO SELF-REPORT NO ACTIVE LEISURE TIME, BASED ON THE QUESTION: ""DURING THE PAST MONTH, OTHER THAN YOUR REGULAR JOB, DID YOU PARTICIPATE IN ANY PHYSICAL ACTIVITIES OR EXERCISES SUCH AS RUNNING, CALISTHENICS, GOLF, GARDENING, OR WALKING FOR EXERCISE?"" THIS INDICATOR IS RELEVANT BECAUSE CURRENT BEHAVIORS ARE DETERMINANTS OF FUTURE HEALTH AND THIS INDICATOR MAY ILLUSTRATE A CAUSE OF SIGNIFICANT HEALTH ISSUES, SUCH AS OBESITY AND POOR CARDIOVASCULAR HEALTH. NOTE: IN 2021, THE CDC UPDATED THE METHODOLOGY USED TO PRODUCE ESTIMATES FOR THIS INDICATOR. ESTIMATED VALUES FOR PRIOR YEARS (2004 - 2017) HAVE BEEN UPDATED IN THIS PLATFORM TO ALLOW COMPARISON ACROSS YEARS. USE CAUTION WHEN COMPARING WITH SAVED ASSESSMENTS GENERATED PRIOR TO NOVEMBER 10, 2021.TOBACCO USAGE - CURRENT SMOKERS THIS INDICATOR REPORTS THE PERCENTAGE OF ADULTS AGE 18 AND OLDER WHO REPORT HAVING SMOKED AT LEAST 100 CIGARETTES IN THEIR LIFETIME AND CURRENTLY SMOKE EVERY DAY OR SOME DAYS. WITHIN THE REPORT AREA THERE ARE 25.3% OF ADULTS WHO HAVE SMOKED OR CURRENTLY SMOKE OUT OF THE TOTAL POPULATION.HEALTH OUTCOMES MEASURING MORBIDITY AND MORTALITY RATES ALLOWS LINKAGES TO BE ASSESSED BETWEEN SOCIAL DETERMINANTS OF HEALTH AND OUTCOMES. BY COMPARING, FOR EXAMPLE, THE PREVALENCE OF CERTAIN CHRONIC DISEASES TO INDICATORS IN OTHER CATEGORIES (E.G., POOR DIET AND EXERCISE) WITH OUTCOMES (E.G., HIGH RATES OF OBESITY AND DIABETES), VARIOUS CAUSAL RELATIONSHIPS MAY EMERGE, ALLOWING A BETTER UNDERSTANDING OF HOW CERTAIN COMMUNITY HEALTH NEEDS MAY BE ADDRESSED. CANCER INCIDENCE - ALL SITES THIS INDICATOR REPORTS THE AGE ADJUSTED INCIDENCE RATE (CASES PER 100,000 POPULATION PER YEAR) OF CANCER (ALL SITES) ADJUSTED TO 2000 U.S. STANDARD POPULATION AGE GROUPS (UNDER AGE 1, 1-4, 5- 9, ..., 80-84, 85 AND OLDER). WITHIN THE REPORT AREA, THERE WERE 169 NEW CASES OF CANCER REPORTED. THIS MEANS THERE IS A RATE OF 446.4 FOR EVERY 100,000 TOTAL POPULATION.CHRONIC CONDITIONS - ASTHMA (MEDICARE POPULATION) THIS INDICATOR REPORTS THE NUMBER AND PERCENTAGE OF THE MEDICARE FEE-FOR-SERVICE POPULATION WITH ASTHMA. DATA IS BASED UPON MEDICARE ADMINISTRATIVE ENROLLMENT AND CLAIMS DATA FOR MEDICARE BENEFICIARIES ENROLLED IN THE FEE-FOR-SERVICE PROGRAM. WITHIN THE REPORT AREA, THERE WERE 195 BENEFICIARIES WITH ASTHMA BASED ON ADMINISTRATIVE CLAIMS DATA IN THE LATEST REPORT YEAR. THIS REPRESENTS 4.5% OF THE TOTAL MEDICARE FEE-FOR-SERVICE BENEFICIARIES."

CHRONIC CONDITIONS - DIABETES (ADULT)
THIS INDICATOR REPORTS THE NUMBER AND PERCENTAGE OF ADULTS AGE 20 AND OLDER WHO HAVE EVER BEEN TOLD BY A DOCTOR THAT THEY HAVE DIABETES. THIS INDICATOR IS RELEVANT BECAUSE DIABETES IS A PREVALENT PROBLEM IN THE U.S.; IT MAY INDICATE AN UNHEALTHY LIFESTYLE AND PUTS INDIVIDUALS AT RISK FOR FURTHER HEALTH ISSUES. WITHIN THE REPORT AREA, 2,779 OF ADULTS AGE 20 AND OLDER HAVE DIABETES. THIS REPRESENTS 10.8% OF THE TOTAL SURVEY POPULATION. NOTE: IN 2021, THE CDC UPDATED THE METHODOLOGY USED TO PRODUCE ESTIMATES FOR THIS INDICATOR. ESTIMATED VALUES FOR PRIOR YEARS (2004 - 2017) HAVE BEEN UPDATED IN THIS PLATFORM TO ALLOW COMPARISON ACROSS YEARS. USE CAUTION WHEN COMPARING WITH SAVED ASSESSMENTS GENERATED PRIOR TO NOVEMBER 10, 2021.CHRONIC CONDITIONS - DIABETES (MEDICARE POPULATION) THIS INDICATOR REPORTS THE NUMBER AND PERCENTAGE OF THE MEDICARE FEE-FOR-SERVICE POPULATION WITH DIABETES. DATA IS BASED UPON MEDICARE ADMINISTRATIVE ENROLLMENT AND CLAIMS DATA FOR MEDICARE BENEFICIARIES ENROLLED IN THE FEE-FOR-SERVICE PROGRAM. WITHIN THE REPORT AREA, THERE WERE 1,527 BENEFICIARIES WITH DIABETES BASED ON ADMINISTRATIVE CLAIMS DATA IN THE LATEST REPORT YEAR. THIS REPRESENTS 35.2% OF THE TOTAL MEDICARE FEE-FOR-SERVICE BENEFICIARIES.CHRONIC CONDITIONS - HEART DISEASE (MEDICARE POPULATION) THIS INDICATOR REPORTS THE NUMBER AND PERCENTAGE OF THE MEDICARE FEE-FOR-SERVICE POPULATION WITH ISCHEMIC HEART DISEASE. DATA IS BASED UPON MEDICARE ADMINISTRATIVE ENROLLMENT AND CLAIMS DATA FOR MEDICARE BENEFICIARIES ENROLLED IN THE FEE-FOR-SERVICE PROGRAM. WITHIN THE REPORT AREA, THERE WERE 1,142 BENEFICIARIES WITH ISCHEMIC HEART DISEASE BASED ON ADMINISTRATIVE CLAIMS DATA IN THE LATEST REPORT YEAR. THIS REPRESENTS 26.4% OF THE TOTAL MEDICARE FEE-FOR-SERVICE BENEFICIARIES.CHRONIC CONDITIONS - HIGH BLOOD PRESSURE (MEDICARE POPULATION) THIS INDICATOR REPORTS THE NUMBER AND PERCENTAGE OF THE MEDICARE FEE-FOR-SERVICE POPULATION WITH HYPERTENSION (HIGH BLOOD PRESSURE). DATA IS BASED UPON MEDICARE ADMINISTRATIVE ENROLLMENT AND CLAIMS DATA FOR MEDICARE BENEFICIARIES ENROLLED IN THE FEE-FOR-SERVICE PROGRAM. WITHIN THE REPORT AREA, THERE WERE 3,000 BENEFICIARIES WITH HYPERTENSION (HIGH BLOOD PRESSURE) BASED ON ADMINISTRATIVE CLAIMS DATA IN THE LATEST REPORT YEAR. THIS REPRESENTS 69.3% OF THE TOTAL MEDICARE FEE-FOR-SERVICE BENEFICIARIESLOW BIRTH WEIGHT (CDC)THIS INDICATOR REPORTS THE PERCENTAGE OF LIVE BIRTHS WHERE THE INFANT WEIGHED LESS THAN 2,500 GRAMS (APPROXIMATELY 5 LBS., 8 OZ.). THIS DATA IS REPORTED FOR A 7-YEAR AGGREGATED TIME PERIOD. DATA WAS FROM THE NATIONAL CENTER FOR HEALTH STATISTICS - NATALITY FILES (2014-2020) AND ARE USED FOR THE 2022 COUNTY HEALTH RANKINGS. WITHIN THE REPORT AREA, THERE WERE 347 INFANTS BORN WITH LOW BIRTH WEIGHT. THIS REPRESENTS 12.2% OF THE TOTAL LIVE BIRTHS. NOTE: DATA IS SUPPRESSED FOR COUNTIES WITH FEWER THAN 10 LOW BIRTHWEIGHT BIRTHS IN THE REPORTING PERIOD.MORTALITY - CANCER THIS INDICATOR REPORTS THE 2016-2020 FIVE-YEAR AVERAGE RATE OF DEATH DUE TO MALIGNANT NEOPLASM (CANCER) PER 100,000 POPULATION. FIGURES ARE REPORTED AS CRUDE RATES, AND AS RATES AGE-ADJUSTED TO YEAR 2000 STANDARD. RATES ARE RE-SUMMARIZED FOR REPORT AREAS FROM COUNTY LEVEL DATA, ONLY WHERE DATA IS AVAILABLE. THIS INDICATOR IS RELEVANT BECAUSE CANCER IS A LEADING CAUSE OF DEATH IN THE UNITED STATES. WITHIN THE REPORT AREA, THERE IS A TOTAL OF 344 DEATHS DUE TO CANCER. THIS REPRESENTS AN AGE-ADJUSTED DEATH RATE OF 177.1 PER EVERY 100,000 TOTAL POPULATION. NOTE: DATA IS SUPPRESSED FOR COUNTIES WITH FEWER THAN 20 DEATHS IN THE TIME FRAME.SPECIAL TOPICS - COVID-19- CONFIRMED CASESTHIS INDICATOR REPORTS INCIDENCE RATE OF CONFIRMED COVID-19 CASES PER 100,000 POPULATION. DATA FOR THIS INDICATOR IS UPDATED DAILY AND DERIVED FROM THE JOHNS HOPKINS UNIVERSITY DATA FEED. IN THE REPORT AREA, THERE HAVE BEEN 10,465 TOTAL CONFIRMED CASES OF COVID-19. THE RATE OF CONFIRMED CASES IS 34,200.46 PER 100,000 POPULATION, WHICH IS GREATER THAN THE STATE AVERAGE OF 31,572.09. DATA IS CURRENT AS OF 08/04/2022.COVID-19 MORTALITYIN THE REPORT AREA, THERE HAVE BEEN 146 TOTAL DEATHS AMONG PATIENTS WITH CONFIRMED CASES OF THE CORONAVIRUS DISEASE COVID-19. THE MORTALITY RATE IN THE REPORT AREA IS 477.14 PER 100,000 POPULATION, WHICH IS HIGHER THAN THE STATE AVERAGE OF 357.82. DATA IS CURRENT AS OF 08/04/2022.PRIORITY ISSUES AND IMPLEMENTATION PLAN MCLEOD HEALTH UTILIZES RESOURCES SUCH AS U.S. DEPARTMENT OF HEALTH AND SOUTH CAROLINA STATE HEALTH IMPROVEMENT PLAN WHICH SERVES TO GUIDE HEALTH PROMOTION AND DISEASE PREVENTION EFFORTS. THE SOUTH CAROLINA STATE HEALTH IMPROVEMENT PLAN (SHIP) LAYS OUT THE FOUNDATION FOR GIVING EVERYONE A CHANCE TO LIVE A HEALTHY LIFE. IT IS A CALL TO ACTION FOR SOUTH CAROLINIANS TO TAKE DATA-DRIVEN, EVIDENCE-BASED STEPS TO ADVANCE THE HEALTH AND WELL-BEING OF ALL SOUTH CAROLINIANS. THE PLAN HIGHLIGHTS GOALS AND STRATEGIES ON WHICH COMMUNITIES CAN FOCUS SO THE STATE CAN MAKE MEASURABLE HEALTH IMPROVEMENT BY 2023. ATTENTION IS FOCUSED ON DETERMINANTS THAT AFFECT THE PUBLIC'S HEALTH THAT CONTRIBUTE TO HEALTH DISPARITIES BY ADDRESSING IDENTIFIED NEEDS THROUGH EDUCATION, PREVENTION, TARGETED INITIATIVES VALIDATED THROUGH RESEARCH, AND THE DELIVERY OF HEALTH SERVICES. CROSS-SECTOR COLLABORATION IS NOW WIDELY CONSIDERED AS ESSENTIAL FOR HAVING MEANINGFUL IMPACTS ON BUILDING HEALTHIER COMMUNITIES. THROUGH COLLABORATION WITH PUBLIC HEALTH AGENCIES, HEALTH CARE ORGANIZATIONS AND PROVIDERS, COMMUNITY LEADERS, AND INPUT FROM ACROSS BUSINESS SECTORS AND OTHERS IN THE COMMUNITY, MCLEOD HEALTH CAN BETTER SERVE ITS MISSION. IN PRIORITIZATION OF NEEDS, CONSIDERATION WAS GIVEN TO THE FOLLOWING: -BASED ON IMPORTANCE TO COMMUNITY -CAPACITY TO ADDRESS CHANGE -ALIGNMENT TO MCLEOD HEALTH MISSION, VISION AND VALUES -COLLABORATION WITH EXISTING ORGANIZATIONS-MAGNITUDE/SEVERITY OF PROBLEM -NEED AMONG VULNERABLE POPULATIONS -WILLINGNESS TO ACT ON ISSUE -ABILITY TO HAVE MEANINGFUL IMPACT -AVAILABILITY OF HOSPITAL RESOURCES PLAN PRIORITIES MCLEOD HEALTH DILLON HAS SELECTED THE FOLLOWING AREAS WHICH TO COLLABORATE WITH COMMUNITY PARTNERS FOR IMPROVING COMMUNITY HEALTH IN DILLON COUNTY.-CHRONIC DISEASES -ACCESS TO CARE -MENTAL HEALTH & SUBSTANCE ABUSE-SEXUAL HEALTHIMPLEMENTATION PLAN PRIORITY ISSUES WERE DETERMINED FROM THE COMMUNITY INPUT GATHERED FOR THE CHNA. THROUGH SUCCESSFUL PARTNERSHIPS AND COLLABORATIONS WITH PUBLIC HEALTH AGENCIES, HEALTH CARE ORGANIZATIONS AND PROVIDERS, COMMUNITY LEADERS, AND INPUT FROM ACROSS BUSINESS SECTORS AND OTHER IN OUR COMMUNITY, MCLEOD HEALTH CAN MORE EFFECTIVELY SATISFY ITS LONG STANDING MISSION DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING IN OUR REGION THROUGH EXCELLENCE IN HEALTH CARE.

MCLEOD MEDICAL CENTER DILLON:
PART V, SECTION B, LINE 11: MCLEOD MEDICAL CENTER DILLON IS WORKING WITH THE COMMUNITY PARTNERS SHOWN IN THE IMPLEMENTATION PLAN TO IMPROVE THE SURROUNDING AREAS. THERE HAS NOT BEEN ADEQUATE TIME OR RESOURCES TO ADDRESS ALL THE NEEDS.

PART I, LINE 6A:
THE COMMUNITY BENEFIT REPORT FOR MCLEOD HEALTH (SOLE MEMBER OF MCLEOD MEDICAL CENTER DILLON) IS FILED ANNUALLY WITH SOUTH CAROLINA HOSPITAL ASSOCIATION. HIGHLIGHTS ARE PUBLISHED IN MCLEOD MAGAZINE WHICH IS A PUBLICATION THAT IS DISTRIBUTED FREE TO THE PUBLIC. THE ENTIRE REPORT IS AVAILABLE TO ANYONE UPON REQUEST.

PART I, LINE 7:
THE COST-TO-CHARGE RATIO WAS USED TO CALCULATE AMOUNTS ON LINES 7A-7D. THIS WAS CALCULATED BY USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS ON LINES 7E-7I

PART I, LINE 7, COLUMN (F):
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 $ 12,921,648.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE MAIN EXAMPLE OF A COMMUNITY-BUILDING ACTIVITY PERFORMED BY MCLEOD MEDICAL CENTER-DILLON IN FISCAL YEAR 2020 WAS THAT THERE WAS A DISASTER COORDINATOR THAT HELPED DILLON COUNTY FOR A FEW HOURS PER WEEK WITH EMERGENCY PLANNING. HE WORKED WITH THE SCHOOL SYSTEMS AND ALL PUBLIC SAFETY WITHIN THE COUNTY TO AID IN EMERGENCY PREPAREDNESS WORK.

PART III, LINE 2:
THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990 PART IX.

PART III, LINE 3:
THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE PROGRAM IS 7.1% OF TOTAL BAD DEBTS.

PART III, LINE 4:
ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF MCLEOD HEALTH'S FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING MCLEOD HEALTH'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, MCLEOD HEALTH RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.

PART III, LINE 8:
THE ORGANIZATION FEELS THE TOTAL SHORTFALL OF MEDICARE REIMBURSEMENT COMPARED TO COMPUTED MEDICARE ALLOWABLE COSTS SHOULD BE TREATED AS COMMUNITY BENEFIT. THE HOSPITAL IMPROVES ACCESS TO PATIENT CARE BY PROVIDING SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY OR THEHOSPITAL'S ABILITY TO RECEIVE FULL COST REIMBURSEMENT FOR SERVICES. THE HOSPITAL ALSO RELIEVES THE GOVERNMENT OF A FINANCIAL BURDEN WHEN IT PROVIDES CARE TO PUBLICLY-INSURED PATIENTS WHERE REIMBURSEMENT IS LESS THAN COST OF PROVIDING THE SERVICE.

PART III, LINE 9B:
MCLEOD'S CHARITY POLICY OUTLINES THE CRITERIA USED TO DETERMINE PATIENTS WHO QUALIFY FOR CHARITY. WHEN PATIENTS HAVE FURNISHED THE REQUIRED INFORMATION, IT IS REVIEWED AND A DETERMINATION IS MADE. IF APPROVED FOR CHARITY CARE, THEIR ACCOUNT BALANCES ARE ADJUSTED BASED ON THE PERCENTAGE THEY QUALIFY FOR USING A CHARITY ADJUSTMENT CODE. IF ALL REQUIREDINFORMATION IS NOT FURNISHED, THE PATIENT IS NOTIFIED THAT THEIR CHARITY APPLICATION WAS NOT APPROVED DUE TO FAILURE TO PROVIDE THE NECESSARY INFORMATION. FOLLOWING THAT NOTIFICATION, THE ACCOUNT GENERALLY TRANSFERS TO BAD DEBT FOR FURTHER COLLECTION ACTION.

PART VI, LINE 2:
IN ADDITION TO THE CHNA DESCRIBED ABOVE FOR PART V, SECTION B, MCLEOD MEDICAL CENTER- DILLON HAS A COMMUNITY ADVISORY BOARD CONSISTING OF PHYSICIANS AND INFLUENTIAL LEADERS IN THE COMMUNITY. IT MEETS QUARTERLY TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. ADDITIONALLY, MCLEODMEDICAL CENTER-DILLON ALONG WITH THE REST OF THE MCLEOD HEALTH SYSTEM IS ACTIVELY INVOLVED IN AGENCIES LIKE UNITED WAY, AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY, CHILDREN'S MIRACLE NETWORK TO FURTHER STAY ON THE PULSE OF THE HEALTH NEEDS OF THE COMMUNITY.

PART VI, LINE 3:
UNINSURED PATIENTS ARE SCREENED AT THE TIME OF REGISTRATION FOR THEIR ABILITY TO PAY FOR THEIR HEALTH CARE SERVICES. IF THE PATIENT HAS NO ABILITY TO PAY AND IS DEEMED INELIGIBLE FOR GOVERNMENTAL PROGRAMS (MEDICARE, MEDICAID, ETC.) THEN THEY ARE INFORMED OF THE HOSPITAL CHARITY PROGRAM. THEY ARE PROVIDED WITH AN APPLICATION AND A LISTING OF THE APPROPRIATE DOCUMENTS NECESSARY TO ESTABLISH ELIGIBILITY FOR THE HOSPITAL CHARITY PROGRAM.

PART VI, LINE 4:
MCLEOD MEDICAL CENTER - DILLON (MMC-D), TOGETHER WITH ITS RELATED ORGANIZATIONS, MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC., MCLEOD LORIS SEACOAST HOSPITAL, MCLEOD HEALTH CHERAW, MCLEOD HEALTH CLARENDON, AND MCLEOD PHYSICIAN ASSOCIATES II, CONSIDERS ITS PRIMARYSERVICE AREA (PSA) AS THE SOUTH CAROLINA COUNTIES OF FLORENCE, DARLINGTON, CHESTERFIELD, DILLON, CLARENDON, HORRY, MARION, AND MARLBORO, AND ITS SECONDARY SERVICE AREA (SSA) AS THE SOUTH CAROLINA COUNTIES OF GEORGETOWN, LEE, SUMTER, AND WILLIAMSBURG. THESE TWELVE COUNTIES MAKE UP THE NORTHEASTERN PORTION OF SOUTH CAROLINA. MMC-D HAS THE GREAT MAJORITY OF ITS DISCHARGES FROM THE COUNTY OF DILLON.

PART VI, LINE 7:
LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: SC

PART VI, LINE 5:
COMMUNITY BENEFIT REPORT:WITH A STRONG HISTORY IN THE DILLON COMMUNITY SINCE 1943, MCLEOD DILLON HAS CONTINUED TO GROW AND EXPAND TO SERVE RESIDENTS OF DILLON (SC) AND ROBESON (NC) COUNTIES WITH EXCELLENCE IN PATIENT CARE. MCLEOD DILLON OFFERS GENERAL AND ORTHOPEDIC SURGERY, WOMEN'S SERVICES, EMERGENCY SERVICES INTENSIVE CARE, SLEEP LAB SERVICES, REHABILITATIVE SERVICES AND CARDIAC/PULMONARY REHABILITATION. INVESTMENTS IN STATE OF THE ART TECHNOLOGY TO IMPROVE PATIENT CARE HAVE INCLUDED MRI, DIGITAL MAMMOGRAPHY, 4D ULTRASOUNDS, VASCULAR STUDIES, CT SCANS AND NUCLEAR STUDIES.MCLEOD DILLON IS A 79-BED COMMUNITY HOSPITAL IN DILLON, SC, AND SERVES AS THE PRIMARY HEALTHCARE PROVIDER IN ONE OF THE MORE ECONOMICALLY-CHALLENGED COUNTIES IN SOUTH CAROLINA. MCLEOD DILLON PRIMARILY SERVES DILLON COUNTY, AS WELL AS PORTIONS OF MARLBORO COUNTY AND ROBESON COUNTY, NC. DILLON COUNTY HAS A POPULATION OF APPROXIMATELY 32,000. DILLON COUNTY IS IN THE NORTHEASTERN CORNER OF SOUTH CAROLINA AND IS A COUNTY ASSIGNED TO THE PEE DEE REGION OF THE STATE. THE COUNTY'S PER CAPITA INCOME AND POVERTY HAS LAGGED NATIONAL AND STATE AVERAGES. BOTH THE UNEMPLOYMENT RATE AND THE PERCENTAGE OF THE POPULATION THAT HAS RECEIVED A HIGH SCHOOL DIPLOMA IS ALSO SIGNIFICANTLY HIGHER THAN THE NATIONAL AND STATE AVERAGES. IN DILLON COUNTY, THE NUMBER OF UNINSURED UNDER 65 YEARS OF AGE IS CONSISTENTLY GREATER THAN 20%.

PART VI, LINE 6:
"MCLEOD HEALTH IS THE SOLE MEMBER OF MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC. AND OTHER RELATED ORGANIZATIONS WHICH COMPRISE THE REGIONAL MCLEOD HEALTH SYSTEM. DESCRIPTIONS OF EACH ENTITY FOLLOWS:MCLEOD REGIONAL MEDICAL CENTER OF THE PEE DEE, INC. (MRMC) IS THE LARGEST ENTITY IN THE MCLEOD HEALTH SYSTEM AND OWNS AND OPERATES THE FOLLOWING ORGANIZATIONS,WHICH OPERATE AS DIVISIONS OF MRMC:-MCLEOD REGIONAL MEDICAL CENTER, THE SYSTEM'S MAIN HOSPITAL CAMPUS LOCATED IN FLORENCE, SOUTH CAROLINA, WHICH INCLUDES A 517-BED TERTIARY CARE FACILITY AND A 48-BED NEONATAL INTENSIVE CARE UNIT; -MCLEOD BEHAVIORAL HEALTH, A 23-BED PSYCHIATRIC FACILITY LOCATED IN DARLINGTON, SOUTH CAROLINA;-MCLEOD HOME CARE, WHICH CONSISTS OF MCLEOD HOME HEALTH, A FIVE-COUNTY HOME HEALTHCARE ORGANIZATION WITH OFFICES IN FLORENCE, SOUTH CAROLINA, AND MCLEOD HOSPICE HOUSE, A 24-BED INPATIENT HOSPICE FACILITY LOCATED IN FLORENCE, SOUTH CAROLINA;-MCLEOD HEALTH & FITNESS CENTER, A COMPREHENSIVE HEALTH AND FITNESS CENTER LOCATED IN FLORENCE, SOUTH CAROLINA;ADDITIONALLY, MRMC IS THE MAJORITY OWNER IN A JOINT VENTURE, MCLEOD MEDICAL PARTNERS, LLC, WHICH OWNS AND OPERATES THREE MEDICAL OFFICE BUILDINGS ON THE CAMPUS.MCLEOD MEDICAL CENTER-DILLON IS A SOUTH CAROLINA NONPROFIT CORPORATION AND AN ORGANIZATION DESCRIBED UNDER SECTIONS 501(C)(3) AND 509(A)(1) OF THE CODE. MCLEOD MEDICAL ENTER-DILLON OWNS AND OPERATES A 79-BED COMMUNITY HOSPITAL LOCATED INTHE CITY OF DILLON IN DILLON COUNTY, SOUTH CAROLINA. DILLON COUNTY BORDERS FLORENCE COUNTY TO THE NORTHEAST.MCLEOD LORIS SEACOAST HOSPITAL JOINED MCLEOD HEALTH IN JANUARY 2012 AND CONSISTS OF THE FOLLOWING DIVISIONS:-MCLEOD LORIS, A 50-BED COMMUNITY HOSPITAL LOCATED IN LORIS, SOUTH CAROLINA.-MCLEOD SEACOAST, A 155-BED COMMUNITY HOSPITAL LOCATED IN LITTLE RIVER, SOUTH CAROLINA.MCLEOD HEALTH CHERAW IS A 59-BED COMMUNITY HOSPITAL THAT JOINED MCLEOD HEALTH IN JUNE 2015.MCLEOD HEALTH CLARENDON JOINED MCLEOD HEALTH IN JULY 2016 AND IS AN 81-BED COMMUNITY HOSPITAL LOCATED IN MANNING, SC.MCLEOD PHYSICIAN ASSOCIATES II (MPA II) IS A SOUTH CAROLINA NONPROFIT CORPORATION AND AN ORGANIZATION DESCRIBED UNDER SECTIONS 501(C)(3) AND 509(A)(2) OF THE CODE THAT OPERATES A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE OF OVER 140 EMPLOYED PHYSICIANS PROVIDING PRIMARY AND SPECIALTY CARE SERVICES THROUGH OVER 55 OFFICES IN NORTHEASTERN SOUTH CAROLINA. MPA II SUPPORTS THE MISSION OF MCLEOD HEALTH, PROVIDING COMPREHENSIVE MEDICAL AND SURGICAL SERVICES, INCLUDING A WIDE RANGE OF PHYSICIAN SPECIALTIES, TO MCLEOD'S PATIENTS FROM A 12-COUNTY SERVICE AREA.MCLEOD HEALTH FOUNDATION WAS ORGANIZED IN 1986 AS A SOUTH CAROLINA NONPROFIT CORPORATION AND IS AN ORGANIZATION DESCRIBED UNDER SECTIONS 501(C)(3) AND 509(A)(3) OF THE CODE. THE FOUNDATION IS PRINCIPALLY ENGAGED IN FUNDRAISING ACTIVITIES FOR THE SYSTEM. ACCORDING TO ITS BYLAWS, THE FOUNDATION'S GOVERNING BODY CONSISTS OF NOT LESS THAN 15 AND NOT MORE THAN 30 MEMBERS, EACH OF WHICH IS APPOINTED BY THE BOARD OF TRUSTEES OF MCLEOD HEALTH (THE ""MCLEOD HEALTH BOARD OR THE ""BOARD""). CURRENTLY, THERE ARE 29 MEMBERS OF THE FOUNDATION'S GOVERNING BODY. AT LEAST ONE MEMBER OF THE FOUNDATION'S GOVERNING BODY MUST BE A MEMBER OF THE MCLEOD HEALTH BOARD.MCLEOD MEDICAL PARTNERS, LLC IS A FOR-PROFIT ENTITY THAT OWNS AND OPERATES THREE MEDICAL OFFICE BUILDINGS ON THE MCLEOD REGIONAL MEDICAL CENTER CAMPUS. MRMC OWNS A 63% SHARE IN THE EQUITY OF THIS COMPANY.MCLEOD PHYSICIAN ASSOCIATES, INC. IS A SOUTH CAROLINA FOR-PROFIT CORPORATION THAT FORMERLY OPERATED A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE, BUT IS NOW INACTIVE. EFFECTIVE OCTOBER 1, 2006, SUBSTANTIALLY ALL ASSETS AND OPERATIONS OF MCLEOD PHYSICIAN ASSOCIATES, INC. WERE TRANSFERRED TO MPA II."