4A (Expenses $ 23519 including grants of $ 0) (Revenue $ 30237318)
The hospitals in the joint venture offer the latest in high-tech medical equipment, surgical and diagnostic procedures, and personal patient care for families in South Texas, including Cameron, willacy and Eastern Hidalgo County. The number of uninsured in the region is estimated at 35%, and the population under the federal poverty index is estimated at just under 50%. The percentage of persons on Medicaid in the region served is more than twice the rate for all of Texas and the US.

PART V SECTION B LINE 3 THIS SURVEY WAS CONDUCTED BY PHONE INTERVIEWS OF 600 RESPONDENTS IN 3 COUNTIES THE HOSPITAL SERVES. FOCUS GROUPS WERE ALSO USED (COMPRISED OF PHYSICIANS, NURSES, AND COMMUNITY LEADERS WITH HEALTH-RELATED JOBS) AS A SOURCE OF KEY INFORMATION PART V SECTION B LINE 4 BOTH OF THE VALLEY BAPTIST HOSPITAL ENTITIES (HARLINGEN & BROWNSVILLE) WERE INVOLVED. PART V SECTION B LINE 5 WE PROVIDE THIS INFORMATION TO THE REGIONAL ACADEMIC HEALTH CENTER (UT). THE HOSPITALS' COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT: HTTP://WWW.VALLEYBAPTIST.NET/CONNECT-WITH-US/WELLNESS-SERVICES PART V SECTION B LINE 20 ALL PATIENTS ARE CHARGED USING THE SAME FEE SCHEDULES REGARDLESS OF PAYOR CLASSIFICATION. PART V SECTION B LINES 21 AND 22 ALL PATIENTS ARE CHARGED USING THE SAME FEE SCHEDULES REGARDLESS OF PAYOR CLASSIFICATION. THE AMOUNT CHARGED IS AFTER THE SELF-PAY DISCOUNT IS APPLIED TO THE FEE SCHEDULES.

PART I, LINE 7, COLUMN F VB MEDICAL HOLDINGS HAD MINIMAL FUNCTIONAL EXPENSES. SECTION 7 IS BASED ON THE ACTIVITIES OF THE JOINT VENTURE (VHS-VALLEY HEALTH SYSTEM), WHICH IS THE ONLY ASSET OF VB MEDICAL HOLDINGS. AMOUNTS ARE REPORTED AT 49% WHICH IS VB MEDICAL HOLDINGS PORTION OF THE JOINT VENTURE. PART III, LINE 4 THE HOSPITALS' FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE, ACCOUNTS RECEIVABLE, OR ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITALS PROVIDE AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. ACCOUNTS ARE CONSIDERED DELINQENT AND WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. BASED ON 49% OF THE ACTIVITIES OF THE JOINT VENTURE. AMOUNT REPORTED ON LINE 2 IS BASED ON BAD DEBTS PER AUDITED FINANCIAL STATEMENTS AFTER APPLYING THE COST TO CHARGE RATIO. AMOUNT REPORTED IN LINE 3 ARE THE HOSPITALS' ESTIMATE OF THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE PATIENTS ESTIMATED AT 15%. PART III, LINE 8 COST TO CHARGE RATIO IS THE METHOD USED. THE HOSPITALS USE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES. THE HOSPITALS HAVE A WRITTEN POLICY COVERING PROCEDURES FOR COLLECTING AND WRITING OFF BAD DEBTS. ACCORDING TO THE POLICY, IF A PATIENT APPEARS TO BE INDIGENT

NEEDS ASSESSMENT THE HOSPITALS' COMMUNITY HEALTHCARE NEEDS ASSESSMENT UPDATE PROVIDES A SNAPSHOT OF SUBURBAN, URBAN, AND RURAL SERVICE AREAS WITHIN TEXAS USING KEY HEALTH INDICATORS, WHICH FACILITATE COMPARISONS LOCALLY, REGIONALLY, AND OVER TIME. THE COMMUNITY HEALTHCARE NEEDS ASSESSMENT UPDATE REPORT IS INTENDED TO ASSIST INTERNAL STAKEHOLDERS, COMMUNITY HEALTH COUNCIL MEMBERS, AND THE COMMUNITY HEALTH IMPROVEMENT DEPARTMENT IN DECIDING WHERE TO ALLOCATE RESOURCES AND ADDRESS HEALTH INEQUALITIES, ALL ENTITY ADVOCATES USE NATIONAL, STATE,AND LOCAL SECONDARY AND PRIMARY DATA SOURCES TO PROVIDE A CURRENT OVERVIEW OF LOCAL HEALTH NEEDS, FACTORS IMPACTING DISEASE AND INJURY BURDEN, SOCIOECONOMIC STATUS, ACCESS TO HEALTH CARE, AGE DISTRIBUTION, INDICATORS AND LIFESTYLE BEHAVIORS, THIS DATA IS USED TO GALVANIZE JOINT COMMUNITY HEALTH EFFORTS TO IMPROVE HEALTH AND REDUCE HEALTH INEQUALITIES AND TO EMPOWER THE GREATER COMMUNITY.

PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION PUBLISHES THE CHARITY CARE POLICY ANNUALLY IN THE LOCAL NEWSPAPER AS WELL AS POSTING THE POLICY IN ALL ADMISSION AREAS. ALL SELF-PAY PATIENTS AND THOSE WHO HAVE HIGH COSTS AFTER INSURANCE COVERAGE HAS BEEN APPLIED ARE ROUTED TO A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR REVIEWS APPLICABLE FEDERAL/STATE GOVERNMENT PROGRAMS AND THE CHARITY CARE POLICY IN AN EFFORT TO SET UP PAYMENT PLANS OR OTHER METHODS TO HELP. REPRESENTATIVES FOLLOW UP TO ASSIST WITH APPLICATION FOR FINANCIAL ASSISTANCE.

COMMUNITY INFORMATION THE PRIMARY SERVICE AREA FOR VHS-VALLEY HEALTH SYSTEM IS CAMERON AND WILLACY COUNTIES, AND THE MERCEDES/WESLACO REGION OF HIDALGO COUNTY. THE SECONDARY SERVICE AREA EXTENDS INTO HIDALGO COUNTY. REFERRALS COME FROM THROUGHOUT HIDALGO AND STARR COUNTIES AS WELL. -- THE FOUR-COUNTY AREA, CALLED THE RIO GRANDE VALLEY OF TEXAS, ENCOMPASSES APPROXIMATELY 5,000 SQUARE MILES, WHICH CLOSELY APPROXIMATES THE SIZE OF THE STATE OF CONNECTICUT, WHICH IS 5,544 SQUARE MILES. THE RIO GRANDE VALLEY POPULATION IS ESTIMATED AT 1.35 MILLION IN 2012. -- THE POPULATION OF THE PRIMARY SERVICE AREAS (PSA'S) OF VALLEY BAPTIST MEDICAL CENTER-HARLINGEN (VBMC-H) AND VALLEY BAPTIST MEDICAL CENTER-BROWNSVILLE (VBMC-B) HAS A COMBINED POPULATION OF 375,647, AND 417,404 FOR CAMERON COUNTY. CAMERON COUNTY, WITH A POVERTY RATE OF 34.7%, IS THE POOREST COUNTY IN THE U.S. THE AVERAGE HOUSEHOLD INCOME IN THE PSA IS $41,970, AND 26% OF HOUSEHOLDS EARN LESS THAN $l5KlYEAR IN THIS AREA THAT IS 88% HISPANIC. ALMOST 29% OF THE POPULATION IS 14 YEARS OF AGE OR YOUNGER, AND 45% IS 24 YEARS OF AGE OR YOUNGER. ABOUT 28% OF ADULTS RESIDING IN THIS AREA HAVE LESS THAN A HIGH SCHOOL EDUCATION, AND 14% HAVE A BACHELOR'S DEGREE OR GREATER. THE NUMBER OF UNINSURED IN THE REGION IS ESTIMATED AT ALMOST 40%. -- CAMERON COUNTY HAS SOME CENSUS TRACTS DESIGNATED AS AN UNDER-SERVED AREAS (MUA) AND AS A HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA), AND HAS AN AVERAGE OF 58 PRIMARY CARE PHYSICIANS PER 100,000

PROMOTION OF COMMUNITY HEALTH HEALTH EDUCATION ADDRESSING SHORTAGE OF HEALTH CARE PROFESSIONALS THE SHORTAGE OF HEALTH CARE PROVIDERS IN THE RIO GRANDE VALLEY CONTINUES TO BE PROBLEMATIC. THIS IS DUE IN PART TO RAPID POPULATION GROWTH, AND ADDITIONAL HEALTH CARE FACILITIES OPENING IN THE AREA. THERE IS SIGNIFICANT LOCAL EFFORT TO INCREASE THE SUPPLY OF HEALTH CARE PROFESSIONALS IN OUR SERVICE AREA. -- THE REGIONAL ACADEMIC HEALTH CENTER (RAHC), THE MEDICAL EDUCATION COMPONENT OF THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO, IS LOCATED IN HARLINGEN. VALLEY BAPTIST MEDICAL CENTER-HARLINGEN SERVES AS A TRAINING AND RESIDENCY SITE FOR THESE MEDICAL STUDENTS. VALLEY BAPTIST IS THE PRINCIPAL INPATIENT-TRAINING HOSPITAL FOR THE MEDICAL SCHOOL PROGRAM, AND SU CLINICA FAMILIAR'S MAIN BRANCH IN HARLINGEN IS THE PRINCIPAL OUTPATIENT-TRAINING CLINIC. THE RAHC PROVIDES TRAINING FOR THIRD AND FOURTH YEAR MEDICAL STUDENTS AND ADDITIONAL RESIDENCY PROGRAMS. EVIDENCE SUPPORTS THAT PHYSICIANS OFTEN PRACTICE WHERE THEY TRAIN, AND SOME OF THE RAHC RESIDENTS HAVE CHOSEN TO STAY IN THE VALLEY, OR EVEN RETURN AFTER RECEIVING ADDITIONAL SPECIALTY TRAINING ELSEWHERE. VALLEY BAPTIST FUNDS ALL THE INTERNAL MEDICINE RESIDENTS FROM THE UNIVERSITY OF TEXAS SAN ANTONIO MEDICAL BRANCH THAT COME TO TRAIN AT THE REGIONAL ACADEMIC HEALTH CENTER IN HARLINGEN. VALLEY BAPTIST HAS ALSO COMMITTED TO FUND A PSYCHIATRIC RESIDENCY POSITION, AND HAS FULLY SUPPORTED THE UTHSCSA EFFORT

AFFILIATED HEALTH CARE SYSTEM ROLES VB MEDICAL HOLDINGS INCLUDES ONE ASSET, VHS VALLEY HEALTH SYSTEM, LLC WHICH IS THE 49% EQUITY INVESTMENT IN THE JOINT VENTURE THAT COMMENCED SEPTEMBER 1, 2011 WITH VANGUARD HEALTH SYSTEMS. THE JOINT VENTURE OPERATES THE TWO VALLEY BAPTIST ACUTE CARE HOSPITALS, VALLEY BAPTIST MEDICAL CENTER - HARLINGEN AND VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE.

TX

PART III, SECTION A, LINE 2 THE HOSPITAL DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION DATA, AND EXISTING ECONOMIC CONDITIONS. THE HOSPITALS FOLLOW POLICY TO DETERMINE WHEN AN ACCOUNT IS CONSIDERED DELINQUENT AND WRITTEN OFF AS BAD DEBT BASED ON THE INDIVIDUAL'S CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. PART III, SECTION A, LINE 3 THE METHODOLOGY USED IS COST TO CHARGE RATIO. THE HOSPITALS USE THE COST REPORT METHODOLOGY WHICH WILL APPORTION ROUTINE COSTS BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES. THE HOSPITALS HAVE A WRITTEN POLICY COVERING PROCEDURES FOR COLLECTING AND WRITING OFF BAD DEBTS. ACCORDING TO THE POLICY, IF A PATIENT APPEARS TO BE INDIGENT, ACCOUNTS SHOULD BE REVIEWED, AT ANY TIME DURING THE COLLECTION PROCESS, FOR POSSIBLE CONSIDERATION AS A CHARITY CASE IN ACCORDANCE WITH THE HOSPITAL'S CHARITY CARE POLICY.