4A (Expenses $ 17223773 including grants of $ 0) (Revenue $ 34916740)
RADIOLOGY: PROVIDED PERSONNEL, SUPPLIES, FACILITIES AND EQUIPMENT FOR 9,702 CT PROCEDURES, 2,327 MRI PROCEDURES, 335 NUCLEUR MED PROCEDURES, 18,838 RADIOLOGY PROCEDURES, 7,338 ULTRASOUND PROCEDURES, 2,750 MAMMOGRAMS, 1,591 INTERVENTIONAL RADIOLOGY PROCEDURES, 1,765 DIAGNOSTIC IMAGING PROCEDURES.

4B (Expenses $ 19624282 including grants of $ 0) (Revenue $ 19526311)
LABORATORY SERVICES: PROVIDED PERSONNEL, SUPPLIES, FACILITIES AND EQUIPMENT FOR 249,859 DIAGNOSTIC TESTS.

4C (Expenses $ 35196762 including grants of $ 0) (Revenue $ 17742013)
EMERGENCY ROOM: PROVIDED PERSONNEL, SUPPLIES, FACILITIES AND EQUIPMENT FOR 24,052 VISITS.

SCHEDULE H, PART V, SECTION B, LINE 5
CHNA INPUT FROM REPRESENTATIVES OF THE COMMUNITY: IN NOVEMBER OF 2020, VAL VERDE REGIONAL MEDICAL CENTER GATHERED INFORMATION FROM A NUMBER OF COMMUNITY MEMBERS FROM DEL RIO AND VAL VERDE COUNTY. THE FOCUS GROUPS INCLUDED INDIVIDUALS FROM THE FOLLOWING CONSTITUENCIES: COUNTY AND CITY GOVERNMENT LEADERS, PUBLIC SAFETY OFFICERS AND PERSONNEL, SCHOOL EDUCATORS, CONGREGATIONAL FAITH LEADERS, COMMUNITY NON-PROFIT ORGANIZATIONS, SOCIAL SERVICE AGENCIES, DIVERSE PRIVATE CITIZENS, BUSINESS LEADERS, HOSPITAL DEPARTMENT LEADERS, HOSPITAL BOARD OF DIRECTORS, PHYSICIANS AND OTHER ADVANCED PRACTICE PROFESSIONALS, FEDERALLY QUALIFIED HEALTH CENTER ADMINISTRATIVE AND CLINICAL LEADERS, MEXICAN CONSULATE REPRESENTATIVES, AND LAUGHLIN AIR FORCE BASE HEALTH AND WELLNESS OFFICERS. THERE WERE A TOTAL 79 PEOPLE THAT WERE INTERVIEWED. ADDITIONAL FOCUS GROUPS WERE ALSO HELD WITH THE HOSPITAL'S EXECUTIVE TEAM AND DEPARTMENT MANAGERS. TOPICS DISCUSSED INCLUDED THE MAJOR HEALTH NEEDS OF THE COMMUNITY AND THE INDIVIDUALS PERCEPTIONS OF THE HOSPITAL.

SCHEDULE H, PART V, SECTION B, LINES 7A & 10A
CHNA AND IMPLEMENTATION STRATEGY: THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: https://www.vvrmc.org/about-us/community-health-needs-assessment/

SCHEDULE H, PART V, SECTION B, LINE 11
IDENTIFIED NEEDS ADDRESSED AND NOT ADDRESSED: IN CONDUCTING THE 2020 CHNA, THREE NEEDS WERE IDENTIFIED THAT WERE MOST OFTEN REPEATED BY A SIGNIFICANT NUMBER OF PARTICIPANTS. THESE NEEDS ARE CONDENSED VERSIONS OF THE SAME NEEDS IDENTIFIED IN THE PRIOR CHNA. THEY HAVE BEEN PRIORITIZED TO BE ADDRESSED IN THE IMPLEMENTATION STRATEGY: 1. PHYSICIAN ACCESS THE HOSPITAL PLANS TO EXPLORE AND DEVELOP A PLAN TO A CREATE HOME HEALTH PROGRAM UTILIZING PARAVISITS OR ANOTHER TYPE OF CARE. THERE ARE PLANS TO ESTABLISH A POPULATION HEALTH MODEL THROUGH THE RHC. THE HOSPITAL ALSO PLANS TO APPLY FOR GRANT OPPORTUNITIES AND OTHER COMMUNITY PROGRAMS. 2. SERVICE ENHANCEMENTS THE HOSPITAL PLANS TO EXPAND ITS RHC FOOTPRINT TO INCREASE WOMEN AND CHILDREN SERVICES BY INCREASING THE PRESENCE OF FAMILY MEDICINE. THERE WILL ALSO BE AN INCREASE IN PODIATRY SERVICES. INVESTMENT IN NEW PHONES SYSTEMS WILL IMPROVE THE ACCESS TO CARE AT THE HOSPITAL AND SURROUNDING CLINICS. OTHER COMMUNITY OUTREACH PROGRAMS WILL BE ANALYZED AND CREATED BASED ON THE FINDINGS OF THE NEEDS ASSESSMENT. 3. COMMUNITY OUTREACH & COMMUNICATION THE HOSPITAL WANTS TO BE THE PROVIDER OF CHOICE FOR THE RESIDENTS OF DEL RIO. THE HOSPITAL PLANS TO DEVELOP A BRAND CAMPAIGN THROUGH SOCIAL MEDIA, THE WEBSITE, AND OTHER PUBLIC EVENTS. ALL OF THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT HAVE BEEN ADDRESSED IN THE IMPLEMENTATION STRATEGY. FOR MORE INFORMATION ON THE PROGRESS THE HOSPITAL MADE DURING FISCAL YEAR 2022, SEE SCHEDULE H, PART VI.

SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C
FINANCIAL ASSISTANCE POLICY AVAILABILITY: THE FINANCIAL ASSISTANCE POLICY, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE UPON REQUEST AND AT THE FOLLOWING WEBSITE: https://www.vvrmc.org/patients-visitors/patient-financial-services/

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE: THE AMOUNT REPORTED IS BASED ON THE BAD DEBT PER THE ORGANIZATION'S FINANCIAL STATEMENTS.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION HAS ESTIMATED THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY AT 25%. BAD DEBT EXPENSE SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THIS IS UNCOMPENSATED HEALTHCARE PROVIDED TO RESIDENTS OF THE COMMUNITY.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT FOOTNOTE: THE MEDICAL CENTER REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYERS, PATIENTS AND OTHERS. THE MEDICAL CENTER PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS.

SCHEDULE H, PART III, SECTION B, LINE 8
COSTING METHODOLOGY: THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $211,880. THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. THE MEDICAL CENTER USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICAID OR MEDICARE DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION PRACTICES: 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 ORGANIZATION'S CHARITY CARE POLICY. ONCE A PATIENT HAS BEEN DETERMINED TO QUALIFY FOR THE HOSPITAL'S CHARITY CARE PROGRAM, NO ADDITIONAL COLLECTION EFFORTS WILL BE MADE ON THAT ACCOUNT.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT: THE COMMUNITY'S NEEDS INFORMATION IS GARNERED FROM PATIENT SATISFACTION SURVEYS, EMPLOYEES, AND PHYSICIANS IN ADDITION TO THE CHNA CONDUCTED IN 2021.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: WHEN AN UNINSURED PATIENT FIRST REGISTERS FOR SERVICES, THE REGISTRAR IDENTIFIES THE SERVICES TO BE OFFERED AND REQUESTS PAYMENT FOR THOSE SERVICES PRIOR TO SENDING THE PATIENT TO THE DEPARTMENT. IF THE PATIENT IS UNABLE TO PAY, THE ELIGIBILITY DEPARTMENT IS NOTIFIED AND THE PATIENT IS ESCORTED TO THAT DEPARTMENT WHERE THEY ARE SCREENED FOR A FUNDING SOURCE. IF IT IS IDENTIFIED THAT PATIENT DOES QUALIFY, APPLICATIONS ARE COMPLETED, AND NECESSARY DOCUMENTATION IS REQUESTED PRIOR TO SERVICES BEING RENDERED. THE DOCUMENTS ARE THEN FORWARDED TO THE ON-SITE TEXAS DEPARTMENT OF HEALTH SOCIAL WORKER WHO VERIFIES ALL DOCUMENTS ARE COMPLETE. IF NO FUNDING SOURCE CAN BE IDENTIFIED, THE PATIENT IS SCREENED FOR THE FACILITIES CHARITY CARE PROGRAM. IF THEY QUALIFY, A CHARITY FINANCIAL CLASS IS ASSIGNED AND SERVICES RENDERED.

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION: THE HOSPITAL OWNS AND OPERATES A HOSPITAL IN DEL RIO, TEXAS. THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF VAL VERDE COUNTY WITH A POPULATION OF APPROXIMATELY 50,000. THE MEDIAN INCOME IN THE COUNTY IS APPROXIMATELY $42,500 FOR A HOUSEHOLD COMPARED TO THE $55,800 TEXAS STATE AVERAGE. THE PER CAPITA INCOME FOR THE COUNTY IS $17,107. THE MEDIAN AGE WAS 32.5 YEARS OF AGE COMPARED TO 34.5 YEARS FOR TEXAS. ABOUT 22.2% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 32% OF THOSE UNDER AGE 18 AND 26% OF THEM AGE 65 OR OVER.

SCHEDULE H, PART VI, LINE 5
"PROMOTION OF COMMUNITY HEALTH: EVERY MONTH VVRMC HOSTS A COMMUNITY HEALTH EDUCATION SERIES PRESENTATION. THE PRESENTATIONS ARE ADVERTISED ON OUR WEBSITE, IN THE DEL RIO NEW HERALD, AND ON LOCAL RADIO STATIONS. THEY ARE PRESENTED BY DOCTORS AND/OR EXPERTS IN CERTAIN FIELDS OF INTEREST. THE PRESENTATIONS COVER VARIOUS TOPICS TO HELP EDUCATE OUR COMMUNITY ON IMPORTANT HEALTH ISSUES. THE PRESENTATIONS ARE FREE TO THE PUBLIC; ON AVERAGE 40 PEOPLE ATTEND. IT HAS GROWN IN POPULARITY IN TERMS OF INDIVIDUALS WHO EXPRESS AN INTEREST IN PRESENTING AND THE NUMBER OF ATTENDEES. DURING THE FINAL SIX MONTHS OF THE FY2020 WE SUSPENDED ALL IN PERSON OUTREACH ACTIVITIES AND TRANSITIONED TO MORE ONLINE COMMUNICATION VIA THE WEBSITE AND SOCIAL MEDIA. IN PERSON EDUCATION RESUMED IN SPRING OF 2022. Teen Outreach targets teens in junior high and high school, programs began in person and then moved to a virtual platform due to COVID. These programs include: ""Making Proud Choices"" is a junior high curriculum taught through a series of modules focusing basic sex education, including teen pregnancy, STDs, domestic violence, etc. ""Teen Fit"" was a summer program for teens with a focus on healthy eating and exercise. ""Chit Chat Chicas"" is a series of classes, in person or online, for teen girls that addresses the life choices they make during their high school years. MATERNAL CHILD OUTREACH THROUGH THE RMOMS PROGRAM AND GRANT IS A COMPREHENSIVE OUTREACH PROGRAM FOR EXPECTING MOM'S AND THEIR NEWBORNS. A PERINATAL CASE MANAGER WORKS WITH MOMS THROUGHOUT THEIR PREGNANCY AND POSTPARTUM CARE. THE PROGRAM PROVIDES EDUCATIONAL RESOURCES SUCH AS PERINATAL CLASSES, BEHAVIORAL HEALTH SUPPORT, ETC. IT ALSO HELPS MOMS NAVIGATE THE MEDICAID PROCESS, ACCESS PROGRAMS SUCH AS WIC AND COORDINATES CARE FOR HIGH-RISK PREGNANCY IN SAN ANTONIO. CANCER NAVIGATION SERVICES AND OUTREACH ASSIST CITIZENS IN VAL VERDE COUNTY WHEN DIAGNOSED WITH CANCER. THE PROGRAM PROVIDES FINANCIAL ASSISTANCE FOR GAS, LODGING AND FOOD FOR PATIENTS GOING THROUGH CHEMO/RADIATION TREATMENT. IT ALSO PROVIDES PATIENTS WITH WIGS, BRAS, PROSTHESES AND OTHER SUPPLIES, AND IT HELPS COORDINATE CARE, CANCER TREATMENTS AND ASSISTANCE WITH ACCESSING OTHER RESOURCES IN THE COMMUNITY, OTHER CITIES AND WITHIN THE STATE. VVRMC PARTICIPATES IN A FEW HEALTH FAIRS INCLUDING THE ANNUAL BACK TO SCHOOL HEALTH FAIR, ANDALE DEL RIO, AND THE AMISTAD BINATIONAL HEALTH COUNCIL WELLNESS EXPO, TO NAME A FEW. VVRMC ALSO PROVIDES THE MEDICAL SERVICES FOR COMMUNITY RUN FUNDRAISERS, SUCH AS THE ANDALE DEL RIO AND CHILLY 5K, FREE OF CHARGE. CANCER NAVIGATION SERVICES ALSO COORDINATES FUNDRAISING ACTIVITIES, MEMORIALS, EDUCATION PROGRAMS AND OTHER EVENTS THROWN TO RAISE AWARENESS ON CANCER PREVENTION. THE FOLLOWING PROGRAMS ARE ON GOING ALTHOUGH MANY OF THESE OUTREACH PROGRAMS AND FOCUS GROUPS MOVED TO AN ONLINE ZOOM PLATFORM: BREAST FEEDING CLASSES SAFE KIDS - CAR SEAT PROGRAM, HELMET/BICYCLE SAFETY, WATER/SWIMMING SAFETY EDUCATION FIRE SAFETY CHILD BIRTH CLASSES COMMUNITY HEALTH WORKER TRAINING (HIGH SCHOOL STUDENTS)"

SCHEDULE H, PART I, LINE 7, COLUMN F
PERCENT OF TOTAL EXPENSE: BAD DEBT EXPENSE OF $2,376,557 WAS INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT WAS SUBTRACTED FROM TOTAL EXPENSE FOR THE CALCULATION OF PERCENT OF TOTAL EXPENSE IN THIS COLUMN.

SCHEDULE H, PART I, LINE 3C
FACTORS OTHER THAN FPG DETERMINING FREE OR DISCOUNTED CARE: HOSPITAL USES THE FOLLOWING CRITERIA TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE: -ASSET LEVEL -MEDICAL INDIGENCY -INSURANCE STATUS

SCHEDULE H, PART I, LINE 7
COSTING METHODOLOGY FOR COMMUNITY BENEFIT COSTS: THE AMOUNTS REPORTED ON THE TABLE ON PART I, LINE 7 WERE CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM COMPLETING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES FROM THE IRS INSTRUCTIONS.

SCHEDULE H, PART VI, LINE 6
AFFILIATED HEALTH CARE SYSTEM: VAL VERDE HOSPITAL CORPORATION D/B/A VAL VERDE REGIONAL MEDICAL CENTER (THE MEDICAL CENTER) IS A 93 BED ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE, AND MENTAL HEALTH SERVICES TO PATIENTS IN DEL RIO, TEXAS, AND AREAS SURROUNDING VAL VERDE COUNTY. VAL VERDE COUNTY HOSPITAL DISTRICT (VVCHD) IS THE SOLE MEMBER OF THE MEDICAL CENTER. DURING 2011, THE MEDICAL CENTER FORMED VAL VERDE HEALTH CLINIC D/B/A AMISTAD MEDICAL PROFESSIONALS (THE CLINIC), A CORPORATION, FORMED PRIMARILY FOR THE PURPOSE OF PROVIDING PHYSICIAN SERVICES TO THE MEDICAL CENTER'S PATIENTS. IN 2015, A HOSPITAL BASED RURAL HEALTH CLINIC WAS ESTABLISHED TO CONTINUE TO PROVIDE PHYSICIAN SERVICES TO VAL VERDE COUNTY. IN 2019, THE CLINIC WAS CLOSED DOWN AND THE OPERATIONS WERE MOVED TO THE HOSPITAL.

SCHEDULE H, PART VI, LINE 7
STATE FILING OF COMMUNITY BENEFIT REPORT: N/A