4A (Expenses $ 542138607 including grants of $ 212314) (Revenue $ 759181736)
CHARITY CARE PROGRAM: HENDRICK MEDICAL CENTER, IN KEEPING WITH ITS MISSION, VISION, AND VALUES AS A BAPTIST ORGANIZATION, HAS ALWAYS MAINTAINED A GENEROUS CHARITY CARE PROGRAM TO ASSURE THAT THOSE WITH THE INABILITY TO PAY HAVE ACCESS TO THE SERVICES PROVIDED BY HENDRICK. THE CHARITY POLICY IN EFFECT DURING THE PERIOD COVERED BY THIS REPORT PROVIDES THAT FAMILIES WITH INCOMES BELOW 250% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR SERVICES, WITH NO PERSONAL FINANCIAL RESPONSIBILITY. FAMILIES WITH INCOMES ABOVE 250% OF THE FEDERAL POVERTY GUIDELINES RECEIVE CARE WITH PARTIAL FINANCIAL RESPONSIBILITY INCREASING AS THE FAMILY INCOME EXCEEDS THE FEDERAL POVERTY GUIDELINES. HENDRICK PROVIDES FINANCIAL COUNSELORS AND SOCIAL WORKERS TO HELP PATIENTS WITH HEALTHCARE NEEDS BY IDENTIFYING COMMUNITY RESOURCES AVAILABLE AND BY ASSISTING THEM IN THEIR EFFORTS TO IDENTIFY AND QUALIFY FOR GOVERNMENT-SPONSORED PROGRAMS. PROVIDING GOVERNMENT PROGRAMS BELOW COST: HENDRICK IS ALSO COMMITTED TO PARTICIPATING IN GOVERNMENT FUNDED PROGRAMS SUCH AS MEDICARE, MEDICAID, TRICARE, COUNTY INDIGENCY, ETC. THE COST OF SERVICES OFTEN EXCEEDS THE REIMBURSEMENT PROVIDED BY THESE PROGRAMS.

4B (Expenses $ 295832 including grants of $ 295832) (Revenue $ 0)
PROFESSIONAL HEALTH EDUCATION: HENDRICK MEDICAL CENTER HAS AFFILIATION AGREEMENTS AND PROVIDES FINANCIAL SUPPORT TO MANY PROFESSIONAL HEALTH EDUCATIONAL EFFORTS FOR THE PURPOSES OF ENHANCING THE KNOWLEDGE OF EXISTING HEALTH PROFESSIONALS AND EDUCATING NEW HEALTH PROFESSIONALS TO MEET THE INCREASING DEMAND. HENDRICK'S EFFORTS ARE FOCUSED IN AREAS OF STUDY WHERE SHORTAGES COULD POTENTIALLY LIMIT THE CAPACITY OF THE HEALTHCARE SYSTEM TO MEET THE NEEDS OF THE TEXAS MIDWEST. HENDRICK HAS PROVIDED FUNDING AND HAS ENTERED INTO EDUCATIONAL RELATED AFFILIATIONS AGREEMENTS. SOME OF WHICH ARE IDENTIFIED: 1. TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER - SCHOOL OF PHARMACY, BSN 2ND DEGREE PROGRAM AND BSN TRADITIONAL PROGRAM. 2. PATTY HANKS SHELTON SCHOOL OF NURSING - RN, BSN, MSN AND MSN/FNP PROGRAMS. 3. CISCO JR. COLLEGE - LVN/ADN, SURGERY TECHNICIAN, PHARMACY TECHNICIAN, MEDICAL ASSISTANT AND RESPIRATORY THERAPY PROGRAMS. 4. TEXAS STATE TECHNICAL COLLEGE - ADN, EMT, TRANSCRIPTION, NURSE CLERK, NURSE AIDE AND PHLEBOTOMY PROGRAMS. 5. ABILENE CHRISTIAN UNIVERSITY - SPEECH/LANGUAGE PATHOLOGY, SOCIAL WORK, PSYCHOLOGY, EXERCISE HEALTH SCIENCE, BIBLE AND FAMILY STUDIES, BODY AND SOUL. 6. HARDIN-SIMMONS UNIV. - DOCTORATE OF PHYSICAL THERAPY, SOCIAL WORK, THEOLOGY, COMMUNICATION, ATHLETIC TRAINING. 7. TEXAS STATE UNIVERSITY - RESPIRATORY THERAPY PROGRAM 8. HENDRICK SCHOOL OF RADIOGRAPHY. A STUDENT LOAN PROGRAM IS AVAILABLE FOR STUDENTS ENROLLED IN THE SCHOOL. STUDENTS CAN APPLY FOR A LOAN UP TO $6,332 FOR THE COST OF THE TUITION, BOOKS, UNIFORMS AND EXAMS. 9. ABILENE IND SCHOOL DISTRICT - HOLLAND MEDICAL HIGH SCHOOL. A TUITION REIMBURSEMENT PROGRAM IS PROVIDED FOR STUDENTS IN CRITICAL NEED POSITIONS AT HENDRICK MEDICAL CENTER UPON VERIFICATION OF STUDENT LOAN DEBT.

SCHEDULE H, PART V, SECTION B, LINE 5
COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF COMMUNITY STAKEHOLDERS. THE INFORMATION GATHERED WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UN-INSURED PERSONS, LOW-INCOME AND UNDERSERVED POPULATIONS, AND THE COMMUNITY AS A WHOLE. COMMUNITY SURVEYS WERE ALSO CONDUCTED ALONG WITH MARKETING AND TREND ANALYSIS.

SCHEDULE H, PART V, SECTION B, LINE 7A & 10A
THE HOSPITAL'S CHNA AND IMPLEMENTATION STRATEGY ARE POSTED AT THE FOLLOWING WEBSITE: WWW.HENDRICKHEALTH.ORG/COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

SCHEDULE H, PART V, SECTION B, LINE 11
HMC'S CHNA IDENTIFIED 34 COMMUNITY NEEDS. THE IMPLEMENTATION PLAN ESTABLISHED THE FOLLOWING CATEGORIES TO ADDRESS THE NEEDS THAT FALL UNDER HMC'S PROGRAMS: 1. ACCESS TO APPROPRIATE CARE, 2. AWARENESS, PREVENTION, AND SCREENING, AND 3. CRISIS, EMERGENCY, AND BEHAVIORIAL SERVICES. HMC IS ACTIVELY WORKING TO ADDRESS THE NEEDS INCLUDED IN THE THREE CATEGORIES. THERE WERE COMMUNITY NEEDS IDENTIFIED THAT ARE OUTSIDE OF THE HMC'S CORE PURVIEW THAT ARE NOT BEING ADDRESSED DIRECTLY BY HMC. HMC WILL COLLABORATE WITH COMMUNITY AGENCIES, AS APPROPRIATE, TO ASSIST IN COORDINATION OF CARE AND EDUCATION WHEN NEEDED.

SCHEDULE H, PART V, SECTION B, LINES 16A, 16B,& 16C
THE FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE AT THE FOLLOWING WEBSITE: https://www.hendrickhealth.org/patients-visitors/billing/financial-assista nce/

SCHEDULE H, PART I, LINE 3C
IN ADDITION TO USING FEDERAL POVERTY GUIDELINES FOR ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE, HMC USES MEDICAL INDIGENCY, INSURANCE STATUS, AND RESIDENCY.

SCHEDULE H, PART I, LINE 7
HENDRICK MEDICAL CENTER USES A COMBINATION OF COST-TO-CHARGE RATIO AND COST ACCOUNTING SYSTEM FIGURES FOR CALCULATING THE COMMUNITY BENEFIT AMOUNTS REPORTED FOR EACH LINE. THE RATIO CALCULATED IN SCHEDULE H INSTRUCTIONS WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, WAS USED FOR LINES 7A AND 7B. AN INTERNAL COST ACCOUNTING SYSTEM WAS USED FOR LINES 7F AND 7I. HENDRICK MEDICAL CENTER RECEIVED APPROXIMATELY $14M IN DELIVERY SYSTEM REFORM INCENTIVE PAYMENTS (DSRIP) IN FISCAL 2022. IN TEXAS, THE DSRIP PROGRAM ENDED AUGUST 31, 2021. AS THE PROGRAM UNWOUND, ADDITIONAL FUNDS WERE AVAILABLE FOR DISTRIBUTION TO PARTICIPATING PROVIDERS. HENDRICK MEDICAL CENTER RECEIVED THE APPROXIMATELY $14M AS PART OF THIS DISTRIBUTION IN FY2022, BUT QUALIFIED FOR THE DISTRIBUTION IN PREVIOUS YEARS. HAD HENDRICK RECEIVED THE ADDITIONAL $14M IN THE FISCAL YEAR FOR WHICH IT QUALIFIED INSTEAD OF IN FY2022, THE FY 2022 FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST AS A PERCENT OF TOTAL EXPENSE IN PART 1, LINE 7K, COLUMN (F) WOULD HAVE BEEN 2.99%. COMBINING THE ABOVE 2.99% WITH THE MEDICARE SHORTFALL IN PART III, SECTION B., LINE 7 THE TOTAL COMMUNITY BENEFITS AT COST AS A PERCENTAGE OF TOTAL EXPENSE FOR PART 1, LINE 7K, COLUMN (F) WOULD BE 6.33% FOR FY2022. HENDRICK TREATS THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT.

SCHEDULE H, PART III, SECTION A, LINE 2
THE HOSPITAL ADOPTED 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 AUGUST 31, 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
THE ORGANIZATION'S ESTIMATE OF THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE PATIENTS IS ESTIMATED AT 6%.

SCHEDULE H, PART III, SECTION A, LINE 4
HENDRICK HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN FASB ASC 606-10-50-14(A) AND, THEREFORE, IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT IS LOCATED ON PAGES 19-20 OF THE AUDITED FINANCIAL STATEMENT REPORT.

SCHEDULE H, PART III, SECTION B, LINE 8
THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $21,770,808. THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS A COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT.

SCHEDULE H, PART III, SECTION C, LINE 9B
NEITHER THE ORGANIZATION, NOR THIRD PARTIES AUTHORIZED BY THE ORGANIZATION, TAKE ANY ACTIONS UPON NON-PAYMENT FROM A PATIENT BEFORE MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR THE FACILITY'S FINANCIAL ASSISTANCE POLICY.

SCHEDULE H, PART VI, LINE 2
HENDRICK MEDICAL CENTER (HENDRICK) CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN JANUARY THROUGH JUNE OF 2021, WITH THE ASSISTANCE OF CRESCENDO CONSULTING GROUP. THE ASSESSMENT DETERMINED THE MOST PRESSING HEALTH NEEDS OF TAYLOR, JONES AND CALLAHAN COUNTIES. BASED ON CURRENT LITERATURE AND OTHER GUIDANCE FROM THE TREASURY AND THE IRS, THE FOLLOWING STEPS WERE TAKEN AS PART OF HENDRICK'S CHNA: - THE COMMUNITY SERVED WAS DEFINED UTILIZING INPATIENT DATA REGARDING PATIENT ORIGIN. - POPULATION DEMOGRAPHICS AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY WERE GATHERED AND REPORTED UTILIZING VARIOUS THIRD PARTIES. - HEALTH STATUS OF THE COMMUNITY WAS REVIEWED. - AN INVENTORY OF HEALTH CARE FACILITIES AND RESOURCES WAS PREPARED. - COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF COMMUNITY STAKEHOLDERS. THE INFORMATION GATHERED WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UN-INSURED PERSONS, LOW-INCOME AND UNDERSERVED POPULATIONS, AND THE COMMUNITY AS A WHOLE.

SCHEDULE H, PART VI, LINE 3
HENDRICK PROVIDES MANY OPPORTUNITIES FOR PATIENT EDUCATION ON FINANCIAL ASSISTANCE. THE PROGRAMS ARE OUTLINED ON HENDRICK'S WEBSITE, SIGNS AND BROCHURES ARE AT EVERY REGISTRATION POINT, PRE-ADMIT LETTERS ARE SENT TO SURGERY PATIENTS THAT CONTAIN FINANCIAL ASSISTANCE INFORMATION, AND APPLICATIONS ARE GIVEN TO EVERY UNINSURED TRAUMA CENTER PATIENT.

SCHEDULE H, PART VI, LINE 4
HENDRICK IS ACTIVELY DELIVERING CARE FOR A 24 COUNTY SERVICE AREA WITH A BROAD RANGE OF DEMOGRAPHICS.

SCHEDULE H, PART VI, LINE 5
THE COMMUNITY BUILDING ACTIVITIES ARE USED TO POSITIVELY IMPACT THE COMMUNITY AND EDUCATE THE COMMUNITY ON HEALTH TOPICS. THESE ARE DESIGNED TO MEET THE SPECIFIC NEEDS OF THE COMMUNITY.

SCHEDULE H, PART VI, LINE 7
TEXAS

SCHEDULE H, PART VI, LINE 6
HENDRICK MEDICAL CENTER IS PART OF AN ORGANIZATION OF AFFILIATED COMPANIES THAT PROVIDE MEDICAL AND OTHER HEALTH CARE RELATED SERVICES TO TAYLOR COUNTY AND SURROUNDING COUNTY SERVICE AREAS. THE PRIMARY BUSINESS AREAS ARE INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES, SUB-ACUTE CARE, INPATIENT AND OUTPATIENT REHABILITATION, LONG-TERM CARE, NURSING HOME CARE, HOME HEALTH CARE, HOSPICE CARE, MEDICAL OFFICE BUILDING LEASING, DURABLE MEDICAL EQUIPMENT SALES AND LEASING, PHYSICIAN PRACTICES AND A REGIONAL HEALTH MAINTENANCE ORGANIZATION. AFFILIATES INCLUDE HENDRICK MEDICAL CENTER FOUNDATION, HENDRICK PROVIDER NETWORK, HENDRICK MEDICAL OFFICE BUILDINGS, LLC, HENDRICK ANESTHESIA NETWORK, HENDRICK HOSPICE CARE, HENDRICK SOUTHWESTERN HEALTH DEVELOPMENT CORPORATION, HENDRICK HEALTH NETWORK, HENDRICK SURGERY CENTER, HMC HOSPICE PROPERTIES, HENDRICK DIALYSIS CENTER LLC AND HENDRICK MEDICAL CENTER BROWNWOOD.