4A (Expenses $ 20507019 including grants of $ 1977) (Revenue $ 26530911)
MOTHER FRANCES HOSPITAL - WINNSBORO IS A HOSPITAL WITH 25 AVAILABLE BEDS LOCATED IN WINNSBORO, TEXAS. THE HOSPITAL SERVES THE NORTHEAST TEXAS AREA OF WOOD, FRANKLIN, HOPKINS, RAINS, AND CAMP COUNTIES AND OFFERS A WIDE RANGE OF SERVICES INCLUDING GENERAL SURGERY, CARDIAC REHABILITATION, INPATIENT GERIATRIC PSYCH SERVICES, AND 24-HOUR EMERGENCY DEPARTMENT. THE HOSPITAL HAD 9,504 EMERGENCY DEPARTMENT VISITS, 28 INPATIENT SURGERY PROCEDURES, 161 OUTPATIENT SURGERY PROCEDURES, 400 PATIENTS WHO WERE ADMITTED TO ITS HOSPITALS FOR CARE, AND 26,143 PATIENTS WHO RECEIVED OUTPATIENT CARE DURING THE YEAR. MFH - WINNSBORO PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS INCLUDING MEDICARE AND MEDICAID FOR REIMBURSEMENT THAT DOES NOT ALWAYS COVER THE COST OF PROVIDING THE CARE. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH FINANCIALLY INDIGENT AND MEDICALLY INDIGENT PATIENTS. TO THE EXTENT REIMBURSEMENT FOR SERVICES IS BELOW COST, MFH - WINNSBORO RECOGNIZES DIFFERENCES AS CHARITY CARE. CHRISTUS NORTHEAST TEXAS HEALTH SYSTEM CORPORATION RECOGNIZES THE LEADERSHIP AND VALUE OF OUR ASSOCIATES IN GIVING THEIR TIME AND GUIDANCE TO OTHER NOT FOR PROFIT ORGANIZATIONS THAT WORK TO IMPROVE THE LIVES OF THE PEOPLE OF TEXAS. INDIVIDUALS WHO GIVE OF THEIR TIME AND ARE COMPENSATED FOR IT WILL REPORT THE EVENT AS A COMMUNITY BENEFIT. THIS PROGRAM FOCUSES ON THE PLANNING, DEVELOPMENT, AND IMPLEMENTATION OF STAFF TIME ON COMMUNITY HEALTH NEEDS ASSESSMENT. IT INCLUDES THE WRITING, EDITING, DEVELOPMENT OF MEETINGS, SELECTION OF INDIVIDUALS TO PARTICIPATE, AND REPORTING OUT THE PROCESS TO LEADERSHIP INTERNALLY AND EXTERNALLY. THESE PROGRAMS ADDRESS COMMUNITY-WIDE WORKFORCE ISSUES - NOT THE WORKFORCE NEEDS OF THE HEALTH CARE ORGANIZATION. THESE HEALTH CAREER MENTORING PROJECTS INCLUDE JOB SHADOWING. MANY TIMES IT IS ALSO A COMMUNITY COLLABORATION THAT INCLUDES SCHOOLS, COLLEGES, UNIVERSITIES, OR PRIVATE BUSINESSES. IT MAY ALSO INCLUDE SPECIAL NEED STUDENTS. OFFERINGS WILL BE AVAILABLE FOR STUDENTS FROM ALL ECONOMIC AREAS AND NEEDS. HOURS SPENT INTERVIEWING, ORIENTING, SCHEDULING, AND TOURING HIGH SCHOOL AND COLLEGE JOB SHADOW STUDENTS. ORIENTATIONS INCLUDE TRAINING ON OUR HEALTH SYSTEM, CONFIDENTIALITY AND HIPPA, INFECTION CONTROL, HOSPITAL CODES, AND OTHER POLICIES AND PROCEDURES.

Schedule H, Part V, Section B, Line 3E
CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: 1) BEHAVIORAL HEALTH 2) HIGH EMERGENCY DEPARTMENT USE 3) SPECIALTY CARE AND CHRONIC ILLNESS 4) PRIMARY CARE AND ELDERLY NEEDS 5) EDUCATION

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. IN THE MOST RECENT CHNA PERSONS FROM THE COMMUNITY PARTICIPATED IN FOCUS GROUPS WITH INPUT TO HELP IDENTIFY AND DISCUSS THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. THE INTERVIEWEES INCLUDED BUT WERE NOT LIMITED TO, INDIVIDUALS FROM THE FOLLOWING LIST SERVING PEOPLE IN WOOD AN SURROUNDING COUNTIES: TYLER FAMILY CIRCLE OF CARE (FQHC), ANDREWS CENTER, NORTHEAST TEXAS PUBLIC HEALTH DISTRICT, EAST TEXAS HUMAN NEEDS NETWORK, BEHAVIORAL HEALTH LEADERSHIP TEAM, ALZHEIMER'S ALLIANCE OF SMITH COUNTY, EAST TEXAS HUMAN NEEDS NETWORK, BEHAVIORAL HEALTH LEADERSHIP TEAM, GLEN OAKS, HEART OF HOPE, CAN HELP, HOPKINS PLACE ASSISTED LIVING.

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. CHRISTUS MOTHER FRANCES HOSPITAL, LOUIS PEACHES OWEN HEART HOSPITAL, CHRISTUS MOTHER FRANCES HOSPITAL - JACKSONVILLE, CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO, CHRISTUS MOTHER FRANCES HOSPITAL - SULPHUR SPRINGS, CHRISTUS MOTHER FRANCES - SOUTH TYLER

Schedule H, Part V, Section B, Line 11 Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. THE NEEDS IDENTIFIED IN THE CHNA: CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO IDENTIFIED AND ADDRESSED THE FOLLOWING PRIORITIES THROUGH ITS IMPLEMENTATION PLAN: 1) BEHAVIORAL HEALTH 2) HIGH EMERGENCY DEPARTMENT USE 3) SPECIALTY CARE AND CHRONIC ILLNESS 4) PRIMARY CARE AND ELDERLY NEEDS 5) EDUCATION CNTHSC'S CHIP FOR THE UPCOMING TRIENNIUM REFLECTS THE ORGANIZATION'S ONGOING PURSUIT OF REGIONAL HEALTH EQUITY AND COMMITMENT TO PROMOTE CONDITIONS THAT ALLOW EVERY PERSON TO ATTAIN THE HIGHEST POSSIBLE STANDARD OF HEALTH. 1) BEHAVIORAL HEALTH - EXPAND AND SUPPORT BEHAVIORAL HEALTH SERVICES IN THE COMMUNITY FOR INDIVIDUALS AND FAMILIES. - ADDRESS SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH. - SERVED ON PARKS AND RECREATIONAL BOARD FOR ONE MONTH DUE TO COVID - SERVED ON NETRAC (NORTHEAST TEXAS CHILD ADVOCACY) BOARD FOR CHILD ABUSE PREVENTION AWARENESS. 2) HIGH EMERGENCY DEPARTMENT USE - EDUCATE THE PUBLIC ON THE APPROPRIATE USE OF THE EMERGENCY DEPARTMENT AND ALTERNATIVE COMMUNITY RESOURCES. FOCUS IS ON DEVELOPMENT OF PLAN FOR THE INCLUSION IN THE INFORMATION FOR SUPPORT GROUPS AND JOB SHADOWING INFORMATION. - SUPPORT AND EXPAND ACCESS TO FQHC SERVICES AS A SUBSTITUTE FOR INAPPROPRIATE ED USE. THERE IS NO FQHC IN WINNSBORO - SO WILL NOT BE ADDRESSED AT THIS TIME. - TRACK REFERRALS TO FQHC'S AND INAPPROPRIATE USE OF THE ED. 3) SPECIALTY CARE AND CHRONIC ILLNESS - SUPPORT ONGOING AND NEW CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION PROGRAMS. - PROVIDE FREE ORTHOPEDIC SERVICES TO LOW INCOME SCHOOLS, INCLUDING (1) ON-SITE SERVICES AND SCREENINGS, AND (2) FREE/SUBSIDIZED ORTHOPEDIC AND SPORTS MEDICINE PROFESSIONALS AS NEEDED. SCHOOLS IN WOOD COUNTY WHO HAVE ASKED FOR ASSISTANCE ARE: WINNSBORO, MINEOLA AND ALBA-GOLDEN, HAWKINS. - PROVIDE MAMMOGRAM PROGRAMS AS LOW-INCOME WOMEN IN NEED OF SCREENING IN THE COMMUNITY THROUGH THE MOBILE MAMMOGRAPHY UNIT OR CLINICS. THE MOBILE MAMMOGRAPHY UNIT COMES TO THE COMMUNITIES IN WOOD COUNTY AS REQUESTED FOR MAMMOGRAMS AND SEVERAL OF THE CLINICS HAVE PARTICIPATED IN THE DISCOUNTED RATES OR FREE MAMMOGRAMS IN THE MEDICAID WAIVER PROGRAM SUPPORTED BY THE SYSTEM. 4) ACCESS TO PRIMARY CARE AND ELDERLY NEEDS - SUPPORT AND EXPAND ACCESS TO FQHC. THERE IS NO FQHC IN WINNSBORO - SO WILL NOT BE ADDRESSED AT THIS TIME. - PROVIDE COMMUNITY BASED SCREENING, ASSESSMENTS, AND EDUCATION TO LOW INCOME, UNINSURED, AND SPECIAL REQUEST POPULATIONS. THIS WAS NOT DONE IN YEAR 1, 2 , OR 3 DUE TO COVID. 5) EDUCATION - MAINTAIN AND INCREASE EDUCATION AND TRAINING OPPORTUNITIES FOR HEALTH PROFESSIONALS WHILE ENCOURAGING YOUTH AND YOUNG ADULTS TO ENTER CAREERS AS HEALTH PROFESSIONALS OR PARA-PROFESSIONALS.

Schedule H, Part V, Section B, Line 13 Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. UNINSURED PATIENTS WHO APPLY FOR THE FINANCIAL ASSISTANCE PROGRAM MAY ALSO QUALIFY FOR ASSISTANCE UNDER THE POLICY, REGARDLESS OF INCOME LEVEL, IF THEY HAVE MEDICAL OR HOSPITAL BILLS THAT EXCEED 10% OF THEIR GROSS FAMILY INCOME.

Schedule H, Part V, Section B, Line 15 Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. IN ADDITION TO REGULAR APPLICATIONS, THE HOSPITAL ALSO ASSESSED PATIENTS FOR PRESUMPTIVE ELIGIBILITY TO FACILITATE GIVING ASSISTANCE TO NEEDY PATIENTS. THE HOSPITAL IMPLEMENTED ELECTRONIC ELIGIBILITY TOOLS THAT USED PATIENT DEMOGRAPHIC DATA, CREDIT REPORTS, AND OTHER PUBLICLY AVAILABLE INFORMATION TO ESTIMATE A PATIENT'S INCOME, ASSETS, AND LIQUIDITY. PATIENTS WERE SCREENED AS PART OF THE COLLECTION ATTEMPT PROCESS. WHEN ELECTRONIC SCREENING WAS USED AS THE BASIS FOR PRESUMPTIVE ELIGIBILITY, THE HIGHEST DISCOUNT OF FULL FREE CARE WAS GRANTED FOR ELIGIBLE SERVICES FOR RETROSPECTIVE DATES OF SERVICE ONLY. IF A PATIENT DID NOT QUALIFY UNDER THE ELECTRONIC ENROLLMENT PROCESS, THE PATIENT COULD STILL BE CONSIDERED UNDER THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS.

Schedule H, Part V, Section B, Line 16 Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. A SUMMARY OF THE POLICY AND DOCUMENTS NEEDED TO APPLY FOR ASSISTANCE WAS WIDELY AVAILABLE AT WWW.CHRISTUSHEALTH.ORG/CHARITYCARE. (THIS WEBSITE WAS THE FIRST RESULT IN GOOGLE WHEN PATIENTS SEARCHED FOR THE HOSPITAL NAME AND CHARITY CARE OR FINANCIAL ASSISTANCE.) EFFECTIVE JULY 1, 2016, THE INDIVIDUAL HOSPITAL'S HOMEPAGE HAD A CONSPICUOUS FINANCIAL ASSISTANCE LINK DIRECTING PATIENTS TO THE CHARITY CARE HOMEPAGE. FINANCIAL COUNSELORS ALSO PUBLICIZED THE AVAILABILITY OF FINANCIAL ASSISTANCE DURING ONE-ON-ONE VISITS WITH PATIENTS. THE HOSPITAL ATTEMPTED TO PROVIDE ALL UNINSURED PATIENTS WITH FINANCIAL COUNSELING. SPENDING TIME FACE-TO-FACE WITH PATIENTS ALLOWED COUNSELORS TO FACILITATE THE APPLICATION PROCESS FOR PATIENTS WHO OTHERWISE MIGHT NOT HAVE SOUGHT ASSISTANCE. COUNSELORS HELPED COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND EVALUATE PAYMENT PLANS FOR OUTSTANDING BALANCES. UNINSURED PATIENTS WERE SCREENED FOR MEDICAID ELIGIBILITY, AND COUNSELORS ALSO ASSISTED ELIGIBLE PATIENTS IN COMPLETING THOSE APPLICATIONS.

Schedule H, Part V, Section B, Line 20 Facility , 1
Facility , 1 - MOTHER FRANCES HOSPITAL - WINNSBORO. WHEN COLLECTION CALLS RESULTED IN PATIENT CONTACT, BUSINESS AGENTS PERFORMED A VERBAL SCREENING TO SEE IF THE PATIENT MIGHT BE ELIGIBLE FOR CHARITY CARE. IN ADDITION, BILLING STATEMENTS CONTAINED THE FOLLOWING NOTICE: YOU MAY QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON YOUR INCOME LEVEL. IF YOU DO NOT QUALIFY AND CANNOT MAKE PAYMENT IN FULL, WE WILL WORK WITH YOU TO SET UP AN ACCEPTABLE PAYMENT PLAN .

Schedule H, Part V, Section B, Line 17
THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS.

Schedule H, Part V, Section B, Line 18
THE HOSPITAL DID NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS DURING THE TAX YEAR. THE POLICY STRICTLY PROHIBITED TAKING LEGAL ACTION AGAINST PATIENTS AND ALSO FORBADE PLACING A LIEN ON THE PATIENT'S HOME. IN THE EVENT OF NONPAYMENT, THE HOSPITAL AND ITS COLLECTIONS GROUPS WOULD SEND STATEMENTS AND MAKE PHONE CALLS.

Schedule H, Part V, Section B, Line 22
THE HOSPITAL USED THE AVERAGE COMMERCIAL INSURANCE REIMBURSEMENT RATE FROM FISCAL YEAR ENDING 6/30/09 TO DETERMINE AMOUNTS GENERALLY BILLED TO PATIENTS WITH INSURANCE. THIS AVERAGE RATE WAS THE AVERAGE REIMBURSEMENT RECEIVED FOR CATEGORIES OF SERVICES FROM ALL PRIVATE INSURERS THAT REIMBURSE HOSPITALS ACROSS THE CHRISTUS HEALTH SYSTEM, EXCEPT FOR ST. VINCENT AND LONG-TERM HOSPITALS, AND EXCLUDING IMPLANT AND DRUG CONTRIBUTION DOLLARS. ALL UNINSURED PATIENTS WERE CHARGED NO MORE THAN 40% OF CHARGES FOR THE RELEVANT SERVICE LINE. PATIENTS ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE WERE CHARGED NO MORE THAN THE AVERAGE RATE (FOR INCOME LEVELS FROM 301% TO 400% OF FPL) OR RECEIVED FREE CARE (FOR INCOMES AT OR BELOW 300% OF THE FPL). FOR LAB SERVICES, ELIGIBLE PATIENTS WERE CHARGED A PERCENTAGE OF THE MEDICARE RATE.

Schedule H, Part I, Line 3c
FACTORS OTHER THAN THE FPG DETERMINING FREE OR DISCOUNTED CARE THE HOSPITALS USES THE FOLLOWING OTHER CRITERIA TO DETERMINE ELIGIBILITY FOR FREE DISCOUNTED CARE: 1) INCOME LEVEL 2) ASSET LEVEL 3) MEDICAL INDIGENCY 4) INSURANCE STATUS 5) UNDERINSURANCE STATUS 6) RESIDENCY

Schedule H, Part I, Line 5a BUDGETED CHARITY CARE
THE ORGANIZATION BUDGETS CHARITY CARE FOR INTERNAL FINANCIAL REVIEW PURPOSES ONLY. THE PROVISION OF CHARITY CARE IS NOT LIMITED TO AMOUNTS ESTABLISHED FOR BUDGETARY PURPOSES.

Schedule H, Part I, Line 6a ANNUAL COMMUNITY BENEFIT REPORT
A REPORT OF COMMUNITY BENEFIT IS INCLUDED IN A WRITTEN ANNUAL REPORT FOR CHRISTUS HEALTH, THE ORGANIZATION'S PARENT COMPANY. CHRISTUS HEALTH IS AN INTERNATIONAL, CATHOLIC, FAITH BASED, NONPROFIT HEALTH SYSTEM FORMED IN 1999 WITH A MISSION TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST. THE ANNUAL COMMUNITY BENEFIT REPORT SUMMARIZES ACTIVITIES AND PROGRAMS CONDUCTED DURING THE PAST YEAR TO IMPROVE HEALTH INCLUDING PROACTIVE COMMUNITY HEALTH SERVICES. HOWEVER, THE ANNUAL REPORT IS ONLY A SNAPSHOT OF HOW THE ORGANIZATION DISTINGUISHES ITSELF IN ITS VISION TO BE A LEADER, A PARTNER, AND AN ADVOCATE IN CREATING INNOVATIVE HEALTH AND WELLNESS SOLUTIONS THAT IMPROVE THE LIVES OF INDIVIDUALS AND COMMUNITIES.

Schedule H, Part I, Line 7f PERCENT OF TOTAL EXPENSE
TOTAL EXPENSE FROM FORM 990, PART IX, LINE 25, COLUMN (A) IS $ 23,114,303 . THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $2,404,355. THIS LEAVES A TOTAL EXPENSE OF $20,709,948 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F).

Schedule H, Part I, Line 7f FIN ASSISTANCE/OTHER BENEFITS AS PERCENTAGE OF COST
THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS REPORTED ON PART I, LINE 7K, COLUMN (C) AS A PERCENTAGE OF TOTAL EXPENSE IS 14.64, WHICH EXCEEDS THE AMOUNT REPORTED ON PART I, LINE 7K COLUMN (F) WHICH IS COMPUTED USING NET COMMUNITY BENEFIT EXPENSE.

Schedule H, Part I, Line 7i CASH AND IN-KIND CONTRIBUTIONS
MOTHER FRANCES HOSPITAL-WINNSBORO MADE OVER $1,803 IN CASH AND IN KIND CONTRIBUTIONS DURING FISCAL YEAR 2022. THE AFOREMENTIONED AMOUNT IS DETERMINED IN ACCORDANCE WITH REPORTING RULES FOR SCHEDULE H, WORKSHEET 8. AS SUCH THIS AMOUNT DIFFERS FROM GRANTS REPORTED AT FORM 990, SCHEDULE I, GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS, GOVERNMENTS, AND INDIVIDUALS AND PART IX, LINES 1 THROUGH 3 GRANTS AND OTHER ASSISTANCE.

Schedule H, Part III, Line 2 BAD DEBT REPORTING IN ACCORDANCE WITH HFMA STATEMENT 15
CHRISTUS HEALTH FOLLOWS IN PRINCIPLE HEALTHCARE FINANCIAL MANAGEMENT ASSOCATION STATEMENT NO. 15. THE SYSTEM HAS ADOPTED AN UNCOMPENSATED CARE POLICY WHERE REVENUE FROM SERVICES PROVIDED TO THE UNINSURED IS RECOGNIZED AT THE TIME OF PAYMENT, RATHER THAN AT THE TIME OF SERVICE. THIS POLICY IS THE RESULT OF A LACK OF REASONABLE ASSURANCE OF COLLECTION FOR SERVICES PROVIDED TO THE UNINSURED DUE TO THE SYSTEM'S HISTORICALLY LOW COLLECTION RATE. MANAGEMENT HAS ESTIMATED THAT THE DIFFERENCE BETWEEN RECORDING REVENUE FROM THE UNINSURED ON A CASH BASIS, RATHER THAN THE ACCRUAL BASIS, IS IMMATERIAL. ACCORDINGLY, ALL ACCOUNTS RECEIVABLE FROM THE UNINSURED HAVE BEEN FULLY RESERVED IN THE ALLOWANCE FOR UNCOMPENSATED CARE.

Schedule H, Part II COMMUNITY BUILDING ACTIVITIES
THE CHRISTUS HEALTH ADVOCACY DEPARTMENT IS WORKING IN PARTNERSHIP WITH LOCAL, STATE AND FEDERAL POLICY MAKERS TO ENSURE ACTIVITIES AND PROGRAMS ARE IN PLACE THAT WILL ENHANCE PUBLIC HEALTH AND ADVANCE GENERAL KNOWLEDGE. DURING FY 2022, CHRISTUS HEALTH ADVOCATED FOR IMPROVING PUBLIC POLICIES, WORKING TO ESTABLISH, AND IN SOME INSTANCES, AUGMENT, GRASSROOTS ADVOCACY AND GREATER ACCESS TO HEALTH CARE SERVICES FOR THE PATIENTS WE SERVE. SOME OF THE MAIN COMMUNITY BUILDING ACTIVITIES ARE IMPROVING ACCESS TO HEALTH SERVICES AND BUILDING COLLABORATIVE RELATIONSHIPS WITH OTHER ORGANIZATIONS SEEKING TO ADDRESS CHRONIC CONDITIONS THAT DISPROPORTIONATELY IMPACT THE POOR AND UNDERSERVED.

Schedule H, Part I, Line 7 EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE
LINE 7A: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7B: RATIO OF PATIENT CARE COST TO CHARGES BASED ON SCHEDULE H, WORKSHEET 2 LINE 7E: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7F: ACTUAL EXPENSES LESS ANY DIRECT OFFSETTING REVENUE LINE 7I: ACTUAL EXPENSE OF THE CONTRIBUTIONS

Schedule H, Part V, Section B, Line 7 OTHER WEBSITE
https://www.christushealth.org/-/media/christus-health/connect-with-christus/files/community-involvement-and-commitment/trinity-mother-frances-winnsboro/tmf_winnsboro_chna_2023.ashx

Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE
https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/v2financial-assistance-application.ashx

Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE
https://www.christushealth.org/-/media/christus-health/plan-care/files/bill-pay/financial-assistance/financial-language-documents/2021plainlanguagesummaryhospitalenglish.ashx

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE ORGANIZATION'S TOTAL BAD DEBT EXPENSE (TOTAL OF ALL HOSPITAL FACILITIES) IS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL STATEMENTS, WHICH IS COMPUTED AS BAD DEBT NET OF CONTRACTUAL ALLOWANCE, PAYMENTS RECEIVED AND RECOVERIES OF BAD DEBT PREVIOUSLY WRITTEN OFF.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
THE MEDICAL CENTER USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE FILING ORGANIZATION RECOGNIZED THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO SEEK FINANCIAL ASSISTANCE DUE TO BARRIERS SUCH AS EDUCATIONAL LEVEL, LITERACY, DOCUMENTATION REQUIREMENTS, OR BEING INTIMIDATED BY THE APPLICATION PROCESS. IN ORDER TO ESTIMATE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT SUBMITTED AN APPLICATION, THE ORGANIZATION ENGAGED PARO DECISION SUPPORT, LLC. PARO CHARITY SCORE IS DESIGNED TO IDENTIFY PATIENTS THAT LIKELY QUALIFY FOR FINANCIAL ASSISTANCE BASED ON A PREDICTIVE MODEL AND OTHER FINANCIAL AND ASSET ESTIMATES FOR THE PATIENT DERIVED FROM PUBLIC RECORD SOURCES. FOR THE FISCAL YEAR ENDING JUNE 30, 2011, THE ORGANIZATION REPORTED THAT 30% OF BAD DEBT EXPENSES WERE ATTRIBUTABLE TO PATIENTS WHO MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE BUT WERE NOT RESPONSIVE TO THE APPLICATION PROCESS EXISTING AT THAT TIME. THIS FIGURE WAS BASED ON THE PARO ANALYSIS AND ESTIMATES OF PATIENTS' FINANCIAL NEEDS THAT EXAMINED WHETHER PATIENTS WERE CHARACTERSTIC OF OTHERS WHO HISTORICALLY QUALIFIED FOR ASSISTANCE UNDER THE TRADITIONAL APPLICATION PROCESS. THE PRESUMPTIVE CHARITY CARE ANALYSIS PERFORMED FOR THE PRIOR FISCAL YEAR DETERMINED A BENCHMARK OF BAD DEBT ACCOUNTS IN THE CHRISTUS HEALTH SYSTEM THAT LACKED THE INFORMATION TO QUALIFY FOR CHARITY CARE UNDER THE FILING ORGANIZATION'S CUSTOMARY PROCESS BUT WOULD HAVE LIKELY QUALIFIED FOR ASSISTANCE. DURING THE FISCAL YEAR ENDING JUNE 30, 2022, THE ORGANIZATION UTILIZED THE PARO SCORE TO IDENTIFY THE ACCOUNTS OF INDIVIDUAL PATIENTS THAT WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE DESPITE HAVING NOT COMPLETED AN APPLICATION, AND SUCH ANALYSIS DETERMINED THAT 3.73% OF SUCH ACCOUNTS WERE LIKELY ELIGIBLE FOR FINANCIAL ASSISTANCE. THE ORGANIZATION GRANTED PRESUMPTIVE ELIGIBILITY FOR THESE ACCOUNTS AND THEY WERE RECLASSIFIED UNDER OUR FINANCIAL ASSISTANCE POLICY. THE AMOUNTS WERE NOT REPORTED AS BAD DEBT. THE AMOUNT REPORTED ON SCHEDULE H, PART III, LINE 3 IS THE DIFFERENCE BETWEEN THE PRESUMPTIVE CHARITY CARE BENCHMARK ESTABLISHED IN THE FISCAL YEAR ENDING JUNE 30, 2011 AND THE AGGREGATE OF INDIVIDUAL ACCOUNTS FOR WHICH THE ORGANIZATION GRANTED PRESEUMPTIVE ELIGIBILITY IN THE FISCAL YEAR ENDING JUNE 30, 2022. THUS, THE ORGANIZATION ESTIMATES THAT ONLY 0.64% OF THE BAD DEBT EXPENSES IN FISCAL YEAR ENDING JUNE 30, 2022 ARE ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE. IT IS IMPORTANT TO NOTE THAT THE FIGURE CALCULATED FOR FISCAL YEAR ENDING JUNE 30, 2011 WAS ESTIMATED AND NOT EXACT, AND THEREFORE THE DIFFERENCE BETWEEN THE AMOUNTS QUALIFIED AS PRESUMPTIVE CHARITY CARE IN ANY FISCAL YEAR MAY VARY FROM THE BENCHMARK ESTABLISHED IN FISCAL YEAR ENDING JUNE 30, 2011.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
THE FOOTNOTE TO THE CHRISTUS HEALTH CONSOLIDATED FINANCIAL STATEMENTS SAYS, THE PREPARATION OF THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS IN CONFORMITY WITH UNITED STATES GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (U.S. GAAP) REQUIRES MANAGEMENT OF THE SYSTEM TO MAKE ASSUMPTIONS, ESTIMATES, AND JUDGMENTS THAT AFFECT THE AMOUNTS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS, INCLUDING THE NOTES THERETO, AND RELATED DISCLOSURES OF COMMITMENTS AND CONTINGENCIES, IF ANY AT THE DATE OF THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN MAKING ITS JUDGMENTS AND ESTIMATES. ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THESE ESTIMATES.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
IT IS THE POLICY OF THE ORGANIZATION TO PURSUE COLLECTIONS OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR THESE SERVICES. CHRISTUS HEALTH APPLIES ITS COLLECTION EFFORTS CONSISTENTLY AND FAIRLY TO ALL PATIENTS REGARDLESS OF INSURANCE. IF A PATIENT DOES NOT HAVE THE FINANCIAL RESOURCES TO PAY THEIR OUTSTANDING BALANCES, THE GOAL OF THE ORGANIZATION IS TO QUALIFY THESE PATIENTS THROUGH THE ORGANIZATION'S CHARITY POLICY OR SCREEN THE PATIENTS THROUGH ORGANIZATION'S PRESUMPTIVE CHARITY TESTS. IF THE PATIENT QUALIFIES UNDER EITHER POLICY THE ACCOUNT WILL BE WRITTEN OFF BASED UPON LEVEL OF QUALIFICATION. THESE POLICIES SUPPORT THE MISSION AND VISION OF THE ORGANIZATION AND ARE APPROVED BY SENIOR LEADERSHIP.

Schedule H, Part V, Section B, Line 16a FAP website
- MOTHER FRANCES HOSPITAL - WINNSBORO: Line 16a URL: https://www.christushealth.org/plan-care/bill-pay/financial-assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- MOTHER FRANCES HOSPITAL - WINNSBORO: Line 16b URL: SEE SUPPLEMENTAL INFO;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- MOTHER FRANCES HOSPITAL - WINNSBORO: Line 16c URL: SEE SUPPLEMENTAL INFO;

Schedule H, Part VI, Line 4 Community information
CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO IS LOCATED IN A RURAL AREA WITH A POPULATION OF JUST OVER 44,227 RESIDENTS WITH A MEDIAN HOUSEHOLD INCOME FOR THE SERVICE AREA OF $45,753, 41% IS LOW INCOME, 16.6% HOUSEHOLDS LIVE AT OR BELOW THE POVERTY LEVEL. THE HOSPITAL'S SERVICE AREA HAS AN UNINSURED RATE OF 31% OF THE POPULATION, AND 30% HAVING MENTAL ILLNESS.

Schedule H, Part VI, Line 6 Affiliated health care system
MOTHER FRANCES HOSPITAL-WINNSBORO IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED CHRISTUS NORTHEAST TEXAS HEALTH SYSTEM CORPORATION. CHRISTUS NORTHEAST TEXAS IS A FAITH-BASED ORGANIZATION DEDICATED TO CREATING HEALTHY LIVES FOR PEOPLE AND COMMUNITIES. MFH-WINNSBORO AND ITS AFFILIATES PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY PROVIDING ACUTE CARE FACILITIES AND CRITICAL ACCESS FACILITIES, WHOSE OPERATIONS CONSIST PRIMARILY OF PROVIDING INPATIENT AND OUTPATIENT ACUTE CARE AND MEDICAL SERVICES TO PATIENTS RESIDING IN EAST TEXAS.

Schedule H, Part VI, Line 7 State filing of community benefit report
TX

Schedule H, Part VI, Line 2 Needs assessment
THE HOSPITAL'S COMMUNITY HEALTH PROFILES PROVIDE A SNAPSHOT OF SUBURBAN, URBAN, AND RURAL SERVICE AREAS WITHIN TEXAS USING KEY HEALTH INDICATORS, WHICH FACILITATE COMPARISONS LOCALLY, REGIONALLY, AND OVER TIME. COMMUNITY HEALTH PROFILES ARE 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 HEALTH EFFORTS TO IMPROVE HEALTH AND REDUCE HEALTH INEQUALITIES AND TO EMPOWER THE GREATER COMMUNITY.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
MOTHER FRANCIS HOSPITAL - WINNSBORO MAKES EVERY EFFORT TO EDUCATE PATIENTS ON ITS CHARITY AND DISCOUNT POLICY AND ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS DURING REGISTRATION, PRE REGISTRATION (FOR SCHEDULED TESTS AND SURGERIES), POST REGISTRATION (DURING THEIR HOSPITALIZATION) AND FOLLOWING DISCHARGE (TELEPHONE OR WRITTEN INQUIRY) IN LANGUAGES APPROPRIATE FOR THE POPULATION BEING SERVED. PATIENTS ARE GIVEN INFORMATION AND FORMS BY A FINANCIAL COUNSELOR WHO HELPS THEM COMPLETE THE FORMS DURING THEIR INPATIENT AND OUTPATIENT VISITS. PATIENTS ARE ASKED TO BRING OR MAIL SUPPORTING DOCUMENTATION TO DETERMINE INCOME, ASSETS AND HOUSEHOLD EXPENSES. THE BUSINESS OFFICE REVIEWS THE APPLICATION BASED ON THE INFORMATION PROVIDED BY THE PATIENT. IF THE PATIENT QUALIFIES FOR CHARITY CARE OR A DISCOUNT, A NEW BILL IS GENERATED. PATIENTS WHO DO NOT PROVIDE THE REQUIRED DOCUMENTATION ARE CONSIDERED INELIGIBLE AND ARE BILLED ACCORDINGLY. IF THE DOCUMENTATION IS PROVIDED AT A LATER TIME, THE PATIENT MAY THEN BE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR A DISCOUNT. DOCUMENTATION IS RETAINED BY THE BILLING OFFICE FOR SEVEN YEARS. A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY IS POSTED IN PROMINENT PLACES THROUGHOUT THE HOSPITALS, INCLUDING BUT NOT LIMITED TO THE EMERGENCY ROOM WAITING AREAS AND THE ADMISSIONS OFFICE WAITING AREAS, AS REQUIRED BY BOTH THE STATE OF TEXAS COMMUNITY BENEFIT STANDARD (WHICH ADDRESSES THE DUTIES AND RESPONSIBILITIES OF NONPROFIT HOSPITALS) AND CHRISTUS HEALTH COMMUNITY BENEFIT GUIDELINES #050. IN ADDITION, A PUBLIC NOTICE REGARDING THE CHARITY CARE POLICY AND INFORMATION ON FINANCIAL ASSISTANCE ARE ALSO POSTED ON THE CHRISTUS HEALTH WEBSITE. THE INFORMATION ON FINANCIAL ASSISTANCE INCLUDES EXPLANATIONS ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, WHO QUALIFIES, AND HOW TO APPLY FOR FINANCIAL ASSISTANCE.

Schedule H, Part VI, Line 5 Promotion of community health
CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO PROMOTES HEALTHCARE AND WELLNESS EDUCATION BY OFFERING OUTREACH PROGRAMS AND SPECIAL INITIATIVES THAT IMPROVE THE QUALITY OF LIFE AND HEALTH IN THE COMMUNITIES SERVED. COMMUNITY BENEFIT IS PROVIDED THROUGH MANY REDUCED PRICE SERVICES AND FREE PROGRAMS TO THE COMMUNITY. THESE SERVICES ARE ESSENTIAL TO PROVIDE COMPLETE HEALTHCARE TO THE COMMUNITIES SERVED. SOME OF THESE PROGRAMS INCLUDE: 1. EMS STUDENT EDUCATION DESCRIPTION: STUDENTS PARTICIPATE IN JOB SHADOWING PROJECTS THROUGHOUT THE YEAR AND LEARN FROM PROFESSIONALS AND REQUIREMENTS AND DUTIES EMS RELATED JOBS. THEY SPENT TIME IN THE AREAS TO SEE FIRSTHAND WHAT THE JOBS ENTAILED. PURPOSE: TO PROVIDE YOUNG STUDENTS THE OPPORTUNITY TO LEARN MORE ABOUT HEALTH CARE PROFESSIONALS AND OTHERS WHO SUPPORT THE SYSTEM, AND THE HEALTHCARE WORK ENVIRONMENT. INFORMATION WAS GIVEN ON JOB OPPORTUNITIES AND JOB PROJECTED SHORTAGES OF WORKERS IN ALL AREAS NEEDING ROTATIONS IN RURAL HOSPITALS HAVE THE OPPORTUNITY TO COME TO WINNSBORO FROM LOCAL COLLEGES. 2. SCHOOL ASSISTANCE DESCRIPTION: HIGH SCHOOL PHYSICALS AND PRE-PARTICIPATION EXAMS WERE DONE AT NO COST TO THE WINNSBORO SCHOOL DISTRICT. ATHLETIC STUDENTS ARE SEEN IN THE FALL AT SATURDAY SPORTS CLINICS. ALL PROGRAMS ARE OPEN TO ANYONE TO PARTICIPATE PROVIDED THEY HAVE PARENTAL APPROVAL. SUPPORT FOR ON-SITE TRAINERS IS ALSO PROVIDED ON AN AS NEEDED BASIS. PURPOSE: MANY OF THE PUBLIC SCHOOLS DO NOT HAVE MONEY TO SUPPORT FAMILIES WHOSE CHILDREN CHOOSE TO PARTICIPATE IN EXTRACURRICULAR ACTIVITIES. TO ENSURE EVERY CHILD WHO NEEDS A PHYSICAL HAS ACCESS TO ONE; CHRISTUS TRINITY MOTHER HEALTH SYSTEM FUNDS OPEN SPORTS PRE-PARTICIPATION EXAMS FOR THE HIGH SCHOOLS AND COLLEGES IN THE AREA. OFTEN A CHILD MAY BE HURT DURING A GAME BUT DOES NOT FEEL THE INJURY IS BAD ENOUGH TO WARRANT GOING TO THE EXPENSE OF SEEING A DOCTOR. FREE SPORTS INJURY CLINICS FOR ATHLETES ARE OFFERED DURING FOOTBALL SEASON. 3. BLOOD DRIVE DESCRIPTION: CHRISTUS MOTHER FRANCES HOSPITAL - WINNSBORO HOSTED 4 BLOOD DRIVES DURING THE YEAR AT THEIR FACILITY. DURING AUGUST, NOVEMBER, FEBRUARY AND JUNE BLOOD DRIVES WERE HELD IN THE COMMUNITY THAT INCLUDED PARTICIPATION NOT ONLY WITHIN THE HEALTH SYSTEM BUT IT WAS OPEN TO THE COMMUNITY PURPOSE: BLOOD DRIVES ARE AN INTEGRAL PART OF SECURING THE MUCH-NEEDED BLOOD SUPPLIES IN EAST TEXAS. OUR REGIONAL HOSPITALS ARE OFTEN IN A CRISIS FOR BLOOD AND SUPPORTING THOSE NEEDS IS A WAY OF GIVING BACK TO OUR COMMUNITY AND OUR TRANSFER RECEIVING HOSPITALS.