4A (Expenses $ 32749101 including grants of $ 112316) (Revenue $ 42972923)
MOAB REGIONAL HOSPITAL (MRH) OPERATES A 17-BED ACUTE CARE CRITICAL ACCESS HOSPITAL (CAH), WHICH PROVIDES EMERGENCY, INPATIENT, OUTPATIENT, ACUTE CARE AND SUBACUTE SERVICES IN HOSPITAL AND CLINIC SETTINGS. THE HOSPITAL PROVIDED 5,322 EMERGENCY DEPARTMENT VISITS, 2,240 DAYS OF INPATIENT SERVICES, 30,275 CLINIC VISITS, 1,319 HOSPICE DAYS, AND 75 BIRTHS DURING THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 888,869 FOR CHARITY CARE, 4,165,096 FOR MEDICAID, 11,063,914 FOR MEDICARE, AND 5,976,065 FOR OTHER THIRD-PARTY PAYERS DURING THE YEAR.

FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 3E
IDENTIFICATION AND PRIORITIZATION OF SIGNIFICANT HEALTH NEEDS BEGIN ON PAGE 31 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE.

FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 5
MOAB REGIONAL HOSPITAL PARTNERED WITH THE NATIONAL RURAL HEALTH RESOURCE CENTER (NRHRC) TO CONDUCT ITS 2020 COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY MAILING OUT 800 SURVEYS TO A RANDOM STRATIFIED SAMPLE OF COMMUNITY MEMBERS. NRHRC FACILITATED A SERIES OF FOCUS GROUPS MADE UP OF A DIVERSE GROUP OF COMMUNITY MEMBERS, REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY TO SUPPLEMENT THE ASSESSMENT WITH QUALITATIVE DATA. THE FOCUS GROUPS INCLUDED: HEALTHCARE PROFESSIONALS; COMMUNITY LEADERS; YOUTH ORGANIZATIONS AND PARENTS; SENIORS; AND MULTICULTURAL GROUPS. AN EXTENSIVE LIST OF INVITEES WAS COMPILED BY THE MRH DIRECTOR OF COMMUNITY RELATIONS TO ENSURE QUALITY REPRESENTATION OF VARIOUS COMMUNITY ORGANIZATIONS, GOVERNMENT COUNCILS AND LOCAL RESIDENTS.

FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 6B
MOAB REGIONAL HOSPITAL PARTNERED WITH THE NATIONAL RURAL HEALTH RESOURCE CENTER TO CONDUCT ITS 2020 COMMUNITY HEALTH NEEDS ASSESSMENT TO IMPROVE THE UNDERSTANDING OF THE HEALTH STATUS OF THE COMMUNITY IT SERVES.

FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 7D
THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DISTRIBUTED TO LOCAL INTERESTED AGENCIES, INCLUDING THE SOUTH EASTERN UTAH HEALTH DEPARTMENT, THE MOAB FREE HEALTH CLINIC, AND ALL COMMUNITY LEADERS INVOLVED IN THE FOCUS GROUP. HARD COPIES OF THE LATEST COMMUNITY HEALTH NEEDS ASSESSMENT AND MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY ARE ALSO AVAILABLE UPON REQUEST WITHOUT CHARGE AND POSTED ON THE HOSPITAL WEBSITE AT THE FOLLOWING URL: HTTP://MRHMOAB.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 11
AFTER RECEIVING THE 2020 COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS, THE MOAB REGIONAL HOSPITAL COMMUNITY RELATIONS DIRECTOR INVITED COMMUNITY AND HOSPITAL LEADERS TO PARTICIPATE IN A STRATEGIC PLANNING SESSION TO PRIORITIZE TARGET AREAS FOR THE COMMUNITY HEALTH ASSESSMENT ACTION PLAN. THE DATA WAS ALSO SHARED AND DISCUSSED WITH HOSPITAL LEADERSHIP GROUPS AND GOVERNING BODIES. THE TOP THREE IDENTIFIED HEALTH NEEDS INCLUDE: 1) ACCESS TO MENTAL AND BEHAVIORAL HEALTHCARE 2) ACCESS TO PRIMARY CARE PROVIDERS AND SPECIALISTS 3) REMOVE FINANCIAL BARRIERS TO CARE THE HOSPITAL IS ADDRESSING THESE NEEDS USING THE FOLLOWING STRATEGIES: RECRUIT FULL-TIME PSYCHIATRIST, PSYCHOLOGIST, AND CHILD PSYCHIATRIST ADD MID-LEVEL PROVIDER TO WORK WITH PSYCHIATRIST FOR BEHAVIORAL HEALTH PATIENTS AND MENTAL HEALTH PROGRAM NURSE COORDINATOR PROVIDE ACCESS TO TELE-MENTAL HEALTH PROVIDE SPONSORSHIP TO COMMUNITY ORGANIZATIONS THAT ARE WORKING TO REDUCE RISK FACTORS AND INCREASE PROTECTIVE FACTORS RECRUIT FAMILY PRACTICE PHYSICIAN WITH OB, NURSES FOR TRIAGE AND CARE COORDINATION, AND VISITING SPECIALISTS SUCH AS CARDIOLOGIST,OTOLARYNGOLOGIST (ENT), PEDIATRICIAN, GERONTOLOGIST ADD OUT-PATIENT NURSING SERVICES PROGRAM MANAGER AND ONCOLOGY NAVIGATOR IMPLEMENT ECHO PROGRAM EMPLOY FULL-TIME FINANCIAL NAVIGATORS REDUCE LAB CHARGES EXPAND LOW-COST BLOOD DRAWS THROUGHOUT THE YEAR MRH IS NOT ACTIVELY FOCUSING RESOURCES ON THE OTHER HEALTH CONCERNS OUTLINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDING: ILLEGAL AND PRESCRIPTION DRUG USE/UNDERAGE ALCOHOL, TOBACCO, AND DRUG USE. THERE ARE MANY OTHER COMMUNITY ORGANIZATIONS, SUCH AS THE SOUTHEAST UTAH HEALTH DEPARTMENT, THE MOAB FREE HEALTH CLINIC, AND FAMILY SUPPORT SERVICES, THAT HAVE ROBUST PROGRAMS THAT ADDRESS THESE CONCERNS. THE HOSPITAL SUPPORTS AND PARTNERS WITH THESE ORGANIZATIONS WHEN APPROPRIATE; HOWEVER, THE HOSPITAL FELT THAT THE COMMUNITY HEALTH ASSESSMENT ACTION PLAN GOALS SHOULD ADDRESS GAPS IN LOCAL SERVICES RATHER THAN DUPLICATING AVAILABLE PROGRAMS. MRH WILL COLLABORATE WITH OTHER COMMUNITY CHAMPIONS ON THIS EFFORT. MRH IS CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED.

FACILITY 1, MOAB VALLEY HEALTHCARE, INC. - PART V, LINE 16J
THE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS PROVIDED IN THE EMERGENCY AND WAITING ROOMS. PATIENTS ARE PROVIDED FINANCIAL AID INFORMATION AND AN APPLICATION AT THE TIME OF SERVICE. THE HOSPITAL ALSO INFORMS PATIENTS THAT FINANCIAL AID IS AVAILABLE IN ALL INVOICES. IN ADDITION, THE HOSPITAL PUBLICIZED THE FINANCIAL ASSISTANCE POLICY THROUGH NEWSPAPER ARTICLES AND EDUCATIONAL SEMINARS WITH THE COMMUNITY SENIOR CITIZENS AND MINORITY POPULATIONS. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HOSPITAL WEBSITE AS FOLLOWS. FAP: HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2021/11/CHARITY-CARE-POLICY- MRH-2020-REVISED-11.22.PDF FAP APPLICATION: HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2022/02/FINANCIAL- ASSISTANCE-PROGRAM-APPLICATION-2022.PDF FAP PLAIN LANGUAGE SUMMARY: HTTPS://MRHMOAB.ORG/WP- CONTENT/UPLOADS/2022/02/FINANCIAL-ASSISTANCE-PROGRAM-SUMMARY-2022.1.PDF

SCHEDULE H, PART I, LINE 7G
THE HOSPITAL HAS INCLUDED COSTS ASSOCIATED WITH PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES IN PART I, LINE 7G IN THE AMOUNT OF 3,676,211 IN COLUMN C AND 2,730,239 IN COLUMN D.

SCHEDULE H, PART I, LINE 7
THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR FIGURES REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES).

SCHEDULE H, PART II
GRAND COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AREA AND HAS A SHORTAGE OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT.

SCHEDULE H, PART III, LINE 2
BAD DEBT EXPENSE ON LINE 2 IS REPORTED AT CHARGES.

SCHEDULE H, PART III, LINE 3
THE HOSPITAL DETERMINED THE ESTIMATED AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE BY REVIEWING THEIR RECORDS FOR THE PERCENTAGE OF PATIENTS THAT WOULD HAVE BEEN ELIGIBLE HAD THEY COMPLETED THE FINANCIAL ASSISTANCE PROCESS. THE HOSPITAL ESTIMATED 14% OF ITS BAD DEBTS WOULD HAVE QUALIFIED.

SCHEDULE H, PART III, LINE 4
THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 5 ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS ATTACHED. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 10 BEGINNING ON PAGE 17 OF THE AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
SERVICES ARE PROVIDED TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THAT NOT ALL COSTS ASSOCIATED WITH PROVIDING THESE SERVICES WILL BE RECOVERED. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. THEREFORE, ANY MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES & REGULATIONS SET FORTH BY CENTERS FOR MEDICARE AND MEDICAID SERVICES.

SCHEDULE H, PART III, LINE 9B
"IT IS THE POLICY OF MOAB REGIONAL HOSPITAL TO UTILIZE A COLLECTION AGENCY AS A RESOURCE FOR COLLECTING BAD DEBT. ALL PATIENTS WILL RECEIVE A MONTHLY STATEMENT REGARDING ANY OPEN BALANCES ON THEIR ACCOUNTS. THE PATIENT WILL RECEIVE TWO STATEMENTS APPROXIMATELY 30 DAYS APART. THE THIRD STATEMENT AT 90 DAYS WILL BE STAMPED FINAL NOTICE. AT 120 DAYS AFTER THE FIRST BILLING IF THE OPEN BALANCE HAS NOT BEEN ADDRESSED BY THE PATIENT THESE ACCOUNTS WILL BE FORWARDED ON TO THE COLLECTION AGENCY FOR ADDITIONAL ACTION (E.G. ACCRUING INTEREST, GARNISHING OF WAGES AND LEGAL ACTION) IF NECESSARY. IF AT ANY TIME DURING THE COLLECTION ACTIONS THE COLLECTION AGENCY DETERMINES THE PATIENT WOULD BE POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE, THE AGENCY WILL ENCOURAGE THE PATIENT TO CONTACT THE HOSPITAL TO APPLY FOR FINANCIAL ASSISTANCE. ONCE THE PATIENT CONTACTS THE HOSPITAL, THE ACCOUNT IS IMMEDIATELY MOVED TO ""APPLYING FOR ASSISTANCE"" STATUS AND NO FURTHER COLLECTION ACTIONS ARE TAKEN. THE PATIENT THEN HAS AN ADDITIONAL 120 DAYS TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. IF THE INDIVIDUAL RECEIVES DISCOUNTED CARE, THE REMAINING SELF-PAY PORTION IS MOVED TO AN INTEREST-FREE MONTHLY PAYMENT PLAN. IF AFTER SIX MONTHS THERE ARE NO FURTHER PAYMENTS MADE, THE HOSPITAL CONTACTS THE PATIENT TO DETERMINE IF THE PATIENT NEEDS TO LOWER THEIR MONTHLY PAYMENT AND INCREASE THE PAYMENT TIMELINE."

SCHEDULE H, PART VI, LINE 2
IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED EVERY THREE YEARS, THE HOSPITAL REVIEWS LOCAL THIRD PARTY HEALTH DATA, SUCH AS DATA FROM THE HEALTH DEPARTMENT AND THE UTAH STUDENT HEALTH RISK AND POPULATION (SHARP) SURVEY. THE HOSPITAL ALSO COLLECTS FEEDBACK FROM PATIENTS TO HELP IMPROVE SERVICES. THE MOST RECENT COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE AVAILABLE UPON REQUEST OR A COPY CAN BE FOUND ON THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2020/07/2019-CHNA-REPORT- FINALPOSTED-ON-WEBSITE-COMPRESSED.PDF HTTPS://MRHMOAB.ORG/WP-CONTENT/UPLOADS/2020/07/2019-CHNA-IMPLEMENTAION- PLAN-FINAL-POSTED-ON-WEBSITE-2.PDF

SCHEDULE H, PART VI, LINE 3
THE HOSPITAL POSTS ITS CHARITY CARE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES IN WHICH ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. IT ALSO PROVIDES A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ITS ADMISSION PACKET AS PART OF THE INTAKE PROCESS. A COPY OF THE POLICY, OR A SUMMARY THEREOF, AND FINANCIAL ASSISTANCE CONTACT INFORMATION TO PATIENTS ARE ALSO INCLUDED WITH DISCHARGE MATERIALS. ASSIGNED HOSPITAL STAFF ALSO DISCUSS WITH THE PATIENT THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFITS, SUCH AS MEDICAID OR STATE PROGRAMS, AND ASSISTS THE PATIENT WITH QUALIFICATION FOR SUCH PROGRAMS, AS APPLICABLE.

SCHEDULE H, PART VI, LINE 4
THE HOSPITAL'S DEFINED SERVICE AREA EXTENDS OUT APPROXIMATELY 70 MILES IN ALL DIRECTIONS CAPTURING A SERVICE AREA POPULATION OF APPROXIMATELY 17,000. THE ENTIRE SERVICE AREA (SOUTHEAST UTAH) IS RURAL OR FRONTIER IN NATURE. IT INCLUDES ALL OF GRAND COUNTY (9,700), AND THE SETTLEMENTS OF GREEN RIVER (790), LA SAL (260), MONTICELLO (2,570), AND BLANDING (3,600). SMALL HOSPITALS SERVE MONTICELLO AND BLANDING, BUT MAJOR SURGICAL AND ANCILLARY SERVICES ARE PROVIDED IN MOAB. LARGER COMMUNITIES IN COLORADO (CORTEZ AND GRAND JUNCTION) OFFER TERTIARY CARE HOSPITALS, BUT ARE MORE THAN 100 MILES AWAY FROM ANY OF THE COMMUNITIES DESCRIBED. THE ECONOMY OF GRAND COUNTY IS PRIMARILY DRIVEN BY A RECREATION-BASED TOURISM INDUSTRY THAT IS FUELED BY OVER 3 MILLION VISITORS ANNUALLY. THE MEDIAN HOUSEHOLD INCOME FOR GRAND COUNTY IS 56,639, COMPARED WITH 74,197 FOR UTAH AND 64,994 NATIONALLY. 14% OF PERSONS IN GRAND COUNTY FALL BELOW THE POVERTY LINE. APPROXIMATELY 33.5% OF THE HOSPITAL'S PATIENT MIX IS MEDICARE WITH 13.6% COVERED BY THE MEDICAID PROGRAM.

SCHEDULE H, PART VI, LINE 5
THE HOSPITAL'S GOVERNING BODY IS VOLUNTEER BOARD OF DIRECTORS AND IS COMPRISED OF INDIVIDUALS THAT LIVE IN THE REGION, MOST OF WHOM HAVE BEEN RESIDENTS FOR DECADES. THEY BRING AN EXCELLENT MIX OF SKILLS AND EXPERIENCE AND INCLUDE A LICENSED CLINICAL SOCIAL WORKER, A VA NURSE, A FORMER GRAND COUNTY SCHOOL DISTRICT ADMINISTRATOR, AS WELL AS PHYSICIANS AND BUSINESS OWNERS. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. AS A NON-PROFIT CORPORATION, THE HOSPITAL DOES NOT HAVE ANY SHAREHOLDERS, THEREFORE ALL SURPLUS FUNDS ARE APPLIED TO IMPROVEMENTS IN THE FACILITY, EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, AND EDUCATION. THE HOSPITAL SPONSORS EDUCATIONAL PROGRAMS TO ADDRESS SPECIFIC COMMUNITY HEALTH CONCERNS, SUCH AS SUBSTANCE USE DISORDER, MENTAL HEALTH, MEDICAL CARE PLANNING, CHILDBIRTH, AND OTHERS. THE HOSPITAL ALSO PARTICIPATES IN ACTIVITIES TO PROMOTE THE HEALTH OF THE COMMUNITY, INCLUDING MAKING CASH AND IN-KIND DONATIONS THAT PROVIDE CRUCIAL PROGRAM SUPPORT TO ORGANIZATIONS THAT MAKE IMPORTANT IMPACTS ON THE LOCAL COMMUNITY. THESE INCLUDE YOUTH-ORIENTED ORGANIZATIONS, ADVOCATES FOR RECOVERY AWARENESS, LOCAL DOMESTIC VIOLENCE SHELTER, AND OTHERS. THE HOSPITAL REGULARLY PARTNERS WITH AND PROVIDES SUPPORT TO THE LOCAL FREE HEALTH CLINIC, HOSTS REGULAR BLOOD DRIVES, PROVIDES MATURATION EDUCATION TO 5TH GRADE STUDENTS, AND SPONSORS A BREAST CANCER AWARENESS CAMPAIGN EVERY OCTOBER.