4A (Expenses $ 3748349 including grants of $ 3602620) (Revenue $ 4338029)
"FHI SERVICES IS A 501(C) (3) NON-PROFIT CORPORATION. FHI SERVICES IS GOVERNED BY THE SAME BOARD AND MANAGEMENT TEAM AS ITS PARENT ORGANIZATION, FHS SERVICES, AND ITS BROTHER/SISTER ORGANIZATION, THE FAUQUIER HEALTH FOUNDATION (DBA THE PATH FOUNDATION). THE THREE ENTITIES, COLLECTIVELY, ARE REFERRED TO AS THE ORGANIZATION"". THE ORGANIZATION'S"" MISSION IS TO STRENGTHEN THE HEALTH AND VITALITY OF THE COMMUNITIES OF FAUQUIER, RAPPAHANNOCK AND NORTHERN CULPEPER COUNTIES. FAUQUIER HEALTH IS OPERATED BY A JOINT VENTURE (FAUQUIER HOLDING COMPANY) OWNED IN PART BY FHI SERVICES (20%) AND LIFEPOINT HEALTH (80%). FHI SERVICES APPOINTS 50% OF THE MEMBERS OF THE FAUQUIER HOLDING COMPANY LLC'S GOVERNING BOARD AND FHI SERVICES HAS MAJORITY GOVERNANCE WITH RESPECT TO ITEMS/ISSUES IMPACTING THE TAX-EXEMPT PURPOSE OF FHI SERVICES (CHARITABLE OVERRIDE PROVISION).THE COMMUNITY BENEFIT CONTRIBUTION OF FHI SERVICES INCLUDES PROGRAMS AND ACTIVITIES THAT IMPROVE ACCESS TO HEALTHCARE AND IMPROVE HEALTH IN FAUQUIER, RAPPAHANNOCK AND NORTHERN CULPEPER COUNTIES. ORGANIZATIONAL COMMITMENT TO PROVIDING A COMMUNITY BENEFIT INCLUDES: FAUQUIER HEALTH (FH) IS A 97 BED NOT-FOR-PROFIT ACUTE CARE FACILITY THAT PROVIDES COMPREHENSIVE HEALTHCARE SERVICES TO THE COMMUNITIES IT SERVES. THE MISSION IS TO MAKE THE COMMUNITIES IT SERVES HEALTHIER. FH IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA OF FAUQUIER COUNTY WITH A POPULATION OF 109, 986. THE SERVICE AREA IS GROWING AND AGING, WITH OVERALL PROJECTED GROWTH BETWEEN 2017-2022 OF 6.3% AND WITH A 45+ POPULATION COMPRISING 45% OF THE TOTAL IN 2022.TO ADDRESS THE GROWING AND CHANGING HEALTHCARE NEEDS RESULTING FROM THESE POPULATION CHANGES, FH CONTINUES TO SUPPORT FIFTEEN PHYSICIANS, TWO OBSTETRICS/GYNECOLOGISTS, TWO FAMILY MEDICINE PHYSICIANS, A RHEUMATOLOGIST, A NEUROLOGIST, AN INFECTIOUS DISEASE SPECIALIST, FIVE INTERNAL MEDICINE PHYSICIANS, TWO UROLOGISTS, AND A HEMATOLOGIST/ONCOLOGIST. ALL PATIENTS AT FH HAVE IMPARTIAL ACCESS TO TREATMENT OR ACCOMMODATIONS THAT ARE AVAILABLE OR MEDICALLY INDICATED, REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, RELIGION, OR SOURCE OF PAYMENT FOR CARE. THE 24-HOUR EMERGENCY DEPARTMENT IS OPEN TO EVERYONE IN THE COMMUNITY, REGARDLESS OF ABILITY TO PAY, AND PARTICIPATES IN MEDICARE, MEDICAID, AND CHAMPUS/TRICARE STANDARD.FH HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA.THE MAJORITY OF THE MEMBERS OF THE GOVERNING BODIES FOR FH ARE INDEPENDENT REPRESENTATIVES OF THE COMMUNITIES SERVED.FH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND IN ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS.FH HAS A FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE CARE FOR PATIENTS WITHIN 200% OF THE FEDERAL POVERTY GUIDELINES AND DISCOUNTED CARE FOR PATIENTS WITHIN 300% OF THE FEDERAL POVERTY GUIDELINES. THE FINANCIAL ASSISTANCE PROGRAM ALSO PROVIDES FREE CARE TO PATIENTS WHO RESIDE IN OTHER AREAS WHO ARE WITHIN 100% OF THE FEDERAL POVERTY GUIDELINES. IN ADDITION, THROUGH A CONTINUING CARE FUND, FAUQUIER HEALTH OFFERS ASSISTANCE TO INDIVIDUALS WHO HAVE INADEQUATE FINANCIAL MEANS TO COVER THE COST OF POST-HOSPITALIZATION HEALTH SERVICES, SUCH AS NURSING CARE.TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS. FH STAFF PROVIDED APPROXIMATELY 23,059 HOURS AT A COST OF APPROXIMATELY $779,920.64. IN ADDITION, PARTNERSHIPS HAVE BEEN ESTABLISHED WITH LOCAL NON-PROFITS (E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTS AND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFIT ACTIVITIES ARE COORDINATED BY A FULL-TIME COMMUNITY OUTREACH STAFF PERSON, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND AUXILIARY VOLUNTEERS AS NEEDED.IN ADDITION TO THE CONTRIBUTIONS MADE BY THE HOSPITAL, FHI SERVICES INVESTS IN THE COMMUNITY BY PROVIDING GRANTS RELATED TO THE FOUR PRIORITY AREAS OF CHILDHOOD WELLNESS, MENTAL HEALTH, SENIOR SERVICES AND ACCESS TO HEALTH. FHI SERVICES OFFERS SEVERAL GRANT CYCLES DURING THE YEAR TO HELP NONPROFITS AND GOVERNMENT AGENCIES BETTER THE COMMUNITIES IT SERVES. IN THE CURRENT YEAR, COMPETITIVE PROGRAM AND PLANNING GRANTS, GENERAL OPERATIONS GRANTS, NON-COMPETITIVE HEALTH PRIORITY GRANTS, AND RESPONSIVE GRANTS, WERE FUNDED. PROGRAM AND PLANNING GRANTS THESE 12-MONTH GRANTS ARE DESIGNED TO SUPPORT CLEARLY DEFINED PROGRAM-BASED INITIATIVES AND/OR SPECIFIC ORGANIZATIONAL PLANNING STRATEGIES. OFFERED ANNUALLY, THE OBJECTIVES OF THESE GRANTS ARE TO PROVIDE ONGOING SUPPORT TO SIGNATURE PROGRAMS OF ESTABLISHED ORGANIZATIONS; ENCOURAGE INNOVATION IN CREATING AND INTRODUCING NEW INITIATIVES AND OFFERINGS; AND TO STRENGTHEN EVOLVING ORGANIZATIONS FOCUSED ON CAPACITY AND PROCESS IMPROVEMENT. PROGRAMS MAY BE NEW OR ONGOING AND FUNDS MAY BE USED TO CREATE, IMPLEMENT AND/OR SUSTAIN SPECIFIC PROGRAMS. PLANNING GRANTS MAY BE CONSIDERED FOR A VARIETY OF PROCESSES INCLUDING STRATEGIC PLANNING, BOARD DEVELOPMENT, MASTER FACILITY PLANS, SURVEYS AND EVALUATIONS, PILOT PROGRAMS AND OTHER CAPACITY-BUILDING ACTIVITY. ALL PROGRAM AND PLANNING GRANTS RELATE TO ONE OF FOUR KEY PRIORITIES: ACCESS TO HEALTH, CHILDHOOD WELLNESS, MENTAL HEALTH, SENIOR SERVICES TOTALING $505,583 IN FY2017. (CONTINUED BELOW)"

THE FAUQUIER HOSPITAL
PART V, SECTION B, LINE 5: OVER 90 INDIVIDUALS FROM 56 COMMUNITY AND HEALTH CARE ORGANIZATIONS COLLABORATED TO IMPLEMENT A COMPREHENSIVE CHNA PROCESS FOCUSED ON IDENTIFYING AND DEFINING SIGNIFICANT HEALTH NEEDS, ISSUES, AND CONCERNS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. THE THREE-MONTH PROCESS CENTERED ON GATHERING AND ANALYZING DATA AS WELL AS RECEIVING INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY AND HAD SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH TO PROVIDE DIRECTION FOR THE COMMUNITY, THE FAUQUIER HEALTH FOUNDATION, THE VIRGINIA DEPARTMENT OF HEALTH, AND FH TO CREATE A PLAN TO IMPROVE THE HEALTH OF THE COMMUNITY.42 COMMUNITY MEMBERS, NOT-FOR-PROFIT ORGANIZATIONS (REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, ELDERLY AND CHILDREN), FOUNDATIONS, SCHOOLS, HEALTH PROVIDERS, AND GOVERNMENT REPRESENTATIVES PARTICIPATED IN THREE FOCUS GROUPS FOR THEIR PERSPECTIVES ON COMMUNITY HEALTH NEEDS AND ISSUES ON APRIL 4 AND 5, 2017.INFORMATION GATHERING USING SECONDARY PUBLIC HEALTH SOURCES OCCURRED IN FEBRUARY AND MARCH OF 2017. TWENTY-FIVE COMMUNITY PHYSICIANS AND 285 FAUQUIER HEALTH EMPLOYEES WERE SURVEYED ELECTRONICALLY REGARDING THEIR PERSPECTIVES ON COMMUNITY HEALTH STATUS AND NEEDS FROM MARCH 1 THROUGH MARCH 27, 2017. 584 COMMUNITY SURVEYS WERE COMPLETED; 206 BY TELEPHONE (LANDLINE AND CELL PHONES), 268 ELECTRONIC SURVEYS, AND 124 PRINT SURVEYS IN ENGLISH AND 6 IN SPANISH WERE CONDUCTED BETWEEN MARCH 1 AND MARCH 31, 2017. COMMUNITY PARTNERS SENT THE SURVEY OUT TO CLIENTS AND EMPLOYEES. A COMMUNITY HEALTH TOWN HALL WAS CONDUCTED ON APRIL 6, 2017 WITH OVER 60 COMMUNITY STAKEHOLDERS. THE AUDIENCE CONSISTED OF HEALTHCARE PROVIDERS, BUSINESS LEADERS, LAW ENFORCEMENT, GOVERNMENT REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATIONS (MENTAL HEALTH, SUBSTANCE ABUSE, ELDERLY SERVICES, MINORITY POPULATIONS, ETC.), AND OTHER COMMUNITY MEMBERS.INPUT OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WAS RECEIVED DURING THE FOCUS GROUPS, THE COMMUNITY HEALTH TOWN HALL, AND THE COMMUNITY SURVEY. AGENCIES REPRESENTING THESE POPULATIONS WERE INTENTIONALLY INVITED TO THE FOCUS GROUPS AND TOWN HALL. NOT-FOR-PROFIT AND GOVERNMENT AGENCIES DISTRIBUTED THE COMMUNITY SURVEY TO THEIR CLIENTS TO ENSURE INPUT FROM THESE POPULATIONS. HOSPITAL EMPLOYEES AND COMMUNITY PHYSICIANS WERE ALSO SURVEYED, PROVIDING INSIGHT INTO THE HEALTH NEEDS OF THE MEDICALLY UNDERSERVED AND THE COMMUNITY AT-LARGE.

THE FAUQUIER HOSPITAL
PART V, SECTION B, LINE 7D: AS OF AUGUST 1, 2017, THIS REPORT WAS MADE WIDELY AVAILABLE TO THE COMMUNITY VIA FAUQUIER HEALTH'S WEBSITE, WWW.FAUQUIERHEALTH.ORG, AND THE FAUQUIER HEALTH FOUNDATION'S (DBA THE PATH FOUNDATION) WEBSITE, WWW.PATHFORYOU.ORG. OUTSIDE OF THE WEBSITES, PAPER COPIES ARE AVAILABLE FREE OF CHARGE AT BOTH FAUQUIER HOSPITAL AND THE FAUQUIER HEALTH FOUNDATION.

THE FAUQUIER HOSPITAL
PART V, SECTION B, LINE 11: AT THE COMMUNITY HEALTH TOWN HALL, ATTENDEES REVIEWED THE MOST SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY FOR THE NEXT THREE-YEARS AS IDENTIFIED BY THE FOCUS GROUPS AND THE COMMUNITY SURVEY. THE COMMUNITY HEALTH TOWN HALL AFFIRMED THE PRIORITIES, LISTED BELOW.WITH THE FOLLOWING ISSUES PRIORITIZED, ATTENDEES BRAINSTORMED GOALS AND ACTIONS AT THE COMMUNITY HEALTH TOWN HALL, CREATING THE FOUNDATION FOR FAUQUIER AND RAPPAHANNOCK COUNTIES' HEALTH INITIATIVES.SUBSTANCE ABUSE (INCLUDING ALCOHOL, TOBACCO, AND DRUGS), MENTAL HEALTH SERVICES, HEALTHY EATING/ACTIVE LIVING (ADDRESSING GENERAL HEALTH AND OBESITY), SOCIOECONOMICS (HOUSING, JOBS), ACCESS TO CARE (UNINSURED, COST OF INSURANCE AND CARE, AND CATCHING PEOPLE IN THE SERVICE GAP), CHILDHOOD WELLNESS (MENTAL HEALTH, NUTRITION, AND PHYSICAL ACTIVITY) AND SENIOR SERVICES (HOME CARE, WELLNESS, AND CHRONIC DISEASE MANAGEMENT).TO ADDRESS HEALTH EDUCATION AND LEADING CAUSES OF DEATH, THE HOSPITAL HOSTS FREE, MONTHLY HEALTH LECTURES ON VARIOUS TOPICS IDENTIFIED IN THE ASSESSMENT SUCH AS CANCER, HEART DISEASE, STROKE AND TIA, CHOLESTEROL, DIABETES, OBESITY, CONGESTIVE HEART FAILURE AND NUTRITION. FREE BLOOD PRESSURE SCREENINGS WERE ALSO OFFERED AT THE FAUQUIER HOSPITAL BISTRO DURING TUESDAYS AND THURSDAYS SENIOR SUPPER HOURS. FAUQUIER HEALTH ADDRESSES DIABETES BY PROVIDING DIABETES EDUCATION INCLUDING SUPPORT GROUPS, SELF-MANAGEMENT CLASSES, SCREENINGS, COUNSELING, AND TALKS AT SCHOOLS ON DIABETES TO SCHOOL CHILDREN. FREE MAMMOGRAMS ARE PROVIDED TO WOMEN TURNING 40. TO ADDRESS AGING SERVICES, FAUQUIER HEALTH FACILITATES SUPPORT GROUPS FOR ALZHEIMER'S, DEMENTIA, CANCER, CAREGIVERS AND DIABETES. FAUQUIER HEALTH HOSTED A SENIOR RESOURCE FAIR FOR COMMUNITY MEMBERS. IN ADDITION, FAUQUIER PARTNERS WITH THE LOCAL COMMUNITY SERVICE BOARD AND AGING TOGETHER TO HOST MEDICARE/MEDICAID COUNSELING, A FALL SYMPOSIUM AND AN ALZHEIMER'S/DEMENTIA WORKSHOP.TO ADDRESS CHILDHOOD WELLNESS, FAUQUIER HEALTH OFFERS MONTHLY JUNIOR CHEF CLASSES. DURING THE CLASS, THE KIDS LEARN HOW TO COOK HEALTHY MEALS. TO ADDRESS SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES, FAUQUIER HEALTH PROVIDES FREE MEETING SPACE TO SEVERAL SUPPORT GROUPS, INCLUDING FAMILIES OVERCOMING DRUG ADDICTION, NAMI (NATIONAL ALLIANCE ON MENTAL ILLNESS), AND THE ADDICTION RECOVERY SUPPORT GROUP. ADDITIONAL SUPPORT GROUPS THAT MEET AT THE HOSPITAL INCLUDE RHEUMATOID ARTHRITIS, BEREAVEMENT, LYME DISEASE, AND BREASTFEEDING. OTHER HEALTH NEEDS IDENTIFIED THAT THE HOSPITAL IS NOT ADDRESSING ARE HANDLED BY LOCAL ORGANIZATIONS OR GOVERNMENT ENTITIES. EXAMPLES INCLUDE, SOCIOECONOMICS WHICH ARE ADDRESSED BY THE LOCAL HEALTH DEPARTMENT AND SOCIAL SERVICES.BEHAVIORAL HEALTH IS CURRENTLY ADDRESSED BY THE LOCAL COMMUNITY SERVICES BOARD AND THE FAUQUIER FREE CLINIC; HOWEVER, THE HOSPITAL IS EXPLORING INITIATIVES TO ADDRESS THE NEED IN THE COMMUNITY. THE HOSPITAL SUPPORTS THE LOCAL FREE CLINIC FINANCIALLY AND WITH DONATED LAB AND RADIOLOGY SERVICES TO PROVIDE CARE TO THE UNINSURED POPULATION.

THE FAUQUIER HOSPITAL
PART V, SECTION B, LINE 16J: IN ADDITION TO PUBLISHING THE FINANCIAL ASSISTANCE POLICY ON THE HOSPITAL'S WEBSITE, SIGNAGE IS POSTED STRATEGICALLY THROUGHOUT THE HOSPITAL (INCLUDING ALL INPATIENT, OUTPATIENT, ANCILLARY AND EMERGENCY DEPARTMENT REGISTRATION OFFICES) WHICH INDICATES THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDES CONTACT INFORMATION FOR FINANCIAL COUNSELORS WHO CAN HELP WITH THE APPLICATION PROCESS. NOTIFICATION REGARDING THE POLICY ARE AVAILABLE IN BOTH ENGLISH AND SPANISH, THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY FAUQUIER HEALTH. REPRESENTATIVES OF OUR FINANCIAL ASSISTANCE ELIGIBILITY PARTNERS AND MEDASSIST, ALSO DIRECT ALL PATIENTS WHO ARE SCREENED FOR STATE OR FEDERAL ASSISTANCE PROGRAMS BUT DO NOT QUALIFY TO THE HOSPITAL FINANCIAL COUNSELORS FOR HOSPITAL CHARITY SCREENING.

PART I, LINE 3C:
ALL PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME LEVELS ARE AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES (FPG),ARE ELIGIBLE FOR FREE CARE. THIS PROCESS REQUIRES AN APPLICATION AND VERIFICATION OF ALL SOURCES OF INCOME. IN ADDITION,ALL PATIENTS WHOSE INCOME IS BETWEEN 200-300% OF FPG ARE ELIBLE FOR DISCOUNTED CARE. BEFORE FINAL COLLECTION ACTION, ACCOUNTS ARE PUT THROUGH CREDIT SCORING SOFTWARE TO HELP IDENTIFY THOSE PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAVE NOT CONTACTED FH OFFICE UP TO THAT POINT. IF THE SOFTWARE INDICATES THAT THE PATIENT'S INCOME LEVEL MEETS FINANCIAL ASSISTANCE ELIGIBILITY, THE ACCOUNT IS PRESUMPTIVELY WRITTEN OFF TO CHARITY AND FURTHER COLLECTION ACTIVITY IS NOT PURSUED.PART I, LINE 7THE HOSPITAL FACILITY WAS CONTRIBUTED TO FAUQUIER HOLDING COMPANY, LLC AS PART OF THE LIFEPOINT TRANSACTION IN TAX YEAR 2013. UP UNTIL MAY 2018, FHI SERVICES RETAINS A 20% OWNERSHIP INTEREST IN FAUQUIER HOLDING COMPANY, LLC, AND APPOINTS 50% OF THE MEMBERS OF THE GOVERNING BOARD AND MAINTAINS RESERVE POWERS OVER EXEMPT ACTIVITIES OF THE JOINT VENTURE. FAUQUIER HOLDING COMPANY, LLC HAS A CALENDAR YEAR FISCAL YEAR AND ISSUES ITSFORM K-1 BASED UPON THE CALENDAR YEAR. AS A RESULT, THE INFORMATION PROVIDED IN PART I LINE 7 AND PART II REFLECTS THE OPERATIONS REFLECTED ON THE K-1 ISSUED BY FAUQUIER HOLDING COMPANY, LLC, WHICH IS 20% OF THE TOTAL COSTS INCURRED BY FAUQUIER HOSPITAL, FOR ITS YEAR ENDING WITHIN FHI SERVICES' FISCAL YEAR ( FROM JANUARY 1, 2017 THROUGH DECEMBER 31, 2017). FHI SERVICES' FISCAL YEAR WAS 10/1/2017 - 9/30/2018.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIES SUPPORT THE HEALTH OF THE COMMUNITY BY OFFERING ENVIRONMENTAL IMPROVEMENTS AND COMMUNITY SUPPORT.ENVIRONMENTAL IMPROVEMENTS - FAUQUIER HEALTH'S ANNUAL MEDICATION AND SHARPS COLLECTION EVENTS HELPED TO SAFELY DISPOSE OF SHARPS AND MEDICATIONS. RATHER THAN COMMUNITY MEMBERS FLUSHING MEDICATIONS INTO THE GROUND WATER OR DISPOSING OF SHARPS AT THE LANDFILL, FAUQUIER HEALTH COLLECTS THEM AND WORKS WITH A MEDICAL WASTE MANAGEMENT COMPANY THAT DISPOSES OF THE ITEMS.COMMUNITY SUPPORT ACTIVITIES INCLUDED MED SHARPS,EMERGENCY DRUG SUPPLIES AND DISASTER ASSISTANCE.

PART III, LINE 2:
THE AMOUNT OF ORGANIZATION'S BAD DEBT EXPENSE WAS ESTIMATED BY MULTIPLYING THE TOTAL BAD DEBT EXPENSE FOR FAUQUIER HEALTH BY THE COST-TO-CHARGE RATIO CALCULATED IN WORKSHEET II. THE AMOUNT REPORTED IS 20% OF THIS COST WHICH IS THE FHI SERVICES INTEREST IN THE FAUQUIER HOLDING COMPANY, LLC.

PART III, LINE 3:
BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY WAS ESTIMATED BY USING THE TOTAL BAD DEBT EXPENSE FOR FAUQUIER HEALTH MULTIPLIED BY THE COST-TO-CHARGE RATIO TO CALCULATE COST. THE BAD DEBT EXPENSE AT COST IS MULTIPLIED BY 29% WHICH IS THE ESTIMATED PERCENTAGE ATTRIBUTABLE TO PATIENTS THAT WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S POLICY. THE AMOUNT REPORTED IS 20% OF THIS COST WHICH IS THE FHI SERVICES INTEREST IN THE FAUQUIER HOLDING COMPANY, LLC.

PART III, LINE 4:
ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR THE EXCESS OF CHARGES OVER THE PAYMENTS ON PATIENT ACCOUNTS TO BE RECEIVED FROM THIRD PARTY PAYERS AND ESTIMATES OF UNCOLLECTIBLE AMOUNTS. THE SYSTEM'S POLICY IS TO WRITE-OFF ALL PATIENT ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE. ANY ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT MAY BECOME UNCOLLECTABLE IN FUTURE PERIODS BASED ON MANAGMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS FOR EACH OF ITS MAJOR PAYERS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS , AND OTHERS FOR SERVICES RENDERED, AND INCLUDE ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGERSUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS. FAUQUIER HOSPITAL PERIODICALLY EMPLOYED CREDIT SCORING SOFTWARE TO HELP IDENTIFY PATIENTS THAT MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, WHICH HAD NOT COMPLETED A FINANCIAL ASSISTANCE APPLICATION. IF THE SOFTWARE INDICATED THAT THE PATIENT'S INCOME LEVEL MET FINANCIAL ASSISTANCE ELIGIBILITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THEN THE ACCOUNT WAS WRITTEN OFFTO CHARITY AND FURTHER COLLECTION ACTIVITY WAS NOT PURSUED. BECAUSE OF THE PERIODIC USE OF SUCH CREDIT SCORING SOFTWARE THROUGHOUT THE YEAR, IT IS DIFFICULT TO ESTIMATE THE AMOUNT OF THE BAD DEBT EXPENSE ATTRIBUTABLETO PATIENTS THAT MIGHT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.

PART VI, LINE 2:
FAUQUIER HEALTH ASSESSES THE HEALTH NEEDS OF THE COMMUNITY BY CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS AS WELL AS CONTINUALLY COMMUNICATING WITH THE COMMUNITY STAKEHOLDERS WHO ARE SERVING OUR AREA'S RESIDENTS. FOR EXAMPLE, FAUQUIER HEALTH MEETS REGULARLY WITH THE FAUQUIER FREE CLINIC LEADERSHIP AND PROVIDES FINANCIAL AND IN-KIND ASSISTANCE TO THE CLINIC WHICH SERVES THE LOW INCOME AND UNINSURED IN FAUQUIER AND RAPPAHANNOCK COUNTIES.

PART VI, LINE 6:
UP UNTIL MAY 2018, LIFEPOINT HEALTH WAS 80% OWNER OF FAUQUIER HEALTH, A LEADING HEALTHCARE COMPANY DEDICATED TO MAKING COMMUNITIES HEALTHIER WITH FACILITIES IN 30 STATES. FHI SERVICES HELD A 20% OWNERSHIP INTEREST IN FAUQUIER HOLDING COMPANY, LLC UNTIL MAY 2018, WHEN THE FHI SERVICES BOARD ELECTED TO EXERCISE THE PUT OPTION. UP UNTIL MAY 2018, TOGETHER THEY OPERATED FAUQUIER HEALTH.

PART III, LINE 8:
THE SHORTFALL FOR MEDICARE IS NOT CURRENTLY INCLUDED/CONSIDERED IN COMMUNITY BENEFIT. HOWEVER, THE SHORTFALL IS DUE TO THE REIMBURSEMENT FROM MEDICARE FALLING SHORT OF THE COST INCURRED TO PROVIDE CARE TO THE MEDICARE POPULATION SERVED BY THE FAUQUIER HOSPITAL. AS WITH THE SHORTFALL EXPERIENCED FOR THE MEDICAID POPULATION, THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS WELL. IT IS PART OF THE ORGANIZATION'S MISSION TO PROVIDE THE BEST POSSIBLE CARE TO PATIENTS WITHIN OUR COMMUNITY, AND THE ORGANIZATION BELIEVES PROVIDING SUCH CARE HAS IMPROVED THE OVERALL HEALTH OF THE COMMUNITY. BY PROVIDING SUCH CARE TO MEDICARE PATIENTS, THE GOVERNMENT'S BURDEN FOR CARING FOR SUCH INDIVIDUALS IS LESSENED. THE MEDICARE COST REPORT WAS UTILIZED AS OUTLINED IN THE SCHEDULE H,PART III, SECTION B, WORKSHEET B, WHICH UTILIZES THE COST TO CHARGE RATIO DEVELOPED WITHIN THE MEDICARE COST REPORT TO DETERMINE THE ALLOWABLE COST.

PART III, LINE 9B:
"FAUQUIER HEALTH'S (FH) FINANCIAL ASSISTANCE POLICY CONTAINS THE FOLLOWING PROVISION ON COLLECTION PRACTICES FOR THOSE PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE: FH'S MANAGEMENT SHALL DEVELOP POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES (INCLUDING ACTIONS THE HOSPITAL MAY TAKE IN THE EVENT OF NON-PAYMENT, INCLUDING COLLECTIONS ACTION AND REPORTING TO CREDIT AGENCIES) THAT TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR CHARITY CARE OR DISCOUNTED CARE; A PATIENT'S GOOD FAITH EFFORTS TO APPLY FOR GOVERNMENTAL ASSISTANCE PROGRAMS OR FINANCIAL ASSISTANCE FROM FH, AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS WITH FH. FH WILL NOT IMPOSE EXTRAORDINARY COLLECTIONS ACTIONS SUCH AS LAWSUITS, WAGE GARNISHMENTS, ARRESTS, BODY ATTACHMENTS, LIENS ON RESIDENCES, OR OTHER SIMILAR LEGAL ACTIONS AGAINST ANY PATIENT WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER THAT PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS FINANCIAL ASSISTANCE POLICY. ""REASONABLE EFFORTS"" INCLUDE NOTIFICATIONS BY THE HOSPITAL OF THIS FINANCIAL ASSISTANCE POLICY UPON ADMISSION AND IN WRITTEN AND ORAL COMMUNICATIONS WITH THE PATIENT REGARDING THE PATIENT'S BILL, INCLUDING INVOICES AND TELEPHONE CALLS BEFORE COLLECTION ACTION OR REPORTING TO CREDIT AGENCIES IS INITIATED. IF A PATIENT IS FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE AFTER COLLECTION ACTIONS HAVE STARTED, ALL COLLECTION ACTIVITY IS IMMEDIATELY STOPPED, NOTIFICATIONS ARE SENT TO THE CREDIT BUREAU IF NECESSARY AND PATIENTS ARE NOT CHARGED FOR COLLECTION FEES. IF A PATIENT IS FOUND TO QUALIFY FOR FINANCIAL ASSISTANCE AFTER MAKING PAYMENTS TOWARDS THEIR BALANCE, THE PAYMENTS ARE REFUNDED TO THE PATIENT."

PART VI, LINE 3:
"NOTIFICATION OF FAUQUIER HEALTH'S FINANCIAL ASSISTANCE PROGRAM IS DISSEMINATED BY VARIOUS MEANS, INCLUDING NOTIFICATION OF CONTACT INFORMATION FOR FINANCIAL COUNSELORS ON ALL OUR BILLING STATEMENTS AND SIGNAGE IN ALL OUR PATIENT REGISTRATIONS AREAS. THE POLICY ITSELF IS AVAILABLE ON THE HOSPITAL WEBSITE, WHICH ALSO PROVIDES CONTACT INFORMATION FOR OUR FINANCIAL COUNSELORS. REQUESTS FOR FINANCIAL ASSISTANCE MAY BE MADE AT ANY POINT IN THE COLLECTION CYCLE. EVERY BILLING STATEMENT RECEIVED BY A PATIENT INCLUDES THE FOLLOWING LANGUAGE: ""IN MEETING YOUR FINANCIAL OBLIGATIONS FOR THE CARE PROVIDED BY FAUQUIER HEALTH WE ASK THAT YOU WORK WITH US ON ANY BILLS THAT YOU ARE HAVING DIFFICULTY PAYING. YOU WILL FIND OUR STAFF UNDERSTANDING AND EAGER, TO HELP YOU."" THIS MESSAGE IS FOLLOWED BY A LIST OF TELEPHONE NUMBERS THAT THE PATIENT MAY CALL TO REACH THE ORGANIZATION'S FINANCIAL COUNSELING STAFF, HOURS OF OPERATION, AND AN EMAIL ADDRESS. WHEN PATIENTS CALL THE FINANCIAL COUNSELING TELEPHONE NUMBER, THEY ARE PROMPTED TO SELECTIONS TO REACH THE STAFF MEMBER THAT IS MOST LIKELY ABLE TO HELP THEM (E.G; UNINSURED, SPANISH SPEAKING, BILLING QUESTIONS, ETC.). IN ADDITION, UNINSURED INPATIENTS AND THOSE WITH MEDICARE INSURANCE AND NO SECONDARY CARRIER ARE CONTACTED (USUALLY WITH A PERSONAL VISIT IN THEIR HOSPITAL ROOM) BY AN EMPLOYEE OF ONE OF OUR PARTNERS, MEDASSIST. THE MEDASSIST PERSONNEL SCREEN THESE PATIENTS FOR ELIGIBILITY FOR AVAILABLE STATE OR FEDERAL PROGRAMS. IF THESE PATIENTS DO NOT MEET CRITERIA FOR THESE PROGRAMS, THEY ARE THEN REFERRED TO A FINANCIAL COUNSELOR FOR SCREENING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. UNINSURED PATIENTS WHO VISIT OUR EMERGENCY DEPARTMENT ARE ALSO GIVEN A PACKET OF INFORMATION THAT INCLUDES A FINANCIAL ASSISTANCE APPLICATION AND A BUSINESS CARD WITH THE NAME AND CONTACT INFORMATION FOR ONE OF OUR FINANCIAL COUNSELORS. LASTLY, WE DO USE CREDIT SCORING SOFTWARE TO HELP IDENTIFY PATIENTS WHO MIGHT QUALIFY FOR FINANCIAL ASSISTANCE BUT HAVE NOT CONTACTED OUR OFFICE. OUR FINANCIAL ASSISTANCE POLICY STATES THAT WE MAY USE THIS KIND OF SOFTWARE, WHICH USES INFORMATION FROM CREDIT BUREAUS AND SCREENS PATIENTS AGAINST THE CRITERIA OF OUR FINANCIAL ASSISTANCE POLICY."

PART VI, LINE 4:
FAUQUIER HEALTH (FH) IS A 97-BED, NOT-FOR-PROFIT, ACUTE CARE FACILITY ESTABLISHED IN 1954 TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES TO THE RURAL COMMUNITIES IT SERVES. OUR MISSION IS TO MAKE COMMUNITIES HEALTHIER. FAUQUIER HEALTH IS THE ONLY HOSPITAL IN OUR PRIMARY SERVICE AREA, WHICH INCLUDES FAUQUIER AND MINOR PORTIONS OF FIVE SURROUNDING COUNTIES. THE PRIMARY SERVICE AREA HAS A POPULATION OF 109,986. THE AVERAGE HOUSEHOLD INCOME IS $102,185. 6.2% OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINE. 17.5% OF FAUQUIER HEALTH'S PATIENTS ARE MEDICAID RECIPIENTS OR SELF-PAY. THE FOLLOWING DISTRICTS WITHIN FAUQUIER COUNTY ARE CONSIDERED MEDICALLY UNDERSERVED AREAS AND POPULATIONS (MUA/P) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA): LEE DISTRICT AND MARSHALL DISTRICT.

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FAUQUIER HEALTH PROMOTES THE HEALTH OF THE COMMUNITY BY: - ENSURING THAT THE MAJORITY (78%) OF THE INDIVIDUALS SERVING ON THE FAUQUIER HOSPITAL BOARD OF DIRECTORS RESIDE IN THE PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION.- EXTENDING MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO ARE INTERESTED. - FAUQUIER HEALTH USES SURPLUS FUNDS TO IMPROVE PATIENT CARE BY UPGRADING THE TOOLS NEEDED TO CARE FOR PATIENTS AND PLANNING FOR IMPROVEMENTS. FAUQUIER HEALTH CONTINUES TO SUPPORT FIFTEEN EMPLOYED PHYSICIANS, TWO OBSTETRICS/GYNECOLOGISTS, TWO FAMILY MEDICINE PHYSICIANS, A RHEUMATOLOGIST, A NEUROLOGIST, AN INFECTIOUS DISEASE SPECIALIST, FIVE INTERNAL MEDICAL PHYSICIANS, TWO UROLOGISTS AND A HEMATOLOGIST/ONCOLOGIST. A TRANSITIONS TO HOME PROGRAM WAS DEVELOPED TO ADDRESS CHRONIC DISEASE MANAGEMENT AND READMISSION RATES FOR PATIENTS.- FH PARTNERS WITH LOCAL NON-PROFIT ORGANIZATIONS(E.G. FAUQUIER FREE CLINIC, THE CHAMBER OF COMMERCE, SCHOOLS AND CHURCHES) AND NATIONAL ORGANIZATIONS (E.G. THE AMERICAN CANCER SOCIETY) TO SUPPORT LOCAL EVENTSAND PROVIDE COMMUNITY HEALTH AND WELLNESS PROGRAMS. THESE COMMUNITY BENEFITS ACTIVITIES ARE COORDINATED BY A FULL-TIME COMMUNITY OUTREACH STAFF PERSON, SUPPORTED BY ADMINISTRATIVE AND CLINICAL DEPARTMENTS, AND OUR AUXILIARY VOLUNTEERS AS NEEDED. - TO HELP TRAIN AND EDUCATE HEALTH CARE PROFESSIONALS, FH WORKS WITH LOCAL COMMUNITY COLLEGES TO PROVIDE TOURS, LECTURES, AND INTERNSHIPS FOR STUDENTS. -ADDITIONALLY, THE ORGANIZATION PROVIDES ASSISTANCE TO THE FAUQUIER FREE CLINIC (FFC). FFC PROVIDES PRIMARY HEALTH AND DENTAL CARE TO UNINSURED RESIDENTS OF FAUQUIER AND RAPPAHANNOCK COUNTIES. FAUQUIER HEALTH PROVIDED LABORATORY, CARDIOLOGY/NEUROLOGY/PULMONARY SERVICES AND RADIOLOGY SERVICES AT NO CHARGE TO FFC PATIENTS. ADDITIONALLY, FREE CLINICAL CARE WAS PROVIDED BY COMMUNITY PHYSICIANS AND CLINICAL STAFF. COMMUNITY HEALTH EDUCATION, SCREENINGS AND OUTREACH PROGRAMS:FAUQUIER HEALTH PROVIDED 66 HEALTH EDUCATION SEMINARS (WHICH INCLUDE CLASSES AND LECTURES) AND HEALTH SCREENINGS AT 16 LOCAL EVENTS. LUNG CANCER EDUCATION AND PROSTATE SCREENING WAS PROVIDED TO THE COMMUNITY. FAUQUIER HEALTH ALSO PROVIDES SPEAKERS FOR LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS TO BUILD RELATIONSHIPS WITHIN THE COMMUNITY, PROMOTE COLLABORATION IN MANAGING HEALTH AND WELLNESS, AND EDUCATE THE COMMUNITY ON THE HEALTH SYSTEM.HEALTH EDUCATION THROUGH ADVERTISING, MEDIA, AND PUBLICATIONS. FAUQUIER HEALTH HAS ONE PUBLICATION WHICH IS A COMMUNITY NEWSLETTER, HEALTHY HAPPENINGS, INTENDED TO EDUCATE THE PUBLIC ABOUT HEALTH ISSUES AND HEALTH CARE AND HOSPITAL SERVICES. PUBLISHED QUARTERLY, IT REACHES 104,000 HOMES IN FAUQUIER AND SURROUNDING COUNTIES. EMERGENCY SERVICES:FAUQUIER HEALTH PROVIDES MEDICAL OVERSIGHT, DIRECTION, AND ORDERS TO PARAMEDICS IN THE FIELD AND IN ROUTE TO THE HOSPITAL. OUR EMERGENCY DEPARTMENT OFFERS 24-HOUR ACCESS TO MEDICAL SERVICES AND HELICOPTER TRANSPORT FOR CRITICALLY ILL OR INJURED INDIVIDUALS. SUPPORT GROUPS AND COMMUNITY GROUPS. FAUQUIER HEALTH SPONSORED, ASSISTED, OR PROVIDED MEETING SPACE FOR NINE SUPPORT GROUPS THAT MET WEEKLY OR MONTHLY. ADDITIONALLY, FAUQUIER HEALTH PROVIDED MEETING SPACE OR CASH DONATIONS FOR SEVERAL NON-PROFIT COMMUNITY GROUPS, (E.G. THE AMERICAN RED CROSS, AGING TOGETHER AND AMERICAN CANCER SOCIETY FAUQUIER CHAPTER). FAUQUIER HEALTH EMPLOYEES PROVIDED REPRESENTATION ON COMMUNITY BOARDS AND COALITIONS.PHYSICIAN REFERRAL. THE PHYSICIAN REFERRAL PROGRAM HELPS THE COMMUNITY WITH QUESTIONS ON PHYSICIANS, CLASSES AND PROGRAMS REGISTRATION, AND HEALTH RESOURCES AVAILABLE THROUGH THE HOSPITAL OR IN THE COMMUNITY.