4A (Expenses $ 36406351 including grants of $ 112500) (Revenue $ 48532325)
BEDFORD MEMORIAL HOSPITAL EXISTS TO SERVE THE HEALTHCARE NEEDS OF ITS COMMUNITY, REGARDLESS OF PATIENT ABILITY TO PAY. BEDFORD'S ACUTE HOSPITAL ADMITTED 1,696 PATIENTS DURING 2021 AND PROVIDED 5,969 DAYS OF CARE DURING THE YEAR. HOSPITAL PROGRAMS INCLUDE PROVISION OF NURSING CARE; EXTENSIVE INPATIENT AND OUTPATIENT SURGICAL AND ENDOSCOPIC SERVICES; AND DIAGNOSTIC IMAGING SERVICES INCLUDING CT, MRI, AND MAMMOGRAPHY. BEDFORD MEMORIAL HOSPITAL WAS HOME TO OAKWOOD MANOR, A LONG-TERM CARE FACILITY WHICH PROVIDED 22,348 DAYS OF SKILLED AND INTERMEDIATE CARE UNTIL NOVEMBER 2021. BEDFORD PROVIDES A NUMBER OF SERVICES TARGETING THE SPECIFIC HEALTH NEEDS OF ITS POPULATION, INCLUDING DIABETES MANAGEMENT; HOME HEALTH AND HOSPICE CARE; PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPY PROGRAMS; AN ADULT DAY CARE CENTER; AND CARDIAC AND RESPIRATORY REHAB. BEDFORD ALSO PROVIDES AN EMERGENCY DEPARTMENT WITH 24-HOUR CARE, EMERGENCY TRANSPORTATION, AND A CHEST PAIN AND STROKE PROGRAM. WITH 18,152 VISITS DURING 2021, BEDFORD'S EMERGENCY DEPARTMENT SERVICES ARE A CRITICAL COMPONENT OF THE HEALTH SAFETY NET IN ITS SERVICE AREA, ACTING AS A KEY HEALTH PROVIDER FOR A SIGNIFICANT NUMBER OF UNINSURED PATIENTS. 2021 COMMUNITY BENEFIT HIGHLIGHTS * IN FURTHERANCE OF ITS MISSION, BEDFORD PROVIDED EXTENSIVE UNCOMPENSATED CARE DURING 2021, $2,194,228 IN CHARGES AT AN ESTIMATED COST OF $570,574 WAS CONTRIBUTED AS TRADITIONAL CHARITY CARE TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. ELIGIBILITY FOR CHARITY CARE IS BASED ON POVERTY INCOME LEVELS SET BY THE STATE. * CHARGES OF $5,459,690, AT AN ESTIMATED COST OF $1,419,706 WAS CONTRIBUTED AS BAD DEBT TO PATIENTS WHO DID NOT HAVE THE ABILITY TO PAY. * LOSS FROM MEDICARE BASED ON COST TO CHARGE RATIO TOTALED $0. * LOSS FROM MEDICAID BASED ON COST TO CHARGE RATIO TOTALED $0. BEDFORD MEMORIAL HOSPITAL SUPPORTS COMMUNITY SCREENINGS AND EDUCATION ON CHRONIC DISEASE PREVENTION AND MANAGEMENT. BEDFORD MEMORIAL HOSPITAL EMPLOYEES CONTINUALLY OFFER SUPPORT TO THE COMMUNITY VIA PROFESSIONAL HEALTH EDUCATION ON CHRONIC DISEASE PREVENTION AND MANAGEMENT, HEALTH SCREENINGS, COUNSELING AND SUPPORT GROUPS. SOME EXAMPLES ARE LISTED BELOW. DURING 2021, THE HOSPITAL OFFERED EDUCATIONAL MATERIALS, ON TOPICS SUCH AS DIABETES, HEART DISEASE, SKIN CANCER, NUTRITION/WEIGHT MANAGEMENT, ETC., AT LOCAL COMMUNITY FESTIVALS. THE HOSPITAL ALSO CONDUCTED HEALTH SCREENINGS AT LOCAL EXPOS AND HEALTH FAIRS. HOSPITAL PERSONNEL ALSO LEAD MANY HEALTH EDUCATION SEMINARS THROUGHOUT THE YEAR WITH TOPICS SUCH AS HEART DISEASE/HEALTHY HEART, NUTRITION/WEIGHT MANAGEMENT, ETC. VOLUNTEERS BEDFORD MEMORIAL HOSPITAL IS HONORED TO HAVE MANY VOLUNTEERS FROM THROUGHOUT OUR SERVICE AREA MAKING A DIFFERENCE TO OUR PATIENTS, VISITORS, AND STAFF. OUR VOLUNTEERS ARE AN INVALUABLE PART OF OUR OPERATIONS, AS THEY SERVE VARIOUS LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS, FRONT DESK, REGISTRATION, EMERGENCY DEPARTMENTS, TRANSPORT, ETC. IN 2021, 44 VOLUNTEERS DONATED 5,017 HOURS TO OUR VOLUNTEER PROGRAM. DUE TO COVID-19, IN 2021 THERE WERE FEWER COMMUNITY BENEFIT EVENTS AND SCREENINGS OFFERED. HOWEVER, BMH CONTINUED SERVING THE COMMUNITY THROUGH PARTICIPATION IN SERVICE-ORIENTED ORGANIZATIONS SUCH AS ROTARY CLUB, LIONS CLUB, THE BEDFORD AREA CHAMBER OF COMMERCE, AND THE CENTRAL VIRGINIA BUSINESS COALITION. COMMUNITY SUPPORT WAS ALSO GIVEN THROUGH SPONSORSHIPS AND DONATIONS. THE COVID 19 PANDEMIC NEGATIVELY IMPACTED 2021 COMMUNITY OUTREACH PROGRAMMING AT BEDFORD MEMORIAL HOSPITAL. THE FOLLOWING IS A LIST OF PROGRAMS AND NUMBER OF PARTICIPANTS. *COMMUNITY HEALTH EDUCATION - GENERAL (C), HEART DISEASE/HEART EDUCATION, 1 SESSION, 100 PARTICIPANTS *COMMUNITY HEALTH EDUCATION - GENERAL (C), WALK/RUN EVENT, 1 SESSION, 100 PARTICIPANTS *COMMUNITY BENEFIT OPERATIONS (G), COMMUNITY HEALTH NEEDS ASSESSMENT - CHNA MEETINGS, 20 SESSIONS, 432 PARTICIPANTS *COMMUNITY BUILDING ACTIVITIES (X), COALITION BUILDING - MEETINGS, 9 SESSIONS, 238 PARTICIPANTS *COMMUNITY BUILDING ACTIVITIES (X), ECONOMIC DEVELOPMENT, 8 SESSIONS, 112 PARTICIPANTS IN 2021, THE TOTAL COMMUNITY BENEFIT REALIZED FOR BEDFORD MEMORIAL HOSPITAL WAS $1,895.68, THIS IS JUST A FEW WAYS IN WHICH BEDFORD MEMORIAL HOSPITAL REACHES OUT INTO THE COMMUNITY TO BRING AWARENESS TO HEALTH ISSUES AND ASSIST INDIVIDUALS IN OBTAINING THE HEALTHCARE NEEDED IN ORDER FOR THEM AND THEIR FAMILY MEMBERS TO STAY HEALTHY. IN 2021, BEDFORD HOSPICE VOLUNTEERS DONATED 2,273 HOURS OF SERVICE TO THE HOSPICE PROGRAM. VOLUNTEER SERVICE VISITS WERE MADE BY PORCH VISITS TO HOMES AND FACILITIES. VOLUNTEER VISITS ARE STILLL RESTRICTED BY HOSPICE ADMINATION DUE TO THE COVID19 RESTRICTIONS FOR VOLUNTEERS. A LARGE PORTION OF THEIR TIME AND TALENT WAS COMMITTED TO THE HOSPICE HOUSE. VOLUNTEERS SUPPORT THE HOSPICE HOUSE BY GROCERY SHOPPING, MEAL, AND MEDICATION DELIVERY. VOLUNTEERS DEVELOPED A NEW PROGRAM OF SENDING CARDS, PHONE CALLS AND SMALL GIFTS TO PATIENTS AND FAMILIES. HOSPICE MEMORIAL SERVICES MOVED TO ON VIRTUAL FORMAT ON FACEBOOK LIVE. DEVELOPING A NEW VIRTUAL SERVICE WHICH WAS PROVIDE EACH QUARTER OUR VOLUNTEERS USE THEIR OWN CARS AND HAVE REPORTED DRIVING 17,685 MILES IN 2021.

PART V, SECTION B, LINE 5:
"IN 2021, CENTRA'S DEPARTMENT OF COMMUNITY HEALTH CONDUCTED THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR CENTRA BEDFORD MEMORIAL HOSPITAL LOCATED IN BEDFORD, VIRGINIA. CENTRA DEFINES ITS TRIENNIAL CHNA AS A CONTINUOUS PROCESS FOR EVALUATING THE HEALTH NEEDS OF THE COMMUNITIES SERVED. IT IS USED TO SUPPORT THE SYSTEM'S ""JUST CAUSE"" WHICH IS ""PARTNERING WITH YOU TO LIVE YOUR BEST LIFE."" IN 2021-2022, CENTRA IS UNDERGOING A STRATEGIC PLANNING PROCESS AND THE CHNA WILL HELP INFORM THE DESIGN AND IMPLEMENTATION OF NEW SERVICES, PROGRAMS, AND PARTNERSHIPS IN RESPONSE TO IDENTIFIED UNMET COMMUNITY HEALTH NEEDS. IN ADDITION, THE CHNA AND IMPLEMENTATION PLAN IS USED TO GUIDE THE ACTIONS OF CENTRA'S BOARD OF DIRECTORS' COMMUNITY BENEFIT COMMITTEE, WHICH PROVIDES COMMUNITY-BASED GRANT FUNDING TO AREA NON-PROFIT ORGANIZATIONS ADDRESSING PRIORITIZED NEEDS IDENTIFIED THROUGH THE CHNA. LASTLY, THE COMPLETION OF BOTH THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND SUCCESSFUL EXECUTION OF THE ASSOCIATED IMPLEMENTATION PLAN ENSURES COMPLIANCE WITH THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 WHICH IS PROMULGATED IN REGULATION BY THE INTERNAL REVENUE AS DOCUMENTED ANNUALLY IN CENTRA'S FORM 990- SCHEDULE H. THE SERVICE AREA FOR THE CHNA IS REFERRED TO AS THE BEDFORD AREA AND INCLUDES THE TOWN OF BEDFORD AND COUNTY OF BEDFORD. THE TARGET POPULATION IS DEFINED AS (1) THE MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS AND THOSE SUFFERING FROM CHRONIC DISEASE; (2) THE GEOGRAPHIC AREA SERVED BY THE HOSPITAL(S); AND (3) TARGETED POPULATIONS SERVED BY THE HOSPITAL(S) (I.E., CHILDREN, WOMEN, SENIORS, CANCER PATIENTS). THE 2021 BEDFORD AREA COMMUNITY HEALTH NEEDS ASSESSMENT FOCUSED ON LIFTING THE VOICE OF THE COMMUNITY THROUGH THE COLLECTION OF 857 COMMUNITY HEALTH SURVEYS AS WELL AS CONDUCTING A STAKEHOLDER FOCUS GROUP/SURVEY. IN ADDITION, OVER 65 SOURCES OF PUBLICLY AVAILABLE SECONDARY DATA WERE COLLECTED. CHNA ACTIVITIES BEGAN IN MARCH 2021 AND CONCLUDED IN LATE SEPTEMBER WITH THE PRIORITIZATION OF NEEDS."

SCHEDULE H, PART V, SECTION B, LINE 7D:
HARD COPIES OF THE CHNA & IMPLEMENTATION PLAN WERE SENT TO ALL CHNA COMMUNITY ADVISORY BOARD MEMBERS.

PART V, SECTION B, LINE 11:
BEDFORD MEMORIAL HOSPITAL WORKS HARD TO COLLABORATE WITH STAKEHOLDERS IN THE BEDFORD COMMUNITY REGARDING THE HEALTH NEEDS OF BEDFORD. IN 2021, THE HOSPITAL FOCUSED ON THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT. IT TOOK NINE MONTHS TO CREATE THE FINAL DOCUMENT. BMH SPEARHEADED THE PROCESS, INCLUDING CONDUCTING SURVEYS AND COMPILING THE DATA THAT PROVIDED THE BASIS OF THE ASSESSMENT. THE HOSPITAL COLLABORATED CLOSELY WITH SEVERAL STAKEHOLDERS INCLUDING THE NEWLY FORMED PARTNERSHIP FOR HEALTHY COMMUNITIES, COMMUNITY ACCESS NETWORK, THE BEDFORD COMMUNITY HEALTH FOUNDATION, THE GREATER LYNCHBURG COMMUNITY FOUNDATION, JOHNSON HEALTH CENTER AND UNITED WAY OF CENTRAL VIRGINIA. THE ASSESSMENT IDENTIFIED THE FOLLOWING TOP 10 NEEDS IN THE BEDFORD COMMUNITY: -MENTAL HEALTH & SUBSTANCE USE DISORDERS -ACCESS TO HEALTHCARE SERVICES -ISSUES IMPACTING CHILDREN & THEIR FAMILIES -TRANSPORTATION -AGING & ELDER CARE -CHRONIC DISEASE -EMPLOYMENT/JOB ASSISTANCE -FINANCIAL STABILITY -HOUSING -DENTAL CARE & DENTAL PROBLEMS THE HOSPITAL ALSO SERVED, AND STILL SERVES, ON THE STEERING COMMITTEE OF THE BEDFOARD AREA RESOURCE COUNCIL. BMH PARTICIPATED IN THE STRATEGIC PLANNING PROCESS THAT HELPED BUILD THE INFRASTRUCTURE OF THIS COUNCIL. THE HOSPITAL ALSO HELPED PLAN A WEB SITE FOR B.A.R.C. THAT PROVIDES COMPREHENSIVE LISTINGS OF COMMUNITY RESOURCES IN BEDFORD COUNTY.

PART I, LINE 6A:
INFORMATION ON COMMUNITY BENEFITS IS REPORTED ANNUALLY THROUGH A REPORT PREPARED BY CENTRA HEALTH, INC., SOLE MEMBER OF BEDFORD MEMORIAL HOSPITAL.

PART I, LINE 7:
COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE EXPENSE.

PART II:
BEDFORD MEMORIAL HOSPITAL CONTINUOUSLY IMPROVES ITS RELATIONSHIP WITH THE COMMUNITY IT SERVES BY OFFERING MANY SERVICES, SUCH AS, ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, COMMUNITY HEALTH IMPROVEMENT, WORKFORCE DEVELOPMENT, ETC. WE ALSO HOST AND/OR PARTICIPATE IN VARIOUS CAREER FAIRS IN ORDER TO REACH OUT TO YOUNG ADULTS WHO MAY BE INTERESTED IN THE HEALTHCARE PROFESSION. ECONOMIC DEVELOPMENT: BEDFORD MEMORIAL HOPSITAL IS A MEMBER OF THE BEDFORD AREA COMMUNITY CHAMBER OF COMMERCE AND FEELS THIS ONLY ENHANCES OUR ABILITY TO REACH MORE AREA COMMUNITY MEMBERS IN ORDER TO KEEP THEM INFORMED OF COMING HEALTHCARE EVENTS AND PROGRAMS WHICH ARE AVAILABLE TO THEM. COMMUNITY SUPPORT: BEDFORD MEMORIAL HOSPITAL CONTINUOUSLY IMPROVES ITS RELATIONSHIP WITH THE COMMUNITY IT SERVES BY PARTICIPATING IN NUMEROUS HEALTH FAIRS, CONDUCTING HEALTH EDUCATION SEMINARS, PROVIDING SCHOOL-BASED HEALTH PROGRAMS, ETC. WE FEEL AN ESSENTIAL PART OF BEING A GOOD NEIGHBOR WITHIN THE COMMUNITY IS TO PROMOTE HEALTH, SAFETY, AND WELL-BEING ACTIVITIES IN ORDER TO BENEFIT THOSE AROUND THE COMMUNITY. LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS: BEDFORD MEMORIAL HOSPITAL STRIVES TO PARTNER WITH ITS COMMUNITY HEALTHCARE SERVICE PROVIDERS IN ORDER TO ENSURE WE ARE WORKING SMOOTHLY TOGETHER FOR THE COMMON GOOD OF ALL OUR COMMUNITY MEMBERS. COALITION BUILDING: BEDFORD MEMORIAL HOSPITAL IS COMMITTED TO REACHING OUT TO THE COMMUNITY IN ORDER TO INFORM THE PUBLIC ABOUT THE NUMEROUS HEALTH FAIRS, HEALTH SEMINARS, AND GENERAL INFORMATIONAL SESSIONS OFFERED BY THE ORGANIZATION THROUGHOUT THE YEAR. WE PARTICIPATE IN LOCAL EVENTS IN ORDER TO PROMOTE HEALTH AND WELL-BEING TO AS MANY INDIVIDUALS AS POSSIBLE. BEING A MEMBER OF THE BEDFORD AREA RESOURCE COUNCIL HELPS US BE MORE CONNECTED TO THE COMMUNITY WE SERVE. WORKFORCE DEVELOPMENT: BEDFORD MEMORIAL HOSPITAL BELIEVES THAT IT IS CRUCIAL TO HAVE EDUCATED, EXPERIENCED HEALTHCARE PROFESSIONALS WORKING WITHIN OUR COMMUNITIES. BY DISCUSSING HEALTHCARE WITH CHILDREN BEGINNING AT AN EARLY AGE, WE FEEL IT WILL SPARK INTEREST AND HAVE OUR YOUTH THINKING ABOUT POSSIBLY SEEKING A CAREER IN HEALTHCARE AS THEY GET OLDER. WE PARTICIPATED IN A CAREER AND TECHNICAL EXPO IN OCTOBER 2021 AND SHARED INFORMATION AND MATERIALS ABOUT HEATH CAREER CHOICES AND THE ACADEMIC PATHWAY TO THOSE CAREERS.

PART III, SECTION A, LINE 1:
(HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STMT NO. 15): ON JANUARY 1, 2012, CENTRA HEALTH, INC. AND SUBSIDIARIES ADOPTED ACCOUNTING STANDARDS UPDATE (ASU) 2011-07, WHICH CHANGED CENTRA'S PRESENTATION OF PROVISION FOR DOUBTFUL ACCOUNTS TO A DEDUCTION FROM NET PATIENT SERVICE REVENUE. THIS HAS BEEN DISCLOSED IN THE FOOTNOTES OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THEREFORE, CENTRA HEALTH AND ITS SUBSIDIARIES, INCLUDING SOUTHSIDE COMMUNITY HOSPITAL AND BEDFORD MEMORIAL HOSPITAL REPORT BAD DEBT IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15.

PART III, SECTION A, LINE 2:
SEE DESCRIPTION FOR PART III, SECTION A, LINE 4

PART III, SECTION B, LINE 8:
THE CALCULATION OF MEDICARE SHORTFALL DOES NOT REFLECT ALL OF THE ORGANIZATION'S REVENUES AND COSTS ASSOCIATED WITH ITS PARTICIPATION IN THE MEDICARE PROGRAM, PER IRS INSTRUCTIONS. MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING THE COST TO CHARGE RATIO. THE HOSPITAL DID NOT EXPERIENCE A MEDICARE SHORTFALL IN 2021, THUS NO COMMUNITY BENEFIT WAS RECOGNIZED DUE TO A SHORTFALL.

PART III, SECTION C, LINE 9B:
BEDFORD MEMORIAL HOSPITAL RECOGNIZES THAT MEDICAL EXPENSES ARE OFTEN UNEXPECTED AND CAUSE FINANCIAL HARDSHIP. ALL ACCOUNTS WITH SELF PAY BALANCES WILL FOLLOW UNIFORM COLLECTION PROTOCOLS. THESE PROTOCOLS ARE ELECTRONICALLY ADMINISTERED THROUGH CENTRA'S HOSPITAL INFORMATION SYSTEM. WHEN AN ACCOUNT REACHES THE END OF THE SYSTEM GENERATED COLLECTION CYCLE AND MEETS SAID CRITERIA, THE ACCOUNT BALANCE WILL BE PROCESSED AS BAD DEBT AND REPORTED TO A COLLECTION AGENCY. CRITERIA FOR BAD DEBT WILL BE APPLIED CONSISTENTLY REGARDLESS OF AGE, RACE, RELIGION OR OTHER PROTECTIVE CLASS. PRIOR TO BAD DEBT PROCESSING, ACCOUNTS ARE ELECTRONICALLY SCREENED FOR PRESUMPTIVE FINANCIAL ASSISTANCE AND WRITTEN DOWN TO ZERO WHEN SCORES ARE WITHIN PRE-ESTABLISHED RANGES. BEDFORD MEMORIAL HOSPITAL APPLIES UNIFORM COLLECTION PROTOCOLS TO ALL UNPAID ELIGIBLE CHARGES REGARDLESS OF RACE, SEX, AGE, DISABILITY, NATIONAL ORIGIN OR RELIGION. PATIENTS KNOWN BY CENTRA TO QUALIFY FOR FINANCIAL ASSISTANCE ARE NOT SUBJECT TO COLLECTION PROTOCOLS. IF DURING COLLECTION PROTOCOLS, OR AFTER REFERRAL TO AN OUTSIDE COLLECTION AGENCY, IT IS DISCOVERED PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY, INCLUDING ANY AND ALL EXTRAORDINARY COLLECTION EFFORT, IS IMMEDIATELY STOPPED. FINANCIAL ASSISTANCE FOR ELIGIBLE CHARGES IS AVAILABLE TO ALL CENTRA PATIENTS WHO QUALIFY BASED ON ESTABLISHED AND WIDELY PUBLISHED INCOME AND ASSET CRITERIA.

PART VI, LINE 5:
PROMOTION OF COMMUNITY HEALTH: BEDFORD MEMORIAL HOSPITAL SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO QUALIFIED PROVIDERS AND, IN ADDITION TO CLINICAL CARE, THE HOSPITAL WORKS TO ACHIEVE ITS MISSION THROUGH THE EDUCATION OF HEALTH PROFESSIONALS AND THE COMMUNITY. THE HOSPITAL ALSO PARTICIPATES IN NUMEROUS HEALTH FAIRS AND SCREENINGS THROUGHOUT THE COMMUNITY AT LOCAL EMPLOYERS, COLLEGES, CHURCHES, ETC., IN ORDER TO PROVIDE HEALTH SCREENINGS AND INFORMATION ON MANY HEALTH ISSUES. FOR EXAMPLE, BLOOD PRESSURE, DIABETES, PSA, CANCER SCREENINGS, ETC.

PART VI, LINE 6:
AFFILIATED HEALTH CARE SYSTEM: AS OF JULY 1, 2014, CENTRA HEALTH BECAME SOLE MEMBER OF BEDFORD MEMORIAL HOSPITAL. CENTRA HEALTH SERVES AS A KEY PARTNER IN MANAGING AND PROMOTING HEALTHCARE THROUGHOUT ITS SYSTEM TO ENSURE EXCELLENT CARE TO THE REGIONAL COMMUNITIES IT SERVES. BEDFORD MEMORIAL HOSPITAL'S SOLE AFFILIATION WITH CENTRA HEALTH WILL STRENGTHEN THE ORGANIZATION THROUGH AN EXCHANGE OF BEST PRACTICES AND ACCESS TO MULTIDISCIPLINARY TEAMS, INCLUDING, BUT NOT LIMITED TO, PHYSICIANS FROM CENTRA'S NETWORK OF PRACTICES.

PART VI, LINE 7:
STATE FILING OF COMMUNITY BENEFIT REPORT: VIRGINIA

PART III, SECTION A, LINE 4:
"THE ORGANIZATION BELIEVES THAT ITS PROCEDURES CONCERNING THE APPLICATION OF ITS FINANCIAL ASSISTANCE POLICY ARE SUFFICIENTLY THOROUGH TO EXCLUDE ALL PATIENTS WHO ARE ELIGIBLE FOR CHARITY CARE FROM BAD DEBT. THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING FOOTNOTE ABOUT BAD DEBT: ""GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBELS AND CONINSURANCE, WHICH VARY IN AMOUNT. CENTRA ALSO PROVIDES ERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED A DISCOUNT FROM STANDARD CHARGES. CENTRA ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO AMOUNTS DUE DIRECTLY FROM PATIENTS. ESTIMATED PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, REGARDLESS OF THE AGE OF THOSE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN MADE. THERE HAVE BEEN NO SIGNIFICANT CHANGES IN THE CURRENT YEAR TO THE UNDERLYING ASSUMPTIONS USED BY CENTRA TO ESTIMATE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE NATURE, AMOUNT, TIMING, AND UNCERTAINTY OF THESE REVENUES AND CASH FLOWS. ADJUSTMENTS TO PREVIOUS REIMBURSEMENT ESTIMATES ARE REPORTED IN NET PATIENT SERVICE REVENUES IN THE PERIODS THAT SUCH ADJUSTMENTS BECOME KNOWN. FOR THE YEARS ENDED DECEMBER 31, 2021, AND 2020, THE IMPACT OF CHANGES TO PREVIOUS TRANSACTIONS PRICE ESTIMATES WAS CONSIDERED IMMATERIAL TO THE CURRENT PERIOD."" (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2021 AUDIT REPORT, PAGE 14) ""CONSISTENT WITH CENTRA'S MISSION, SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THEREFORE, CENTRA HAS DETERMINED IT HAS PROVIDED IMPLICIT PRICE CONCESSIONS TO UNINSURED PATIENTS AND PATIENTS WITH OTHER UNINSURANCE BALANCES (FOR EXAMPLE, COPAYS AND DEDUCTIBLES). THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS CENTRA EXPECTS TO COLLECT BASED ON ITS COLLECTION HISTORY WITH THOSE PATIENTS."" (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2021 AUDIT REPORT, PAGE 15) ""PATIENTS WHO MEET CENTRA'S CRITERIA FOR CHARITY CARE ARE PROVIDED CARE WITHOUT CHARGE OR AT AMOUNTS SUBSTANTIALLY LESS THAN ESTABLISHED RATES IN ACCORDANCE WITH CENTRA'S FINANCIAL ASSISTANCE POLICY. SINCE CENTRA DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE DETERMINED TO QUALIFY AS CHARITY CARE AND ARE NOT REPORTED AS REVENUE. WHILE CHARITY CARE IS EXCLUDED FROM NET PATIENT SERVICE REVENUE, CENTRA MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THIS INCLUDES THE AMOUNT OF CHARGES FOREGONE AND THE ESTIMATED COSTS INCURRED FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. COSTS INCURRED ARE ESTIMATED BASED ON THE RATIO OF TOTAL OPERATING EXPENSE TO GROSS CHARGES."" (CENTRA HEALTH, INC. AND SUBSIDIARIES, FY 2021 AUDIT REPORT, PAGE 15-16)"

PART VI, LINE 2:
"A COMMUNITY HEALTH ASSESSMENT TEAM (CHAT) WITH MORE THAN 40 INDIVIDUALS AND A BROAD REPRESENTATION OF COMMUNITY LEADERS AND CROSS-SECTOR STAKEHOLDERS IN THE SERVICE AREA WAS DEVELOPED. THE ROLE OF THE CHAT IS TO OVERSEE, ADVISE AND ASSIST IN CHNA DATA COLLECTION ACTIVITIES, PRIORITIZE NEEDS, AND PARTICIPATE IN THE DEVELOPMENT OF THE IMPLEMENTATION PLAN AS APPROPRIATE. THE PARTNERSHIP FOR HEALTHY COMMUNITIES (PHC) IS A PLANNING INITIATIVE LED BY CENTRA, THE COMMUNITY ACCESS NETWORK, THE CENTRAL VIRGINIA, PIEDMONT, AND PITTSYLVANIA/DANVILLE HEALTH DISTRICTS, THE BEDFORD COMMUNITY HEALTH FOUNDATION, GREATER LYNCHBURG COMMUNITY FOUNDATION, JOHNSON HEALTH CENTER AND UNITED WAY OF CENTRAL VIRGINIA. THE PARTNERS ARE COMMITTED TO REGIONAL ALIGNMENT OF A COLLABORATIVE AND RIGOROUS NEEDS ASSESSMENT PROCESS THAT WILL RESULT IN ACTION-ORIENTED SOLUTIONS TO IMPROVE THE HEALTH OF THE COMMUNITIES THEY SERVE. THE BEDFORD AREA RESOURCE COUNCIL (BARC) (HTTPS://WWW.BEDFORDAREARESOURCECOUNCIL.ORG/) IS A NETWORK OF NON-PROFIT, FOR PROFIT, MEDICAL, FAITH ORGANIZATIONS, AND STATE AND LOCAL GOVERNMENT AGENCIES WHO SERVE THE TOWN AND COUNTY OF BEDFORD. THIS COLLABORATIVE COMMUNITY ENGAGEMENT PROVIDES A PLATFORM TO SHARE INFORMATION AND BUILD AWARENESS OF CURRENT COMMUNITY UNMET NEEDS, AS WELL AS SERVICES AND RESOURCES AVAILABLE, THUS ALLOWING FOR A BETTER COORDINATION IN PLANNING AND DESIGNING FOR EXTENSION OF SERVICES AND RESOURCES FOR THE COMMUNITY. MEMBERS FROM THE PHC AND BARC PARTICIPATED IN THE CHAT. UPON COMPLETION OF PRIMARY AND SECONDARY DATA COLLECTION, THE BEDFORD AREA COMMUNITY HEALTH ASSESSMENT TEAM (CHAT) WAS CHARGED WITH PRIORITIZING THE NEEDS OF THE COMMUNITY. A DETAILED ""PRIORITIZATION OF NEEDS WORKSHEET"" WAS DEVELOPED AND THE CHAT WAS ASKED TO RANK THE TOP PRIORITY AREAS OF NEED. THE TOP 10 PRIORITY AREAS FOR THE BEDFORD AREA IN 2021 WERE: BEDFORD AREA: 2021 PRIORITIZATION OF NEEDS RANKING PRIORITY AREA 1 MENTAL HEALTH AND SUBSTANCE USE DISORDERS & ACCESS TO SERVICES 2 ACCESS TO HEALTHCARE SERVICES 3 ISSUES IMPACTING CHILDREN & THEIR FAMILIES: * CHILDCARE * CHILD ABUSE/NEGLECT 4 TRANSPORTATION 5 AGING AND ELDERCARE 6 CHRONIC DISEASE 7 EMPLOYMENT / JOB ASSISTANCE 8 FINANCIAL STABILITY 9 HOUSING 10 DENTAL CARE & DENTAL PROBLEMS THE CHNA PROVIDES AN OVERVIEW OF THE HEALTH STATUS OF THE COMMUNITIES SERVED BY THE HEALTH SYSTEM. IT IS THE INTENT OF THE REPORT TO PROVIDE READERS WITH A DEEPER UNDERSTANDING OF THE NEEDS OF THE BEDFORD AREA AS WELL AS TO GUIDE CENTRA HEALTH, AND ITS COMMUNITY PARTNERS AND STAKEHOLDERS, IN DEVELOPING IMPLEMENTATION PLANS TO ADDRESS THE PRIORITIZED NEEDS IDENTIFIED BECAUSE OF THE ASSESSMENT PROCESS. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PRIORITIZATION OF NEEDS WAS APPROVED BY THE CENTRA COMMUNITY BENEFIT COMMITTEE ON NOVEMBER 19, 2021, THE CENTRA BEDFORD MEMORIAL HOSPITAL BOARD OF DIRECTORS ON NOVEMBER 30, 2021, AND THE CENTRA BOARD OF DIRECTORS ON DECEMBER 6, 2021."

PART VI, LINE 3:
"PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: BEDFORD MEMORIAL HOSPITAL TAKES A MULTIDISCIPLINARY APPROACH TO INFORMING OUR PATIENTS AND COMMUNITY ABOUT FINANCIAL ASSISTANCE. INFORMATION ABOUT FINANCIAL ASSISTANCE AND CHARITY CAN BE FOUND ON CENTRA'S INTERNET PAGE PROVIDING FULL DISCLOSURE ABOUT QUALIFICATIONS AND THE APPLICATION PROCESS. INDIVIDUALS MAY OBTAIN INFORMATION AND AN APPLICATION FROM ANY REGISTRATION POINT OR CUSTOMER SERVICE UNIT, IN PERSON OR BY PHONE. SIGNS ARE POSTED IN CONSPICUOUS LOCATIONS ALERTING INDIVIDUALS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND WHERE TO OBTAIN ADDITIONAL INFORMATION. BROCHURES ABOUT FINANCIAL ASSISTANCE ARE MADE AVAILABLE IN REGISTRATION AND CUSTOMER SERVICE. WHILE PATIENTS ARE HOSPITALIZED, A FINANCIAL COUNSELOR PROVIDES FINANCIAL ASSISTANCE INFORMATION, SCREENS PATIENTS FOR FEDERAL AND STATE PROGRAMS AND GIVES AN OPPORTUNITY TO ASK QUESTIONS. ADDITIONALLY, ON THE BOTTOM OF THE CURRENT STATEMENTS IS THE FOLLOWING VERBIAGE: ""CAN'T PAY YOUR BILL? FINANCIAL ASSISTANCE AND FLEXIBLE PAYMENT OPTIONS ARE AVAILABLE BY CONTACTING CENTRA CUSTOMER SERVICE AT (434) 200-3777."""

PART VI, LINE 4:
COMMUNITY INFORMATION: BEDFORD MEMORIAL HOSPITAL PRIMARILY SERVES APPROXIMATELY 85,564 RESIDENTS OF THE TOWN OF BEDFORD AND BEDFORD COUNTY. BEDFORD ENCOMPASSES APPROXIMATELY 769 SQUARE MILES OF PIEDMONT PLATEAU IN THE WESTERN CENTRAL PORTION OF VIRGINIA AND IS BORDERED BY THE BLUE RIDGE MOUNTAINS TO THE WEST, THE JAMES RIVER ON ITS NORTHEAST AND SMITH MOUNTAIN LAKE TO THE SOUTH. THE TERRAINE IS ROLLING AND HILLY WITH ELEVATIONS RANGING FROM 800 TO 4,200 FEET ABOVE SEA LEVEL. BEDFORD MEMORIAL HOSPITAL IS A 50-BED HOSPITAL FACILITY. ADDITIONALLY, IN 2021, 17.7% OF THE TOWN OF BEDFORD RESIDENTS HAD A BACHELOR'S DEGREE OR HIGHER AND 30.9% OF THE BEDFORD COUNTY RESIDENTS HAD A BACHELOR'S DEGREE, MUCH LESS THAN THE STATE AVERAGE OF 39.5%. IN 2021, THE TOWN OF BEDFORD HAD A MEDIAN HOUSEHOLD INCOME OF $40,263 AND BEDFORD COUNTY HAD A MEDIAN HOUSEHOLD INCOME OF $67,136, AS COMPARED TO THE STATE MEDIAN OF $76,398. AS OF 2021, 27.2% OF THE TOWN OF BEDFORD POPULATION WAS LIVING IN POVERTY AND 6.8% OF THE BEDFORD COUNTY POPULATION WAS LIVING IN POVERTY COMPARED TO THE STATE AVERAGE OF 9.2%.