Community Benefit Insight - Tax-exempt hospital

View data for this organization below, or select additional hospitals to create a comparison view.

Search tax-exempt hospitals
for comparison purposes.

Capital Hospice

Capital Hospice

2900 Telestar Court
Falls Church, VA 22042

Bed count	15	Medicare provider number	490129	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 541920770

Display data for year:

Community Benefit Spending- 2017
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

9.49%

Spending by Community Benefit Category- 2017
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2017

Additional data

Community Benefit Expenditures: 2017

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 3,270,277 3.31 %
Medicaid as % of operating expenses	$ -908,167 -0.92 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 55,960 0.06 %
Subsidized health services as % of operating expenses	$ 6,948,283 7.03 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 3,045 0.00 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 17,123 0.02 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2017

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 3,817,262 3.86 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2017

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2017

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 73758445 including grants of $ 22198) (Revenue $ 79304854)
CAPITAL HOSPICE PROVIDES EXPERT MEDICAL, EMOTIONAL, SPIRITUAL AND PRACTICAL CARE AND SUPPORT TO PATIENTS WITH SERIOUS, PROGRESSIVE ILLNESS AND THEIR FAMILIES 24 HOURS A DAY, SEVEN DAYS A WEEK TO PATIENTS WHEREVER THEY LIVE BY QUALIFIED PHYSICIANS, NURSES, NURSES' AIDES, SOCIAL WORKERS, NON-DENOMINATIONAL CHAPLAINS AND OTHER PROFESSIONALS. IT IS THE OBJECTIVE OF CAPITAL HOSPICE TO PROVIDE CARE TO ANYONE MEDICALLY ELIGIBLE, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. CAPITAL HOSPICE PROVIDED SERVICES TO 5,788 PATIENTS DURING 2017 AND HAD 407,749 PATIENT DAYS OF CARE. CAPITAL HOSPICE HAD COSTS RELATED TO SERVICES AND SUPPLIES UNDER ITS CHARITY CARE POLICY OF APPROXIMATELY $3,419,000 IN 2017. IN ADDITION, CAPITAL HOSPICE PROVIDED UNCOMPENSATED CARE, WHERE REIMBURSEMENT FOR SERVICES IS LESS THAN THE ACTUAL COST OF CARE PROVIDED, OF APPROXIMATELY $6,249,000

4B (Expenses $ 12412702 including grants of $ 0) (Revenue $ 9108206)
HALQUIST MEMORIAL INPATIENT CENTER AND THE ADLER CENTER FOR CARING PROVIDES CARE FOR OUR HOSPICE PATIENTS THAT NEED CONSTANT MONITORING AND WHOSE PAIN AND SYMPTOMS CAN'T BE ADEQUATELY MANAGED AT HOME. IT IS THE OBJECTIVE OF THE HALQUIST MEMORIAL INPATIENT CENTER AND THE ADLER CENTER FOR CARING TO MAKE OUR PATIENTS AS SYMPTOM FREE AND AS COMFORTABLE AS POSSIBLE. THE HALQUIST MEMORIAL INPATIENT CENTER PROVIDED CARE TO 490 PATIENTS AND HAD 4,402 PATIENT DAYS OF CARE IN 2017. THE ADLER CENTER FOR CARING PROVIDED CARE TO 582 PATIENTS AND HAD 5,000 PATIENT DAYS OF CARE IN 2017. THE CAPITAL CARING CENTER - GREENBELT PROVIDED CARE TO 98 PATIENTS AND HAD 911 PATIENT DAYS OF CARE IN 2017. THE CAPITAL CARING CENTER - WASHINGTON, DC PROVIDED CARE TO 348 PATIENTS AND HAD 3,617 PATIENT DAYS OF CARE IN 2017.

4C (Expenses $ 2582767 including grants of $ 0) (Revenue $ 1578092)
CAPITAL PALLIATIVE CARE CONSULTANTS PROVIDES PHYSICIAN SERVICES TO OUR HOSPICE PATIENTS, AND TO NON-HOSPICE ELIGIBLE PATIENTS WHO ARE IN NEED OF SYMPTOM MANAGEMENT. IT IS THE OBJECTIVE OF CAPITAL PALLIATIVE CARE CONSULTANTS TO PROVIDE PHYSICIAN SERVICES TO ALL PATIENTS IN NEED OF SYMPTOM MANAGEMENT, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. CAPITAL PALLIATIVE CARE CONSULTANTS PROVIDED 20,878 PATIENT VISITS DURING 2017.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

PART V, SECTION A:
SCHEDULE H, PART V, QUESTION 22:THE HOSPITAL FACILITY DETERMINES THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE ELIGIBLE INDIVIDUALS (THAT DO NOT QUALIFY FOR FREE CARE) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THROUGH THE USE OF A SLIDING FEE SCHEDULE FOR FINANCIAL ASSISTANCE PATIENTS. THE SLIDING SCALE BEGINS AT A LEVEL BELOW THE RATES BILLED TO MEDICARE OR ANY COMMERCIAL INSURERS FOR SUCH CARE FOR PATIENTS THAT HAVE FAMILY ANNUAL INCOME OF 300% OF THE FEDERAL POVERTY GUIDELINES AND GOES DOWN TO 25% OF FULL CHARGES (APPROXIMATELY 35-40% OF MEDICARE RATES) FOR PATIENTS THAT HAVE FAMILY ANNUAL INCOME OF 225% OF THE FEDERAL POVERTY GUIDELINES.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 3J: THE HALQUIST MEMORIAL INPATIENT CENTER WAS LICENSED IN 1981 AS ONE OF THE FIRST HOSPICE INPATIENT CENTERS IN THE UNITED STATES AND THE FIRST IN THE STATE OF VIRGINIA. AS SUCH, THE STATE OF VIRGINIA HAD NO CATEGORY FOR LICENSURE THAT WOULD FIT THE FACILITY AND THEREFORE LICENSED THE UNIT AS A GENERAL HOSPITAL. AS A HOSPICE INPATIENT CENTER, THE FACILITY HAS NO EMERGENCY ROOM, OUTPATIENT CENTER, LABS, OR OTHER DIAGNOSTIC SERVICES AS WOULD A GENERAL HOSPITAL. IT SERVES ONLY CAPITAL HOSPICE PATIENTS REQUIRING ACUTE SYMPTOM MANAGEMENT OR PATIENTS IN THEIR FINAL DAYS OF A TERMINAL ILLNESS WHO CAN NO LONGER BE SERVED AT HOME. THE UNIT HAS 15 BEDS AND REPRESENTS ON AVERAGE ONLY 13 OF THE MORE THAN 1100 PATIENTS THAT ARE TREATED BY CAPITAL HOSPICE ON A DAILY BASIS. AS A RESULT, THE COMMUNITY HEALTH NEEDS ASSESSMENT IS NOT APPLICABLE TO HOSPICE INPATIENT BEDS. IN STATES OTHER THAN VIRGINIA, UNITS LIKE HALQUIST ARE LICENSED AS HOSPICE CENTERS AND ARE NOT SUBJECT TO EITHER THE COMMUNITY HEALTH NEEDS ASSESSMENT OR THE H SCHEDULES. IT IS FOR THIS REASON THAT SUCH AN ASSESSMENT WAS NOT PERFORMED IN 2016. SIMILARLY, MEDICARE HAS RECOGNIZED THAT OUR UNIT IS NOT ACTUALLY A HOSPITAL AND HAS NOT REQUIRED US TO COMPLY WITH MANY OF THE REPORTING REQUIREMENT APPLICABLE TO HOSPITALS.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 5: THE HOSPITAL FACILITY RECEIVED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, AS WELL AS LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS. IN PARTICULAR, A SURVEY WAS DEVELOPED BY THE ORGANIZATION, WHICH WAS ADMINISTERED TO LEADERS AND REPRESENTATIVES FROM ORGANIZATIONS ACROSS THE COMMUNITY, INCLUDING: UNIVERSITY OF MARYLAND PREVENTION RESEARCH CENTER, GEORGE WASHINGTON UNIVERSITY HOSPITAL, PROVIDENCE HOSPITAL, DIMENSIONS HEALTHCARE SYSTEM, LIVINRITE HOME HEALTH, AARP DEPARTMENT OF AGING, THE DC OFFICE ON AGING, HEAVEN SENT LLC, MORNINGSIDE HOUSE OF LAUREL, N STREET VILLAGE, SEABURY RESOURCES FOR AGING, AND THE RESIDENCES AT THOMAS CIRCLE.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 7D: THE HALQUIST MEMORIAL INPATIENT CENTER WAS LICENSED IN 1981 AS ONE OF THE FIRST HOSPICE INPATIENT CENTERS IN THE UNITED STATES AND THE FIRST IN THE STATE OF VIRGINIA. AS SUCH, THE STATE OF VIRGINIA HAD NO CATEGORY FOR LICENSURE THAT WOULD FIT THE FACILITY AND THEREFORE LICENSED THE UNIT AS A GENERAL HOSPITAL. AS A HOSPICE INPATIENT CENTER, THE FACILITY HAS NO EMERGENCY ROOM, OUTPATIENT CENTER, LABS, OR OTHER DIAGNOSTIC SERVICES AS WOULD A GENERAL HOSPITAL. IT SERVES ONLY CAPITAL HOSPICE PATIENTS REQUIRING ACUTE SYMPTOM MANAGEMENT OR PATIENTS IN THEIR FINAL DAYS OF A TERMINAL ILLNESS WHO CAN NO LONGER BE SERVED AT HOME. THE UNIT HAS 15 BEDS AND REPRESENTS ON AVERAGE ONLY 13 OF THE MORE THAN 1100 PATIENTS THAT ARE TREATED BY CAPITAL HOSPICE ON A DAILY BASIS. AS A RESULT, THE COMMUNITY HEALTH NEEDS ASSESSMENT IS NOT APPLICABLE TO HOSPICE INPATIENT BEDS. IN STATES OTHER THAN VIRGINIA, UNITS LIKE HALQUIST ARE LICENSED AS HOSPICE CENTERS AND ARE NOT SUBJECT TO EITHER THE COMMUNITY HEALTH NEEDS ASSESSMENT OR THE H SCHEDULES. IT IS FOR THIS REASON THAT SUCH AN ASSESSMENT WAS NOT PERFORMED IN 2016. SIMILARLY, MEDICARE HAS RECOGNIZED THAT OUR UNIT IS NOT ACTUALLY A HOSPITAL AND HAS NOT REQUIRED US TO COMPLY WITH MANY OF THE REPORTING REQUIREMENT APPLICABLE TO HOSPITALS.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 11: IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED IN 2016, THE AREAS OF GREATEST CONCERN TO SURVEY RESPONDENTS WERE IN THE AREAS OF ALZHEIMER'S DISEASE, GENERAL AGING, AND MENTAL ILLNESS. AS A HOSPICE INPATIENT CENTER, THE HALQUIST MEMORIAL INPATIENT CENTER CARES FOR PATIENTS WITH SHORT TERM SYMPTOM MANAGEMENT ISSUES ASSOCIATED WITH A TERMINAL DIAGNOSIS AND FOR PATIENTS REQUIRING INPATIENT CARE DURING THE LAST DAYS OF THEIR TERMINAL ILLNESS. AS SUCH, ONLY 2% OF THE PATIENTS CARED FOR AT HALQUIST IN 2017 SUFFERED FROM MENTAL DISORDERS AS THEIR PRIMARY DIAGNOSIS. NONETHELESS, MORE THAN 80% OF THE PATIENTS THAT CAPITAL CARING SERVES ARE OVER 65 YEARS OF AGE. AS A RESULT, A SIGNIFICANT PORTION OF OUR COMMUNITY OUTREACH AND EDUCATION EFFORTS ARE CENTERED ON THE NEEDS OF THE ELDERLY. THE HALQUIST MEMORIAL INPATIENT CENTER IS LOCATED IN OUR ARLINGTON, VA. REGION. IN 2017 CLASSES WERE HELD AT THE LOCAL ARLINGTON ACUTE CARE HOSPITAL ON DEMENTIA AND DELIRIUM IN THE ELDERLY AND A SIMILAR CLASS WAS HELD AT A LOCAL SCHOOL OF NURSING. IN ADDITION, CLASSES WERE HELD AT LOCAL NURSING HOMES AND ASSISTED LIVING FACILITIES. WORKSHOPS WERE ALSO HELD FOR LOCAL CLERGY AND FAITH COMMUNITY LEADERS AS THESE INDIVIDUALS OFTEN SERVE AS THE PRIMARY SOURCE OF HEALTH INFORMATION AND ADVICE FOR MANY INDIVIDUALS. AS THE RATE OF ALZHEIMER'S DISEASE AND DEMENTIA CONTINUE TO GROW WITHIN OUR COMMUNITIES, WE CONTINUE TO EXPAND OUR OFFERINGS TO THE COMMUNITY ON THESE ISSUES.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 13H: THE HOSPITAL FACILITY DETERMINES THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FINANCIAL ASSISTANCE ELIGIBLE INDIVIDUALS (THAT DO NOT QUALIFY FOR FREE CARE) FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THROUGH THE USE OF A SLIDING FEE SCHEDULE FOR FINANCIAL ASSISTANCE PATIENTS. THE SLIDING SCALE BEGINS AT A LEVEL BELOW THE RATES BILLED TO MEDICARE OR ANY COMMERCIAL INSURERS FOR SUCH CARE FOR PATIENTS THAT HAVE FAMILY ANNUAL INCOME OF 300% OF THE FEDERAL POVERTY GUIDELINES AND GOES DOWN TO 25% OF FULL CHARGES (APPROXIMATELY 35-40% OF MEDICARE RATES) FOR PATIENTS THAT HAVE FAMILY ANNUAL INCOME OF 225% OF THE FEDERAL POVERTY GUIDELINES. IN ADDITION, THE HOSPITAL FACILITY PROVIDES A 20% DISCOUNT TO ALL UNINSURED PATIENTS THAT HAVE FAMILY ANNUAL INCOME UP TO 400% OF THE FEDERAL POVERTY GUIDELINES AND DO NOT QUALIFY UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY. IF THE UNINSURED PATIENT IS DEEMED TO BE MEDICALLY INDIGENT, THEN THE HOSPITAL FACILITY WILL PROVIDE A GREATER DISCOUNT.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 18E: THE HOSPITAL FACILITY MAKES REASONABLE EFFORTS TO DETERMINE A PATIENT'S ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY BEFORE TURNING OVER THE UNPAID ACCOUNT TO A COLLECTION AGENCY FOR ATTEMPTED RECOVERY (NO OTHER 3RD PARTY COLLECTION ACTIVITY OR EXTRAORDINARY COLLECTION ACTIONS ARE UNDERTAKEN BY THE ORGANIZATION). THE HOSPITAL FACILITY VISITS EACH PATIENT BEFORE THE PATIENT IS ADMITTED TO THE FACILITY. AS PART OF THAT VISIT ANY INSURANCE COVERAGE OR ELIGIBILITY FOR MEDICAID IS DISCUSSED. IF IT IS APPARENT THAT INSURANCE COVERAGE OR MEDICAID COVERAGE IS NOT AVAILABLE, OR IS LIMITED, THEN THE FACILITY ENCOURAGES THE PATIENT TO APPLY FOR ITS FINANCIAL ASSISTANCE POLICY. IF THE PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE AT THAT TIME, THE FACILITY CONTINUES TO NOTIFY THE PATIENT OF THE EXISTENCE OF ITS FINANCIAL ASSISTANCE POLICY UPON ADMISSION TO THE FACILITY AND WITH EACH BILL THAT IS SENT TO THE PATIENT. ADDITIONALLY, THE EXISTENCE OF THE FINANCIAL ASSISTANCE POLICY WAS POSTED ON THE HOSPITAL FACILITY'S WEBSITE AND IS MADE AVAILABLE UPON REQUEST.

CAPITAL HOSPICE HALQUIST MEMORIAL CENTER
PART V, SECTION B, LINE 21C: THE HOSPITAL FACILITY SOLELY PROVIDES HOSPICE AND PALLIATIVE CARE. AS A RESULT, THE HOSPITAL FACILITY DOES NOT PROVIDE ANY EMERGENCY CARE SERVICES.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
IN ADDITION TO USING THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY, THE ORGANIZATION WILL, ON A CASE BY CASE DETERMINATION, ASSESS A PATIENT'S LIQUID ASSETS. THE PATIENT'S LIQUID ASSETS WILL BE ASSESSED IF THE PATIENT HAS HIGH MEDICAL DEBT OUTSTANDING.

PART I, LINE 7:
THE COSTING METHODOLOGY USED TO CALCULATE AMOUNTS REPORTED IN LINE 7 WAS A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.

PART I, LINE 7G:
CAPITAL HOSPICE UNDERTAKES SEVERAL PROGRAMS AT A SIGNIFICANT LOSS IN ORDER TO MEET IDENTIFIED NEEDS IN THE COMMUNITY. FIRST, CAPITAL HOSPICE OPERATES A 15 BED INPATIENT UNIT FOR TREATMENT OF HOSPICE PATIENTS THAT NEED CONSTANT MONITORING BUT WHOSE PAIN AND SYMPTOMS CANNOT BE ADEQUATELY TREATED AT HOME. THE REIMBURSEMENT FOR THIS PROGRAM, PRIMARILY FROM MEDICAID AND MEDICARE, IS SIGNIFICANTLY LESS THAN THE COST TO OPERATE. IN ADDITION, CAPITAL HOSPICE PROVIDES CONTINUOUS CARE SERVICES FOR HOSPICE PATIENTS THAT NEED MONITORING, BUT WHO CAN REMAIN AT HOME. THE ORGANIZATION PROVIDES SUCH CONTINUOUS HOME CARE SERVICES PRIMARILY TO MEDICARE PATIENTS ANND IS REIMBURSED SIGNIFICANTLY LESS THAN COST.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE REPORTED IN THE ORGANIZATIONS AUDITED FINANCIAL STATEMENT IS $3,817,262 WHICH WAS REMOVED FROM TOTAL EXPENSES TO DETERMINE THE PERCENTAGES OF TOTAL EXPENSES.

PART III, LINE 4:
"WE DO NOT HAVE A BAD DEBT FOOTNOTE IN OUR FINANCIAL STATEMENTS. THE FOOTNOTE TITLED ""PATIENT ACCOUNTS RECEIVABLE"" STATES, ""PATIENT ACCOUNTS RECEIVABLE INCLUDE BILLINGS TO MEDICARE, MEDICAID (COMMONWEALTH OF VIRGINIA, DISTRICT OF COLUMBIA AND MARYLAND MEDICAL ASSISTANCE), BLUE CROSS (BLUE CROSS AND BLUE SHIELD OF THE NATIONAL CAPITAL AREA, CAREFIRST AND ANTHEM), TRICARE, COMMERCIAL INSURERS, AND SELF PAYING PATIENTS. PATIENT ACCOUNTS RECEIVABLE ARE SHOWN NET OF ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS, WHICH IS ESTIMATED BY MANAGEMENT BASED ON HISTORICAL COLLECTION ACTIVITIES. WE DO NOT INCLUDE ANY OF THE BAD DEBT AS A COMMUNITY BENEFIT. THE ORGANIZATION DOES NOT BELIEVE THAT ANY OF THE BAD DEBT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANZATIONS FINANCIAL ASSISTANCE POLICY."

PART III, LINE 8:
THE COSTING SOURCE IS THE MEDICARE COST REPORT AND THE METHODOLOGY IS MEDICARE ALLOCABLE COSTS TO MEDICARE REVENUE RECEIVED.

PART III, LINE 9B:
THE ORGANIZATION PROVIDES FINANCIAL ASSISTANCE TO ALL PATIENTS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION DOES NOT MAKE ANY ATTEMPT TO COLLECT FROM SUCH PATIENTS, IF WE BECOME AWARE THAT A PATIENT THAT WAS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE DOES IN FACT QUALIFY FOR FINANCIAL ASSISTANCE, THEN THE PATIENT RECEIVES FINANCIAL ASSISTANCE AND ALL COLLECTION EFFORTS (IF COMMENCED) ARE STOPPED IMMEDIATELY. PATIENTS DETERMINED TO BE FULLY ELIGIBLE FOR FINANCIAL ASSISTANCE SUBSEQUENT TO THE DATE OF SERVICE MAY BE ELIGIBLE FOR A REFUND OF PAYMENTS MADE IF IT IS DETERMINED THAT THE PATIENT WAS ELIGIBLE FOR FINANCIAL ASSISTANCE AT THE TIME OF SERVICE.

PART VI, LINE 2:
ANALYSIS RELATED TO THE NEEDS OF THE COMMUNITY IS AN INTERGRAL PART OF CAPITAL HOSPICE'S STRATEGIC PLANNING PROCESS. EMPIRICAL DATA IS COLLECTED BY: *REFERRAL CENTER STAFF (WHICH FACILITATES ADMISSION INTO OUR PROGRAM); *ACCESS STAFF, WHO INTERACT DIRECTLY WITH THE HOSPITALS, CLINICS, NURSING HOMES, ASSISTED LIVING FACILITIES AND PHYSICIAN PRACTICES THAT SERVE AS THE MAIN SOURCE OF REFERRALS INTO OUR CARE; UTREACH STAFF, WHO INTERACT DIRECTLY WITH MUNICIPAL AGENCIES, FAITH COMMUNITIES AND COMMUNITY ORGANZIATIONS; *EDUCATION STAFF, WHO INTERACT WITH LOCAL UNIVERSITIES, AND *PUBLIC RELATIONS STAFF ARE PRESENT AT COMMUNITY HEALTH FAIRS AND OTHER PUBLIC EVENTS. *ADDITIONALLY, CAPITAL HOSPICE MONITORS AND ANALYZES GOVERNMENT-PROVIDED STATISTICS TO COMPARE THE NUMBER OF DEATHS SERVED BY HOSPICE TO THE TOTAL NUMBER OF DEATHS IN OUR SERVICE AREA TO REVEAL WHERE SERVICES ARE UNDER-UTILIZED.

PART VI, LINE 3:
ALL PATIENTS RECEIVE AN ADMISSION VISIT BEFORE BEING ADMITTED INTO OUR HOSPICE CARE. AS PART OF THAT VISIT ANY INSURANCE COVERAGE IS VERIFIED. IF THE PATIENT HAS NO, OR LIMITED INSURANCE COVERAGE, THEN WE INQUIRE AS TO THE PATIENT'S ABILITY TO BE COVERED BY MEDICAID. IF IT IS APPARENT THAT NO MEDICAID COVERAGE IS AVAILABLE THEN THE PATIENT IS ENCOURAGED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION FORM. BASED ON THE INFORMATION OBTAINED FROM THE FINANCIAL ASSISTANCE FORM THEN FINANCIAL ASSISTANCE IS GRANTED. IF THE PATIENT DOES NOT APPLY FOR FINANCIAL ASSISTANCE AT THE TIME OF THE ADMISSION VISIT, THE FACILITY CONTINUES TO NOTIFY THE PATIENT OF THE EXISTENCE OF ITS FINANCIAL ASSISTANCE POLICY UPON ADMISSION TO THE FACILITY AND WITH THE BILL THAT IS SENT TO THE PATIENT. ADDITIONALLY, THE EXISTENCE OF THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL FACILITY'S WEBSITE AND IS MADE AVAILABLE UPON REQUEST.

PART VI, LINE 4:
CAPITAL HOSPICE SERVES AN ETHNIC, RACIAL, RELIGIOUS AND CULTURALLY DIVERSE REGION THAT ENCOMPASSES MUCH OF TWO STATES (VIRGINIA AND MARYLAND) AND THE DISTRICT OF COLUMBIA. COMMUNITIES SPAN THE SPECTRUM FROM URBAN/INNER CITY (DC) TO SUBURBAN (PRINCE GEORGE'S COUNTY, MD., FAIRFAX COUNTY, VA) TO RURAL (FAUQUIER COUNTY AND PARTS OF LOUDOUN COUNTY, VA). THE SOCIO-ECONOMIC COMPOSITION OF THE COMMUNITIES WE SERVE IS EQUALLY DIVERSE, RANGING FROM THE INDIGENT HOMELESS TO THE LOW-MODERATE INCOME TO ONE OF THE MOST AFFLUENT COUNTIES IN THE UNITED STATES. OUR SERVICE AREA ALSO IS HOME TO A VERY LARGE INTERNATIONAL COMMUNITY WITH A MULTITUDE OF LANGUAGES, TRADITIONS AND VALUES.

PART VI, LINE 6:
CAPITAL HOSPICE IS NOT PART OF AN AFFILIATED GROUP.

PART VI, LINE 5:
"REGARDLESS OF THE VENUE OR CIRCUMSTANCE, CAPITAL HOSPICE STAFF AND VOLUNTEERS MAKE CLEAR THAT LACK OF INSURANCE OR RESOURCES TO PAY FOR OUR SERVICES IS NOT A BARRIER TO RECEIVING CARE. THAT ALSO IS CLEARLY STATED IN OUR LITERATURE AND OUR WEBSITE. ADDITIONALLY, CAPITAL HOSPICE PROVIDES GRIEF AND LOSS SERVICES (SEMINARS, WORKSHOPS, SUPPORT GROUPS) THROUGHOUT OUR SERVICE AREA, OFFERED AT NO CHARGE; THIS INCLUDES AN ANNUAL SUMMER WEEKEND CAMP FOR GRIEVING CHILDREN, TEENS AND ADULTS. ATTENDING/REFERRING PHYSICIANS FROM THE COMMUNITY ARE ENCOURAGED TO PARTICIPATE IN OR FOLLOW THEIR PATIENTS' CARE. PHYSICIANS SEEKING BOARD CERTIFICATION IN THE MEDICAL SUB-SPECIALTY OF PALLIATIVE MEDICINE CAN APPLY FOR THE PHYSICIAN FELLOWSHIP PROGRAM CAPITAL HOSPICE OFFERS JOINTLY WITH THE NATIONAL INSTITUTES OF HEALTH CLINICAL CENTER. HOSPICE PARTNERS WITH AREA HOSPITALS, NURSING HOMES AND PHYSICIAN PRACTICES TO PROVIDE FACILITY CLINICS FOR PALLIATIVE CARE CONSULTATIONS REQUESTED BY COMMUNITY PHYSICIANS. COMMUNITY ADVISORY BOARDS ARE UTILIZED TO DEVELOP STRATEGIES TO INCREASE AWARENESS OF CAPITAL HOSPICE SERVICES WITHIN THEIR RESPECTIVE COMMUNITIES. CAMINANDO JUNTOS IS AN OUTREACH PROGRAM DEDICATED TO RAISING AWARENESS OF THE AVAILABILITY OF CAPITAL HOSPICE SERVICES WITHIN THE LATINO COMMUNITY. CAPITAL HOSPICE STAFF REGULARLY CONDUCT TEACHING/TRAINING SESSIONS TO IMPROVE CARE PROVIDED JOINTLY WITH NURSING HOMES, HOSPITALS AND ASSISTED LIVING FACILITIES. THESE ARE OFFERED AT OUR PARTNERS' FACILITIES FOR NO CHARGE. CAPITAL HOSPICE REGULARLY OFFERS PALLIATIVE CARE GRAND ROUNDS AND JOSEFINO MAGNO PALLIATIVE CARE CONFERENCE SERIES AS INSTRUCTIONAL SESSIONS FOR COMMUNITY PHYSICIANS AND OTHER PROFESSIONAL HEALTH CARE PROVIDERS; PARTICIPATES IN AND OFFERS ""VIEWING SITES"" TO THE COMMUNITY FOR THE ANNUAL HOSPICE FOUNDATION OF AMERICA EDUCATIONAL TELECONFERENCE. MORE THAN A MAJORITY OF CAPITAL HOSPICE'S GOVERNING BODY IS COMPRISED OF INDEPENDENT PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. CAPITAL HOSPICE HAS AN OPEN MEDICAL STAFF POLICY, PURSUANT TO WHICH ALL QUALIFIED PHYSICIANS MAY BECOME MEMBERS OF THE MEDICAL STAFF. ANY SURPLUS FUNDS EARNED BY CAPITAL HOSPICE ARE USED TO IMPROVE PATIENT CARE AND PROVIDE FURTHER COMMUNITY BENEFIT."

Operating expenses	$ 98,905,123
Total amount spent on community benefits as % of operating expenses	$ 9,386,521 9.49 %