4A (Expenses $ 21090318 including grants of $ 356352) (Revenue $ 18240308)
ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS DBA ATMORE COMMUNITY HOSPITAL (ACH) OPERATES ONE ACUTE CARE HOSPITAL IN THE ESCAMBIA COUNTY COMMUNITY. ACH ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN FISCAL YEAR 2022, THE HOSPITAL TREATED 1,148 INPATIENTS FOR A TOTAL OF 4,554 PATIENT DAYS. THE THREE RURAL HEALTH CLINICS SAW 34,501 PATIENT VISITS DURING THE FISCAL YEAR.

FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 3E
BASED ON THE INPUT FROM THE COMMUNITY AND FROM DATA ANALYSIS, THE HOSPITAL STEERING COMMITTEE FACILITATED A PLANNING PROCESS, WHEREBY THE CHNA STEERING COMMITTEE PRIORITIZED THE COMMUNITY HEALTH NEEDS TO BE ADDRESSED WITHIN THE NEXT THREE YEARS. THE FINAL PRIORITIZED NEEDS REFLECTED THOSE PRIORITIZED BY THE COMMUNITY MEMBERS. GOALS, OBJECTIVES, AND ACTIONS WERE DEVELOPED AND DOCUMENTED TO ADDRESS THE PRIORITY AREAS. THE TOP NEEDS AND GOALS PRIORITIZED BY THE CHNA STEERING COMMITTEE BASED WERE AS FOLLOWS: GOAL: EXPAND ACCESS TO CARE WITH NEW URGENT CARE FACILITY OBJECTIVE 1: EXPAND ACCESS WITH NEW URGENT CARE FACILITY. OBJECTIVE 2: EXPAND WITH NEW MODEL THAT WILL INVOLVE POARCH TO INCLUDE THEIR EMPLOYEES FOR THE WELLNESS PROGRAM. GOAL: GOAL: PROVIDE MORE COMMUNITY OPPORTUNITIES FOR DIABETIC EDUCATION. OBJECTIVE 1: EXPAND DIABETIC AWARENESS AND EDUCATION IN THE COMMUNITY. OBJECTIVE 2: RESUME DIABETIC AWARENESS LUNCH AND LEARN SESSIONS WITH ASSISTANCE OF PCI DIABETIC EDUCATOR. GOAL: ACHIEVE ELIGIBILITY THRESHOLD TO MEET 340B REQUIREMENTS OBJECTIVE 1: CONTINUE FOCUS ON ENSURING THAT SELF-PAY PATIENTS ARE ENROLLED IN MEDICAID, IF ELIGIBLE. OBJECTIVE 2: CONTINUE TO MONITOR COST REPORT ANNUALLY FOR ELIGIBILITY TO PARTICIPATE IN THE 340B PROGRAM

FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 5
COMMUNITY INPUT WAS SOLICITED THROUGH FOCUS GROUPS AND A COMMUNITY SURVEY. KEY COMMUNITY STAKEHOLDERS WERE ALSO INVOLVED IN REVIEWING AND INTERPRETING FINDINGS FROM THE CHNA AND DEVELOPING AN IMPLEMENTATION PLAN TO ADDRESS PRIORITIZED COMMUNITY NEEDS. THE COMMUNITY SURVEY AND FOCUS GROUP INTERVIEWS ASSESSED LOCAL HEALTH CARE ACCESS AND NEEDS OF THE PEOPLE RESIDING IN THE SERVICE AREA OF ATMORE COMMUNITY HOSPITAL. THE COMMUNITY SURVEY WAS DISSEMINATED TO RESIDENTS OF THE HOSPITALS PRIMARY SERVICE AREA VIA THE HOSPITALS SOCIAL MEDIA WEBPAGES AND EMAIL LISTSERVS, AS WELL AS THOSE OF LOCAL COMMUNITY PARTNERS. FOCUS GROUP PARTICIPANTS WERE ALL KEY COMMUNITY STAKEHOLDERS OF ESCAMBIA COUNTY. COLLECTIVELY, PERSPECTIVES OBTAINED FROM THE SURVEYS AND FOCUS GROUPS PROVIDED A HOLISTIC VIEW OF LIFE IN THE COMMUNITY AND THE HEALTH AND HEALTH CARE NEEDS OF THE RESIDENTS. THE ESCAMBIA COUNTY PUBLIC HEALTH DEPARTMENT PARTICIPATED IN THIS PROCESS. INFORMATION FROM THESE PRIMARY DATA COLLECTION EFFORTS WAS SUPPLEMENTED BY SECONDARY QUANTITATIVE DATA ON THE COMMUNITYS DEMOGRAPHIC AND ECONOMIC PROFILE, HEALTH CARE ACCESS, AND UTILIZATION. THESE DATA WERE OBTAINED FROM MULTIPLE PUBLICLY AVAILABLE SOURCES. FINDINGS FROM ALL THE ABOVE-DESCRIBED PRIMARY AND SECONDARY DATA COLLECTION EFFORTS INFORMED THE IDENTIFICATION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS, AS WELL AS THE DEVELOPMENT OF AN IMPLEMENTATION PLAN TO ADDRESS THESE NEEDS.

FACILITY 1, ATMORE COMMUNITY HOSPITAL - PART V, LINE 11
THE COMMUNITY SURVEY AND FOCUS GROUP INTERVIEWS ASSESSED LOCAL HEALTH CARE ACCESS AND NEEDS OF THE PEOPLE RESIDING IN THE SERVICE AREA OF ATMORE COMMUNITY HOSPITAL. THE COMMUNITY SURVEY WAS DISSEMINATED TO RESIDENTS OF THE HOSPITALS PRIMARY SERVICE AREA VIA THE HOSPITALS SOCIAL MEDIA WEBPAGES AND EMAIL LISTSERVS, AS WELL AS THOSE OF LOCAL COMMUNITY PARTNERS. FOCUS GROUP PARTICIPANTS WERE ALL KEY COMMUNITY STAKEHOLDERS OF ESCAMBIA COUNTY. COLLECTIVELY, PERSPECTIVES OBTAINED FROM THE SURVEYS AND FOCUS GROUPS PROVIDED A HOLISTIC VIEW OF LIFE IN THE COMMUNITY AND THE HEALTH AND HEALTH CARE NEEDS OF THE RESIDENTS. A REPRESENTATIVE OF THE ESCAMBIA COUNTY PUBLIC HEALTH DEPARTMENT PARTICIPATED IN THE PROCESS. SEVERAL CORE ISSUES WERE IDENTIFIED AS PROBLEMS, INCLUDING: HIGH LEVELS OF POVERTY. HIGH PREVALENCE OF UNHEALTHY BEHAVIORS (INCLUDING SMOKING, PHYSICAL INACTIVITY AND POOR NUTRITION LEADING TO OVERWEIGHT/OBESITY). LIMITED ACCESS TO HEALTH CARE INSURANCE AND TRANSPORTATION. MENTAL HEALTH, SUBSTANCE ABUSE, AND CHRONIC CONDITIONS WERE THE TOP CONDITIONS AFFECTING THE COMMUNITY. ADDRESSING THESE CORE ISSUES IS BEYOND THE FINANCIAL RESOURCES OF THE ORGANIZATION.

SCHEDULE H, PART I, LINE 7
"THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S ""A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008"". SEE ALSO THE DESCRIPTION FOR PART III, LINE 2."

SCHEDULE H, PART III, LINE 2
AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE.

SCHEDULE H, PART III, LINE 4
THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS.

SCHEDULE H, PART III, LINE 9B
FOR PATIENTS WHO ARE FINANCIALLY OR MEDICALLY INDIGENT (BASED UPON THE PATIENTS HOUSEHOLD INCOME AS DEFINED ANNUALLY BY THE U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN THE FEDERAL REGISTER AS THE FEDERAL POVERTY LEVEL (FPL GUIDELINES): A) PATIENTS ARE DEEMED FINANCIALLY INDIGENT IF THEIR INCOME IS BELOW 200% OF FPL. IF A PATIENT MAKES BETWEEN 200% AND 350% OF THE FPL, THEN THEY MAY ONLY RECEIVE A PARTIAL WRITE-OFF. B) PATIENTS MAY BE DEEMED MEDICALLY INDIGENT IF THEIR HOUSEHOLD MEDICAL EXPENSES EXCEED 25% OF THE ANNUAL HOUSEHOLD INCOME REGARDLESS OF INCOME LEVEL. FOR ANY PATIENT THAT QUALIFIES UNDER THE ORGANIZATIONS CHARITY CARE POLICY, THE PATIENT ACCOUNT IS WRITTEN OFF AS CHARITY CARE AND THE ORGANIZATION DOES NOT PURSUE ANY COLLECTIONS.

SCHEDULE H, PART VI, LINE 2
THE ORGANIZATION CONDUCTS REGULAR NEEDS ASSESSMENT THROUGH FORMAL AND INFORMAL SURVEYS AND PROCESSES, INCLUDING COLLABORATIONS WITH PUBLIC AND COMMUNITY AGENCIES. THROUGH STRATEGIC PLANNING AND COMMUNITY INTERVIEWS, THE ORGANIZATION DEVELOPS PROGRAMS AND SERVICES THAT CONSIDER THE ECONOMIC IMPERATIVES OF THE REGION, THE EFFECT OF LEGISLATION AND THE INVOLVEMENT OF OTHER COMMUNITY-BASED ORGANIZATIONS AND PARTNERS.

SCHEDULE H, PART VI, LINE 3
ALL EMPLOYEES WORKING IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENT AREA HAVE BEEN TRAINED TO BE FULLY VERSED IN ALL FINANCIAL ASSISTANCE-RELATED POLICIES, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE REPRESENTATIVES FOR NON-EMERGENCY PURPOSES. EVERY FILE FOR A PATIENT THAT HAS PRE-SCHEDULED AN OFFICE VISIT OR PROCEDURE IS REVIEWED BEFORE THE PATIENT ARRIVES AT THE HOSPITAL. A FINANCIAL COUNSELOR IS ASSIGNED TO THAT PATIENT IF IT IS DETERMINED THAT THE INDIVIDUAL MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ETC. ALSO, WHEN A PATIENT RECEIVES A BILL, THE ORGANIZATION INCLUDES PAPERWORK EXPLAINING THAT FINANCIAL ASSISTANCE IS AVAILABLE.

SCHEDULE H, PART VI, LINE 4
ATMORE COMMUNITY HOSPITAL (ACH) IS LOCATED IN ATMORE, ALABAMA, IN ESCAMBIA COUNTY, ALABAMA. APPROXIMATELY 90 PERCENT OF THE PATIENTS ADMITTED TO ACH RESIDE IN ESCAMBIA COUNTY, ALABAMA. ACH IS LOCATED APPROXIMATELY 30 MILES FROM D.W. MCMILLAN MEMORIAL HOSPITAL. GEOGRAPHICALLY, ESCAMBIA COUNTY IS LOCATED IN SOUTH ALABAMA AND BORDERS BALDWIN, MONROE, CONECUH, AND COVINGTON COUNTIES IN ALABAMA AND THREE COUNTIES IN NORTH FLORIDA. THE COUNTY ENCOMPASSES 953 SQUARE MILES OF WHICH 99 PERCENT IS UNDEVELOPED LAND. THE POPULATION OF THE COUNTY IS ONLY 36,666. ALMOST 50 PERCENT OF THE POPULATION LIVES IN THE MUNICIPALITIES OF BREWTON, EAST BREWTON, AND ATMORE, WHERE BOTH HOSPITALS ARE LOCATED. APPROXIMATELY 18 PERCENT OF THE POPULATION IS AGED 65 AND OLDER AND ACCORDING TO THE CENTER FOR ECONOMIC BUSINESS AND RESEARCH AT THE UNIVERSITY OF ALABAMA, THAT NUMBER IS PROJECTED TO GROW SUBSTANTIALLY THROUGH 2040 WHILE THE OVERALL POPULATION IS EXPECTED TO DECREASE. THESE PATIENT DEMOGRAPHICS WILL REQUIRE ADDITIONAL RESOURCES AND HEALTHCARE FOR THIS GROUP AS STUDIES SHOW THE ELDERLY TYPICALLY HAVE MULTIPLE COMORBIDITIES AND SUBSEQUENTLY REQUIRE MORE SERVICES. THE MEDIAN AGE IN ESCAMBIA COUNTY IS 39.6 AND THE MEDIAN HOUSEHOLD INCOME IS 38,464. THE POVERTY RATE IS 18.3 PERCENT COMPARED TO THE NATIONAL AVERAGE OF 13.4 PERCENT AND FEMALES AGED 25-34 MAKE UP THE LARGEST DEMOGRAPHIC GROUP LIVING IN POVERTY. 29.9 PERCENT OF THE CHILDREN IN ESCAMBIA COUNTY ARE LIVING IN POVERTY COMPARED TO 25 PERCENT OF CHILDREN LIVING IN POVERTY THROUGHOUT ALABAMA. APPROXIMATELY 84.4 PERCENT OF THE POPULATION HAVE HEALTH COVERAGE WITH THE MAJORITY OF THAT COVERAGE FALLING UNDER EMPLOYEE PLANS (41%) AND 15.6 PERCENT OF THE POPULATION ARE UNINSURED. ACCORDING TO THE MOST RECENT DATA FROM THE ALABAMA DEPARTMENT OF LABOR, ESCAMBIA COUNTY'S UNEMPLOYMENT RATE WAS 4.2 PERCENT.

SCHEDULE H, PART VI, LINE 5
ACH FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH IN THE COMMUNITY IN A VARIETY OF WAYS AS WELL AS THOSE ALREADY DESCRIBED IN SCHEDULE H. THE GOVERNING BODY IS PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE HOSPITAL'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. FOR THOSE PHYSICIANS IN THE REGION WHO DO NOT HAVE PRIVILEGES, ACH PROVIDES A PROCESS FOR ADMITTING PATIENTS VIA THE HOSPITALISTS OR THROUGH OTHER PHYSICIANS. FUNDS RECEIVED FROM THE OPERATIONS OF THE HOSPITAL AND FACILITIES (AFTER OPERATING EXPENSES) ARE USED TO SUPPORT VARIOUS OUTREACH EFFORTS DESCRIBED IN SCHEDULE H; TO FURTHER IMPROVEMENT IN PATIENT CARE BY PROVIDING MEDICAL EDUCATION TO PATIENTS AND THE COMMUNITY, CONDUCTING RESEARCH, AND IMPLEMENTING TECHNOLOGY THAT NOT ONLY PROVIDES THE LATEST IN TREATMENT, BUT ALLOWS PATIENTS TO RECEIVE HIGH QUALITY CARE IN THEIR OWN COMMUNITY AND ALLOWS US TO CONTINUALLY IMPROVE PATIENT SAFETY BY IMPLEMENTING TECHNOLOGY THAT PREVENTS MEDICATION ERRORS, ETC.

SCHEDULE H, PART VI, LINE 6
ESCAMBIA COUNTY HEALTH CARE AUTHORITY (AUTHORITY) IS A PUBLIC, NONPROFIT CORPORATION CREATED TO OPERATE, CONTROL AND MANAGE ALL MATTERS CONCERNING THE HEALTHCARE FUNCTIONS IN ESCAMBIA COUNTY, ALABAMA. THE AUTHORITY WAS ORIGINALLY CREATED UNDER ACT NO. 46 ENACTED AT THE 1949 REGULAR SESSION OF THE LEGISLATURE OF ALABAMA (CODIFIED AS DIVISION ONE OF ARTICLE FOUR OF CHAPTER 21 OF TITLE 22 OF THE CODE OF ALABAMA 1975), INCORPORATED AS THE ESCAMBIA COUNTY HOSPITAL BOARD UNDER A CERTIFICATE OF INCORPORATION FILED IN THE OFFICE OF THE JUDGE OF PROBATE OF ESCAMBIA COUNTY, ALABAMA, ON APRIL 4,1951, AND REINCORPORATED AS THE ESCAMBIA COUNTY HEALTH CARE AUTHORITY PURSUANT TO THE PROVISIONS OF ARTICLE 11 OF CHAPTER 21 OF TITLE 22 OF THE CODE OF ALABAMA 1975, AS AMENDED, PURSUANT TO A CERTIFICATE OF REINCORPORATION APPROVED AND FILED IN THE OFFICE OF THE JUDGE OF PROBATE OF ESCAMBIA COUNTY, ALABAMA ON MARCH 9, 1983. THE AUTHORITY OPERATES TWO HOSPITALS AND THEIR RELATED RURAL HEALTH CLINICS, D.W. MCMILLAN EMS, D.W. MCMILLAN HOME HEALTH EQUIPMENT, AND MANAGES THE AD VALOREM TAX REVENUES RECEIVED. THE AUTHORITY OWNS AND OPERATES D. W. MCMILLAN HOSPITAL (MCMILLAN), A 49- BED ACUTE CARE HOSPITAL, PROVIDING INPATIENT, OUTPATIENT, EMERGENCY AND RURAL HEALTH CLINIC SERVICES IN BREWTON, ALABAMA AND THE SURROUNDING AREAS. THE MEMBERS OF THE AUTHORITY'S BOARD ALSO SERVE AS MEMBERS OF MCMILLAN'S BOARD OF DIRECTORS; THEREFORE, MCMILLAN IS PRESENTED AS A BLENDED COMPONENT UNIT OF THE AUTHORITY. MCMILLAN HOSPITAL HEALTH CARE FOUNDATION OF BREWTON (FOUNDATION) IS A NOT- FOR-PROFIT 501(C)(3) CORPORATION ORGANIZED EXCLUSIVELY TO SERVE AS AN INSTRUMENT TO ASSIST, ADVANCE AND STRENGTHEN MCMILLAN IN ITS MINISTRY OF HEALING AND TO PROMOTE BROAD-BASED SUPPORT OF MCMILLAN. THE AUTHORITY ELECTS OR APPOINTS THE BOARD OF DIRECTORS OF THE FOUNDATION. UPON DISSOLUTION OF THE FOUNDATION, THE REMAINING NET ASSETS REVERT TO THE AUTHORITY. ACCORDINGLY, THE FOUNDATION IS PRESENTED AS A BLENDED COMPONENT UNIT OF THE AUTHORITY IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE AUTHORITY IS THE SOLE CORPORATE MEMBER OF ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC. WHICH IS A NON-PROFIT 501(C)(3) ORGANIZATION DOING BUSINESS AS ATMORE COMMUNITY HOSPITAL (ATMORE). ATMORE IS A 49-BED ACUTE CARE HOSPITAL PROVIDING INPATIENT, OUTPATIENT, EMERGENCY AND RURAL HEALTH CLINIC SERVICES IN ATMORE, ALABAMA AND THE SURROUNDING AREAS. THE MEMBERS OF THE AUTHORITY'S BOARD ALSO SERVE AS MEMBERS OF ATMORE'S BOARD OF DIRECTORS. THE AUTHORITY IS THE SOLE CORPORATE MEMBER OF ATMORE URGENT CARE, INC. (URGENT CARE). DURING FISCAL YEAR 2022, URGENT CARE WAS FORMED FOR THE PURPOSE OF OWNING AND CONSTRUCTING AN URGENT CARE FACILITY TO SERVE THE COMMUNITY OF ESCAMBIA COUNTY, ALABAMA.