4A (Expenses $ 310647929 including grants of $ 22750) (Revenue $ 377222259)
ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO ITS COMMUNITY. 2021 CHARITY CARE $3,721,794. CHARITY CARE IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO THOSE WHO CANNOT AFFORD TO PAY AND WHO MEET ALL CRITERIA FOR FINANCIAL ASSISTANCE. CHARITY CARE IS BASED ON ACTUAL COSTS, NOT CHARGES, AND DOES NOT INCLUDE BAD DEBT. UNREIMBURSED COST OF PUBLIC PROGRAMS $38,167,979. UNREIMBURSED COST OF PUBLIC PROGRAMS IS DEFINED AS THE SHORTFALL EXPERIENCED WHEN PAYMENTS RECEIVED ARE BELOW THE COST OF TREATING PUBLIC BENEFICIARIES THROUGH MEDICAID AND OTHER LOCAL PUBLIC PROGRAMS. COMMUNITY HEALTH IMPROVEMENT SERVICES $491,595. COMMUNITY HEALTH IMPROVEMENT SERVICES ARE DEFINED AS CLINICAL AND NON-CLINICAL SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH, WHICH ARE PROVIDED TO THE COMMUNITY FOR FREE OR FOR FEES THAT DID NOT COVER COSTS. FINANCIAL CONTRIBUTIONS $30,905. FINANCIAL CONTRIBUTIONS ARE DEFINED AS CONTRIBUTIONS, INCLUDING CASH, NON-CASH ITEMS SUCH AS FOOD, FURNITURE, EQUIPMENT, SUPPLIES, AND LOANED STAFF FOR VOLUNTEER AND CHARITABLE PURPOSES, MADE TO INDIVIDUALS, COMMUNITY GROUPS, OR NONPROFIT ORGANIZATIONS FOR CHARITABLE PURPOSES. HEALTH PROFESSIONS EDUCATION $7,064. HEALTH PROFESSIONS EDUCATION IS DEFINED AS DIRECT COSTS INCURRED FOR ACCREDITED TRAINING AND EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, ALLIED HEALTH PROFESSIONALS AND TECHNICIANS (DOES NOT INCLUDE ONGOING EDUCATION FOR STAFF). COMMUNITY BUILDING ACTIVITIES $196,778. COMMUNITY BUILDING ACTIVITIES ARE DEFINED AS PROGRAMS THAT, WHILE NOT DIRECTLY RELATED TO HEALTH CARE, PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL ISSUES. COSTS FOR THESE ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS. COMMUNITY BENEFIT OPERATIONS $883. COMMUNITY BENEFIT OPERATIONS ARE DEFINED AS COSTS ASSOCIATED WITH DEDICATED STAFF AND COMMUNITY HEALTH NEEDS AND/OR ASSETS ASSESSMENT, AS WELL AS, OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT STRATEGY AND OPERATIONS. TOTAL BENEFIT TO THE COMMUNITY FOR 2021 $42,616,998.

PART V, SECTION B
FACILITY REPORTING GROUP A

GROUP A-FACILITY 2 -- FROEDTERT PLEASANT PRAIRIE HOSPITAL PART V, SECTION B, LINE 5:
AS PART OF THE CHNA PROCESS, 25 INTERVIEWS AND TWO FOCUS GROUPS, A TOTAL OF 39 KEY INFORMANTS WERE CONDUCTED WITH KEY INFORMANTS IN KENOSHA COUNTY WHO WERE IDENTIFIED BY THE KENOSHA COUNTY DIVISION OF HEALTH, FROEDTERT SOUTH, AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, KENOSHA COMMUNITY HEALTH CENTER, AND UNITED WAY OF KENOSHA COUNTY. AMONG THE KEY INFORMANTS WERE LEADERS FROM PUBLIC HEALTH, EDUCATION, AND COMMUNITY ORGANIZATIONS. THESE KEY INFORMANTS REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED, INCLUDING MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS. THE INTERVIEWERS USED A STANDARD INTERVIEW SCRIPT THAT INCLUDED THE FOLLOWING ELEMENTS: RANKING OF UP TO FIVE PUBLIC HEALTH ISSUES, BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN, THAT ARE THE MOST IMPORTANT ISSUES FOR THE COUNTY; AND FOR THOSE FIVE PUBLIC HEALTH ISSUES: EXISTING STRATEGIES TO ADDRESS THE ISSUE. BARRIERS AND CHALLENGES TO ADDRESSING THE ISSUE. ADDITIONAL STRATEGIES NEEDED. KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH TO IMPROVE COMMUNITY HEALTH. IDENTIFICATION OF SUBGROUPS OR SUBPOPULATIONS WHERE EFFORTS COULD BE TARGETED. WAYS EFFORTS CAN BE TARGETED TOWARD EACH SUBGROUP OR SUBPOPULATION. ALL INFORMANTS WERE MADE AWARE THAT PARTICIPATION WAS VOLUNTARY AND THAT RESPONSES WOULD BE SHARED WITH THE CENTER FOR URBAN POPULATION HEALTH FOR ANALYSIS AND REPORTING. BASED ON THE SUMMARIES PROVIDED TO THE CENTER FOR URBAN POPULATION HEALTH, THE REPORT PRESENTS THE RESULTS OF THE 2019 KEY INFORMANT INTERVIEWS FOR KENOSHA COUNTY.

GROUP A-FACILITY 2 -- FROEDTERT PLEASANT PRAIRIE HOSPITAL PART V, SECTION B, LINE 6A:
AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, AND FROEDTERT KENOSHA HOSPITAL

GROUP A-FACILITY 2 -- FROEDTERT PLEASANT PRAIRIE HOSPITAL PART V, SECTION B, LINE 6B:
AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, UNITED WAY OF KENOSHA COUNTY, FROEDTERT KENOSHA HOSPITAL, AND KENOSHA COUNTY PUBLIC HEALTH DEPARTMENT ALONG WITH JKV RESEARCH, LLC, AND CENTER FOR URBAN POPULATION HEALTHFROEDTERT PLEASANT PRAIRIE HOSPITAL:PART V, SECTION B, LINE 7A:HTTPS://WWW.FROEDTERTSOUTH.COM/ABOUT-US/COMMUNITY-BENEFITS/

GROUP A-FACILITY 2 -- FROEDTERT PLEASANT PRAIRIE HOSPITAL PART V, SECTION B, LINE 7D:
FROEDTERT SOUTH WORKED IN COLLABORATION WITH SEVERAL UNRELATED HOSPITAL ORGANIZATIONS FACILITIES, GOVERNMENTAL DEPARTMENTS, AND NONPROFIT ORGANIZATIONS, INCLUDING AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, AND THE KENOSHA COMMUNITY HEALTH CENTER TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR CALENDAR YEARS 2020 THROUGH 2022, AND ADOPTED AN IMPLEMENTATION STRATEGY TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PRIOR TO THE EXTENDED DEADLINE DATE OF DECEMBER 31, 2020 (AS EXTENDED BY THE IRS PURSUANT TO NOTICE 2020-56). CONSISTENT WITH THE REQUIREMENTS OF SECTION 501(R)(3), FROEDTERT SOUTH'S CHNA [1] DEFINED THE COMMUNITY IT SERVES, [2] ASSESSED THE HEALTH NEEDS OF THE KENOSHA COUNTY COMMUNITY, [3] INCLUDED SIGNIFICANT FEEDBACK FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE KENOSHA COUNTY COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH, [4] WAS DOCUMENTED IN A WRITTEN REPORT THAT WAS ADOPTED FOR THE HOSPITAL FACILITY AND [5] WAS MADE WIDELY AVAILABLE TO THE PUBLIC IN PAPER FORMAT AT THE HOSPITAL FACILITIES, FOR PUBLIC INSPECTION, AND UPON REQUEST PRIOR TO THE EXTENDED DEADLINE DATE OF DECEMBER 31, 2020. HOWEVER, FROEDTERT SOUTH WAS UNABLE TO MAKE THE CHNA WIDELY AVAILABLE, VIA THE FROEDTERT SOUTH WEBSITE UNTIL SHORTLY AFTER THE DECEMBER 31, 2020, DATE RESULTING FROM A REBUILD OF ITS FACILITY WEBSITE, WHICH DID NOT GO LIVE UNTIL SHORTLY AFTER THE EXTENDED DEADLINE DATE. HAVING SAID THAT, CHNA SURVEY AND REPORT FOR CALENDAR YEARS 2020 THROUGH 2022 CONDUCTED WITH AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, AND THE KENOSHA COMMUNITY HEALTH CENTER WAS PUBLISHED AND MADE WIDELY AVAILABLE VIA THEIR RESPECTIVE WEBSITES ON, OR BEFORE, DECEMBER 31, 2020. FROEDTERT PLEASANT PRAIRIE HOSPITAL:PART V, SECTION B, LINE 10A:HTTPS://WWW.FROEDTERTSOUTH.COM/ABOUT-US/COMMUNITY-BENEFITS/

GROUP A-FACILITY 2 -- FROEDTERT PLEASANT PRAIRIE HOSPITAL PART V, SECTION B, LINE 11:
USING THESE CRITERIA, FROEDTERT SOUTH PRIORITIZED THE FOLLOWING SIGNIFICANT HEALTH NEEDS TO ADDRESS IN THE 2020-2022 IMPLEMENTATION STRATEGY: REDUCE BARRIERS FOR PATIENTS TO ACCESS CARE.GOAL: ACCESS AND IMPROVE ACCESS TO CARE FOR MEDICALLY UNDERSERVED AND VULNERABLE GROUPS OF ALL AGES AND POPULATIONS. STRATEGY 1: INCREASE PATIENT CAPACITY WITHIN THE FROEDTERT SOUTH MEDICAL GROUP THROUGH RECRUITMENT AND RETENTION OF PHYSICIANS AND MID-LEVEL PROVIDERS WITHIN THE FROEDTERT SOUTH MEDICAL GROUP. STRATEGY 2: ENHANCE AND EXPAND TELEMEDICINE OPPORTUNITIES. STRATEGY 3: ENHANCE AWARENESS OF AVAILABLE SERVICES OFFERED THROUGH FROEDTERT SOUTH AND THE FROEDTERT SOUTH MEDICAL GROUP. STRATEGY 4: WORK IN COLLABORATION WITH INTERNAL AND EXTERNAL RESOURCES TO ASSIST PATIENTS AS IT RELATES TO DETERMINING ELIGIBILITY FOR MEDICAID, CHIP AND ACA MARKETPLACE ENROLLMENT, INCLUDING SPECIAL ENROLLMENT PERIODS, AND ELIGIBILITY TO ASSIST IN REMOVING BARRIERS TO CARE. FOCUS ON HEALTH OUTREACH AND EDUCATION - CORONAVIRUS/COVID-19 PANDEMIC RESPONSEGOAL: INCREASE THE AMOUNT OF OUTREACH AND EDUCATION RESOURCES AVAILABLE TO KENOSHA COUNTY RESIDENTS DURING THE COVID-19 PANDEMIC. STRATEGY 1: LAUNCH A DRIVE-THRU COVID-19 TESTING FACILITY TO AID THE COMMUNITY WITH ACCESSIBLE, AND CONVENIENT, COVID-19 TESTING. STRATEGY 2: ENHANCE AND EXPAND TELEMEDICINE OPPORTUNITIES IN ORDER TO PROVIDE NECESSARY CARE FOR PATIENTS WHILE MINIMIZING THE TRANSMISSION RISK OF COVID-19. STRATEGY 3: IMPLEMENT APPROPRIATE PROTOCOLS, INCLUDING A COVID-19 TESTING PROTOCOL FOR PATIENTS SCHEDULED FOR ELECTIVE SURGICAL CASES AND PROCEDURES. STRATEGY 4: DEVELOP A COVID-19 VACCINATION CLINIC TO AID THE KENOSHA COUNTY HEALTH DEPARTMENT IN AN EFFORT TO OBTAIN HERD IMMUNITY WITHIN KENOSHA COUNTY. INCREASE AWARENESS OF PREVENTION METHODS, SCREENINGS, AND CARE FOR CHRONIC DISEASES.GOAL: EXPAND AND TARGET EDUCATIONAL PROGRAMS TO REACH A LARGER AUDIENCE IN THE AT-RISK POPULATIONS. STRATEGY 1: IMPLEMENT THE EPIC ELECTRONIC HEALTH RECORD TO PROVIDE A GREATER ABILITY TO COMMUNICATE INFORMATION TO PATIENTS OF FROEDTERT SOUTH VIA MYCHART, AND OTHER, SIMILAR MECHANISMS. STRATEGY 2: ENHANCE AND EXPAND THE USE OF RECALL/FOLLOW-UP MECHANISMS TO IMPROVE THE ABILITY FOR FROEDTERT SOUTH TO ENSURE PATIENTS ARE RECEIVING ROUTINE PREVENTATIVE CARE AS RECOMMENDED BY THE U.S. PREVENTATIVE TASK FORCE. STRATEGY 3: INCREASE THE KNOWLEDGE OF HIGH-RISK POPULATIONS ON WAYS TO MANAGE CHRONIC DISEASES.

FROEDTERT KENOSHA HOSPITAL:
"PART V, SECTION B, LINE 22B: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL NOT BE CHARGED INDIVIDUALLY MORE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERAGE FOR SUCH CARE (""AGB""). FURTHERMORE, CHARGES FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE LESS THAN THE GROSS CHARGES FOR SUCH SERVICES. THE ORGANIZATION CALCULATES ONE OR MORE AGB PERCENTAGES USING THE ""LOOK-BACK METHOD AND INCLUDING MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE ORGANIZATION, ALL INACCORDANCE WITH 501(R). THESE CALCULATIONS ARE MADE AS FOLLOWS:1. THE ORGANIZATION DETERMINES AGB BY MULTIPLYING THE GROSS CHARGES FOR THE APPLICABLE MEDICAL CARE BY THE AGB PERCENTAGE, WHICH IS DETERMINED ANNUALLY BY DIVIDING (A) THE SUM OF THE AMOUNTS FOR ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED DURING THE AGB PERIOD BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBLES BY (B) THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS.2. ""GROSS CHARGES"" MEANS THE ORGANIZATION'S FULL, ESTABLISHED PRICE FOR MEDICAL CARE THAT THE ORGANIZATION CONSISTENTLY AND UNIFORMLY CHARGES PATIENTS BEFORE APPLYING ANY CONTRACTUAL ALLOWANCES, DISCOUNTS, OR DEDUCTIONS.3. THE ""AGB PERIOD"" MEANS EACH PRIOR 12-MONTH PERIOD ENDING ON DECEMBER 31ST.4. THE ORGANIZATION WILL BEGIN TO APPLY THE ANNUALLY DETERMINED AGB PERCENTAGE WITHIN 120 DAYS FOLLOWING THE END OF THE AGB PERIOD THAT WAS USED IN CALCULATION THE AGB PERCENTAGE.5. ANY CAPITALIZED TERMS NOT DEFINED IN THIS DOCUMENT WILL HAVE THE MEANING ASSIGNED TO SUCH TERM IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.THESE LIMITATIONS ON CHARGES FOR MEDICAL SERVICES SHALL NOT APPLY IF AN INDIVIDUAL HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE APPLICATION AS OF THE TIME THE CHARGES ARE BILLED TO SUCH INDIVIDUAL; PROVIDED, HOWEVER, THAT ADJUSTMENTS WILL BE MADE IF AMOUNTS ARE CHARGED IN EXCESS OF THESE LIMITATIONS AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE."

FROEDTERT PLEASANT PRAIRIE HOSPITAL:
"PART V, SECTION B, LINE 22B: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL NOT BE CHARGED INDIVIDUALLY MORE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERAGE FOR SUCH CARE (""AGB""). FURTHERMORE, CHARGES FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE LESS THAN THE GROSS CHARGES FOR SUCH SERVICES. THE ORGANIZATION CALCULATES ONE OR MORE AGB PERCENTAGES USING THE ""LOOK-BACK METHOD AND INCLUDING MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE ORGANIZATION, ALL INACCORDANCE WITH 501(R). THESE CALCULATIONS ARE MADE AS FOLLOWS:1. THE ORGANIZATION DETERMINES AGB BY MULTIPLYING THE GROSS CHARGES FOR THE APPLICABLE MEDICAL CARE BY THE AGB PERCENTAGE, WHICH IS DETERMINED ANNUALLY BY DIVIDING (A) THE SUM OF THE AMOUNTS FOR ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED DURING THE AGB PERIOD BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBLES BY (B) THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS.2. ""GROSS CHARGES"" MEANS THE ORGANIZATION'S FULL, ESTABLISHED PRICE FOR MEDICAL CARE THAT THE ORGANIZATION CONSISTENTLY AND UNIFORMLY CHARGES PATIENTS BEFORE APPLYING ANY CONTRACTUAL ALLOWANCES, DISCOUNTS, OR DEDUCTIONS.3. THE ""AGB PERIOD"" MEANS EACH PRIOR 12-MONTH PERIOD ENDING ON DECEMBER 31ST.4. THE ORGANIZATION WILL BEGIN TO APPLY THE ANNUALLY DETERMINED AGB PERCENTAGE WITHIN 120 DAYS FOLLOWING THE END OF THE AGB PERIOD THAT WAS USED IN CALCULATION THE AGB PERCENTAGE.5. ANY CAPITALIZED TERMS NOT DEFINED IN THIS DOCUMENT WILL HAVE THE MEANING ASSIGNED TO SUCH TERM IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.THESE LIMITATIONS ON CHARGES FOR MEDICAL SERVICES SHALL NOT APPLY IF AN INDIVIDUAL HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE APPLICATION AS OF THE TIME THE CHARGES ARE BILLED TO SUCH INDIVIDUAL; PROVIDED, HOWEVER, THAT ADJUSTMENTS WILL BE MADE IF AMOUNTS ARE CHARGED IN EXCESS OF THESE LIMITATIONS AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE."

PART I, LINE 7:
THE COST METHOD USED TO CALCULATE THE COST OF THE COMMUNITY BENEFIT PROGRAMS WAS THE COST-TO-CHARGE RATIO. WORKSHEET 2 WAS USED TO CALCULATE THE RATIO OF PATIENT CARE COST TO CHARGES.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $6,697,198.

PART II, COMMUNITY BUILDING ACTIVITIES:
MANY STAFF MEMBERS ARE UTILIZED TO PROMOTE THE HEALTH OF THE COMMUNITY AND THE GENERAL WELL-BEING OF THE COMMUNITY WE SERVE. THROUGH OUR EMERGENCY PREPAREDNESS COMMITTEE, STAFF ARE ALWAYS PLANNING AND PREPARING TO BE READY TO MEET THE NEEDS OF THE COMMUNITY AS EVENTS OCCUR. ADDITIONALLY, A VARIETY OF STAFF WORK WITH LOCAL SCHOOLS AND OTHER ORGANIZATIONS TO GIVE TALKS PROMOTING HEALTH AND CAREERS IN HEALTHCARE. A NUMBER OF STAFF MEMBERS ARE INVOLVED IN MENTORING PROGRAMS WITHIN THE LOCAL SCHOOLS. RECOGNIZING THE IMPORTANCE OF SUSTAINING AND GROWING OUR ECONOMY, WE PARTICIPATE IN OUR LOCAL BUSINESS ALLIANCE.

PART III, LINE 2:
THE ORGANIZATIONS UTILIZED THE HMFA #15 METHODOLOGY FOR DETERMINING BAD DEBT EXPENSE.

PART III, LINE 3:
SINCE THE ORGANIZATION UTILIZES HMFA #15, THERE IS NO PORTION OF THE BAD DEBT THAT WOULD BE CONSIDERED CHARITY CARE.

PART III, LINE 4:
MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION EXPERIENCE AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. WORKSHEET A IN THE INSTRUCTIONS WAS USED TO DETERMINE THE COSTING METHODOLOGY.

PART III, LINE 8:
MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY CMS.

PART III, LINE 9B:
OUR COLLECTION PROCESS IS THE SAME FOR ALL PATIENTS. IF A PATIENT EXPRESSES A NEED FOR FINANCIAL ASSISTANCE WE OFFER THE FINANCIAL ASSISTANCE APPLICATION. WE BILL ALL INSURANCES. PATIENT DOES NOT RECEIVE A COPY OF THE BILL UNTIL IT IS THEIR BALANCE. OUR EXTENDED BUSINESS OFFICE SENDS THREE STATEMENTS AND OUR REQUIRED FINAL REQUEST STATEMENT. FROM THIS POINT THE OUTSTANDING BALANCE IS HANDLED BY THE COLLECTION AGENCY. THE ACCOUNT DOES STAY ACTIVE ON OUR FINANCIAL SYSTEM FOR ONE YEAR. AT THAT TIME THE OUTSTANDING BALANCE IS MOVED OVER TO A BAD DEBT STATUS.

PART VI, LINE 2:
IN AN EFFORT TO UNDERSTAND AND ASSIST IN ADDRESSING THE NEEDS OF THE COMMUNITY WE SERVE, FROEDTERT SOUTH HAS INVOLVEMENT IN A VARIETY OF COMMUNITY COMMITTEES. FROEDTERT SOUTH HAS MULTIPLE STAFF, MANAGEMENT AND ADMINISTRATIVE LEVEL EMPLOYEES PARTICIPATE IN COMMITTEES THAT ARE SET UP TO ASSESS AND ADDRESS NEEDS IN THE COMMUNITY SUCH AS A HEALTHY LIFESTYLE COMMITTEE, MENTAL HEALTH COMMITTEE, INJURY PREVENTION COMMITTEE, SUICIDE PREVENTION COMMITTEE, INFANT MORTALITY COMMITTEE. THROUGH OUR PARTICIPATION IN COMMUNITY COMMITTEES WE GAIN AN UNDERSTANDING ABOUT THE NEEDS OF THE COMMUNITY AS WELL AS THE OPPORTUNITY TO WORK TOGETHER TO ADDRESS THE NEEDS.

PART VI, LINE 3:
WHEN STATEMENTS ARE SENT FROM OUR EXTENDED BUSINESS OFFICE, THERE IS A PHONE NUMBER FOR THE PATIENT TO CALL FOR ASSISTANCE WITH THEIR BALANCES. PATIENTS CALL AND THEY WORK WITH THEM TO SET UP PAYMENT ARRANGEMENTS. IF THEY EXPRESS ANY CONCERNS FOR FINANCIAL NEEDS THEY OFFER TO SEND THEM A COMMUNITY CARE APPLICATION.

PART VI, LINE 4:
KENOSHA COUNTY IS A FAST GROWING LAKESHORE COMMUNITY IN SOUTHEASTERN WISCONSIN. LOCATED BETWEEN CHICAGO AND MILWAUKEE, KENOSHA COUNTY BOASTS A DIVERSE ECONOMY. KENOSHA IS THE FOURTH LARGEST CITY IN THE STATE OF WISCONSIN WITH 100,164 RESIDENTS REPORTED BY THE UNITED STATES CENSUS BUREAU IN THE 2018 POPULATION ESTIMATES. KENOSHA IS NOW THE EIGHTH LARGEST COUNTY IN WISCONSIN IN TERMS OF POPULATION WITH 169,561 RESIDENTS. FROEDTERT SOUTH SERVES PEOPLE IN SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS THROUGH ITS TWO HOSPITAL LOCATIONS, FROEDTERT PLEASANT PRAIRIE HOSPITAL AND FROEDTERT KENOSHA HOSPITAL. ADVOCATE AURORA MEDICAL CENTER ALSO HAS A HOSPITAL CAMPUS IN KENOSHA.

PART VI, LINE 5:
FROEDTERT SOUTH IS COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS AND NEIGHBORS. WE OFFER A VARIETY OF COMMUNITY OUTREACH PROGRAMS TO HELP THE GENERAL PUBLIC MAINTAIN GOOD HEALTH. THESE INCLUDE FREE COMMUNITY EDUCATION SEMINARS, HEALTH SCREENINGS, AND VARIOUS SUPPORT GROUPS.

PART VI, LINE 7, REPORTS FILED WITH STATES
WI