Community Benefit Insight - Tax-exempt hospital

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Wyoming Medical Center Inc

Wyoming Medical Center

1233 E Second Street
Casper, WY 82601

Bed count	217	Medicare provider number	530012	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 830279242

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

15.08%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

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	$ 24,820,057 9.39 %
Medicaid as % of operating expenses	$ 11,286,726 4.27 %
Costs of other means-tested government programs as % of operating expenses	$ 527,202 0.20 %
Health professions education as % of operating expenses	$ 97,665 0.04 %
Subsidized health services as % of operating expenses	$ 3,017,703 1.14 %
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.	$ 125,098 0.05 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 501,116 0.19 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
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	$ 501,116 0.19 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 0 0 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 501,116 100 %
Other as % of community building expenses	$ 0 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: 2021

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	$ 5,845,964 2.21 %
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: 2021

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: 2021

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 $ 211117718 including grants of $ 24500) (Revenue $ 274771392)
WYOMING MEDICAL CENTER IS A NOT-FOR-PROFIT HOSPITAL. THE HOSPITAL WAS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS UNTIL SEPTEMBER 30, 2020. EFFECTIVE OCTOBER 1, 2020 THE WMC BOARD OF DIRECTORS AND THE WMC FOUNDATION BOARD APPROVED AN AGREEMENT WITH BANNER HEALTH, WITH PLANS TO FULLY INTEGRATE WMC INTO THE BANNER SYSTEM BY 2022. IN ADDITION, THE BOARD OF TRUSTEES, APPROVED A SEPARATE $157 MILLION SALE OF LAND, BUILDINGS AND EQUIPMENT ASSOCIATED WITH WMC TO BANNER HEALTH. BANNER HEALTH IS NON-PROFIT HEALTH SYSTEM HEADQUARTERED IN ARIZONA. IT OPERATES 29 ACUTE-CARE HOSPITALS IN SIX STATES.WYOMING MEDICAL CENTER PROVIDED $4,053,761 IN CHARITY CARE SERVICES BASED ON TOTAL DIRECT AND INDIRECT COSTS.

Facility Information

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

WYOMING MEDICAL CENTER
PART V, SECTION B, LINE 5: WYOMING MEDICAL CENTER WORKED VERY CLOSELY WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT FOR MORE THAN A YEAR ON GATHERING DATA TO PERFORM AN OVERALL HEALTH ASSESSMENT OF OUR COMMUNITY. THE COMMUNITY HEALTH STATUS REPORT REPRESENTS THAT WORK. WE USED A ROBUST METHODOLOGY FOR IDENTIFYING RELEVANT COMMUNITY HEALTH INDICATORS. THERE ARE A NUMBER OF RESOURCES THAT PROVIDE LISTS OF HEALTH INDICATORS RECOMMENDED FOR USE DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. WE CHOSE INDICATORS MOST COMMONLY USED FOR CHNAS, AND THEN CONTINUED TO DIG DEEPER INTO LOCAL DATA THAT WE HAD TO FURTHER CHARACTERIZE OUR COMMUNITY'S HEALTH. THE FULL DOCUMENT IS AVAILABLE ON OUR WEBSITE.OVER THE COURSE OF A YEAR, WE HELD THREE LARGER FORUMS WITH MANY KEY HEALTH STAKEHOLDERS IN THE COMMUNITY TO HELP US MOVE FORWARD WITH OUR IMPLEMENTATION STRATEGY. WE IDENTIFIED THE TOP 10 ISSUES IN OUR COUNTY BASED ON THE FINDINGS FROM THE CHNA AND PROVIDED A SURVEY TO KEY HEALTH STAKEHOLDERS ACROSS THE COUNTY. STAKEHOLDERS REPRESENTED VARIOUS ORGANIZATIONS INCLUDING LAW ENFORCEMENT, EDUCATORS, PHYSICIANS AND OTHER PROVIDERS, LOCAL HEALTH ADMINISTRATORS, AND MORE. ORGANIZATIONS INCLUDED, BUT ARE NOT LIMITED TO: CASPER AREA CHAMBER OF COMMERCE, WYOMING BUSINESS COALITION ON HEALTH, ELKHORN VALLEY REHABILITATION HOSPITAL, CITY OF CASPER, CASPER COLLEGE, PLATTE RIVER TRAILS, CENTRAL WYOMING HOSPICE, NATRONA COUNTY SCHOOL DISTRICT, SUMMIT MEDICAL CENTER, MOUNTAIN-PACIFIC QUALITY HEALTH, WYOMING HEALTH FAIRS, CASPER FAMILY YMCA, MERCER HOUSE, SENIOR PATIENT ADVOCATES, CASPER HOUSING AUTHORITY AND MORE.

WYOMING MEDICAL CENTER
PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN COLLABORATION WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT.

WYOMING MEDICAL CENTER
PART V, SECTION B, LINE 11: FOUR SIGNIFICANT COMMUNITY HEALTH NEEDS WERE IDENTIFIED IN THE CHNA CONDUCTED FOR THE YEAR ENDED JUNE 30, 2019:- HEALTHY EATING / ACTIVE LIFESTYLE- SAFE / AFFORDABLE HOUSING- SUBSTANCE ABUSE / OTHER USE- MENTAL HEALTH / SUICIDEFOUR GROUPS WERE IDENTIFIED IN THE FY2019 COMMUNITY HEALTH NEEDS ASSESSMENT AND TO ADDRESS ISSUES AND SOLUTIONS RELATED TO THE NEEDS IDENTIFIED. FY2019 WAS THE FIRST YEAR OF THE ASSESSMENT AND THE WAS A GOAL-SETTING YEAR. FY2020 AND 2021 PRESENTED CHALLENGES WITH IN-PERSON MEETINGS AND SOME GOALS DUE TO THE COVID-19 PANDEMIC. IN FY2021 WMC HAS WORKED ON THE FOLLOWING:HEALTHY LIVING / ACTIVE LIFESTYLE: IN PARTNERSHIP WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT, WE DISTRIBUTED HANDBOOKS TO PARENTS OF STUDENTS IN THE NATRONA COUNTY SCHOOL DISTRICT GRADES 6-12 ON ALL HEALTH INSSUES, INCLUDING HOW TO TALK TO YOUR KIDS ABOUT HEALTHY EATING, SUBSTANCE ABUSE AND MISUSE, AND SUICIDE/MEANTAL HEALTH. WYOMING MEDICAL CENTER SIGNED A FIVE-YEAR LEASE WITH THE CASPER COMMUNITY GREENHOUSE PROJECT (CCGP) IN JANUARY 2020. THE NON-PROFIT HAS PLANNED AN URBAN GARDEN ON THE VACANT LAND AND STARTED CONSTRUCTION IN SUMMER 2020. THE PROJECT SCOPE INCLUDES A GREENHOUSE, AN ORCHARD, A FRUIT STAND, AND SEVERAL WALKWAYS WILL SERVE AS A CLASSROOM FOR LOCAL RESIDENTS TO LEARN ABOUT ORGANIC FARMING AND FRUITS AND VEGETABLES THAT ARE NATIVE TO WYOMING AND HOW PEOPLE CAN TAKE ADVANTAGE OF URBAN GARDENING. SUBSTANCE ABUSE / OTHER USE: THE GROUP GOALS INCLUDE CREATING A MEDICATION DISPOSAL PROGRAM, CREATING AN INFORMATIONAL CAMPAIGN TO EDUCATE ON DISPOSAL AND COMMUNITY OPTIONS, INCREASING ACCESS TO OTHER COMMUNITY ENTITIES ENCOURAGING APPROPRIATE DISPOSAL, AND INSTITUTING MORE COMMUNITY ENTITIES PROVIDING DRUG DISPOSAL / DEACTIVTION BAGS WITH PRESCRIPTIONS. THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT DISTRIBUTED 332 DETERRA DRUG DISPOSAL BAGS AND 561 SAFE STORAGE DRUG LOCK BOXES. THEY ALSO PROVIDED 47 ALCOHOL AND BEVERAGE SERVICE CLASS (TIPS) VOUCHERS TO MEMBERS OF THE COMMUNITY TO ADD ACCESS TO THE CLASS IN THE COMMUNITY. CNCHD DISTRIBUTED 3,963 EDUCATION BROCHURES ABOUT QUIT TOBACCO PROGRAM, DRUG STORAGE/DISPOSAL AND UNDERAGE DRINKING. MENTAL HEALTH / SUICIDE: WYOMING MEDICAL CENTER CONTINUES TO WORK ON A ZERO SUICIDE INITIATIVE WITH SEVERAL COMMUNITY PARTNERS. CASPER-NATRONA COUNTY HEALTH DEPARTMENT HELD ONE ASSIST SUICIDE PREVENTION PROGRAM CLASS FOR 24 PARTICIPANTS AND FUNDED 1 MENTAL HEALTH FIRST AID CLASS FOR 32 PARTICIPANTS. ADDITIONALLY, 4,785 GUN LOCKS AND 2,690 SUICIDE LIFE LINE CALL NUMBER CARDS WERE DISTRIBUTED. SAFE / AFFORDABLE HOUSING (EXPLORATORY GOAL): SINCE WYOMING MEDICAL CENTER AND THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT HAVE LITTLE DIRECT CONTROL OVER HOUSING, THEY HAVE COMMITTED TO SUPPORTING THE GOALS OF THE CASPER HOUSING AUTHORITY WHICH INCLUDE: CREATING LOW-INCOME HOUSING UNITS, CREATING WORKFORCE HOUSING UNITS AND CREATING AN ONLINE RESOURCE LIST. WYOMING MEDICAL CENTER CARE MANAGEMENT WORKS CLOSELY WITH THE CASPER HOUSING AUTHORITY TO HELP WITH PLACEMENT OF PATIENTS IN NEED.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, THE MEDICAL CARE MUST BE EMERGENT OR MEDICALLY NECESSARY AND THE INDIVIDUAL'S HOUSEHOLD GROSS INCOME MUST BE BELOW 300 PERCENT OF THE FEDERAL POVERTY GUIDELINE THRESHOLDS. ELIGIBILITY FOR FINANCIAL ASSISTANCE SHALL BE EXTENDED TO A PERSON BASED ON HOUSEHOLD INCOME.

PART I, LINE 7:
EXPENSES REPORTED IN PART I, LINES 7A, 7B AND 7C ARE CALCULATED USING THE WORKSHEETS IN THE INSTRUCTIONS TO SCHEDULE H, INCLUDING UTILIZATION OF THE COST-TO-CHARGE RATIO. EXPENSES REPORTED IN PART I, LINES 7E, 7F AND 7G ARE BASED ON ACTUAL COSTS.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES INCLUDE THE WYOMING BEHAVIORAL INSTITUTE AND ENDOCRINE & DIABETES SERVICES.

PART I, LINE 7, COLUMN (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 $ 5,845,964.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY BY PROVIDING NEEDED SPECIALISTS AND PHYSICIANS AS WELL AS DETERMINING WHAT IS NEEDED BY THE RESIDENTS IN THE LOCAL COMMUNITY AND SURROUNDING AREA. WYOMING MEDICAL CENTER SPENT $400,978 IN RECRUITING PHYSICIANS FOR PEDIATRICS, OB/GYN, PRIMARY CARE, RADIOLOGY SERVICES, AND EMERGENCY CARE.

PART III, LINE 2:
FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY BALANCES, WYOMING MEDICAL CENTER RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 3:
WYOMING MEDICAL CENTER FOLLOWS HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. THEREFORE, BAD DEBT DOES NOT INCLUDE AMOUNTS THAT SHOULD BE ATTRIBUTABLE TO CHARITY CARE.

PART III, LINE 4:
FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY BALANCES, WYOMING MEDICAL CENTER RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 8:
WYOMING MEDICAL CENTER USED THE MEDICARE OPERATING COST-TO-CHARGE RATIO TO CALCULATE THE COSTS RELATING TO MEDICARE REVENUE APPLIED AGAINST ACTUAL RECEIPTS.

PART III, LINE 9B:
COLLECTION PRACTICES ARE ONLY PURSUED IF THE PATIENT IS DETERMINED TO NOT QUALIFY FOR CHARITY CARE OR DOES NOT QUALIFY FOR ANOTHER PROGRAM. THIS INCLUDES NOTIFICATION TO THE PATIENT VIA 4 STATEMENT AND A LETTER NOTIFYING THEM OF EXTRAORDINARY COLLECTION ACTIVITIES 30 DAYS PRIOR TO ASSIGNMENT OF AN ACCOUNT TO COLLECTIONS. ONCE A PATIENT IS DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, ALL COLLECTION PRACTICES ARE CEASED.

PART VI, LINE 2:
CONTINUOUS MONITORING OF PUBLIC AND OTHER INTERNAL DATA SOURCES SHOWS THE HOSPITAL WHICH HEALTH CONCERNS ARE OF THE GREATEST IMPACT TO OUR COMMUNITY. WYOMING MEDICAL CENTER USES PUBLIC DATA, INCLUDING THE HEALTHY PEOPLE 2020 STUDY FROM THE OFFICE OF DISEASE PREVENTION AND HEALTH PROMOTION, AS WELL AS DATA FROM REPORTING HOSPITALS OF THE WYOMING HOSPITAL ASSOCIATION. INTERNAL DATA FROM THE HOSPITAL AND ASSOCIATED CLINICS ALSO HELPS TO IDENTIFY AND FIND SOLUTIONS FOR MORE SPECIFIC NEEDS WITHIN THE COMMUNITY. WYOMING MEDICAL CENTER HAS ALSO PARTNERED WITH THE CASPER-NATRONA COUNTY HEALTH DEPARTMENT, WHICH GATHERS VARIOUS HEALTH-RELATED DATA FOR THE WHOLE STATE ON A COUNTY-BY-COUNTY BASIS.

PART VI, LINE 3:
WYOMING MEDICAL CENTER'S PLAIN LANGUAGE SUMMARY AND FULL POLICY ARE AVAILABLE ONLINE AND UPON REQUEST VIA EMAIL, MAIL OR IN-PERSON. WYOMING MEDICAL CENTER HAS FINANCIAL COUNSELORS THAT MEET WITH SELF-PAY INPATIENTS OR ANY PATIENT UPON REQUEST.

PART VI, LINE 4:
WYOMING MEDICAL CENTER HAS 249 BEDS ON TWO HOSPITAL CAMPUSES. WITH OVER 50 SPECIALTIES OFFERED, WYOMING MEDICAL CENTER OFFERS HUNDREDS OF STATEWIDE CLINICS EACH YEAR. A FULL SPECTRUM OF INTEGRATED HEALTHCARE SERVICES INCLUDES EMERGENCY CARE AND TRAUMA, INTENSIVE CARE, SURGICAL, CARDIAC SERVICES, OBSTETRIC AND PEDIATRIC AND ORTHOPEDIC CARE. WYOMING MEDICAL CENTER ALSO OPERATES SEVERAL OUTPATIENT CLINICS IN CASPER.IN ADDITION TO WYOMING MEDICAL CENTER, CASPER CURRENTLY HAS TWO SPECIALTY HOSPITALS, A REHABILITATION HOSPITAL AND A BEHAVIORAL HEALTH CENTER.ACCORDING TO JUNE 30, 2021 U.S. CENSUS DATA, NATRONA COUNTY IS HOME TO JUST OVER 79,000 RESIDENTS WITH 578,000 STATEWIDE. NATRONA COUNTY AND THE STATE OF WYOMING HAVE LOW POPULATION DENSITY, WITH 5.9 PERSONS PER SQUARE MILE AND 15.0 PERSONS PER SQUARE MILE, RESPECTIVELY. NATRONA COUNTY IS 92.4% WHITE, 1.2% BLACK, 2.8% AMERICAN INDIAN AND ALASKA NATIVE, 1.1% ASIAN, 0.1% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER, 2.4% OF PEOPLE REPORT TWO OR MORE RACES AND 10.6% ARE OF HISPANIC OR LATINO ORIGIN.ACCORDING TO CENSUS DATA, 9.2% OF PEOPLE IN NATRONA COUNTY ARE BELOW THE POVERTY LEVEL AND 9.4% ARE BELOW THE POVERTY LEVEL IN WYOMING. MEDIAN HOUSEHOLD INCOME IS $65,304 IN NATRONA COUNTY AND $62,168 IN WYOMING.

PART VI, LINE 7, REPORTS FILED WITH STATES
WY

PART VI, LINE 5:
WYOMING MEDICAL CENTER IS A NOT-FOR PROFIT HOSPITAL. THE HOSPITAL WAS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS UNTIL THE SEPT. 30, 2020. EFFECTIVE OCT. 1, 2020, THE WMC BOARD OF DIRECTORS AND THE WMC FOUNDATION BOARD APPROVED AN AGREEMENT WITH BANNER HEALTH, WITH PLANS TO FULLY INTEGRATE WMC INTO THE BANNER SYSTEM BY JANUARY 2022. IN ADDITION, THE BOARD OF NATRONA COUNTY COMMISSIONERS AND THE COUNTY-APPOINTED MEMORIAL HOSPITAL BOARD OF TRUSTEES, APPROVED A SEPARATE $157 MILLION SALE OF LAND, BUILDINGS AND EQUIPMENT ASSOCIATED WITH WMC TO BANNER HEALTH. BANNER HEALTH IS NON-PROFIT HEALTH SYSTEM HEADQUARTERED IN ARIZONA. IT OPERATES 29 ACUTE-CARE HOSPITALS IN SIX STATES. WYOMING MEDICAL CENTER'S MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS AND ALLIED HEALTH PROFESSIONALS. THE FACILITY APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH. OUR EMERGENCY DEPARTMENT IS OPEN TO ALL INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. WYOMING MEDICAL CENTER SUBSIDIZED $7,799,024 IN HEALTHCARE SERVICES THROUGH ITS OPERATION OF WYOMING HEALTH MEDICAL GROUP (WHMG), LLC. SERVICES OFFERED INCLUDE NEUROSURGICAL CARE, INTERNAL MEDICINE AND FAMILY PRACTICE, URGENT CARE, PULMONOLOGY, NEPHROLOGY, PAIN AND ENDOCRINOLOGY. ALL SPECIALTIES TREAT ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN MARCH 2020, WHMG ALSO OPENED A RESPIRATORY SYMPTOM SCREENING CLINIC IN RESPONSE TO THE COVID-19 PANDEMIC. THE RESPIRATORY CLINIC CLOSED DURING A REDUCTION IN COVID-19 CASES IN SUMMER 2020, BUT RE-OPENED IN SEPTEMBER 2020 AND OPERATED THROUGH THE FALL SURGE IN WYOMING, SEEING UP TO 300 PATIENTS PER DAY. IN FISCAL YEAR 2021, WYOMING MEDICAL CENTER AND WYOMING HEALTH MEDICAL GROUP OPENED URGENT CARE VIDEO APPOINTMENTS. THE APPOINTMENTS ARE AVAILABLE TO PATIENTS ANYWHERE IN WYOMING WITH A SPECIFIC SET OF SYMPTOMS. ADDITIONALLY, DURING THE COVID-19 PANDEMIC, ALL WYOMING HEALTH MEDICAL GROUP CLINICS EXPANDED THEIR ACCESS TO CARE THROUGH TELEMEDICINE APPOINTMENTS. WYOMING MEDICAL CENTER'S DIABETES EDUCATION IS A SELF-MANAGEMENT EDUCATION PROGRAM THAT INCLUDES A STAFF OF KNOWLEDGEABLE HEALTH PROFESSIONALS WHO PROVIDE PARTICIPANTS WITH COMPREHENSIVE INFORMATION ABOUT DIABETES MANAGEMENT. THE TEAM INCLUDES A MEDICAL DIRECTOR, DIRECTOR AND A HOST OF SPECIALLY TRAINED REGISTERED NURSES AND CERTIFIED DIABETES EDUCATORS. THE COMMUNITY DEVELOPMENT OFFICE MARKETS CLINICAL SERVICES THROUGHOUT THE AREA INCLUDING THE SECONDARY OUTREACH MARKETS. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, FREE EDUCATIONAL SEMINARS BY PHYSICIANS AND OTHER HEALTH PROFESSIONALS. WYOMING MEDICAL CENTER ADVERTISES SCREENING EVENTS AND SUPPORT GROUPS ON ITS WEBSITE AND IN LOCAL NEWSPAPERS. DUE TO THE COVID-19 PANDEMIC, ALL IN-PERSON EVENTS WERE CANCELED DURING FY 2021. WYOMING MEDICAL CENTER WORKS WITH THE WYOMING MEDICAL CENTER FOUNDATION'S MASTERSON PLACE TO PROVIDE SLEEPING ROOMS TO PATIENTS AND THEIR FAMILIES AT REDUCED RATES, OR FREE, WHEN BEING TREATED AT THE HOSPITAL. IN FISCAL YEAR 2018, THE FOUNDATION SOLD MASTERSON PLACE AND BEGAN CONSTRUCTION OF A NEW FACILITY IN CLOSE PROXIMITY TO THE HOSPITAL. THE PROJECT WAS COMPLETED IN SUMMER 2019 AND THE 14-ROOM FACILITY IS FULLY OPERATING. WITH THE ACQUISITION BY BANNER HEALTH IN OCTOBER 2020, MASTERSON PLACE IS NOW FULLY OPERATED BY THE WYOMING MEDICAL CENTER FOUNDATION. WMC'S CEO WORKS IN THE COMMUNITY TO PROVIDE COMMUNITY BENEFIT RELATIONSHIPS. THERE IS ALSO ON-GOING WORK PROVIDED BY WMC PERSONNEL ON THE COMMUNITY HEALTH NEEDS ASSESSMENT.WYOMING MEDICAL CENTER IS A TRAINING SITE FOR MANY SPECIALTIES. WE PROVIDE TRAINING FOR STUDENTS IN NURSING, PHLEBOTOMY, RESPIRATORY THERAPY, PARAMEDIC SERVICES, OCCUPATIONAL THERAPY ASSISTANTS, PHYSICAL THERAPISTS, AND FAMILY PRACTICE RESIDENTS. WYOMING MEDICAL CENTER HAS BEEN INSTRUMENTAL IN IMPLEMENTING A TELEHEALTH STROKE PROGRAM FOR WYOMING. THIS ALLOWS CASPER PHYSICIANS TO VIEW AND TREAT PATIENTS FROM A REMOTE LOCATION GIVING THE PATIENT TIME SENSITIVE CARE. IN FISCAL YEAR 2018, WYOMING MEDICAL CENTER ENTERED INTO A CONTRACT WITH INTOUCH TO PROVIDE TELEHEALTH SERVICES IN HOSPITALS ACROSS THE STATE AND NOW HAS AGREEMENTS WITH TEN REMOTE LOCATIONS ACROSS WYOMING. WYOMING MEDICAL CENTER PROVIDES WOMEN'S SERVICES TO WOMEN WHO ARE PREGNANT OR WANT TO BECOME PREGNANT. THIS INCLUDES PRENATAL AND POST-DELIVERY EDUCATION AND SUPPORT TO MOTHERS. WE ALSO PROVIDE DIABETES EDUCATION AND WEIGHT MANAGEMENT PROGRAMS. DURING FY2020 WYOMING MEDICAL CENTER HAD 30,502 PATIENT DAYS AND 14,238 EMERGENCY DEPARTMENT VISITS. WYOMING MEDICAL CENTER HOUSES THE SAFE KIDS PROGRAM WITH THE HELP OF DONATIONS AND GRANTS FROM VARIOUS SOURCES. THE PROGRAM FOCUSES ON INJURY PREVENTION AND IN ADDITION TO THE OTHER COMMUNITY EDUCATION AND OUTREACH, OFFERS REGULAR CAR SEAT CHECKS AND PROVIDES CAR SEATS TO THOSE WHO CANNOT AFFORD THEM. CAR SEATS ARE PROVIDED THROUGH A VOUCHER PROGRAM ADMINISTERED THROUGH THE DEPARTMENT OF FAMILY SERVICES (DFS) AND THE WOMEN, INFANTS AND CHILDREN (WIC) PROGRAMS. ADDITIONALLY, SAFE KIDS PROVIDES ALL BABIES WHO LEAVE THE HOSPITAL A CAR SEAT IF NEEDED WITHOUT A VOUCHER. THE HOSPITAL PROVIDES SERVICES FOR SEXUALLY ASSAULTED VICTIMS THROUGH THE SANE PROGRAM IN THE EMERGENCY DEPARTMENT. THE HOSPITAL PROVIDES A VARIETY OF HEALTH IMPROVEMENT OPTIONS FOR THE COMMUNITY AND ITS PATIENTS. FOR EXAMPLE, THE HOSPITAL PROVIDES EDUCATION FOR WEIGHT LOSS, DIABETES, STROKE, MENTAL HEALTH, FIRST AID, AND SMOKING CESSATION. THE COMMUNITY BUILDING ACTIVITIES PROMOTE HEALTH OF THE COMMUNITY BY PROVIDING NEEDED SPECIALISTS AND PHYSICIANS AS WELL AS DETERMINING WHAT IS NEEDED BY THE RESIDENTS IN THE LOCAL COMMUNITY AND SURROUNDING AREA. WYOMING MEDICAL CENTER RELEASED ITS REGULAR QUARTERLY PUBLICATION, THE PULSE, TO 10,000 HOMES IN NATRONA AND FREMONT COUNTIES AND EVERY PROVIDER OFFICE IN THE STATE OF WYOMING.

Operating expenses	$ 264,462,786
Total amount spent on community benefits as % of operating expenses	$ 39,874,451 15.08 %