4A (Expenses $ 451645213 including grants of $ 0) (Revenue $ 459466891)
Our 49 bed hospital provided patient and ancillary services to 2,602 inpatients and 166,021 outpatients during the 2021 tax year. The hospital provides emergency medical services regardless of ability to pay. Emergency medical services were provided to 17,438 individuals, and 2,061 of those individuals were admitted to the hospital. 4,575 surgical procedures were performed in the hospital during the tax year. The imaging department performed 52,320 procedures. 68,483 physical therapy 15-minute procedures were provided to area residents. During the 2021 tax year, free medical services in the amount of $7,853,209 (gross charges) were provided to patients eligible for charity care.

4B (Expenses $ 14502703 including grants of $ 0) (Revenue $ 13234559)
Skilled nursing and long term care services were provided by our 60 bed skilled nursing facility. Heritage Place provides healing and compassionate residential care in a home like setting. Total resident days of care for the 2021 tax year were 18,340 days. An average of 50 residents per day were provided long term care and nursing. Ancillary services for residents included 3,835 therapy treatments.

4C (Expenses $ 51089091 including grants of $ 0) (Revenue $ 55205311)
The hospital operates 12 family and specialty physician services clinics providing care in the following areas: Family Medicine, Pediatrics, Neurology, Surgery, Urology, Podiatry, Internal Medicine, Women's Health, Orthopedics, Oncology, Pain Management, and outpatient substance abuse treatment. During the 2021 tax year physician and specialty services were provided for 44,341 visits. The Urgent Care clinic which began operations in tax year 2020 to provide for emergent care visits outside of the hospital had 6,954 visits during the year.

Schedule H, Part V, Section B, Line 5-Central Peninsula Hospital
Every three years, the Hospital conducts a Community Health Needs Assessment to evaluate the needs of the community. This report is prepared by an independent contractor who conducts surveys and interviews community members. The most recent report was prepared for FY2020 - 2022 and indicates that the categories showing the largest increase in perceived need from the prior reporting period were Mental Health Services, Access to Primary Care providers, and Outpatient Urgent Care. In response to these findings, the Hospital has been working to recruit primary care physicians, and has successfully recruited 4 Family Medicine physicians and 2 Internal Medicine physicians. The Hospital also purchased an existing Internal Medicine practice so that Medicare patients can be seen more easily. An Urgent Care clinic was opened in January 2020 to meet emergent needs that do not need to be seen in the emergency department. This clinic is staffed by emergency department physicians. Regarding Mental Health Services, we have contracted with Alaska Regional Hospital to provide for tele-psychiatry services. We also have our detox unit in place, which is up and running with good success. We have also opened a new transitional housing facility. A new Cath Lab was also opened to provide services not previously available on the Kenai Peninsula; including most recently spine injections for long-term pain management. In addition, the Hospital continues to collaborate with local area medical providers, patients, hospital associations and local governments to determine whether community health needs are being met and where opportunities for improvement may exist.

Schedule H, Part V, Section B, Line 11-Central Peninsula Hospital
Every three years, the Hospital conducts a Community Health Needs Assessment to evaluate the needs of the community. This report is prepared by an independent contractor who conducts surveys and interviews community members. The most recent report was prepared for FY2020 - 2022 and indicates that the categories showing the largest increase in perceived need from the prior reporting period were Mental Health Services, Access to Primary Care providers, and Outpatient Urgent Care. In response to these findings, the Hospital has been working to recruit primary care physicians, and has successfully recruited 4 Family Medicine physicians and 2 Internal Medicine physicians. The Hospital also purchased an existing Internal Medicine practice so that Medicare patients can be seen more easily. An Urgent Care clinic was opened in January 2020 to meet emergent needs that do not need to be seen in the emergency department. This clinic is staffed by emergency department physicians. Regarding Mental Health Services, we have contracted with Alaska Regional Hospital to provide for tele-psychiatry services. We also have our detox unit in place, which is up and running with good success. We have also opened a new transitional housing facility. A new Cath Lab was also opened to provide services not previously available on the Kenai Peninsula. In addition, the Hospital continues to collaborate with local area medical providers, patients, hospital associations and local governments to determine whether community health needs are being met and where opportunities for improvement may exist.

Schedule H, Part V, Section B, Line 13h-Central Peninsula Hospital
Employment status, family size, and catastrophic circumstances.

Schedule H, Part V, Section B, Line 16j-Central Peninsula Hospital
Hospital admissions staff attempt to provide a financial assistance brochure to each patient during admission or discharge. The brochure is also available in hard copy at hospital entrances and in the various departments and clinics. It is also available on our website. Financial counselors personally contact all patients with past due balances to explain the policy and their options. They offer assistance with filling out the application and are able to set up monthly payment plans as needed.

Schedule H, Part I, Line 7
In most cases, the costs listed in Line 7 are the actual costs associated with these programs. In cases where the costs for certain activities is too cumbersome to compile, the cost to charge ratio from the most recently filed Medicare Cost Report was used.

Schedule H, Part I, Line 7, Column f
Bad debt expense of $6,853,461 was reported gross in Part IX, line 25 functional expenses. However, they were reported at cost in Schedule H based on the cost to charge ratio.

Schedule H, Part I, Line 7g
The Hospital included losses from subsidized Physician Clinics in Part I, Line 7(g) for family practice and specialty physician practices. Losses included are as follows: Oncology ($1,090,941), Urgent Care ($929,448, Serenity House Detox Center ($515,356) and Medical Center ($929,448), Surgical Services ($171,119), Soldotna Family & Pediatrics ($1,068,425), Neurology ($345,213), Women's Health ($335,532), Foot & Ankle ($58,186), Internal Medicine ($1,219,729), and Kenai Family Practice ($1,096,592).

Schedule H, Part III, Section A, Line 4
Bad debt provisions are made for the amount of revenue that will not be collected from patients to whom services were billed but not paid. The Hospital has determined these patients are neither medically nor financially indigent and do not qualify for the Hospital's charity care program. Bad debt provisions are determined by management's assessment with consideration of business and economic conditions, changes and trends in healthcare coverage, and other collection indicators. the adequacy of this provision is periodically reviewed and further modified based upon the accounts receivable payor composition and aging, and historical write-off experience by payor category. Schedule H, Part III amounts are based on the combined Medicare and Medicaid cost to charge ratio per our most recently filed cost report. It is our belief that all of these bad debts should be considered a community benefit because they provide a necessary and vital health benefit to the community members we serve, regardless of ability to pay.

Schedule H, Part III, Section B, Line 8
It is our belief that the shortfall in actual receipts from Medicare compared to the cost to provide care to Medicare patients should be considered a community benefit. The Hospital is required to write off all contractual allowances for Medicare patients regardless of the amount of the shortfall. The Hospital may only collect the portion which is a patient's copay or deductible and may not engage in collection efforts on the remainder. Medicare patients comprise a significant percentage of our community members, and we must provide needed medical services to this population irrespective of the amount of payment we will receive.

Schedule H, Part III, Section C, Line 9b
The Hospital's collection policy addresses private pay patients and defines the individuals who are eligible to receive financial assistance based on either financial or medical indigence. The collection policy refers to the charity care policy for instruction for determining eligibility. As noted in Part I, the charity care policy is based on FPG which is the basis for a sliding scale between 200 and 300% of those guidelines. Applicants at the upper end of the scale are eligible for a discount on their bill, while those on the lower end of the scale are eligible for free care.

Schedule H, Part VI, Line 2
In addition to the Community Health Needs Assessment and strategic plan, the Hospital also determines health deficiencies in the community in other ways. Hospital Administrators round on patients and meet regularly with an advisory committee comprised of area residents and former patients to determine the needs of the community. An open dialogue exists between Hospital management, community leaders, local governing bodies, patients, staff and medical providers. This community engagement fosters trust in addition to identifying community needs.

Schedule H, Part VI, Line 3
Hospital admissions staff attempt to provide a financial assistance brochure to each patient during admission or discharge. The brochure is also available in hard copy at hospital entrances and in the various departments and clinics. It is also readily available on our website. Financial counselors personally contact all patients with past due balances to explain the policy and their options. They also offer assistance with filling out the application and can set up monthly payments as needed.

Schedule H, Part VI, Line 4
The area served by the Hospital is located on the Kenai Peninsula in South Central Alaska. According to the Kenai Peninsula Borough's FY2022 budget, in 2021 the Kenai Peninsula Borough had a population of 58,934 residents.

Schedule H, Part VI, Line 5
The Hospital engages in numerous community initiatives year-round to improve health and awareness in our service area. In addition to providing monetary donations, the Hospital makes public service announcements on important healthcare issues, provides health professional educational opportunities, holds health fairs and immunization clinics, publishes community health newsletters, and provides meeting space for health and community activities.