4A (Expenses $ 148755553 including grants of $ 120222) (Revenue $ 189006583)
HEALTH FIRST'S CAPE CANAVERAL HOSPITAL (CCH) IS A FULL SERVICE, NOT-FOR-PROFIT HOSPITAL FEATURING A CERTIFIED BABY-FRIENDLY MOTHER/BABY UNIT, FULLY EQUIPPED SURGICAL SERVICES, A STATE-OF-THE-ART CANCER PROGRAM AND FULL-SERVICE LABORATORY. CCH FEATURES 150 BEDS AND HAS OVER 200 HIGHLY SKILLED ATTENDING PHYSICIANS.THE WOMEN'S DIAGNOSTIC CENTER FEATURES STATE-OF-THE-ART, PERSONALIZED SERVICES INCLUDING DIGITAL MAMMOGRAPHY, ULTRASOUND, STEREOTACTIC BREAST BIOPSY, AND MRI BREAST IMAGING AND IS ACCREDITED BY THE AMERICAN COLLEGE OF RADIOLOGY AND THE U.S. FOOD AND DRUG ADMINISTRATION. AS PART OF THE WOMEN'S SERVICE LINE, THERE WERE APPROXIMATELY 775 BIRTHS DURING THE FISCAL YEAR.THE FACILITY ALSO OPERATES A SEVEN-SUITE OPERATING ROOM, TWO-SUITE CATH LAB, TWO-SUITE GI/ENDOSCOPY AVAILABLE FOR BOTH INPATIENT AND OUTPATIENT PROCEDURES AND VITALWATCH EICU WHICH COMBINES TELEMEDICINE, SOFTWARE AND 24/7 ELECTRONIC MONITORING TECHNOLOGY.ADDITIONALLY, CCH INCLUDES A 24-BED EMERGENCY DEPARTMENT AND AN ADJOINING SIX-STORY MEDICAL PLAZA THAT INCLUDES PHYSICIAN'S OFFICES, A CONFERENCE CENTER, PRE-OPERATIVE TESTING, OUTPATIENT REGISTRATION FOR LABORATORY TESTING AND SAME-DAY SURGERY, AS WELL AS A HEALTH RESOURCE CENTER FOR THE COMMUNITY.CCH RECEIVED A 5-STAR RATING BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES IN 2021 AND IS ACCREDITED BY THE JOINT COMMISSION AS A PRIMARY STROKE CENTERTHE COVID-19 PANDEMIC PROVIDED MANY CHALLENGES TO THE HEALTHCARE INDUSTRY AND CCH PIVOTED QUICKLY TO MEET THE NEEDS OF CARING FOR OUR COMMUNITY. NEGATIVE-PRESSURE ROOMS WERE STOOD UP TO PROVIDE A PROPER CARE ENVIRONMENT FOR PATIENTS. EACH OF THE HEALTH FIRST FACILITIES, INCLUDING CCH, ADHERED TO CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) GUIDELINES FOR COVID-19 PRECAUTIONS LIKE SOCIAL-DISTANCING, MASKING, PROPER SANITIZATION, AND ENSURING SAFE ENVIRONMENTS FOR PATIENTS, VISITORS AND ASSOCIATES. FACE MASKS WERE PROVIDED TO THOSE WHO DID NOT HAVE ONE. ALSO, INCREASED ACCESS TO HAND SANITIZING STATIONS WERE PROVIDED THROUGHOUT THE HOSPITAL.CCH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, GENDER, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY, ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL.IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND FURTHER, THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION.IN KEEPING WITH THE HOSPITAL'S COMMITMENT, TO SERVE ALL MEMBERS OF ITS COMMUNITY:(1) FREE CARE AND/OR SUBSIDIZED CARE IS PROVIDED WHERE THE NEED AND/ORINABILITY TO PAY EXISTS AS DETERMINED BY HEALTH FIRST'S FINANCIAL ASSISTANCE POLICY.(2) CARE IS PROVIDED AT BELOW COST TO PERSONS COVERED BY GOVERNMENTALPROGRAMS SUCH AS MEDICARE AND MEDICAID.(3) FREE WELLNESS AND HEALTH ACTIVITIES AND PROGRAMS ARE PROVIDED TO THE COMMUNITY. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR ELDERLY, HANDICAPPED, ANDMENTALLY UNDERSERVED ALONG WITH A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES.AS A NOT-FOR-PROFIT HOSPITAL, CCH IS SUPPORTED IN PART BY CONTRIBUTIONS TO THE HEALTH FIRST FOUNDATION.

CAPE CANAVERAL HOSPITAL
"PART V, SECTION B, LINE 5: THE RESULTS OF THE PRC 2022 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY WERE ANALYZED AND THIRTEEN ""AREAS OF OPPORTUNITY"" WERE IDENTIFIED. A PRESENTATION OF THE DATA WAS MADE TO THE SPACE COAST HEALTH FOUNDATION BOARD OF DIRECTORS, COMMUNITY PARTNERS AND EQUITY FORUM ATTENDEES DURING THREE MEETINGS HELD IN APRIL AND MAY 2022. UPON REVIEW OF THE FINDINGS IN EACH CATEGORY, THE FOLLOWING HEALTH ISSUES WERE PRIORITIZED. THE RESULTS WERE DETERMINED BY AVERAGING MULTIPLE CRITERIA RATINGS (SCOPE/SEVERITY AND ABILITY TO IMPACT) AS LISTED BELOW. A SCALE OF 1 (LOW PRIORITY) TO 10 (HIGH PRIORITY) WAS USED AS THE RANKING CRITERIA. A PANEL OF 130 LEADERS IN THE COMMUNITY, FROM BOTH PUBLIC AND PRIVATE ORGANIZATIONS, WERE CONSULTED IN THE PROCESS OF IDENTIFYING SIGNIFICANT NEEDS OF THE COMMUNITY.A PANEL OF 65 LEADERS IN THE COMMUNITY, FROM BOTH PUBLIC AND PRIVATE ORGANIZATIONS, WERE CONSULTED IN THE PROCESS OF IDENTIFYING SIGNIFICANT NEEDS OF THE COMMUNITY."

CAPE CANAVERAL HOSPITAL
PART V, SECTION B, LINE 6A: HOLMES REGIONAL MEDICAL CENTER, PALM BAY HOSPITAL, & VIERA HOSPITAL

CAPE CANAVERAL HOSPITAL
"PART V, SECTION B, LINE 11: BASED ON THE SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA, HEALTH FIRST WILL ADDRESS THE FOLLOWING:NUTRITION, PHYSICAL ACTIVITY AND WEIGHT -- A HEALTHY DIET HELPS INDIVIDUALS REDUCE THE RISKS FOR MANY HEALTH CONDITIONS AND CHRONIC DISEASES. THE DATA FROM SPACE COAST HEALTH FOUNDATION REVEALED THAT 28.8 PERCENT OF BREVARD COUNTY RESIDENTS EAT FIVE OR MORE SERVINGS OF FRUITS AND/OR VEGETABLES PER DAY AND 27.8 PERCENT FOUND IT ""VERY OR ""SOMEWHAT"" DIFFICULT TO BUY AFFORDABLE FRESH PRODUCE.A TOTAL OF 25 PERCENT OF BREVARD COUNTY ADULTS REPORT NO LEISURE-TIME PHYSICAL ACTIVITY. FOR LOW-INCOME HOUSEHOLDS, ONLY 8.8 PERCENT REGULARLY MET RECOMMENDATIONS FOR PHYSICAL ACTIVITY. AMONG BREVARD COUNTY'S CHILDREN, THE CDC PHYSICAL ACTIVITY GUIDELINES OF ENGAGING IN 60 MINUTES OR MORE OF PHYSICAL ACTIVITY EACH DAY WERE ACHIEVED BY 37.6 PERCENT. THESE FACTORS CONTRIBUTE TO MORE THAN 68.4 PERCENT OF ADULTS AND 25.9 PERCENT OF CHILDREN, AGES 5 TO 17, REPORTED TO BE OVERWEIGHT OR OBESE IN BREVARD COUNTY. BEING OVERWEIGHT OR OBESE INCREASES THE LIKELIHOOD OF HAVING OTHER HEALTH ISSUES THAN THOSE WHO ARE AT A HEALTHY WEIGHT.TO ADDRESS THESE DISPARITIES, THE PLAN IS TO INCREASE THE PREVALENCE OF THOSE MEETING HEALTHY EATING AND ACTIVE LIVING RECOMMENDED GUIDELINES ACROSS SERVICE LINES THROUGH COLLABORATION WITH COMMUNITY PARTNERS INCLUDING BREVARD PUBLIC SCHOOLS, BOYS & GIRLS CLUBS OF CENTRAL FLORIDA, PROMISE IN BREVARD AND JUNIOR LEAGUE OF THE SPACE COAST. HEALTH FIRST SUPPORTS THESE ORGANIZATIONS THROUGH FINANCIAL RESOURCES, IN-KIND RESOURCES AND ADMINISTRATIVE SUPPORT. COMMUNITY PARTNERS ARE CHOSEN BASED ON THEIR DEMONSTRATED ABILITY TO HELP ADDRESS THE ISSUES IDENTIFIED IN THE CHNA RELATED TO HEALTHY EATING AND ACTIVE LIVING, WITH A PREFERENCE TOWARD PROGRAMS SERVING CHILDREN. COMMUNITY PARTNERS ARE ASKED TO ESTABLISH SMART GOALS FOR THE PROGRAMS, AND RESULTS ARE TO BE MEASURED AND REPORTED TO HEALTH FIRST.ACCESS TO HEALTHCARE -- MORE THAN 54 PERCENT OF ADULTS IN BREVARD COUNTY EXPERIENCED DIFFICULTIES OR DELAYS IN RECEIVING NEEDED HEALTHCARE, WITH APPOINTMENT AVAILABILITY AND FINDING A PHYSICIAN IMPACT AMONG THE TOP BARRIERS IDENTIFIED. THE DEMOGRAPHICS OF THOSE WITH RESTRICTED ACCESS INCLUDE 64.6 PERCENT BLACK, 57.9 PERCENT HISPANIC, 63.7 PERCENT LOW INCOME AND 66.9 PERCENT BETWEEN THE AGES OF 18 AND 39.TO ADDRESS THIS DISPARITY, THE PLAN IS TO CONTINUE OUR COMMITMENT TO ENSURE THAT EVERY PATIENT HAS ACCESS TO QUALITY CARE REGARDLESS OF ABILITY TO PAY AND TO ADDRESS THE POTENTIAL FACTORS THAT PREVENT MEMBERS OF OUR COMMUNITY FROM ACCESSING THE CARE THAT THEY NEED. IN ADDITION, HEALTH FIRST WILL PROVIDE OUTREACH SERVICES AND PROGRAMS THAT SPECIFICALLY ADDRESS IDENTIFIED COMMUNITY NEEDS THROUGH PARTNERS INCLUDING BREVARD HEALTH ALLIANCE AS WELL AS SUPPORT OF COMMUNITY ORGANIZATIONS SUCH AS WHO WE PLAY FOR, FLORIDA DEPARTMENT OF HEALTH-BREVARD COUNTY, FAMILY PROMISE OF BREVARD AND WAYS FOR LIFE WITH FINANCIAL AND IN-KIND SUPPORT.SIGNIFICANT HEALTH NEEDS NOT ADDRESSED:1. DIABETES HEALTH FIRST MEDICAL GROUP OFFERS A DIABETES EDUCATION PROGRAM AND MEDICAL NUTRITION THERAPY. RISK FACTORS ASSOCIATED WITH PHYSICAL ACTIVITY AND NUTRITION.2. ORAL HEALTH - HEALTH FIRST-SPONSORED ADULT DENTAL CLINIC IN PARTNERSHIP WITH FLORIDA DEPARTMENT OF HEALTH-BREVARD COUNTY.3. SUBSTANCE ABUSE SERVICES PROVIDED BY CIRCLES OF CARE.4. TOBACCO USE SERVICES PROVIDED BY TOBACCO FREE FLORIDA'S AREA HEALTH EDUCATION CENTERS.5. RESPIRATORY DISEASES RISK FACTOR ASSOCIATED WITH OVERWEIGHT/OBESITY.6. CANCER HEALTH FIRST CANCER INSTITUTE-PROVIDED TREATMENT.7. POTENTIALLY DISABLING CONDITIONS MOST CONDITIONS ARE ASSOCIATED WITH OVERWEIGHT/OBESITY.8. MENTAL HEALTH SERVICES PROVIDED BY CIRCLES OF CARE.9. SOCIAL DETERMINANTS OF HEALTH SERVICES PROVIDED BY SEVERAL COMMUNITY ORGANIZATIONS INCLUDING HEALTH FIRST PARTNER, FAMILY PROMISE OF BREVARD.10. HEART DISEASE/STROKE CARDIOVASCULAR RISK FACTORS ASSOCIATED WITH PHYSICAL INACTIVITY AND OVERWEIGHT/OBESITY.11. INJURY/VIOLENCE SERVICES PROVIDED BY SEVERAL COMMUNITY ORGANIZATIONS INCLUDING SERENE HARBOR AND THE WOMEN'S CENTER."

PART V, SECTION B, LINE 13A
ANY PATIENT FALLING BETWEEN 200% AND 400% OF THE FPG MAY BE REVIEWED FOR DISCOUNTED CARE.

PART V, LINE 16A-16C, FAP WEBSITE:
CAPE CANAVERAL HOSPITAL:HTTPS://HF.ORG/HEALTHCARE-HOME/PATIENTS-VISITORS/PRICE-ESTIMATES-AND-FINANCIAL-ASSISTANCE

PART I, LINE 6A:
THE COMMUNITY BENEFIT REPORT IS PREPARED BY HEALTH FIRST SHARED SERVICES, INC., THE PARENT COMPANY TO THE ORGANIZATION. THE COMMUNITY BENEFITS OF THIS ORGANIZATION ARE INCLUDED WITHIN THAT REPORT.

PART I, LINE 7:
THE ORGANIZATION CALCULATED THE COST AMOUNTS NOTED IN PART I, LINE 7 BY UTILIZING THE COST TO CHARGE RATIO ON THE MEDICARE COST REPORT WHICH ADDRESSES ALL PATIENT SEGMENTS REPORTED ON, INCLUDING, BUT NOT LIMITED TO INPATIENT, OUTPATIENT, MEDICAID, UNINSURED, AND MEDICARE.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIES ARE PRIMARILY SUBSIDIZED BY HEALTH FIRST SHARED SERVICES, INC. (PARENT) AND THEREFORE ARE NOT REPORTED AT EACH INDIVIDUAL HOSPITAL. THE NEEDS IDENTIFIED ARE, IN PART, BASED ON THE COMMUNITY NEEDS ASSESSMENT. HEALTH FIRST SHARED SERVICES, INC. (HFSS) UTILIZED HOURS OF PAID PHYSICIANS AND NURSES TO SUPPORT THE COMMUNITY WHILE ON PAYROLL. IN ADDITION, AN AMOUNT IN EXCESS OF $468K WAS CONTRIBUTED TO VARIOUS LOCAL ORGANIZATIONS PRIMARILY SUPPORTING THE VARIOUS COMMUNITY PUBLIC HEALTH NEEDS. HFSS ALSO SUPPORTED THE ECONOMIC DEVELOPMENT NEEDS, PROVIDED OTHER COMMUNITY SUPPORT, PARTICIPATED IN ENVIRONMENTAL IMPROVEMENTS, COALITION BUILDING PROJECTS, SUPPORTED A COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND SUPPORTED THE LOCAL WORKFORCE DEVELOPMENT PROGRAM. HFSS AND ITS EMPLOYEES ALSO ACTIVELY SUPPORT THE LOCAL UNITED WAY IN EXCESS OF $112K.

PART III, LINE 2:
THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATON STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH IN GAAP. BAD DEBT AT COST IS CALCULATED BY MULTIPLYING ACTUAL BAD DEBT WRITE-OFFS BY THE FILING ORGANIZATION'S COST-TO-CHARGE RATIO ON THE MEDICARE COST REPORT. THE ORGANIZATION USED A COST TO CHARGE RATIO TO DETERMINE THE COST AMOUNT OF THE BAD DEBT EXPENSE. PATIENT CARE COST TO CHARGES, AS PROVIDED IN THE IRS INSTRUCTIONS WAS USED TO VALIDATE THE COST TO CHARGE RATIO WHICH APPROXIMATES INTERNAL COST CALCULATION.

PART III, LINE 3:
BASED ON THE GUIDANCE PROVIDED FOR HEALTH CARE ENTITIES REVENUE RECOGNITION, HEALTH FIRST PERFORMS AN ANNUAL ANALYSIS ON ALL FOUR OF OUR HOSPITALS. THE ANALYSIS PULLS A PATIENT LEVEL DETAIL OF A POPULATION OF CHARITY WRITE-OFF'S FOR SELF PAY AND NON SELF PAY ACCOUNTS DURING THE FISCAL YEAR. THE CLAIMS ARE REVIEWED BY A THIRD PARTY VENDOR SPECIALIZING IN CAPTURING INCOME AND POVERTY LEVEL SCORES AND PROVIDES RESULTS TO BE COMPARED WITH THE DOCUMENTED CHARITY ACCOUNTS MEETING THE APPROPRIATE POVERTY GUIDELINE REQUIREMENTS PER OUR POLICIES.THIS ANALYSIS ALSO REVIEWS THE INCOME LEVEL OF THOSE ACCOUNTS THAT ARE IN OUR BAD DEBT WRITE-OFF POPULATION OF CLAIMS, FOR EXAMPLE THOSE PATIENT ACCOUNTS THAT MAY NOT INITIALLY PRESENT WITH APPROPRIATE INCOME INFORMATION, AND THEREFORE WRITTEN OFF TO BAD DEBT RATHER THAN CHARITY AT THAT TIME.FROM THERE, FOR THOSE ACCOUNTS IN THE BAD DEBT LIST THAT HAVE A INCOME LEVEL SCORE THAT FALLS WITHIN THE CHARITY SCORES, A PERCENTAGE OF THOSE TOTAL CLAIMS IS DERIVED. THIS PERCENTAGE IS THEN APPLIED TO THE BAD DEBT WRITE-OFFS, TO ESTIMATE THE AMOUNTS IN LINE 3.

PART III, LINE 4:
THE ORGANIZATION DOES NOT ISSUE A STANDALONE FINANCIAL STATEMENT; HOWEVER, IT IS INCLUDED AS A PART OF THE HEALTH FIRST, INC. CONSOLIDATED FINANCIAL STATEMENTS. THE FOOTNOTE FROM THE HEALTH FIRST, INC. CONSOLIDATED FINANCIAL STATEMENTS CAN BE FOUND ON PAGES 11-14 OF THE SEPTEMBER 30, 2022 AUDITED STATEMENTS WITHIN THE REVENUE FOOTNOTE.

PART III, LINE 8:
THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. ROUTINE AND ICU COSTS ARE DETERMINED BASED ON AN AVERAGE COST PER DAY MULTIPLIED BY THE NUMBER OF MEDICARE ALLOWABLE DAYS. MEDICARE ANCILLARY COSTS ARE DETERMINED BY THE RATIO OF DEPARTMENT COSTS TO DEPARTMENT CHARGES THEN THE RESULTING % IS APPLIED TO MEDICARE ALLOWABLE CHARGES. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.

PART VI, LINE 2:
THE HEALTH CARE NEEDS OF THE COMMUNITIES ARE ASSESSED THROUGH COLLABORATION WITH LOCAL COMMUNITY PARTNERS INCLUDING BREVARD HEALTH ALLIANCE, A FEDERALLY QUALIFIED HEALTH CENTER, IN ADDITION TO LEADERSHIP PARTICIPATION ON SEVERAL LOCAL NOT-FOR-PROFIT ORGANIZATION'S BOARDS.

PART VI, LINE 7
NOT APPLICABLE. NEITHER THE FILING ORGANIZATION NOR ANY RELATED ORGANIZATION FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH THE COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS, SUCH AS INFORMATION PROVIDED TO THE FLORIDA HOSPITAL ASSOCIATION.

PART III, LINE 9B:
WITHIN THE POLICY'S REASONABLE COLLECTION EFFORTS, PATIENTS ARE EVALUATED FINANCIALLY TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE. THE EVALUATION IS BASED UPON THE CURRENT YEAR'S DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL POVERTY GUIDELINE AND THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PATIENTS OR GUARANTORS DESIRING TO APPLY FOR FINANCIAL ASSISTANCE MAY BE REQUIRED TO COMPLETE A HEALTH FIRST FINANCIAL ASSISTANCE APPLICATION THAT CAN BE OBTAINED FROM THE HEALTH FIRST PATIENT BUSINESS SERVICES, THE HOSPITAL EMERGENCY DEPARTMENT, HOSPITAL REGISTRATION, OR HTTPS://HF.ORG/HEALTHCARE-HOME/PATIENTS-VISITORS/PRICE-ESTIMATES-AND-FINANCIAL-ASSISTANCE. COMPLETED APPLICATIONS MAY BE MAILED TO THE ADDRESS BELOW: HEALTH FIRST PATIENT BUSINESS SERVICES FINANCIAL ASSISTANCE DEPARTMENTTELEPHONE: (321)-434-5427ADDRESS: 3300 FISKE BLVD., BUILIDNG AROCKLEDGE, FL 32955EMAIL: HEALTHFIRSTFA@HF.ORGA. INCOME GUIDELINES FOR QUALIFICATION FOR FINANCIAL ASSISTANCE WILL BE BASED ON THE FEDERAL POVERTY GUIDELINE AS FURNISHED ANNUALLY BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES.B. AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA) GUIDELINES AND DOCUMENTATION REQUIREMENTS MAY BE USED IN ESTABLISHING QUALIFICATIONS FOR PATIENT FINANCIAL ASSISTANCE. PATIENTS WITH HOUSEHOLD INCOMES AT OR BELOW 200% OR WHOSE HOSPITAL-RELATED EXPENSES EXCEED 25% OF THE HOUSEHOLD INCOME WILL BE ENTITLED TO A 100% WRITE OFF OF CHARGES. C. IT IS THE RESPONSIBILITY OF THE PATIENT TO COOPERATE WITH AND FULLY PARTICIPATE IN THE FINANCIAL ASSISTANCE APPLICATION PROCESS. THIS MAY INCLUDE PROVIDING INFORMATION ABOUT THIRD-PARTY HEALTH COVERAGE; PROVIDING IN A TIMELY AND FORTHRIGHT MANNER ALL DOCUMENTATIONS AND CERTIFICATIONS NEEDED TO APPLY FOR FUNDING THROUGH GOVERNMENT OR OTHER PROGRAMS, OR TO DETERMINE THE PATIENT'S ELIGIBILITY FOR OTHER FINANCIAL ASSISTANCE.D. PATIENTS MAY BE REQUIRED TO PROVIDE FINANCIAL INFORMATION TO VERIFY ELIGIBILITY FOR FINANCIAL ASSISTANCE WHICH MAY INCLUDE, BUT IS NOT LIMITED TO:1. COMPLETED AND SIGNED FINANCIAL ASSISTANCE APPLICATION2. PROOF OF HOUSEHOLD INCOME I. FEDERAL TAX RETURNS;II. PAYSTUBS;III. W-2 OR FORM 1099;IV. ANY OTHER VERIFICATION FROM A THIRD-PARTY REGARDING FAMILY INCOME, AWARDS LETTER, BENEFIT STATEMENTS, COURT ORDER, ETC.;V. BANK ACCOUNT, INVESTMENTS, ASSETS, PROPERTY, AUTOMOBILES.E. HEALTH FIRST MAY REQUEST A CREDIT BUREAU REPORT AND/OR ASSET CHECK FROM A REPUTABLE SOURCE. THE REPORT WILL INCLUDE A DATE RANGE FROM THE DATE THE APPLICATION IS RECEIVED BY HEALTH FIRST TO THE THREE PREVIOUS YEARS. F. TRUSTWORTHY METHODS AND SOURCES OF INFORMATION OTHER THAN THE FAP APPLICATION TO INCLUDE PREDICTIVE MODELS AND ALGORITHMS CAN BE USED AS INCOME VERIFICATION DOCUMENTATION.G. PATIENTS WHO ARE ELIGIBLE FOR MEDICAID WILL NOT BE REQUIRED TO COMPLETE A FULL FINANCIAL ASSISTANCE APPLICATION. H. PATIENTS WHO FILE BANKRUPTCY WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE.I. DECEASED PATIENTS WITH NO ESTATE WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE J. HEALTH FIRST ASSERTS SOLE DISCRETION OVER DETERMINING APPLICANT APPROVAL IN THE FINANCIAL ASSISTANCE PROGRAM. K. DOCUMENTED NOTES FROM A TRUSTED OUTSIDE VENDOR WHICH GAUGES THE PATIENT'S ABILITY TO PAY FOR SERVICES BASED ON STATISTICAL DATA.L. PATIENTS WHO ARE UNINSURED AND DO NOT QUALIFY FOR FINANCIAL ASSISTANCE WILL BE ELIGIBLE FOR HEALTH FIRST DISCOUNT FOR SELF PAY PATIENTS.M. HEALTH FIRST WILL ADHERE TO A ONE HUNDRED TWENTY (120) DAY NOTIFICATION PERIOD FOLLOWING THE PATIENT'S FIRST POST-DISCHARGE BILLING STATEMENT DATE.N. PATIENTS MAY APPLY FOR THE FAP AT ANY TIME BETWEEN ADMITTANCE FOR CARE AND TWO HUNDRED FORTY (240) DAYS AFTER THE POST-DISCHARGE BILLING STATEMENT IS PROVIDED AND THE PATIENT HAS LEFT THE HOSPITAL.O. ALL APPROVED FINANCIAL ASSISTANCE APPLICATIONS WILL BE VALID FOR A PERIOD OF UP TO 12 MONTHS UNLESS THE PATIENT'S CIRCUMSTANCES HAVE CHANGED WHICH WOULD WARRANT UPDATED DETERMINATION.

PART VI, LINE 3:
"IT IS THE POLICY OF HEALTH FIRST TO GRANT FINANCIAL ASSISTANCE TO ELIGIBLE INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR A GOVERNMENT PROGRAM, OR OTHERWISE UNABLE TO PAY FOR HEALTH CARE SERVICES DUE TO THEIR LIMITED FINANCIAL RESOURCES. IT IS ALSO HEALTH FIRST POLICY TO PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS (AS DEFINED BY FEDERAL LAW KNOWN AS ""EMTALA"") TO INDIVIDUALS REGARDLESS OF THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY.INFORMATION ABOUT HEALTH FIRST'S FINANCIAL ASSISTANCE PROGRAM SHALL BE MADE AVAILABLE TO PATIENTS AND GUARANTORS BY VARIOUS MEANS, INCLUDING THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN THEEMERGENCY AND ADMITTING DEPARTMENTS, AND AT OTHER PUBLIC PLACES THE HEALTH FIRST FACILITY MAY ELECT. WRITTEN SUMMARY INFORMATION DESCRIBING THE POLICY ALONG WITH FINANCIAL ASSISTANCE CONTACT INFORMATION WILL BE MADEAVAILABLE TO EACH PATIENT IN ALL EMERGENCY AND ADMITTING DEPARTMENTS. THE POLICY WILL ALSO BE POSTED ON THE HEALTH FIRST WEBSITE. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGE SPOKEN BY THE GENERAL POPULATIONS SERVED BY THE HEALTH FIRST FACILITY.ANY HEALTH FIRST ASSOCIATE OR MEMBER OF THE MEDICAL STAFF MAY REFER PATIENTS FOR FINANCIAL ASSISTANCE. A PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIALASSISTANCE ON BEHALF OF THE PATIENT."

PART VI, LINE 4:
BREVARD COUNTY IS THE 15TH-LARGEST COUNTY IN FLORIDA BY AREA, COVERING 1,015 SQUARE MILES. IT STRETCHES MORE THAN 70 MILES ALONG THE ATLANTIC COAST. BEST KNOWN AS THE LOCATION OF THE KENNEDY SPACE CENTER, THE SPACE COAST IS ALSO HOME TO PORT CANAVERAL, ONE OF THE WORLD'S BUSIEST PASSENGER CRUISE PORTS. THE COUNTY IS UNOFFICIALLY DIVIDED INTO THREE SECTIONS: NORTH COUNTY, COMPRISING OF TITUSVILLE, MIMS, AND PORT ST. JOHN; CENTRAL BREVARD, WHICH INCLUDES VIERA, COCOA, ROCKLEDGE, MERRITT ISLAND, AND COCOA BEACH; AND SOUTH COUNTY, INCLUDING MELBOURNE, PALM BAY, GRANT-VALKARIA AND THE SOUTH BEACHES, WHICH STRETCH TO THE SOUTH BREVARD-INDIAN RIVER COUNTY LINE.ACCORDING TO U.S. CENSUS DATA, THE POPULATION OF BREVARD COUNTY WAS 606,612 IN APRIL 2020. BASED ON THE U.S. CENSUS BUREAU'S QUICK FACTS, POPULATION ESTIMATES, JULY 1, 2021:- BREVARD COUNTY'S POPULATION WAS ESTIMATED TO BE 616,628- RACE AND HISPANIC ORIGIN: 82.8 PERCENT WHITE, 11 PERCENT BLACK OR AFRICAN AMERICAN, 11.6 PERCENT HISPANIC OR LATINO, AND 6.3 PERCENT OTHER OR TWO OR MORE RACES. - AGE: 20.1 PERCENT ARE UNDER THE AGE OF 20; AGES 20 TO 64 MAKE UP 55.7 PERCENT; AND 24.2 PERCENT ARE 65 YEARS OF AGE OR OLDER- THE AVERAGE HOUSEHOLD SIZE IS 2.46 PERSONS- 92.5 PERCENT OF BREVARD COUNTY RESIDENTS ARE HIGH SCHOOL GRADUATES OR HIGHER- 11.3 PERCENT OF RESIDENTS LIVE IN POVERTY, COMPARED WITH 11.6 PERCENT NATIONWIDE.ACCORDING TO THE U.S. CENSUS BUREAU'S 2021 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES, BREVARD COUNTY'S MEDIAN AGE IS 47.2 YEARS; 48.8 PERCENT ARE MARRIED COUPLES LIVING TOGETHER; 13.9 PERCENT OF HOUSEHOLDS IN BREVARD COUNTY HAVE CHILDREN UNDER THE AGE OF 18 LIVING WITH THEM. THE UNEMPLOYMENT RATE FOR THE CIVILIAN LABOR FORCE IS 4.8 PERCENT AND 24,677 PERSONS RECEIVED FOOD STAMP/SNAP BENEFITS IN THE PAST 12 MONTHS.THERE ARE SEVEN ACUTE-CARE HOSPITALS SERVING PATIENTS IN BREVARD COUNTY: PARRISH MEDICAL CENTER, LOCATED IN THE NORTH PART OF THE COUNTY; HEALTH FIRST'S CAPE CANAVERAL HOSPITAL, HEALTH FIRST'S VIERA HOSPITAL AND ROCKLEDGE REGIONAL MEDICAL CENTER IN CENTRAL BREVARD COUNTY; AND HEALTH FIRST'S HOLMES REGIONAL MEDICAL CENTER, HEALTH FIRST'S PALM BAY HOSPITAL AND MELBOURNE REGIONAL MEDICAL CENTER IN SOUTH BREVARD.DATA REFERENCES: US CENSUS QUICK FACTS:HTTPS://WWW.CENSUS.GOV/QUICKFACTS/FACT/TABLE/BREVARDCOUNTYFLORIDA,US/PST045218US CENSUS BUREAU AMERICAN COMMUNITY SURVEY DATA: HTTPS://WWW.CENSUS.GOV/PROGRAMS-SURVEYS/ACS/DATA.HTML

PART VI, LINE 5:
THE GOVERNING BODY OF CAPE CANAVERAL HOSPITAL, INC. IS COMPRISED OF PERSONS WHO PRIMARILY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND ARE NEITHER EMPLOYEES NOR CONTRACTORS NOR FAMILY MEMBERSOF THE ORGANIZATION NOR ITS KEY EMPLOYEES.THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS.THE ORGANIZATION DOES APPLY RESOURCES THROUGHOUT THE YEAR TO SUPPORT IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND TRAINING. THE ORGANIZATION SPENT MORE THAN $525K TO SUPPORT LOCAL STUDENTS VIA TRAINING, EDUCATION, AND SCHOLARSHIPS.THE EMERGENCY DEPARTMENT AT CAPE CANAVERAL HOSPITAL, INC. HAD MORE THAN 33,874 VISITS DURING THE YEAR REGARDLESS OF ABILITY TO PAY. IN ADDITION, THE ORGANIZATION PARTICIPATES IN SEVERAL GOVERNMENT SPONSORED HEALTH CARE PROGRAMS, INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID, AND TRICARE.CAPE CANAVERAL HOSPITAL, INC. REINVEST THEIR NET OPERATING INCOME TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.

PART VI, LINE 6:
THE ROOTS OF HEALTH FIRST RUN DEEP IN BREVARD, DATING BACK TO 1931 WHEN BREVARD HOSPITAL FIRST OPENED IN MELBOURNE WITH 27 BEDS. NOW KNOWN AS HOLMES REGIONAL MEDICAL CENTER (HRMC), THE HOSPITAL IS BREVARD'S LARGEST, WITH 550 BEDS. CAPE CANAVERAL HOSPITAL (CCH) OPENED IN 1962 WITH 44 BEDS, AND HAS SINCE GROWN TO 150 BEDS. PALM BAY HOSPITAL (PBH) OPENED IN 1992 AS A SATELLITE OF HRMC WITH 60 BEDS AND HAS SINCE GROWN TO 120 BEDS. VIERA HOSPITAL (VH) OPENED IN APRIL OF 2011 WITH 84 BEDS.HEALTH FIRST WAS FORMED WHEN CCH, HRMC, AND PBH JOINED TOGETHER IN AUGUST 1995 TO CREATE A TRULY INTEGRATED NOT-FOR-PROFIT HEALTHCARE DELIVERY SYSTEM AND FULFILL A COMMON MISSION OF IMPROVING THE HEALTH OF OUR COMMUNITY. THE FIRST NEW SERVICES ADDED IN THE HEALTH FIRST FAMILY WERE HEALTH FIRST PHYSICIANS, OPENING IN LATE 1995, AND HEALTH FIRST HEALTH PLANS, OPENING IN JANUARY 1996. SINCE THEN, WE'VE ALSO ADDED, HOLMES REGIONAL TRAUMA CENTER, VIERA HOSPITAL IN APRIL OF 2011, VITALWATCH - ELECTRONIC INTENSIVE CARE UNIT AND MANY OTHER SERVICES TO OUR FAMILY.OTHER SERVICES INCLUDE STATE-OF-THE-ART ROBOTICS-ASSISTED SURGERY FOR CARDIOTHORACIC, GENERAL SURGERY, UROLOGY AND GYNECOLOGICAL PROCEDURES; OUTPATIENT CENTERS; THE COUNTY'S ONLY TRAUMA CENTER; HOME CARE; SPECIALIZED PROGRAMS FOR CANCER, DIABETES, HEART, STROKE, AND REHABILITATIVE SERVICES; STATE-OF-THE-ART WOMEN'S DIAGNOSTIC CENTER FOR PERSONALIZED SERVICES; CENTRAL BREVARD'S LARGEST MEDICAL GROUP; A FITNESS CENTER; ELECTRONIC MEDICAL RECORDS (EMS)AND MEDICARE ADVANTAGE, COMMERCIAL POS AND HMO HEALTH PLANS.WORKING TOGETHER IN A SEAMLESS SYSTEM, HEALTH FIRST IS DEVOTED TO INTEGRATING QUALITY HEALTHCARE SERVICES WITH STATE-OF-THE-ART TECHNOLOGY. HFSS ALSO WORKS TOGETHER WITH OTHER ORGANIZATIONS AND PHYSICIANS IN OUR COMMUNITY.OUR ASSOCIATES ARE ALSO ACTIVELY BUILDING A HEALTHIER COMMUNITY THROUGH VOLUNTEERING FOR ORGANIZATIONS DEDICATED TO PREVENTING AND TREATING HEALTH CONCERNS SUCH AS CANCER, DIABETES, AND HEART DISEASE. WE'RE ALSO PROUD OF OUR ASSOCIATE CHARITABLE GIVING PROGRAM, SUPPORTING A VARIETY OF SERVICES AND A PATIENT AND FAMILY CARE FUND.