4A (Expenses $ 381695989 including grants of $ 100174) (Revenue $ 436691814)
FLAGSTAFF MEDICAL CENTER PROVIDES COMPREHENSIVE HEALTHCARE SERVICES, INCLUDING PRIMARY CARE AND SPECIALTY PHYSICIAN CLINICS, CANCER CENTERS OF NORTHERN ARIZONA HEALTHCARE, ENTIRECARE REHAB SPORTS MEDICINE, AND FIT KIDS OF ARIZONA. IMPROVING HEALTH, HEALING PEOPLE. ONE OF THE NICEST THINGS ABOUT LIVING IN NORTHERN ARIZONA IS YOU DON'T HAVE TO TRAVEL TO GET EXCELLENT HEALTHCARE. SINCE 1936, FLAGSTAFF MEDICAL CENTER (FMC), A MEMBER OF NORTHERN ARIZONA HEALTHCARE, HAS PROVIDED HIGH QUALITY HEALTHCARE SERVICES TO RESIDENTS AND VISITORS OF NORTHERN ARIZONA. WE ARE DEDICATED TO PATIENT-CENTERED CARE WITH A PERSONAL TOUCH. FMC IS LICENSED BY MEDICARE AND THE STATE OF ARIZONA. FOUNDED BY DR. CHARLES SECHRIST AS FLAGSTAFF HOSPITAL, THE 25-BED HOSPITAL WAS DONATED TO THE COMMUNITY OF FLAGSTAFF IN 1955. TODAY, FLAGSTAFF MEDICAL CENTER REMAINS A NOT-FOR-PROFIT HOSPITAL, GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS. WE TREAT EVERY PATIENT, REGARDLESS OF THEIR ABILITY TO PAY. EVERY YEAR, FLAGSTAFF MEDICAL CENTER INVESTS IN ITS COMMUNITY HOSPITAL TO ENSURE WE ARE PROVIDING THE BEST, SAFEST CARE, CLOSE TO HOME. WE PROVIDE KEY SERVICES TO NORTHERN ARIZONA RESIDENTS AND VISITORS, INCLUDING A REGIONAL TRAUMA CENTER; OPEN-HEART SURGERY; HIGH-TECH IMAGING; A CANCER CENTER; SURGICAL SERVICES; ORTHOPEDIC SERVICES; WOMEN, INFANTS AND CHILDREN'S SERVICES; AND MORE. FMC CURRENTLY HAS: - 268 INPATIENT BEDS - 257 PHYSICIANS ON OUR ACTIVE MEDICAL STAFF - 19,275 ANNUAL INPATIENT HOSPITAL ADMISSIONS - 66,855 INPATIENT DAYS - 106,114 ANNUAL OUTPATIENT HOSPITAL VISITS - 41,736 ANNUAL EMERGENCY DEPARTMENT VISITS - 986 BABIES BORN THIS YEAR AT FMC FLAGSTAFF MEDICAL CENTER'S MISSION AND VISION ----------------------------------------------------------------------------------------------------------------------- MISSION - IMPROVING HEALTH, HEALING PEOPLE. VISION - ALWAYS BETTER CARE. EVERY PERSON, EVERY TIME...TOGETHER.

4B (Expenses $ 28449586 including grants of $ 0) (Revenue $ 36745325)
GUARDIAN AIR PROVIDES AIR TRANSPORTATION SERVICES TO PATIENTS THROUGHOUT THE NORTHERN ARIZONA COMMUNITY, ENABLING FLAGSTAFF MEDICAL CENTER TO EXPAND ITS SCOPE OF SERVICES BY SERVING PATIENTS FROM THE MOMENT TREATMENT BEGINS IN THE AIR TRANSPORT.

4C (Expenses $ 9915095 including grants of $ 0) (Revenue $ 11855286)
GUARDIAN MEDICAL TRANSPORT PROVIDES AMBULANCE SERVICES TO PATIENTS THROUGHOUT THE NORTHERN ARIZONA COMMUNITY, ENABLING FLAGSTAFF MEDICAL CENTER TO EXPAND ITS SCOPE OF SERVICES BY SERVING PATIENTS FROM THE MOMENT TREATMENT BEGINS IN THE GROUND AMBULANCE.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - FLAGSTAFF MEDICAL CENTER. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A FOCUS GROUP WAS HELD IN 2022 IN COLLABORATION WITH COCONINO COUNTY HEALTH AND HUMAN SERVICES AND YAVAPAI COUNTY COMMUNITY HEALTH SERVICES AS PART OF THEIR COMMUNITY HEALTH IMPROVEMENT PLANS. THE FOCUS GROUP INCLUDED KEY INFORMANTS IN THE COMMUNITY, SUCH AS: REPRESENTATIVES FROM PUBLIC HEALTH; PHYSICIANS; OTHER HEALTH PROFESSIONALS; SOCIAL SERVICE PROVIDERS; AND OTHER COMMUNITY LEADERS. AGENCIES REPRESENTED WERE: COCONINO COUNTY CHIP ACCESS TO CARE GROUP: NORTH COUNTRY HEALTHCARE, FLAGSTAFF UNIFIED SCHOOL DISTRICT, NORTHERN ARIZONA UNIVERSITY, NATIVE AMERICANS FOR COMMUNITY ACTION, NORTHERN ARIZONA REGIONAL BEHAVIORAL HEALTH AUTHORITY, HIGHLANDS FIRE DISTRICT, SALVATION ARMY, UNITED WAY OF NORTHERN ARIZONA, NORTHERN ARIZONA COUNSEL ON AGING, FIRST THINGS FIRST, FLAGSTAFF FAMILY FOOD BANK, AND NORTHERN ARIZONA INTERGOVERNMENTAL PUBLIC TRANSPORTATION AUTHORITY. YAVAPAI COUNTY CHIP GROUP: YAVAPAI JUSTICE MENTAL HEALTH COALITION, SPECTRUM HEALTHCARE, COTTONWOOD-OAK CREEK UNIFIED SCHOOL DISTRICT, NAMI SEDONA, NAMI YAVAPAI, CARE 1ST, FAMILY INVOLVEMENT CENTER, EXPECT MORE AZ, NACOG-AAA, VERDE VALLEY CAREGIVERS, ALZHEIMER'S ASSOCIATION, AND FIRST THINGS FIRST. PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. WRITTEN COMMENTS WERE SOLICITED BY THE GROUPS AND INDIVIDUALS LISTED ABOVE, AS WELL AS THE COMMUNITIES SERVED AT LARGE THROUGH A SURVEY MONKEY INSTRUMENT. COMMUNITY MEMBERS ARE ENCOURAGED TO PROVIDE FEEDBACK AND INPUT FOR OUR PRIOR AND CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN. COMMENTS MAY BE EMAILED TO: PUBLICRELATIONS@NAHEALTH.COM

Schedule H, Part V, Section B, Line 6a Facility , 1
Facility , 1 - FLAGSTAFF MEDICAL CENTER. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN CONJUNCTION WITH ITS RELATED HOSPITAL FACILITY, VERDE VALLEY MEDICAL CENTER.

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - FLAGSTAFF MEDICAL CENTER. NAH RANKED IDENTIFIED HEALTH ISSUES AGAINST THE FOLLOWING ESTABLISHED, UNIFORM CRITERIA: - MAGNITUDE. THE NUMBER OF PERSONS AFFECTED, ALSO TAKING INTO ACCOUNT VARIANCE FROM BENCHMARK DATA AND HEALTHY PEOPLE TARGETS. - IMPACT/SERIOUSNESS. THE DEGREE TO WHICH THE ISSUE AFFECTS OR EXACERBATES OTHER QUALITY OF LIFE AND HEALTH-RELATED ISSUES. - FEASIBILITY. THE ABILITY TO REASONABLY IMPACT THE ISSUE, GIVEN AVAILABLE RESOURCES. - CONSEQUENCES OF INACTION. THE RISK OF NOT ADDRESSING THE PROBLEM AT THE EARLIEST OPPORTUNITY. - PRIORITIZATION RESULTS AREAS OF OPPORTUNITY IDENTIFIED THROUGH THIS ASSESSMENT: ACCESS TO HEALTH SERVICES NAH HAS WORKED CONSISTENTLY SINCE 2016 TO IMPROVE ACCESS TO CARE, AS HAVE OTHER HEALTHCARE PROVIDERS. COMMUNITY MEMBERS CONTINUE TO CONSISTENTLY EXPRESS CONCERN ABOUT ACCESS. THEREFORE, THIS IS STILL A PRIORITY FOR THE 2022 CHNA. - ADULT OVERALL HEALTH STATUS - COST AS A BARRIER TO PHYSICIAN VISITS - COST AS A BARRIER TO PHYSICIAN VISITS - DIFFICULTY ACCESSING HEALTHCARE - DIFFICULTY ACCESSING HEALTHCARE - INSURANCE INSTABILITY FOR ADULTS AND CHILDREN - LACK OF ACCESS TO AFFORDABLE HEALTH INSURANCE - LACK OF LOCAL SPECIALISTS (ENDOCRINOLOGIST, NEUROLOGIST, PEDIATRIC) - PROVIDERS (PHYSICIAN/ STAFF) SEEN AS UNCARING, LONG WAIT FOR APPOINTMENTS - ROUTINE CHECKUPS (ADULTS) - TRANSPORTATION RESOURCES AVAILABLE FOR ACCESS TO HEALTH SERVICES (INCLUDING TRANSPORTATION AS A BARRIER) - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) - CAMP VERDE UNIFIED SCHOOL DISTRICT - COCONINO COUNTY HEALTH HUMAN SERVICES - COMMUNITY HEALTH CENTER OF YAVAPAI (FQHC) - COTTONWOOD - OAK CREEK SCHOOL DISTRICT - FLAGSTAFF MEDICAL CENTER - FLAGSTAFF SHELTER SERVICES - FLAGSTAFF UNIFIED SCHOOL DISTRICT - GUARDIAN MEDICAL TRANSPORT - HIGHLANDS FIRE DISTRICT - HOSPICE COMASSUS - INDEPENDENT PROVIDERS - LHC GROUP - LYFT - MINGUS HIGH SCHOOL DISTRICT - MOUNTAIN LINE BUS SYSTEM - NATIVE AMERICANS FOR COMMUNITY ACTION - NORTHCOUNTRY HEALTH CARE (FQHC) - NORTHERN ARIZONA HEALTHCARE MEDICAL GROUP - NORTHERN ARIZONA UNIVERSITY HEALTH SERVICES - NORTHLAND HOSPICE - POORE MEDICAL CLINIC - SACRED PEAKS HEALTH CENTER - SEDONA - OAK CREEK UNIFIED SCHOOL DISTRICT - SEDONA FIRE DEPARTMENT - SPECTRUM HEALTHCARE - UBER - VERDE VALLEY AMBULANCE - VERDE VALLEY CAREGIVERS - VERDE VALLEY CATLINE - VERDE VALLEY MEDICAL CENTER - YAVAPAI COUNTY DEPARTMENT OF HEALTH SERVICES ACTIONS/CHANGES FOR ACCESS TO HEALTHCARE SINCE 2016 CHNA - IDENTIFIED PATIENT POPULATIONS ARE ENROLLED IN COMMUNITY CARE MANAGEMENT AT FMC AND VVMC - NORTHERN ARIZONA HEALTHCARE MEDICAL GROUP PRIMARY CARE CLINICS HAVE INCREASED THE NUMBER OF PROVIDERS TO PROVIDE PRIMARY AND PREVENTIVE HEALTHCARE SERVICES. 1. SAME DAY APPOINTMENTS ARE OFFERED BY FMC AND VVMC PRIMARY CARE OFFICES 2. FMC AND VVMC PRIMARY CARE OFFICES OFFER EXTENDED HOURS TO IMPROVE ACCESS 3. NAH IS IN PARTNERSHIP WITH PATHFINDERHEALTH ACO TO SUPPORT INDEPENDENT PROVIDERS TO INCREASE ACCESS TO THEIR PRACTICES IN THE FMC AND VVMC MARKETS - INSURANCE/PAYOR REGISTRATION SUPPORT FOR FMC AND VVMC PATIENTS - FMC AND VVMC PROVIDE MEDICAL DIRECTION AND SUPPORT FOR COMMUNITY INTEGRATED PARAMEDICINE - FMC AND VVMC PROVIDE REMOTE PATIENT MONITORING FOR PATIENTS MENTAL HEALTH MENTAL DISORDERS MANY MENTAL HEALTH ISSUES TAKE LONGER THAN 3 YEARS TO CHANGE ON A POPULATION BASIS. THEREFORE, THIS IS STILL A PRIORITY FOR THE 2022 CHNA. - SUICIDES - VIOLENT DEATHS (INCLUDING FIREARM-RELATED DEATHS, HOMICIDE SUICIDE) - LACK OF ACCESS TO BEHAVIORAL HEALTH CARE RESOURCES AVAILABLE FOR MENTAL HEALTH MENTAL DISORDERS - ALCOHOLICS ANONYMOUS - BACK2BASICS - CATHOLIC SOCIAL SERVICES - CHILD FAMILY SERVICES - COMMUNITY MENTAL HEALTH FIRST AID - COTTONWOOD COUNTY DRUG TASK FORCE - FLAGSTAFF MEDICAL CENTER - BEHAVIOR HEALTH SERVICES - HEALTH CHOICE INTEGRATED CARE - INDEPENDENT PROVIDERS - MATFORCE - NATIONAL ALLIANCE ON MENTAL ILLNESS - NATIVE AMERICANS FOR COMMUNITY ACTION - NORTH COUNTRY HEALTHCARE BEHAVIORAL HEALTH - NORTHERN ARIZONA REGIONAL BEHAVIORAL HEALTH AUTHORITY - NORTHERN ARIZONA UNIVERSITY COUNSELING SERVICES - NORTHERN ARIZONA UNIVERSITY HEALTH AND PSYCHOLOGY CENTER - SOUTHWEST BEHAVIORAL HEALTH - SOUTHWEST BEHAVIORAL HEALTH SERVICES - SPECTRUM HEALTHCARE - THE GUIDANCE CENTER - VERDE VALLEY GUIDANCE CLINIC - VERDE VALLEY MEDICAL CENTER ACTIONS/CHANGES FOR MENTAL HEALTH SINCE 2016 CHNA - VVMC PARTNERS WITH SPECTRUM HEALTH FOR A COMMUNITY FOCUSED APPROACH TO PATIENTS ARRIVING IN THE ED WITH MENTAL HEALTH NEEDS - FMC AND VVMC ARE INTEGRATING BEHAVIORAL HEALTH INTO PRIMARY CARE - MENTAL HEALTH MATTERS COLLABORATION IN FLAGSTAFF (FMC) - COCONINO JUSTICE COALITION (CJCC): LEGAL ISSUES WITH MENTALLY ILL (FMC) - AA GROUP MEETINGS ON BHU (FMC) - CRISIS CALLS FROM COMMUNITY: INTAKE / REFERRALS (FMC/VVMC) - FOR FLAGSTAFF POLICE DEPARTMENT (FMC) 1. DE-ESCALATION SKILL TRAINING 2. CIT: CRISIS INTERVENTION TRAINING - NACA: SUICIDE PREVENTION GRANT COLLABORATION (FMC) - HEALTH FAIRS (FMC AND VVMC) - SCREENINGS (FMC AND VVMC PRIMARY CARE CLINICS) 1. DEPRESSION 2. SUBSTANCE ABUSE - INTERNAL / EXTERNAL TO NAH DEBRIEFING CRISIS INTERVENTION (FMC/VVMC) - DUI/DRUG COURT TREATMENT PROGRAMS (FMC) - MENTAL HEALTH / VETERAN COURT HEARINGS (FMC) - TITLE 36 (ED INTAKE) - SHORT TERM CRISIS (FMC/VVMC) - TRAUMA START: SCREENINGS AND BRIEF INTERVENTION / ASSESSMENT (FMC) 1. REFERRALS AT DISCHARGE FOR PATIENTS WITH ALCOHOL AND DRUG USE ISSUES - TALKS AND PRESENTATIONS FOR COMMUNITY GROUPS (FMC) - RN AND SW STUDENTS ROTATE THROUGH DEPARTMENT (FMC) - CPI TRAINING (DE-ESCALATION) FOR SITTERS AND ED STAFF (FMC/VVMC) - MENTAL HEALTH AND SUBSTANCE ABUSE INFORMATION FOR NEW GRADS (FMC/VVMC) - PROVIDE MEETING SITE FOR MONTHLY NATIONAL ASSOCIATION OF SUBSTANCE ABUSE COUNSELORS (NASAC) MEETINGS (FMC) - FMC/VVMC OFFER MENTAL HEALTH FIRST AID TRAINING TO EMPLOYEES AND COMMUNITY MEMBERS - FMC IS A SUPPORTING MEMBER OF ""STRONGER AS ONE"" COLLABORATION - WHICH IS AN OUTCOME OF THE 2017 CHNA. CHRONIC DISEASE CHRONIC DISEASE ARE, BY NATURE, HEALTH ISSUES THAT TAKE LONGER THAN 3 YEARS TO CHANGE ON A POPULATION BASIS. THEREFORE, THIS IS STILL A PRIORITY FOR THE 2019 CHNA. - CANCER - CARDIOVASCULAR DISEASE - CIRRHOSIS/LIVER DISEASE - DIABETES - OBESITY - OSTEOPOROSIS/ARTHRITIS - RESPIRATORY HEALTH - RESOURCES AVAILABLE FOR CHRONIC DISEASE - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) - BOUNTIFUL BASKETS - CAMP VERDE UNIFIED SCHOOL DISTRICT - COCONINO COUNTY HEALTH HUMAN SERVICES - COMMUNITY HEALTH CENTER OF YAVAPAI (FQHC) - CORNUCOPIA FOOD PANTRY - COTTONWOOD - OAK CREEK SCHOOL DISTRICT - FIT KIDS OF ARIZONA - FLAGSTAFF COMMUNITY SUPPORTED AGRICULTURE PROJECT - FLAGSTAFF MEDICAL CENTER - FLAGSTAFF SHELTER SERVICES - FLAGSTAFF UNIFIED SCHOOL DISTRICT - GUARDIAN MEDICAL TRANSPORT - HIGHLANDS FIRE DISTRICT - HOSPICE COMASSUS - INDEPENDENT PROVIDERS - LOCAL FARMER'S MARKETS - NATIVE AMERICANS FOR COMMUNITY ACTION - NORTHCOUNTRY HEALTH CARE (FQHC) - NORTHERN ARIZONA HEALTHCARE MEDICAL GROUP - NORTHERN ARIZONA UNIVERSITY HEALTH SERVICES - NORTHLAND HOSPICE - POORE MEDICAL CLINIC - SACRED PEAKS HEALTH CENTER - SEDONA - OAK CREEK UNIFIED SCHOOL DISTRICT - SEDONA FIRE DEPARTMENT - SPECTRUM HEALTHCARE - ST. MARY'S FOOD BANK - VERDE VALLEY AMBULANCE - VERDE VALLEY CAREGIVERS - VERDE VALLEY MEDICAL CENTER - YAVAPAI COUNTY DEPARTMENT OF HEALTH SERVICES - YMCA ACTIONS/CHANGES FOR CHRONIC DISEASE SINCE 2016 CHNA - FOOD IS MEDICINE FOR DIABETES COMMUNITY EDUCATION CLASSES AT FMC AND VVMC - HEALTHY BASICS EATING CLASS AT FMC AND VVMC - CHEF COOKING DEMO'S AT FMC - FMC REFERS PATIENTS TO THE CANCER SUPPORT COMMUNITY PROGRAMS - FREEDOM FROM SMOKING PROGRAM- OFFERED AT VVMC- OPEN TO THE COMMUNITY - SUPPORT GROUPS FOR CHRONIC DISEASE AT VVMC AND FMC - COMPREHENSIVE CARE MANAGEMENT AT VVMC AND FMC - PATHFINDERHEALTH ACO CARE PROCESS MODELS AT VVMC AND FMC - COMMUNITY SCREENINGS FOR CVD AND DIABETES IN THE VVMC AND FMC COMMUNITIES - FMC AND VVMC OFFER DIABETES EDUCATION AND SUPPORT - VVMC OFFERS CARDIAC REHAB AND PULMONARY WELLNESS - FMC AND VVMC ARE DEVELOPING PLANS FOR SUSTAINABLE GROWTH TO EXPAND CHRONIC CARE SERVICE LINES TO THE COMMUNITY - PARTNERING WITH INDIAN HEALTH TO SUPPORT CANCER CARE ON RESERVATIONS"

Schedule H, Part V, Section B, Line 13 Facility , 1
"Facility , 1 - FLAGSTAFF MEDICAL CENTER. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON THE INCOME AND FAMILY SIZE OF THE PATIENT/GUARANTOR. INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY LEVELS (""FPL"")PUBLISHED BY THE FEDERAL REGISTER ANNUALLY. HOUSEHOLD MEMBERS ARE DEFINED AS ALL DEPENDENTS AND ADULTS RESIDING WITH THE PATIENT. APPLICANTS WITH HOUSEHOLD INCOME OF 400% OF FPL OR LOWER MAY RECEIVE FINANCIAL ASSISTANCE BASED UPON A TIERED DISCOUNT."

Schedule H, Part I, Line 3 FEDERAL POVERTY LEVEL WRITE-OFFS
"EXPLANATION FOR VARIOUS PERCENTAGES USED: 200% OF THE FEDERAL POVERTY LEVEL (""FPL"") = 100% CHARITY WRITE-OFF. 201-250% OF FPL = 75% CHARITY WRITE-OFF. 251-300% OF FPL = 50% WRITE-OFF. 301-350% OF FPL = 25% WRITE-OFF. 351-400% OF FPL = 15% WRITE-OFF."

Schedule H, Part I, Line 3c DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE
CHARITY CARE INCOME LEVELS ARE BASED ON THE FEDERAL POVERTY GUIDE PUBLISHED IN THE FEBRUARY FEDERAL REGISTER ON AN ANNUAL BASIS. A TIERED METHOD IS UTILIZED FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR 100%, 75%, 50%, 25%, OR 15% WRITE-OFF OF THE SELF PAY BALANCE.

Schedule H, Part I, Line 6a COMMUNITY BENEFITS REPORT
THE INFORMATION FOR THE COMMUNITY BENEFITS REPORT IS GATHERED BY THE COMMUNICATIONS DEPARTMENT, WHICH IS A DEPARTMENT OF NORTHERN ARIZONA HEALTHCARE. FLAGSTAFF MEDICAL CENTER AND VERDE VALLEY MEDICAL CENTER ARE IDENTIFIED SEPARATELY ON THESE REPORTS. THE COMMUNITY BENEFIT REPORT IS AVAILABLE AT: HTTPS://NAHEALTH.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

Schedule H, Part VI DISCLOSURES IN ACCORDANCE WITH REVENUE PROCEDURE 2015-21
FLAGSTAFF MEDICAL CENTER (HOSPITAL) IS COMPLIANT WITH THE SECTION 501(R) STATUTE AND HAS MADE A GOOD FAITH EFFORT TO BE FULLY COMPLIANT WITH THE REQUIREMENTS OF THE SECTION 501(R) REGULATIONS. DURING 2022, THE HOSPITAL CONDUCTED A CHNA AND PRODUCED A CHNA REPORT FOR ITS TAX YEAR ENDED JUNE 30, 2022, WHICH WAS APPROVED BY THE BOARD OF DIRECTOR IN FEBRUARY 2022. AS PART OF ITS EFFORT TO BE FULLY COMPLIANT AND WITH THE ASSISTANCE OF AN OUTSIDE ACCOUNTING FIRM, THE HOSPITAL REVIEWED ITS 2022 CHNA REPORT FOR ANY AREAS OF IMPROVEMENT IN THE FALL OF 2022. THE HOSPITAL HAS NOT IDENTIFIED ANY PERSONS DIRECTLY AFFECTED BY THE MINOR AND INADVERTENT OMISSIONS RELATED TO ITS CHNA. THE HOSPITAL WILL CONTINUE TO MONITOR ITS COMPLIANCE WITH THE SECTION 501(R) REGULATIONS AND PROCEDURES HAVE BEEN PUT IN PLACE TO MONITOR COMPLIANCE THROUGH PERIODIC REVIEWS.

Schedule H, Part I, Line 7 EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE
FLAGSTAFF MEDICAL CENTER USED A COST-TO-CHARGE RATIO, WHERE APPLICABLE, TO CALCULATE THE MOST ACCURATE COST OF CHARITY CARE AND OTHER COMMUNITY BENEFITS REPORTED IN LINE 7.

Schedule H, Part II Community Building Activities
COMMUNITY BUILDING IS ADVANCED BY FLAGSTAFF MEDICAL CENTER THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
THE COSTING METHODOLOGY USED TO DETERMINE THE BAD DEBT COST COMES FROM THE PERCENTAGE CALCULATED IN SCHEDULE H, PART I, WORKSHEET 2.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
FLAGSTAFF MEDICAL CENTER'S CALCULATION OF FINANCIAL ASSISTANCE COST IS BASED ON ACTUAL FINANCIAL ASSISTANCE WRITE-OFFS BY THE BUSINESS OFFICE MULTIPLIED BY THE COST-TO-CHARGE RATIO. ALL OF THE FINANCIAL ASSISTANCE WRITE-OFFS ARE ATTRIBUTABLE TO PATIENTS WHO QUALIFIED UNDER THE FINANCIAL ASSISTANCE POLICY. AS A NOT-FOR-PROFIT ENTITY, SERVICES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND MAKING THIS AVAILABLE TO THE COMMUNITY QUALIFIES BAD DEBT AS A COMMUNITY BENEFIT.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
FOOTNOTE 2 TO THE FINANCIAL STATEMENTS INDICATES NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE RECEIVED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. MANAGEMENT ESTIMATES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON THE HISTORICAL COLLECTION EXPERIENCE.

Schedule H, Part III, Line 8 Community benefit methodology for determining medicare costs
THE SOURCE USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS THE FY2022 MEDICARE COST REPORT FOR THE ORGANIZATION. A CONTRACTED COST REPORT PROFESSIONAL PREPARED AN ANALYSIS OF THE AMOUNT BASED ON THE SUBMITTED COST REPORT FOR FLAGSTAFF MEDICAL CENTER.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
ACCORDING TO OUR CHARITY CARE POLICY, THE FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR CHARITY CARE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR CHARITY CARE ASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW-UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT.

Schedule H, Part V, Section B, Line 16a FAP website
- FLAGSTAFF MEDICAL CENTER: Line 16a URL: WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/;

Schedule H, Part V, Section B, Line 16b FAP Application website
- FLAGSTAFF MEDICAL CENTER: Line 16b URL: WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- FLAGSTAFF MEDICAL CENTER: Line 16c URL: WWW.NAHEALTH.COM/BILLING-INSURANCE/NORTHERN-ARIZONA-HEALTHCARES-FINANCIAL-ASSISTANCE-PROGRAM/;

Schedule H, Part VI, Line 2 Needs assessment
FLAGSTAFF MEDICAL CENTER ASSESSES COMMUNITY HEALTHCARE NEEDS THROUGH A SURVEY DESIGNED AND ADMINISTERED INTERNALLY. THIS SURVEY WAS LAST CONDUCTED IN 2022 AND WAS A FOLLOW-UP TO OTHER SURVEYS THE HOSPITAL HAS CONDUCTED. THE SURVEY INSTRUMENT USED FOR THIS STUDY IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES.

Schedule H, Part VI, Line 6 Affiliated health care system
FLAGSTAFF MEDICAL CENTER IS AFFILIATED WITH VERDE VALLEY MEDICAL CENTER. THE BOARD MEMBER MEETINGS ARE COMBINED. THE COMMUNITY BENEFIT REPORT IS SUMMARIZED TOGETHER AND POSTED ON THE HOSPITAL'S WEBSITE.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
ACCORDING TO OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL COUNSELORS ASSESS THE PATIENT'S ABILITY TO PAY AT TIME OF ADMISSION/REGISTRATION. IF THE PATIENT STATES THAT THEY ARE UNABLE TO PAY OUT OF-POCKET EXPENSES, A DETERMINATION IS MADE WHETHER COVERAGE IS AVAILABLE THROUGH AHCCCS OR OTHER MEDICAID PROGRAMS. IF NO OUTSIDE ASSISTANCE IS AVAILABLE, AN APPLICATION IS GIVEN TO THE PATIENT TO BE SUBMITTED FOR FINANCIAL ASSISTANCE CONSIDERATION. IF THE PATIENT DOESN'T QUALIFY FOR FINANCIALASSISTANCE, INCOME LEVELS ARE ASSESSED TO DETERMINE IF THEY QUALIFY FOR A LONG-TERM PAYMENT PROGRAM. IF THE CHARITY APPLICATION IS NOT TURNED IN AND PAYMENT HAS NOT BEEN MADE AFTER NUMEROUS FOLLOW UP PHONE CALLS, THE PATIENT ACCOUNT GOES TO BAD DEBT. FLAGSTAFF MEDICAL CENTER WEBSITE HAS A BILLING CONTACT NUMBER. BEFORE PRE-ADMISSION, PATIENTS ARE CONTACTED BY FMC'S CASHIER. WHEN PATIENTS ARE CONTACTED, THEY ARE EDUCATED ABOUT THE FINANCIAL ASSISTANCE POLICY. FMC FINANCIAL COUNSELORS ASSIGNED TO EACH NURSING UNIT ARE ABLE TO ANSWER OR ASSIST WITH BILLING QUESTIONS. AT EACH PATIENT REGISTRATION DESK THERE ARE DISPLAYS AND BROCHURES OF THE BILLING INFORMATION, INCLUDING THE FINANCIAL ASSISTANCE POLICY.

Schedule H, Part VI, Line 4 Community information
"THE STUDY AREA FOR THE SURVEY EFFORT (REFERRED TO AS THE ""NAH SERVICE AREA OR ""FLAGSTAFF OR VERDE VALLEY REGION"" IN THIS REPORT) INCLUDES THE FOLLOWING COUNTIES REPRESENTED IN NORTHERN AZ: COCONINO AND YAVAPAI. COCONINO COUNTY (CC)- AS OF JULY 1, 2021 ESTIMATES, THE TOTAL POPULATION IN COCONINO COUNTY WAS 141,274. THE POPULATION IS 50.6% FEMALE AND 49.4% MALE. THE POPULATION WAS FOUND TO BE 63.9% WHITE (NOT HISPANIC OR LATINO), 26.6% AMERICAN INDIAN OR ALASKAN NATIVE, 14.1% HISPANIC OR LATINO, 1.5% BLACK OR AFRICAN AMERICAN, AND 2.1% ASIAN. YAVAPAI COUNTY (YC)- IN 2018 THERE WERE 228,067 INDIVIDUALS LIVING IN YAVAPAI COUNTY. THE POPULATION IS 50.8% FEMALE AND 49.2% MALE. THE MAJORITY OF THE POPULATION IS WHITE (NOT HISPANIC OR LATINO) AT 91.3%. THE POPULATION IS 14.5% HISPANIC OR LATINO, 2.2% AMERICAN INDIAN OR ALASKAN NATIVE, 1.3% ASIAN, AND 1% BLACK OR AFRICAN AMERICAN. AGE DISTRIBUTION: CC-IN 2021, PERSONS UNDER THE AGE OF 18 IS 20.7%, NEARING THE STATE AVERAGE OF 23.2%. AN ESTIMATED 12.0% OF THE POPULATION IS 65 YEARS OR OLDER. YC- AN ESTIMATED 30.6% OF THE POPULATION IS 65 YEARS OR OLDER AND 16.5% IS UNDER THE AGE OF 18. EDUCATION: CC- A PERCENTAGE OF 38.7% OF PERSONS 25 YEARS OR OLDER, HAS EARNED A BACHELOR'S DEGREE. THESE RATES ARE HIGHER THAN THE STATE AVERAGE OF 28.4%. EDUCATIONAL ATTAINMENT IN THE COUNTY IS HIGHER THAN THE STATE'S AVERAGE WITH RESPECT TO ADULTS THAT HAVE GRADUATED FROM HIGH SCHOOL. YC- 28.0% OF THE POPULATION (25+) HAS EARNED A BACHELOR'S DEGREE. YAVAPAI HAD A HIGH SCHOOL GRADUATION RATE OF 92% FOR THOSE AGED 25 OR OLDER. INCOME AND POVERTY: CC-THE MEDIAN HOUSEHOLD INCOME IN THE COCONINO COUNTY IS $61,888, AND 17.6% OF THE POPULATION ARE BELOW THE POVERTY LEVEL. COCONINO COUNTY HAS 51,037 HOUSEHOLDS WITH AN AVERAGE HOUSEHOLD SIZE OF 2.56. YC- THE MEDIAN HOUSEHOLD INCOME IN YAVAPAI COUNTY IS $56,170, AND 13.0% OF THE YAVAPAI COUNTY POPULATION IS BELOW THE POVERTY LEVEL. THERE ARE 103,934 HOUSEHOLDS IN YAVAPAI COUNTY WITH AN AVERAGE OF 2.20 PERSONS PER HOUSEHOLD."

Schedule H, Part VI, Line 5 Promotion of community health
COMMUNITY HEALTH AND COMMUNITY BUILDING ARE A FOCUS AT FLAGSTAFF MEDICAL CENTER AS EVIDENCED BY THE NUMEROUS ACTIVITIES SPONSORED EACH YEAR. THE CANCER CENTER AT FMC HOSTS A SERIES OF FREE OR LOW-COST SCREENINGS DESIGNED TO HELP RESIDENTS IN THE COMMUNITY DETECT ISSUES AS SOON AS POSSIBLE. THE SAFE CHILD CENTER IS A CHILD ADVOCACY CENTER THAT SERVES CHILDREN FROM BIRTH THROUGH 18 YEARS OLD AND IS DEDICATED TO REDUCING THE STRESS CHILDREN EXPERIENCE AS VICTIMS OF CRIME. FMC'S PALLIATIVE CARE PROGRAM PROVIDES HIGH QUALITY CARE TO PATIENTS WHO HAVE A CHRONIC DISEASE OR LIFE-THREATENING ILLNESS. FIT KIDS OF ARIZONA, WHICH WORKS TO REDUCE THE HEALTH CONSEQUENCES OF CHILDHOOD OBESITY BY PROMOTING HEALTHY LIFESTYLES, AND THE DIABETES TOGETHER COMMUNITY COLLABORATION ARE FMC'S PREMIER COMMUNITY HEALTH INITIATIVES. THE CARE BEYOND WALLS AND WIRES PROGRAM USES TELEMEDICINE TO MONITOR AND SUPPORT PATIENTS WHO LIVE REMOTELY AND HAVE RECENTLY BEEN DIAGNOSED WITH CONGESTIVE HEART FAILURE. COMMUNITY BUILDING IS ADVANCED BY FMC THROUGH ITS SUPPORT OF PHYSICIAN RECRUITMENT AND WORK WITH VARIOUS COMMUNITY ORGANIZATIONS INCLUDING THE AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, FLAGSTAFF LEADERSHIP PROGRAM, FLAGSTAFF CHAMBER OF COMMERCE AND THE ARIZONA HOSPITAL AND HEALTHCARE ASSOCIATION.