4A (Expenses $ 26552180 including grants of $ 1000) (Revenue $ 32207028)
"CHATUGE REGIONAL HOSPITAL (CRH), A 501(C)(3) HEALTHCARE ORGANIZATION, TAKES A PROACTIVE APPROACH TO MEET COMMUNITY HEALTH NEEDS, THE ORGANIZATION'S TAX-EXEMPTION REQUIREMENTS AND OFFERS COMMUNITY BENEFIT PROGRAMS AND SERVICES WHICH RESULT IN A POSITIVE IMPACT ON COMMUNITY HEALTH. CRH AND CHATUGE REGIONAL NURSING HOME (CRNH) HAVE A VISION TO BE THE ""FIRST CHOICE"" PROVIDER OF COMPREHENSIVE MEDICAL SERVICES IN OUR AREA. WE VALUE OUR PATIENTS AND RESIDENTS AND BELIEVE THEY ARE OUR MOST IMPORTANT RESPONSIBILITY. WE SHALL ALWAYS SEEK TO MEET THE PHYSICAL, EMOTIONAL, EDUCATIONAL, AND SPIRITUAL NEEDS OF OUR PATIENTS AND THEIR FAMILIES. WE VALUE OUR MEDICAL STAFF AND WILL SEEK WAYS TO HELP THEM IMPROVE PROFESSIONALLY AND FACILITATE THE PRACTICE OF MEDICINE. WE VALUE OUR EMPLOYEES AND SHALL TREAT EACH OTHER WITH COURTESY, FAIRNESS, RESPECT, AND INTEGRITY. WE SHALL WORK AS A TEAM TO DO OUR BEST TO PROMOTE OUR MISSION AND FULFILL OUR VISION. WE VALUE OUR COMMUNITY. WE ARE COMMITTED TO THE TREATMENT AND CARE OF OUR PATIENTS AND PROMOTION OF HEALTH AND WELLNESS IN OUR COMMUNITY. WE WILL CONFRONT ALL ETHICAL AND MORAL HEALTH-RELATED ISSUES NECESSARY TO ENHANCE THE QUALITY OF LIFE IN OUR COMMUNITY. WE VALUE QUALITY CARE AND WILL SEEK TO DELIVER CUSTOMER-FOCUSED, COST EFFICIENT SERVICES WITH COMPASSION AND CARING. EFFECTIVE MAY 1, 2002, CRH WAS DEEMED TO BE A CRITICAL ACCESS HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) AND BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH (DCH). CRH IS THE ONLY ACUTE CARE HOSPITAL IN TOWNS COUNTY, GEORGIA. CRH IS LIMITED TO 25 ACUTE AND INTENSIVE CARE MEDICAL/SURGICAL BEDS. THESE BEDS ARE ALSO USED FOR SHORT-TERM SKILLED NURSING CARE. OUTPATIENT SERVICES INCLUDE RADIOLOGY, LABORATORY AND OTHER DIAGNOSTIC SERVICES, REHABILITATION SERVICES, AND 24/7 EMERGENCY MEDICAL SERVICES. CRNH IS THE ONLY NURSING FACILITY IN THE COUNTY PROVIDING SKILLED AND INTERMEDIATE LEVELS OF LONG-TERM CARE. CRNH IS LICENSED FOR 112 BEDS AND CONSISTENTLY HAS A WAITING LIST FOR ADMISSIONS. A MAJORITY OF THE RESIDENTS OF CRNH ARE MEDICARE AND MEDICAID BENEFICIARIES. IT IS A LONG-ESTABLISHED POLICY OF CRH TO PROVIDE QUALITY CARE FOR ITS PATIENTS REGARDLESS OF THEIR FINANCIAL CIRCUMSTANCES. QUALIFICATION FOR HOSPITAL INDIGENT CARE IS SET AT 125% OF THE CURRENT FEDERAL POVERTY GUIDELINES AND IS BASED ON SIZE OF THE FAMILY UNIT. CRH AND CRNH ALSO PROVIDE FREE OR REDUCED COST CARE TO ALL ELIGIBLE PERSONS REQUESTING CHARITY CARE ASSISTANCE. FOR EMERGENCY MEDICAL SERVICES, INCLUDING ACTIVE LABOR, NO PERSON WILL BE DENIED CARE DUE TO AN INABILITY TO PAY FOR SERVICES. CRH AND CRNH PARTICIPATE IN MEDICARE, MEDICAID, PEACHCARE, TRICARE, AND/OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS. CRH, IN CONJUNCTION WITH ITS SISTER HOSPITAL, UNION GENERAL HOSPITAL, ARE THE ONLY TAX-EXEMPT, NON-PROFIT HOSPITALS WITHIN THE IMMEDIATE EIGHT-COUNTY AREA OF THE NORTH CENTRAL AND NORTHEAST GEORGIA MOUNTAINS. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC, HAVE SEVERAL VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, HIKING, FISHING AND HUNTING. THE TWISTING MOUNTAIN ROADS ATTRACT BICYCLISTS AND MOTORCYCLISTS THROUGHOUT THE SPRING, SUMMER AND FALL SEASONS. THESE ACTIVITIES MANY TIMES RESULT IN MEDICAL EMERGENCIES, SOME VERY SERIOUS, FOR WHICH THE EMERGENCY DEPARTMENT OF CRH MUST BE PREPARED. CRH ESTABLISHED A FAMILY MEDICAL PRACTICE IN HAYESVILLE, NC (CLAY COUNTY) TO HELP MEET THE MEDICALLY UNDERSERVED IN THE COMMUNITY. THE MEDICAL OFFICE IS STAFFED WITH FAMILY NURSE PRACTITIONERS AND SUPPORTED BY PHYSICIANS FROM CRH'S EMERGENCY DEPARTMENT."

FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 3E
THE COMMUNITY ADVISORY PARTICIPATION COMMITTEE PRIORITIZED THE FOLLOWING COMMUNITY HEALTH NEEDS: 1) HEART/VASCULAR DISEASE 2) OVERWEIGHT/OBESITY 3) DRUG/SUBSTANCE ABUSE 4) CHILD NUTRITION 5) MENTAL HEALTH

FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 5
THE HOSPITAL COLLABORATED WITH GEORGIA SOUTHERN UNIVERSITY TO ENLIST COMMUNITY REPRESENTATIVES TO SERVE ON THE COMMUNITY ADVISORY COMMITTEE (CAC) TO ASSIST WITH DESIGN AND DISTRIBUTION OF A HEALTH NEEDS SURVEY. TWO COMMUNITY MEETINGS WERE SCHEDULED AND HELD REMOTELY USING ZOOM TECHNOLOGY WITH THE CAC DUE TO COVID-19. APPROXIMATELY 250 SURVEYS WERE DISTRIBUTED THROUGHOUT THE COMMUNITY AND 4 KEY STAKEHOLDER INTERVIEWS WERE CONDUCTED.

FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 11
THE FOLLOWING COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY THE CHATUGE REGIONAL HOSPITAL'S COMMUNITY ADVISORY COMMITTEE AS SIGNFICANT HEALTH NEEDS: 1. HEART/VASCULAR DISEASE 2. OVERWEIGHT/OBESITY 3. DRUG/SUBSTANCE ABUSE 4. CHILD NUTRITION 5. MENTAL HEALTH THE HOSPITAL ADDRESSES THE IDENTIFIED NEEDS IN SOME MANNER FROM COLLABORATION WITH OTHER PROVIDERS TO CLINICAL OUTREACH TO COMMUNITY EDUCATION. THE CURRENT CHNA AND IMPLEMENTATION STRATEGIES, AS WELL AS THE PREVIOUS CHNA (WHICH WAS CONDUCTED IN 2018) ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT: HTTP://WWW.UNIONGENERALHEALTHSYSTEM.COM/COMMUNITY-HEALTH/.

FACILITY 1, CHATUGE REGIONAL HOSPITAL, INC - PART V, LINE 16J
A NOTICE IS RUN ANNUALLY IN THE LOCAL NEWSPAPER REGARDING THE AVAILABILITY OF FREE AND DISCOUNTED CARE FOR PATIENTS THAT QUALIFY UNDER THE HOPSITAL'S FINANCIAL ASSISTANCE POLICY. COMPLETE URL FOR COMMUNITY HEALTH NEEDS ASSESSMENTS AND ACTION PLANS (IMPLEMENTATION STRATEGY REPORTS) - HTTP://WWW.UNIONGENERALHEALTHSYSTEM.COM/COMMUNITY-HEALTH/ COMPLETE URL - FAP, FAP SUMMARY AND APPLICATION HTTP://WWW.UNIONGENERALHEALTHSYSTEM.COM/PATIENTS/BUSINESS-DEPARTMENT

SCHEDULE H, PART I, LINE 7
"THE DATA REPORTED IN THIS AREA IS REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S ""A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008"". THE COSTS FOR PART I, LINE 7A AND 7B WERE CALCULATED USING THE RATIO OF COSTS TO CHARGES USING WORKSHEET 2 IN THE INSTUCTIONS TO FORM 990 SCHEDULE H."

SCHEDULE H, PART III, LINE 2
AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE. PURSUANT TO ASU NO. 2014-09 (TOPIC 606) DISCUSSED IN MORE DETAIL BELOW, THE AMOUNT IDENTIFIED AS BAD DEBT ON SCHEDULE H, PART II, LINE 2 PRIMARILY REPRESENTS AMOUNTS ESTIMATED AT THE TRANSACTION DATE THAT ARE CONSIDERED A PRICE CONCESSION.

SCHEDULE H, PART III, LINE 3
BASED ON PAST EXPERIENCE, THE ORGANIZATION HAS FOUND THAT THERE IS A PORTION OF BAD DEBT THAT IS GENERALLY ATTRIBUTABLE TO CHARITY CARE. BASED ON ECONOMIC CENSUS RECORDS, 15.5% OF PERSONS ARE BELOW THE POVERTY LEVEL, WE ESTIMATE THAT 15.5% IF THE BAD DEBT AMOUNT ON LINE 2 WOULD BE ATTRIBUTABLE TO THOSE PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY HAD THEY COMPLETED AN APPLICATION.

SCHEDULE H, PART III, LINE 4
IN MAY 2014, THE FASB ISSUED ASU NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), WHICH IS A NEW COMPREHENSIVE REVENUE RECOGNITION STANDARD. THE CORE PRINCIPLE OF THE REVENUE MODEL IS THAT AN ENTITY RECOGNIZES REVENUE TO DEPICT THE TRANSFER OF PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE ENTITY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE CORPORATION ADOPTED ASU NO. 2014-09 ON MAY 1, 2020 USING THE FULL RETROSPECTIVE METHOD OF TRANSITION WITH PRACTICAL EXPEDIENTS IN FASB ASC 606-10-65-1(F) WITH NO SIGNIFICANT IMPACT. THE CORPORATION PERFORMED AN ANALYSIS OF REVENUE STREAMS AND TRANSACTIONS UNDER ASU NO. 2014-09. IN PARTICULAR, FOR NET PATIENT SERVICE REVENUE, THE CORPORATION PERFORMED AN ANALYSIS INTO THE APPLICATION OF THE PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO GROUP PATIENT CONTRACTS WITH SIMILAR CHARACTERISTICS, SUCH THAT REVENUE FOR A GIVEN PORTFOLIO WOULD NOT BE MATERIALLY DIFFERENT THAN IF IT WERE EVALUATED ON A CONTRACT-BY-CONTRACT BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR BAD DEBTS (REPRESENTING APPROXIMATELY 4 MILLION FOR THE YEAR ENDED APRIL 30, 2020) AND PRESENTED AS A REDUCTION TO NET PATIENT SERVICE REVENUE ON THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS IS NOW TREATED AS A PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS NET PATIENT SERVICE REVENUE. CHANGES IN CREDIT ISSUES NOT ASSESSED AT THE DATE OF SERVICE, ARE RECOGNIZED AS BAD DEBT EXPENSE AND INCLUDED AS A COMPONENT OF OPERATING EXPENSES ON THE STATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS. THE NEW STANDARD ALSO REQUIRES ENHANCED DISCLOSURES RELATED TO THE DISAGGREGATION OF REVENUE AND SIGNIFICANT JUDGMENTS MADE IN MEASUREMENT AND RECOGNITION. THE ADOPTION OF THIS GUIDANCE DID NOT MATERIALLY IMPACT TOTAL OPERATING REVENUES, EXCESS REVENUES (EXPENSES), OR NET ASSETS. SEE FOOTNOTES 2 AND 3 IN THE ATTACHED AUDITED STATEMENTS FOR A DISCUSSION OF NET PATIENT SERVICE REVENUE WHICH INCLUDES A DISCUSSION OF CHARITY CARE AND UNINSURED DISCOUNTS.

SCHEDULE H, PART III, LINE 8
MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS.

SCHEDULE H, PART VI, LINE 2
THE ORGANIZATION PERIODICALLY SOLICITS FEEDBACK FROM THE MEDICAL STAFF AND FROM CITY AND COUNTY OFFICIALS, IN ADDITION TO THE INPUT RECEIVED DURING THE CHNA PROCESS.

SCHEDULE H, PART VI, LINE 3
THE ORGANIZATION PUBLISHES A NOTICE IN THE LOCAL COMMUNITY NEWSPAPER. AT THE TIME OF REGISTRATION, AN AGENT INFORMS THE ACCOUNT GUARANTOR OF THE AVAILABILITY OF INDIGENT AND CHARITY CARE. ACCOUNT COLLECTORS ALSO INFORM THE GUARANTOR OF THE AVAILABILITY OF THE POLICIES. THE FAP, THE PLAIN LANGUAGE SUMMARY AND THE APPLICATION FOR FINANCIAL ASSISTANCE ARE ON THE ORGANIZATION'S WEBSITE. A PLAIN LANGUAGE SUMMARY OF THE POLICY IS OFFERED TO ALL PATIENTS PRIOR TO DISCHARGE. SIGNAGE IN KEY AREAS OF THE HOSPITAL NOTIFY PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE.

SCHEDULE H, PART VI, LINE 4
"CHATUGE REGIONAL HOSPITAL (""CRH"") SERVES A GENERALLY RURAL, MOUNTAINOUS AREA AND IS THE SOLE HOSPITAL IN TOWNS COUNTY. DUE TO THE MOUNTAINOUS TERRAIN AND BEING BOUNDED BY THE CHATTAHOOCHEE NATIONAL FOREST AND LAKE CHATUGE, TOWNS COUNTY AND ITS NEIGHBORING CLAY COUNTY, NC HAVE VERY REMOTE COMMUNITIES FROM WHICH ACCESS TO MEDICAL CARE CAN LITERALLY BE MORE THAN AN HOUR AWAY IN SOME CASES. TOWNS COUNTY ATTRACTS MANY VISITORS FOR CAMPING, BOATING, HIKING, FISHING AND HUNTING, AS WELL AS BICYCLISTS AND MOTORCYCLISTS, WHICH OFTEN LEAD TO SERIOUS INJURY THAT THE EMERGENCY DEPARTMENT MUST BE PREPARED TO MEET. FURTHERMORE, CRH IS A CRITICAL ACCESS HOSPITAL FOR THE RESIDENTS OF TOWNS COUNTY, GA, AND CLAY COUNTY, NC. SIGNIFICANT PORTIONS OF THE RESIDENT POPULATION ARE MEDICARE AND MEDICAID BENEFICIARIES. TOWNS COUNTY IS DEEMED TO HAVE A MEDICALLY UNDERSERVED POPULATION (MUP) BY THE GEORGIA DEPARTMENT OF COMMUNITY HEALTH."

SCHEDULE H, PART VI, LINE 5
THE ORGANIZATION PROMOTES/CONDUCTS HEALTH FAIRS OPEN TO THE COMMUNITY WHEREIN FREE HEALTH SCREENINGS AND LOW-COST BASIC LAB TESTS ARE DONE. OTHER HEALTH INFORMATION IS PROVIDED INCLUDING INFORMATION ON SMOKING CESSATION AND DIABETES. THE ORGANIZATION IS ENTIRELY TOBACCO-FREE, THUS PROMOTING A HEALTHY LIFESTYLE. SURPLUS FUNDS ARE USED TO PROVIDE FOR THE ADDITION, IMPROVEMENT, OR REPLACEMENT OF CAPITAL AND EQUIPMENT NEEDS. THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY VOLUNTEERS. THE HOSPITAL PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS, OFFERS FINANCIAL ASSISTANCE FOR MEDICAL CARE TO ELIGIBLE INDIVIDUALS AND IT HAS AN OPEN MEDICAL STAFF.

SCHEDULE H, PART VI, LINE 7
GEORGIA

SCHEDULE H, PART III, LINE 9B
ONCE A PATIENT IS APPROVED FOR INDIGENT CARE (100% WRITE OFF) THE ACCOUNT(S) IS (ARE) RECLASSIFIED TO INDIGENT CARE AND NO FURTHER COLLECTION ACTIVITY IS CONDUCTED. FOR PATIENTS APPROVED FOR CHARITY CARE (REDUCED CHARGE), THE ACCOUNT GUARANTOR WILL RECEIVE STATEMENTS AND PHONE CALLS TO COLLECT ANY REMAINING BALANCE DUE. PATIENTS WILL RECEIVE THREE (3) STATEMENTS, ONE (1) NOTICE LETTER AND MULTIPLE PHONE CALLS REQUESTING PAYMENT IN FULL OR PAYMENT ARRANGEMENTS BE MADE. STATEMENTS 1. INITIAL A. PATIENTS WILL NORMALLY RECEIVE A STATEMENT FOR SERVICES RENDERED WITHIN THIRTY (30) DAYS OF DISCHARGE AS AN INPATIENT OR TREATMENT AS AN OUTPATIENT (EXCLUDING RECURRING VISITS). B. RECURRING VISIT PATIENTS WILL NORMALLY RECEIVE A BILL FOR SERVICES RENDERED FOR THE PRIOR MONTH WITHIN ONE MONTH. 2. SUBSEQUENT STATEMENTS A. THE SECOND STATEMENT WILL BE ISSUED THIRTY (30) DAYS AFTER THE INITIAL STATEMENT. B. THE THIRD STATEMENT WILL BE ISSUED SIXTY (60) DAYS AFTER THE INITIAL STATEMENT. C. THE NOTICE LETTER WILL BE ISSUED NINETY (90) DAYS AFTER THE INITIAL STATEMENT REQUESTING PAYMENT IN FULL UPON RECEIPT. THIS LETTER WILL NOTIFY THE PATIENT THEIR ACCOUNT WILL BE REFLECTED AS A BAD DEBT AND REFERRED TO AN OUTSIDE COLLECTION AGENCY IF PAYMENT IN FULL IS NOT RECEIVED WITHIN THIRTY (30) CALENDAR DAYS OF THE STATEMENT DATE. THE NOTIFICATION WILL SPECIFY ANY EXTRAORDINARY COLLECTION ACTIONS THAT MAY BE UNDERTAKEN IF THE PATIENT DOES NOT MAKE FULL PAYMENT OR COMPLETE A FINANCIAL ASSISTANCE APPLICATION. D. ONE HUNDRED TWENTY (120) DAYS AFTER THE INITIAL STATEMENT THESE ACCOUNTS WILL BE WRITTEN OFF AS A BAD DEBT ADJUSTMENT AND SENT TO AN OUTSIDE COLLECTION AGENCY. 3. ALL STATEMENTS WILL INCLUDE LANGUAGE THAT INFORMS THE RECIPIENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND INCLUDES A TELEPHONE NUMBER AND THE WEBSITE ADDRESS TO OBTAIN ADDITIONAL INFORMATION. PHONE CALLS THIRTY (30) DAYS AFTER THE INITIAL STATEMENT, THE PATIENT MAY BEGIN TO RECEIVE MULTIPLE PHONE CALLS REQUESTING PAYMENT IN FULL OR PAYMENT ARRANGEMENTS BE MADE. THE PATIENT WILL BE INFORMED THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE AND OFFERED A COPY OF THE PLAIN LANGUAGE SUMMARY OF THE FAP. USE OF OUTSIDE COLLECTION AGENCY WHEN A PATIENT AND/OR GUARANTOR FAIL TO PAY THE PATIENT LIABILITY, THE ACCOUNT WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. REASONABLE EFFORTS - THE BUSINESS OFFICE MANAGER WILL BE RESPONSIBLE FOR ENSURING THAT THE FACILITY HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO ENGAGING IN ANY EXTRAORDINARY COLLECTION ACTION (ECA). EXTRAORDINARY COLLECTION ACTIONS (ECAS) - THE PATIENT AND/OR GUARANTOR SHALL BE PROVIDED AT LEAST THIRTY (30) DAYS WRITTEN NOTICE PRIOR TO ANY ECAS BEING TAKEN. THE WRITTEN NOTICE WILL INCLUDE A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, NOTIFICATION OF ANY ECAS THAT MAYBE INITIATED AGAINST THE PATIENT AND /OR GUARANTOR, AND THE DATE AFTER WHICH ANY ECAS WILL BE INITIATED. ORAL NOTIFICATION TO THE PATIENT AND/OR GUARANTOR WILL BE ATTEMPTED VIA A PHONE CALL PRIOR TO ANY ECAS BEING INITIATED. THE ORAL NOTIFICATION WILL INFORM THE PATIENT AND/OR GUARANTOR ABOUT THE FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN HELP WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. ECAS MAY NOT COMMENCE PRIOR DURING THE NOTIFICATION PERIOD. THE NOTIFICATION PERIOD ENDS ON THE 120TH DAY AFTER THE FACILITY ISSUES THE FIRST POST-DISCHARGE BILLING STATEMENT TO THE PATIENT. IF, BY THE END OF THIS 120 DAY PERIOD THE PATIENT HAS NOT SUBMITTED A FINANCIAL ASSISTANCE APPLICATION, THE FACILITY MAY BEGIN COLLECTION ACTIONS AGAINST THE PATIENT. THE APPLICATION PERIOD DURING WHICH FACILITY WILL ACCEPT AND PROCESS A FINANCIAL ASSISTANCE APPLICATION ENDS ON THE 240TH DAY AFTER THE FACILITY ISSUES THE FIRST POST-DISCHARGE BILLING STATEMENT TO THE PATIENT. LEGAL ACTIONS LEGAL ACTIONS MAY BE INITIATED AGAINST THE PATIENT AND/OR GUARANTOR WHO DEFAULT ON PAYMENT TO THE FACILITY. THESE LEGAL ACTIONS MAY INCLUDE: - PLACING A LIEN ON AN INDIVIDUALS PROPERTY EXCEPT FOR ANY LIEN THE FACILITY IS ENTITLED TO ASSERT UNDER STATE LAW ON THE PROCEEDS OF A JUDGMENT, SETTLEMENT, ORE COMPROMISE OWED TO AN INDIVIDUAL AS A RESULT OF PERSONAL INJURIES FOR WHICH CARE WAS PROVIDED; - FORECLOSING ON AN INDIVIDUALS REAL PROPERTY; - ATTACHING OR SEIZING AN INDIVIDUALS BANK ACCOUNT OR ANY OTHER PERSONAL PROPERTY; - COMMENCING A CIVIL ACTION AGAINST AN INDIVIDUAL; AND - GARNISHING AN INDIVIDUALS WAGES. ALL LEGAL ACTIONS TAKEN BY ANY COLLECTION AGENCY ON BEHALF OF THE FACILITY SHALL HAVE HAD PRIOR REVIEW AND APPROVAL FROM THE FACILITY. THE FACILITY OR ANY COLLECTIONS AGENCY WORKING ON BEHALF OF THE FACILITY SHALL NOT PURSUE ENFORCEMENT OF A JUDGMENT LIEN, WHETHER BY SHERIFFS LEVY AND SALE OR OTHERWISE, ON A PRIMARY RESIDENCE, PURSUE AN INVOLUNTARY BANKRUPTCY PROCEEDING AGAINST A PATIENT AND /OR GUARANTOR, OR TAKE ANY ACTION THAT WOULD CAUSE A BENCH WARRANT (AN ORDER ISSUED BY A JUDGE OR COURT FOR THE ARREST OF A PERSON) TO BE ISSUED. HOWEVER, THE FACILITY MAY PURSUE APPROPRIATE COURT ORDERS, INCLUDING CONTEMPT OF COURT, FOR A PATIENT/JUDGMENT DEBTOR FAILING TO RESPOND TO POST-JUDGMENT DISCOVERY AS REQUIRED BY LAW.