4A (Expenses $ 7068000 including grants of $ 0) (Revenue $ 14987000)
NORTH CANYON MEDICAL CENTER (NCMC) OPERATES AN 18-BED CRITICAL ACCESS HOSPITAL THAT PROVIDES SERVICES THAT INCLUDE: ACUTE CARE, SWING BED CARE, DIAGNOSTIC IMAGING, DIABETIC EDUCATION, EMERGENCY CARE, LABORATORY SERVICES, REHABILITATION SERVICES, RESPIRATORY THERAPY, ADDICTION MEDICINE, BEHAVORIAL HEALTH, DERMATOLOGY, SLEEP STUDIES, ORTHOPEDICS, SPINE, FOOT AND ANKLE, HAND AND WRIST, PAIN MANAGEMENT, UROLGY, GENERAL SURGERY, SURGICAL SERVICES, AND FAMILY MEDICINE. NCMC'S SURGICAL DEPARTMENT PERFORMS SURGICAL AND ENDOSCOPIC PROCEDURES. THE HOSPITAL EMPLOYS A SPINE SURGEON, TWO ORTHOPEDIC SURGEONS, A HAND/WRIST SURGEON, A GENERAL SURGEON, A PODIATRIST, A UROLOGIST, AS WELL AS WELCOMING VISITING SPECIALISTS. IN 2022, THE SURGICAL DEPARTMENT PERFORMED 1,721 CASES.

4B (Expenses $ 3380000 including grants of $ 0) (Revenue $ 3423000)
NORTH CANYON MEDICAL CENTER'S MEDICAL-SURGICAL DEPARTMENT HANDLES ACUTE CARE, SWING BED CARE, OBSERVATION, AND POST SURGICAL CARE. SWING BED CARE IS FOR THOSE PATIENTS DISCHARGED FROM ACUTE CARE BUT REQUIRE ADDITIONAL SKILLED CARE. THE HOSPITAL HAD 367 ADMISSIONS IN 2022, OF WHICH 52% WERE MEDICARE. THE AVERAGE DAILY CENSUS FOR THE YEAR WAS 4.2. THE ACUTE AVERAGE LENGTH OF STAY WAS 3.4 DAYS.

4C (Expenses $ 2596000 including grants of $ 0) (Revenue $ 4845000)
NCMC OFFERS A FULL-SERVICE LABORATORY DEPARTMENT STAFFED BY A TEAM OF SPECIALISTS WHO ARE COMMITTED TO PROVIDING HIGH-QUALITY DIAGNOSTIC SERVICES FOR HEALTH CARE PROVIDERS AND PATIENTS. THE LABORATORY UTILIZES CUTTING- EDGE ANALYZERS AND EQUIPMENT TO ENSURE QUALITY AND ACCURACY. LABORATORY STAFF IS AVAILABLE 24 HOURS A DAY. OUR LABORATORY PERFORMS THE FOLLOWING AREAS OF TESTING: HEMATOLOGY, CLINICAL CHEMISTRY, IMMUNOASSAY, SEROLOGY, COAGULATION, MOLECULAR TESTING, MICROBIOLOGY, URINALYSIS, AND BLOOD BANK. THE LAB PERFORMED AND PROCESSED 135,156 TESTS IN 2022.

4D (Expenses $ 30499806 including grants of $ 2480) (Revenue $ 28462622)
NCMC PROVIDES A WIDE RANGE OF HEALTHCARE SERVICES IN TECHNOLOGICALLY ADVANCED FACILITIES. SERVICES INCLUDE ORTHOPEDICS, FOOT AND ANKLE, HAND AND WRIST, GENERAL SURGERY, PAIN MANAGEMENT, UROLOGY, BEHAVIORAL HEALTH, CARDIOLOGY, DERMATOLOGY, SLEEP STUDIES, AND REHABILITATION SERVICES. OUR REHABILITATION SERVICES ARE PROVIDED BY TRAINED, LICENSED PROFESSIONALS WHO SPECIALIZE IN PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. WE PROVIDE INPATIENT AND OUTPATIENT THERAPY AT NCMC. ADDITIONAL SERVICES PROVIDED BY NCMC INCLUDE LABORATORY SERVICES, DIAGNOSTIC IMAGING, ADDICTION MEDICINE, NUTRITION SERVICES, A SPECIALTY CLINIC, FAMILY PRACTICE CLINICS, AND WOUND CARE. NCMC OFFERS STATE OF THE ART RADIOLOGY EQUIPMENT NOT NORMALLY FOUND IN A RURAL SETTING. NCMC EMPLOYS ONLY CERTIFIED RADIOLOGIC TECHNOLOGISTS TO PERFORM EXAMS, EACH HAVING SPECIALIZED TRAINING IN THE TYPE OF EXAM BEING GIVEN. NCMC EMPLOYS A RADIOLOGIST WHO READS EXAMS ON SITE. ALSO, NCMC RECEIVED DONATIONS FROM THE TOUGH ENOUGH TO WEAR PINK ORGANIZATION THAT WAS USED TO FURTHER BREAST CANCER AWARENESS BY AIDING IN PURCHASING A NEW ULTRASOUND. NCMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 404,144 FOR CHARITY CARE, 11,453,658 FOR MEDICARE, 8,926,875 FOR MEDICAID, AND 19,637,751 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR.

FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 3E
IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 21 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE.

FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 5
TO ENSURE INPUT FROM PERSONS WITH BROAD KNOWLEDGE OF THE COMMUNITY, A COMMUNITY SURVEY WAS ADMINISTERED IN MARCH 2022 THROUGH LOCAL NEWS MEDIA, EMAIL TO CHAMBERS OF COMMERCE AND AREA CIVIC GROUPS ALONG WITH INVITATIONS AND LINKS THROUGH HOSPITAL SOCIAL MEDIA AND WEBSITE WITH OVER 230 RESPONDENTS PRIMARILY FROM THE GOODING AND TWIN FALLS COUNTIES. TWO FOCUS GROUPS WERE THEN HELD IN APRIL WITH COMMUNITY STAKEHOLDERS TO FACILITATE DISCUSSION AND GET INPUT AROUND THE HEALTH NEEDS AND RESOURCES IN THE COMMUNITY. INVITATIONS WERE SENT TO INDIVIDUALS REPRESENTING VARIOUS COMMUNITY, BUSINESS, AND EDUCATIONAL ORGANIZATIONS. REPRESENTATIVES FROM LOCAL HEALTH CARE PROVIDERS AND THE COMMUNITY HEALTH DEPARTMENTS WERE INCLUDED TO BRING IN ADDITIONAL PROFESSIONAL PERSPECTIVE. FOR INVITEES UNABLE TO ATTEND THE FOCUS GROUP SESSIONS, INPUT WAS GATHERED BY EMAIL VIA THE COMMUNITY SURVEY. THE INDIVIDUALS IDENTIFIED TO PARTICIPATE IN THE PROCESS HAVE DIRECT ACCESS TO INDIVIDUALS ACROSS ALL SUBSECTIONS OF THE COMMUNITY AND THEREFORE CAN ADDRESS NEEDS THAT MAY IMPACT THOSE POPULATIONS THAT ARE MEDICALLY UNDERSERVED OR MOST IN NEED. COMMUNITY PARTICIPANTS REPRESENTED THE FOLLOWING COMMUNITY ORGANIZATIONS: NORTH CANYON MEDICAL CENTER GOODING SCHOOL DISTRICT (SOCIAL SERVICES, HOMELESS LIAISON) UNITED WAY JEROME SCHOOL DISTRICT ST. LUKE'S COMMUNITY HEALTH GOODING COUNTY COMMISSIONER JEROME 2020

FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 11
THE NCMC CHNA ADVISORY COMMITTEE IS MADE UP OF SELECTED INDIVIDUALS WITH A WIDE RANGE OF BACKGROUNDS IN HEALTH RELATED AGENCIES AND WITH HEALTH RELATED QUALIFICATIONS. COLLECTIVELY, THESE INDIVIDUALS ADVOCATE ON BEHALF OF THE MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS WITHIN THE COMMUNITY THROUGH THEIR ORGANIZATIONS. IN ORDER TO GATHER FEEDBACK FROM INDIVIDUALS NOT PARTICIPATING IN THE COMMUNITY ADVISORY COMMITTEE, A SURVEY TOOL WAS DEVELOPED TO ADDRESS GENERAL QUESTIONS RELATED TO THE HEALTH OF THE COMMUNITY. THE SURVEY WAS DISTRIBUTED TO AND COMPLETED BY, LOCAL COMMUNITY GROUPS, CHAMBERS OF COMMERCE MEMBERS, HOSPITAL BOARD MEMBERS, EMPLOYEES AND OTHER KEY COMMUNITY MEMBERS REPRESENTING A MIX OF THE COMMUNITY DEMOGRAPHICS. THE SURVEYS WERE RETURNED FOR INDEPENDENT REVIEW AND ANALYSIS. ONCE THE HEALTH NEEDS WERE PRIORITIZED, THE ADVISORY COMMITTEE DEVELOPED AN IMPLEMENTATION STRATEGY IN ORDER TO HAVE A CLEAR SET OF GOALS TO RESPOND TO THE PRIORITIES IDENTIFIED THROUGH THE CHNA. THE IMPLEMENTATION STRATEGY INCLUDED A WRITTEN PLAN THAT ADDRESSED EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, DESCRIBED HOW THE HOSPITAL PLANNED TO MEET THE HEALTH NEEDS, AND IDENTIFIED HEALTH NEEDS THE HOSPITAL DID NOT INTEND TO MEET AND WHY. THE FOLLOWING TOP PRIORITIES WERE IDENTIFIED THROUGH THE CHNA PROCESS. FOR EACH PRIORITY, AN OBJECTIVE OR STRATEGY WAS IDENTIFIED. EACH OBJECTIVE INCLUDED TACTICS ON HOW TO ACHIEVE THE OBJECTIVE, THE RESOURCES NEEDED, THE IMPACT THE PROGRAM OR RESOURCES WOULD HAVE, THE ACCOUNTABLE PARTIES, AND ANY PARTNERSHIPS OR COLLABORATIONS. 1.BETTER COORDINATION OF RESOURCES 2.WOMEN'S HEALTH 3.DIABETIC RESOURCES 4.HEALTH EDUCATION SOME HEALTH ISSUES OR NEEDS THAT WERE IDENTIFIED THROUGH THE CHNA PROCESS ARE NOT PRIORITIZED AS THIS TIME DUE TO BEING OUTSIDE THE SCOPE/ABILITIES OF NCMC AND/OR THE ISSUE IS BEING ADDRESSED BY OTHER COMMUNITY RESOURCES OR ORGANIZATIONS. IN OTHER INSTANCES, THERE ARE ALREADY INITIATIVES IN PLACE AT NORTH CANYON MEDICAL CENTER TO ADDRESS SOME NEEDS. NCMC IS NOT IGNORING THESE ISSUES BUT PLANS TO COLLABORATE (WITHIN ITS ABILITY) WITH OTHER ORGANIZATIONS TO ADDRESS AND MAKE PROGRESS. NCMC ALSO HAS PROGRAMS IN PLACE INCLUDING A SLIDING FEE SCALE, WALK IN CLINIC, PATIENT TRANSPORT, AND FINANCIAL COUNSELORS AVAILABLE WHICH HELP TO ADVOCATE FOR THE PATIENT. DUE TO THE SHORTAGE IN RURAL AREAS INCLUDING GOODING COUNTY, NCMC HAS HAD A DIFFICULT TIME RECRUITING SPECIALISTS FOR PEDIATRICS AND OBGYN SERVICES. NCMC ALSO HAS TO EVALUATE QUALITY AND ECONOMICAL CONSIDERATIONS WHEN ASSESSING THE NEED IN ITS SERVICE AREA IN ORDER TO SUPPORT HAVING SUCH SPECIALISTS. NCMC OPENED A NEW CLINIC IN JEROME, ID, IN SEPTEMBER 2020, AND EMPLOYS A FULLTIME PEDIATRICIAN.

FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 16J
THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS ALSO COMMUNICATED VERBALLY UPON ADMISSION. THE LATEST FINANCIAL ASSISTANCE POLICY (FAP) IS AVAILABLE ON THE HOSPITAL WEBSITE.

FACILITY 1, NORTH CANYON MEDICAL CENTER, INC. - PART V, LINE 24
PATIENTS ARE BILLED THE GROSS CHARGE FOR ALL SERVICES RECEIVED. IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE BILL IS ADJUSTED AS DETERMINED BY OUR CHARITY CARE POLICY GUIDELINES.

SCHEDULE H, PART I, LINE 7
THE HOSPITAL APPLIES THE RATIO OF PATIENT CARE COST-TO-CHARGES FOR AMOUNTS REPORTED IN THE TABLE (TOTAL OPERATING EXPENSES LESS NON-PATIENT CARE ACTIVITIES, TOTAL COMMUNITY BENEFIT, AND TOTAL COMMUNITY BUILDING EXPENSES).

SCHEDULE H, PART II
GOODING COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT.

SCHEDULE H, PART III, LINE 2
THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON SCHEDULE H, PART III, LINE 2 INCLUDES THE COST TO CHARGE RATIO OF PATIENT CARE.

SCHEDULE H, PART III, LINE 3
THE HOSPITAL DOES NOT OFFER DISCOUNTS FOR PAYMENT ON BAD DEBT. THE HOSPITAL APPLIES FUNDS COLLECTED ON BAD DEBT AGAINST THE PATIENT ACCOUNT. WE ESTIMATE THAT OF THE CHARITY CARE APPLICATIONS GIVEN OUT, ABOUT HALF OF THEM COME BACK. DURING THE YEAR, WE RECORDED 404,144 OF CHARITY CARE AT GROSS PATIENT CHARGES WHICH WAS CONVERTED TO 218,238 UTILIZING THE COST TO CHARGE RATIO OF PATIENT CARE. THEREFORE, WE ESTIMATE AN ADDITIONAL 185,906 OF BAD DEBT EXPENSE WHICH COULD BE ATTRIBUTABLE TO PATIENTS UNDER THE CHARITY CARE POLICY.

SCHEDULE H, PART III, LINE 4
THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 5 ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR EXPLICIT PRICE CONCESSIONS (BAD DEBT) IS INCLUDED IN FOOTNOTE 10 STARTING ON PAGE 21 OF THE AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS ARE NOT COUNTED AS COMMUNITY BENEFIT. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR.

SCHEDULE H, PART III, LINE 9B
THE BILLING DEPARTMENT BILLS PATIENTS AND INSURANCE WITHIN 4 DAYS FROM THE DATE OF SERVICE. AFTER INSURANCE PAYMENTS ARE MADE, THE OPEN ACCOUNT GOES TO SELF PAY STATUS AND IS BILLED DIRECTLY TO PATIENTS. ON THE 1ST DAY AFTER INSURANCE HAS PAID, SELF PAY ACCOUNTS ARE SENT A STATEMENT OF CHARGES, WHICH SERVES AS AN INVOICE. THE SAME IS TRUE AFTER INSURANCE PAYMENTS ARE MADE AND THE OPEN ACCOUNT GOES TO SELF PAY STATUS. THROUGHOUT A FULL 120 DAYS, VARIOUS PHONE CALLS AND LETTERS ARE USED TO CONTACT THE PATIENT IN ORDER TO FOLLOW THROUGH WITH COLLECTION PROCESSES AND TO TRY TO QUALIFY PATIENTS FOR CHARITY CARE OR FINANCIAL ASSISTANCE. AT 121 DAYS, A LIST OF UNPAID ACCOUNTS IS COMPILED TO BE SENT TO OUTSIDE COLLECTIONS. THE HOSPITAL'S PATIENT FINANCIAL COUNSELORS REVIEW THIS LIST FOR ACCURACY PRIOR TO SENDING IT TO AN OUTSIDE COLLECTION AGENCY. ANY COLLECTIONS FROM THE OUTSIDE COLLECTION AGENCY ARE APPLIED AS A RECOVERY AGAINST BAD DEBT.

SCHEDULE H, PART VI, LINE 2
THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES BY CONSIDERING SERVICES BEYOND THE TYPICAL SCOPE OF A CRITICAL ACCESS HOSPITAL TO DETERMINE WHICH SERVICES TO PROVIDE BASED UPON STATISTICAL ANALYSIS AND SERVICE REQUIREMENTS THAT THE COMMUNITY IS DEMANDING. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTPS://NORTHCANYON.ORG/ABOUT/IN-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS- ASSESSMENTS/

SCHEDULE H, PART VI, LINE 3
THE HOSPITAL HAS A PATIENT FINANCIAL SERVICES (PFS) DEPARTMENT THAT STRIVES TO TREAT ALL PATIENTS EQUITABLY, WITH DIGNITY, RESPECT AND COMPASSION. PFS INFORMS PATIENTS ABOUT PROGRAMS AVAILABLE, INCLUDING THE CHARITY CARE PROGRAM. IF THE PATIENT IS INTERESTED IN THE PROGRAM, PFS WILL VERBALLY INFORM THE PATIENT ABOUT THE GUIDELINES AND/OR SEND FORMS THAT ARE REQUIRED TO JOIN THE PROGRAM(S).

SCHEDULE H, PART VI, LINE 4
GOODING, IDAHO IS A RURAL COMMUNITY WITH APPROXIMATELY 3,700 RESIDENTS. THERE ARE TWO OTHER HOSPITALS IN COMMUNITIES WITHIN 35 MILES. THE MARKET PLACE IS PRIMARILY COMPRISED OF MEDICAID AND MEDICARE RESIDENTS, DEMONSTRATED BY THE HOSPITAL'S PAYOR MIX. MEDICAID AND MEDICARE MAKE UP APPROXIMATELY 42% OF THIS MIX.

SCHEDULE H, PART VI, LINE 5
THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF OUR COMMUNITY FROM BUSINESS OWNERS TO HOMEMAKERS TO RETIREES. THIS VOLUNTEER BOARD HAS DEDICATED THEIR TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT THE HOSPITAL ARE AVAILABLE TO QUALIFIED AND INTERESTED PHYSICIANS IN THE COMMUNITY WE SERVE. WE ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER GROWING HEALTHCARE NEEDS OF THE COMMUNITY. ANY SURPLUS FUNDS ARE REINVESTED INTO OUR FACILITIES, EQUIPMENT, AND PROFESSIONAL EDUCATION OF OUR EMPLOYEES IN ORDER TO PROVIDE THE HIGHEST QUALITY HEALTHCARE POSSIBLE. THE HOSPITAL ALSO ASSESSES THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY TO DETERMINE IF ADDITIONAL SERVICES TO OUR PATIENTS ARE NEEDED. THE HOSPITAL ALSO PROMOTES HEALTH IN THE COMMUNITY BY OFFERING OR PARTICPATING IN THE FOLLOWING SERVICES: OPERATES AN EMERGENCY ROOM THAT IS AVAILABLE TO ALL REGARDLESS OF ABILITY TO PAY PARTICIPATES IN EDUCATION OF HEALTHCARE PROFESSIONALS PARTICIPATES IN GOVERNMENT SPONSORED HEALTH PROGRAMS SUCH AS MEDICARE AND MEDICAID VOLUNTEER OPPORTUNITIES AVAILABLE SPONSORS AN ANNUAL HEALTH FAIR THAT GIVES COMMUNITY MEMBERS OPPORTUNITIES TO HAVE TESTS PERFORMED AT VERY DISCOUNTED RATES

SCHEDULE H, PART VI, LINE 6
N/A

SCHEDULE H, PART VI
THE COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST.