Community Benefit Insight - Tax-exempt hospital

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Bmh Inc

98 Poplar Street

Blackfoot, ID 83221

EIN: 205126945

The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more

Individual Facility Details: Bingham Memorial Hospital

98 Poplar
Blackfoot, ID 83221

3 hospitals in organization:
(click a facility name to update Individual Facility Details panel)

Idaho Doctors Hospital

Grove Creek Medical Center

Bingham Memorial Hospital

Bed count	25	Medicare provider number	131325	Member of the Council of Teaching Hospitals	YES	Children's hospital	NO

Bmh IncDisplay data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

6.1%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 644,019 0.39 %
Medicaid as % of operating expenses	$ 7,939,201 4.87 %
Costs of other means-tested government programs as % of operating expenses	$ 93,779 0.06 %
Health professions education as % of operating expenses	$ 49,999 0.03 %
Subsidized health services as % of operating expenses	$ 0 0 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 917,600 0.56 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 302,100 0.19 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 1,665,549 1.02 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 416,387 25.00 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 72880691 including grants of $ 318800) (Revenue $ 117148629)
BMH OPERATES A 25-BED ACUTE CARE CRITICAL ACCESS HOSPITAL (CAH) FACILITY WHICH PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE, AND SURGICAL SERVICES FOR RESIDENTS OF BINGHAM COUNTY AND SURROUNDING COUNTIES. THE HOSPITAL PROVIDED SERVICES TO 1,540 INPATIENTS, 399 NEWBORN INFANTS, AND 9,223 EMERGENCY ROOM PATIENTS AS WELL AS PERFORMING 10,606 SURGERIES (INPATIENT AND OUTPATIENT) DURING THE YEAR. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED CHARGES OF PROVIDING CARE TO THESE PATIENTS WAS 1,533,378 FOR CHARITY CARE, 68,796,186 FOR MEDICARE, 48,134,094 FOR MEDICAID, AND 96,356,141 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR ENDED DECEMBER 31, 2021.

4B (Expenses $ 57860004 including grants of $ 0) (Revenue $ 45679486)
BMH OPERATES SEVERAL CLINICS EMPLOYING AND CONTRACTING WITH PHYSICIANS TO PROVIDE MEDICAL CARE TO INDIVIDUALS IN THE COMMUNITY AND SERVICE AREA. DURING THE YEAR, THESE PHYSICIANS PROVIDED 210,870 SEPARATE SERVICE ENCOUNTERS FOR INDIVIDUAL PATIENTS.

4C (Expenses $ 3707472 including grants of $ 0) (Revenue $ 1856691)
BMH OPERATES A NURSING HOME WHICH AVERAGED 33 RESIDENTS PER DAY RECEIVING INPATIENT SERVICES (EITHER SHORT-TERM OR LONG-TERM SKILLED CARE) DURING THE YEAR.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 3E
IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 33 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE.

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 5
BINGHAM MEMORIAL HOSPITAL (BINGHAM), LOCATED IN BLACKFOOT ID, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) BETWEEN MAY 2019 AND NOVEMBER 2019. BINGHAM TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY SOLICITATING COMMENTS FROM KEY STAKEHOLDERS THROUGH AN ELECTRONIC SURVEY. KEY STAKEHOLDERS WERE FROM A DIVERSE GROUP OF COMMUNITY MEMBERS BASED ON THEIR SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, THEIR AFFILIATION WITH LOCAL GOVERNMENT, SCHOOLS AND INDUSTRY, OR THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS (SOCIAL SERVICE AND PUBLIC HEALTH AGENCIES, LOCAL SCHOOLS AND COMMUNITY COLLEGE, LOCAL CITY AND COUNTY GOVERNMENT, MEDICAL PROVIDERS, ETC.).

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 6B
THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH BKD,LLP.

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 11
ANALYSIS AND COMPARISONS OF THE PRIMARY (KEY STAKEHOLDER SURVEYS) AND SECONDARY (PUBLIC DATABASES) SOURCES OF DATA FACILITATED THE IDENTIFICATION OF HEALTH NEEDS IN BINGHAM'S SERVICE AREA. LEADING CAUSES OF DEATH FOR THE COMMUNITY AND THE DEATH RATES FOR THE LEADING CAUSES OF DEATH FOR EACH COUNTY WITHIN THE COMMUNITY WERE COMPARED TO U.S. ADJUSTED DEATH RATES. CAUSES OF DEATH IN WHICH THE COUNTY RATE COMPARED UNFAVORABLY TO THE U.S. ADJUSTED DEATH RATE WERE INCLUDED AS IDENTIFIED NEEDS. THE FOLLOWING WERE IDENTIFIED AS THE 4 MOST HIGHLY PRIORITIZED HEALTH NEEDS, AND ADDRESSED IN THE FOLLOWING MANNER: 1 - MENTAL HEALTH. SERVICES ANGER MANAGEMENT, LOVE AND LOGIC CLASSES, AND COUNSELING SERVICES ARE CURRENTLY OFFERED. LOCAL MENTAL HEALTH SPECIALISTS ARE PROPOSED TO BE PROVIDED TO ADDRESS MENTAL HEALTH ISSUES. 2 - SUBSTANCE ABUSE. A PATIENT CENTERED MEDICAL HOME MODEL IS PROPOSED TO BE OFFERED TO WORK WITH PATIENTS' PRIMARY PHYSICIANS TO ENSURE THAT THEY RECEIVE PROPER CARE. 3 - ADULT OBESITY. A DIABETES PREVENTION PROGRAM IS OFFERED AS WELL AS WEIGHT LOSS SEMINARS TO PREVENT OBESITY. A COOKING MATTERS CLASS IS PROPOSED TO BE OFFERED AS A WAY TO TEACH INDIVIDUALS TO EAT HEALTHIER DIETS. 4 - ACCESS TO PRIMARY CARE PROVIDERS. THERE IS A SHORTAGE IN HEALTH PROFESSIONALS IN THE AREA. IDAHO PUBLIC HEALTH DISTRICT 7 PROVIDES SERVICES TO RESIDENTS OF BONNEVILLE COUNTY. BINGHAM WAS NOT ABLE TO ADDRESS ALL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA DUE TO NOT CURRENTLY HAVING THE STAFF OR FINANCIAL RESOURCES TO DEVOTE TO THE NEED. THE NEEDS IDENTIFIED BUT NOT SPECIFICALLY ADDRESSED INCLUDE HIGH COST OF CARE, UNINSURED/UNDERINSURED, DIABETES, LACK OF HEALTH KNOWLEDGE/EDUCATION, HEART DISEASE, ADULT SMOKING, CHILDREN IN POVERTY, CANCER, EXCESSIVE DRINKING, LUNG DISEASE, CHILDREN IN SINGLE-PARENT HOUSEHOLDS, STROKE, VIOLENT CRIME RATE, ALCOHOL- IMPAIRED DRIVING DEATHS, AND DENTISTS. BINGHAM'S DESIRE TO EXCEED EXPECTATIONS MEANS THAT IT IS CONTINUALLY IMPROVING ON THESE AREAS OF NEEDS THROUGH NEW PROGRAMS AND AFFILIATIONS. WE ARE CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. WHILE ALL SIGNIFICANT NEEDS OF THE COMMUNITY ARE BEING MET, SOME OF THE INITIAL PLANS TO MEET THOSE NEEDS HAVE CHANGED DUE TO NEW HEALTHCARE PROVIDERS, GRANTS, AND PROGRAMS. BINGHAM OFFERS A FINANCIAL ASSISTANCE PROGRAM AND ALSO PARTNERS WITH LOCAL AGENCIES TO ASSIST IN INFORMING THE PUBLIC REGARDING THE PROGRAMS AND SERVICES OFFERED TO THE COMMUNITY.

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 13B
CONSIDERATIONS ARE GIVEN TO INCOME LEVEL IN COMBINATION WITH OTHER LISTED FACTORS.

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 13H
CONSIDERATIONS ARE GIVEN TO MEDICAID/MEDICARE AND HOMELESS.

FACILITY 1, BINGHAM MEMORIAL HOSPITAL - PART V, LINE 16J
ABRIDGED BROCHURE WITH POLICY HIGHLIGHTS WAS MADE AVAILABLE IN THE ER, ADMISSIONS, AND PATIENT FINANCIAL SERVICES. DETAILS REGARDING THE FINANCIAL ASSISTANCE PROGRAM CAN BE FOUND ON OUR WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.BINGHAMMEMORIAL.ORG/BMH-SERVICES/FINANCIAL-SERVICES THE FAP APPLICATION CAN BE FOUND ON OUR WEBSITE AT THE FOLLOWING URL: BINGHAMMEMORIAL.ORG/UPLOADS/FINANCIAL%20STATEMENT%20APPLICATION%20FORM.PDF

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 3E
IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS BEGIN ON PAGE 33 OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE.

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 5
GCMC TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY SOLICITATING COMMENTS FROM KEY STAKEHOLDERS THROUGH AN ELECTRONIC SURVEY. KEY STAKEHOLDERS WERE FROM A DIVERSE GROUP OF COMMUNITY MEMBERS BASED ON THEIR SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, THEIR AFFILIATION WITH LOCAL GOVERNMENT, SCHOOLS AND INDUSTRY, OR THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS (SOCIAL SERVICE AND PUBLIC HEALTH AGENCIES, LOCAL SCHOOLS AND COMMUNITY COLLEGE, LOCAL CITY AND COUNTY GOVERNMENT, MEDICAL PROVIDERS, ETC.).

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 6B
THE HOSPITAL FACILITY'S CHNA WAS CONDUCTED WITH BKD,LLP.

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 11
ANALYSIS AND COMPARISONS OF THE PRIMARY (KEY STAKEHOLDER SURVEYS) AND SECONDARY (PUBLIC DATABASES) SOURCES OF DATA FACILITATED THE IDENTIFICATION OF HEALTH NEEDS IN GCMC'S SERVICE AREA. LOW HEALTH EDUCATION ATTAINMENT WAS IDENTIFIED AS A SIGNIFICANT HEALTH NEED. GCMC WAS NOT ABLE TO ADDRESS ALL HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA DUE TO BINGHAM MEMORIAL HOSPITAL AND OTHER LOCAL AGENCIES BETTER SUITED TO ADDRESS THOSE NEEDS IDENTIFIED. WE ARE CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW WE CAN BETTER SERVE OUR COMMUNITY BASED ON NEED. GCMC OFFERS A FINANCIAL ASSISTANCE PROGRAM AND ALSO PARTNERS WITH BINGHAM MEMORIAL HOSPITAL AND LOCAL AGENCIES TO ASSIST IN INFORMING THE PUBLIC REGARDING THE PROGRAMS AND SERVICES OFFERED TO THE COMMUNITY.

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 13B
CONSIDERATIONS ARE GIVEN TO INCOME LEVEL IN COMBINATION WITH OTHER LISTED FACTORS.

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 13H
CONSIDERATIONS ARE GIVEN TO MEDICAID/MEDICARE AND HOMELESS.

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 15E
CONSIDERATIONS ARE GIVEN TO INCOME LEVEL, MEDICAL INDIGENCE, INSURANCE STATUS, UNINSURED DISCOUNT, MEDICAID/MEDICARE, ASSET LEVEL, AND HOMELESSNESS.

FACILITY 2, GROVE CREEK MEDICAL CENTER - PART V, LINE 16J
ABRIDGED BROCHURE WITH POLICY HIGHLIGHTS WAS MADE AVAILABLE IN THE ER, ADMISSIONS, AND PATIENT FINANCIAL SERVICES. THE FAP APPLICATION FORM CAN BE FOUND ON THE WEBSITE AT THE FOLLOWING URL: BINGHAMMEMORIAL.ORG/UPLOADS/FINANCIAL%20STATEMENT%20APPLICATION%20FORM.PDF

Supplemental Information

Schedule H (Form 990) Part VI

SCHEDULE H, PART I, LINE 7
THE COSTING METHODOLOGY USED TO DETERMINE THE FINANCIAL ASSISTANCE IS THE COST TO CHARGE RATIO.

SCHEDULE H, PART III, LINE 2
THE COSTING METHODOLOGY USED TO DETERMINE BAD DEBT EXPENSE IS THE COST TO CHARGE RATIO.

SCHEDULE H, PART III, LINE 3
PATIENTS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE PROGRAM VIA APPOINTMENTS WITH PATIENT FINANCIAL COUNSELORS, CALLS WITH PATIENT FINANCIAL ADVOCATES AND BROCHURES AVAILABLE IN THE ADMISSION AND BUSINESS OFFICE AREAS OF THE HOSPITAL. EVEN THOUGH THERE ARE MULTIPLE AVENUES USED TO EDUCATE AND ASSIST PATIENTS IN APPLYING FOR THE FINANCIAL ASSISTANCE PROGRAM, SOME PATIENTS ARE RELUCTANT TO SPEND THE TIME GOING THROUGH THE QUALIFICATION PROCESS. THERE ARE ALSO THOSE PATIENTS THAT APPLY FOR THE PROGRAM BUT FAIL TO PROVIDE THE NECESSARY PAPERWORK TO SUPPORT THE APPLICATION. THIS PREVENTS ACCURATELY IDENTIFYING THEIR FINANCIAL NEEDS. MANY PATIENTS IN THE AREA HAVE A STEADY INCOME PROVIDED TO THEM BY THE GOVERNMENT AND HAVE NO NEED FOR A HEALTHY CREDIT SCORE. THERE ARE ALSO PATIENTS THAT ARE WELL ABOVE THE FINANCIAL GUIDELINES FOR FINANCIAL ASSISTANCE THAT ALLOW THEIR ACCOUNTS TO GO TO A BAD DEBT AGENCY. IN ADDITION, THERE ARE THOSE PATIENTS THAT DO NOT PLACE A HIGH IMPORTANCE ON PAYING MEDICAL BILLS AND BELIEVE THAT CREDITORS DO NOT FAULT THEM FOR HAVING MEDICAL BAD DEBT FOR THE ABOVE REASONS. IT IS ESTIMATED THAT THE PERCENTAGE OF THE BAD DEBT EXPENSE THAT WOULD QUALIFY AS CHARITY UNDER OUR FINANCIAL ASSISTANCE PROGRAM IS 25%.

SCHEDULE H, PART III, LINE 4
THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 3 ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 11 BEGINNING ON PAGE 22 OF THE AUDITED FINANCIAL STATEMENTS.

SCHEDULE H, PART III, LINE 8
THE SHORTFALL IN MEDICARE UNREIMBURSED COST SHOULD BE INCLUDED AS COMMUNITY BENEFIT AS SERVICES ARE RENDERED TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY AND/OR THE REIMBURSEMENT EXPECTED TO BE RECEIVED FROM MEDICARE, MEDICAID OR OTHER PAYERS. THE COSTING METHODOLOGY USED TO DETERMINE MEDICARE COSTS IS THE COST OF CHARGE RATIO. BINGHAM MEMORIAL IS DESIGNATED A CRITICAL ACCESS HOSPITAL AS SUCH, A PORTION OF ITS MEDICARE CHARGES IS PAID UNDER A COST BASED REIMBURSEMENT SYSTEM. ONLY THAT PORTION OF THE TOTAL MEDICARE REVENUE EARNED AND THE ASSOCIATED ALLOWABLE COSTS INCURRED BY THE ORGANIZATION IS REPORTED ON ITS MEDICARE COST REPORT. PER THE SCHEDULE H INSTRUCTIONS THE AMOUNTS REPORTED IN PART III LINES 5-7 ARE FROM OUR MEDICARE COST REPORT. THE RESULTANT SHORTFALL ON LINE 7 IS 447,472. THERE IS SIGNIFICANT DIFFERENCE, HOWEVER, BETWEEN OUR TOTAL MEDICARE PROGRAM SERVICES AND THE SUBSET OF THE TOTAL WHICH IS ACCOUNTED FOR ON THE COST REPORT. IN ORDER TO CLEARLY AND FULLY DESCRIBE THESE SERVICES, MANAGEMENT HAS MADE INTERNAL CALCULATIONS, WHICH TAKE INTO CONSIDERATION OUR MEDICARE SERVICES IN ITS ENTIRETY. BINGHAM MEMORIAL OPERATES 24 CLINICS (BOTH PRIMARY CARE AND SPECIALTY). BINGHAM HAS RECRUITED AND EMPLOYS 43 PHYSICIANS AND 13 MID-LEVEL PROFESSIONALS, PROVIDING VITAL CARE FOR OUR COMMUNITY'S CITIZENS. MUCH OF THESE ARE REIMBURSED USING FEE SCHEDULE RATES THAT ARE (IN THE AGGREGATE) BELOW THE COST OF PROVIDING THAT CARE. IN ORDER TO SUPPORT THE DELIVERY OF THESE HEALTH SERVICES, THE HOSPITAL INCURS OTHER ASSOCIATED COSTS, LIKE DIRECT SUPPORT STAFF, INFRASTRUCTURE, SUPPORTING DEPARTMENTS (ACCOUNTING, PATIENT FINANCIAL SERVICES, INFORMATION TECHNOLOGY, HUMAN RESOURCES, ETC) AND EXECUTIVE LEADERSHIP. IF NOT FOR TAX EXEMPT AND CRITICAL ACCESS HOSPITALS, SUCH AS BINGHAM MEMORIAL, ABSORBING THE DEFICIT ATTACHED TO PROVIDING THESE VITAL SERVICES TO MEDICARE RECIPIENTS, THE CENTERS FOR MEDICARE AND MEDICAID SERVICES WOULD BEAR THE FINANCIAL BURDEN OF THESE CITIZENS' CARE.

SCHEDULE H, PART III, LINE 9B
ONCE A PATIENT APPLIES FOR FINANCIAL ASSISTANCE, WE HOLD ALL COLLECTIONS EFFORTS UNTIL A DETERMINATION IS MADE. WE SEND THE PATIENT A LETTER NOTIFYING THEM OF APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE. APPROVED FINANCIAL ASSISTANCE IS GOOD FOR 3 MONTHS UNLESS FINANCIAL SITUATION HAS CHANGED, AND THEN A PATIENT MUST REAPPLY FOR ASSISTANCE. ANY NON-EMERGENCY SERVICES REQUIRE A NEW APPLICATION.

SCHEDULE H, PART VI, LINE 2
THE HOSPITAL'S DEPARTMENT OF PUBLIC RELATIONS UTILIZES A COMMUNITY SURVEY TO IDENTIFY THE HEALTHCARE NEEDS OF OUR COMMUNITY. SURVEYS ARE MAILED TO APPROXIMATELY 25% OF OUR COUNTY POPULATION. ON-SITE SURVEYS ARE ALSO DISTRIBUTED AT HOSPITAL EVENTS. SURVEYS ASK WHICH SERVICES AND EDUCATION PROGRAMS COMMUNITY MEMBERS ARE INTERESTED IN. THE RESULTS ARE SHARED WITH ADMINISTRATION, AFTER WHICH, COMMUNITY EVENTS AND OUTREACH EFFORTS ARE PLANNED ACCORDINGLY. THE HOSPITAL ALSO RECEIVES A VARIETY OF DIRECT REQUESTS FROM COMMUNITY ORGANIZATIONS AND MEMBERS TO PROVIDE SERVICES AND EDUCATION. EXAMPLES INCLUDE DISCOUNTED FLU CLINICS, DISCOUNTED LAB TESTING, FREE HEALTH EDUCATION CLASSES AND SEMINARS RELATED TO JOINT PAIN, ARTHRITIS PAIN, WEIGHT LOSS, AND BACK PAIN. WE PERFORM FREE PHYSICAL EXAMS FOR STUDENT ATHLETES, PLACE AN ATHLETIC TRAINER FREE OF CHARGE AT HIGH SCHOOL SPORTING EVENTS, AND PROVIDE FREE EXAMS FOR STUDENT ATHLETES INJURED AT A SPORTING EVENT. BY PROVIDING THESE SERVICES WITHIN OUR COMMUNITY WE ARE REDUCING TRAVEL COSTS FOR COMMUNITY MEMBERS. MANAGEMENT, HOSPITAL DEPARTMENT STAFF AND MANAGERS, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTPS://WWW.BINGHAMMEMORIAL.ORG/ABOUT-BMH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT HTTPS://GROVECREEKMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT

SCHEDULE H, PART VI, LINE 6
N/A

SCHEDULE H, PART VI, LINE 3
WE NOTIFY PATIENTS VERBALLY PRIOR TO ADMISSIONS VIA THE FRONT OFFICE, PATIENT FINANCIAL COUNSELOR OR ADMISSION CLERK. WHEN THEY PRESENT FOR SERVICES, WE SCREEN FOR INSURANCE COVERAGE AND, IF APPROPRIATE, WE GET THEM AN APPOINTMENT WITH A FINANCIAL COUNSELOR. AFTER THE SERVICES, WHEN WE CALL THEM FOR PAYMENTS, WE EXPLAIN THE PROCESS AGAIN TO ANY APPLICABLE PATIENTS. IF THEY ARE HAVING TROUBLE MEETING THEIR OBLIGATIONS, OR IF THEY EXPRESS NEED, WE SEND THEM OUT A LETTER EXPLAINING THE PROCESS AGAIN AND PROVIDE AN APPLICATION FOR THEIR COMPLETION. DETAILS REGARDING THE FINANCIAL ASSISTANCE PROGRAM CAN BE FOUND ON OUR WEBSITE AT THE FOLLOWING URL: HTTPS://WWW.BINGHAMMEMORIAL.ORG/BMH-SERVICES/FINANCIAL-SERVICES THE FAP APPLICATION CAN BE FOUND ON OUR WEBSITE AT THE FOLLOWING URL: BINGHAMMEMORIAL.ORG/UPLOADS/FINANCIAL%20STATEMENT%20APPLICATION%20FORM.PDF

SCHEDULE H, PART VI, LINE 4
BMH, INC. SERVES THE 45,000 RESIDENTS OF BINGHAM COUNTY WITH MEDICAL SERVICES. LOCATED BETWEEN THE FOURTH AND FIFTH LARGEST CITIES IN IDAHO, BINGHAM COUNTY INCORPORATES JUST OVER 2,000 SQUARE MILES. THE COUNTY POPULATION CONSISTS MOSTLY OF YOUNGER FAMILIES WITH CHILDREN WITH A MEDIAN AGE OF 30. THE COUNTY'S POPULATION AGE BREAKDOWN IS AS FOLLOWS: 32% AGE 0-18, 9% AGE 18-25, 12% AGE 25-35, 12% AGE 35-45, 11% AGE 45-55, 12% AGE 55-65, AND 13% OVER AGE 65. BINGHAM COUNTY'S RURAL COMMUNITIES HAVE OVER 5,800 UNINSURED INDIVIDUALS (12.8% OF POPULATION) AND IT IS ESTIMATED TO HAVE AN EVEN GREATER PERCENTAGE OF UNDERINSURED INDIVIDUALS. IN BINGHAM COUNTY'S AGRICULTURAL BASED ECONOMY, THE MEDIAN HOUSEHOLD INCOME, 20,720 (US CENSUS BUREAU 2013 -17), IS 33% LOWER THAN THE NATIONAL AVERAGE OF 31,177 (US CENSUS BUREAU 2013-17). ADDITIONALLY, BMH SERVES THE FORT HALL INDIAN RESERVATION AND ITS 3,000 INHABITANTS, AS WELL AS A NUMBER OF BANNOCK AND BONNEVILLE RESIDENTS.

SCHEDULE H, PART VI, LINE 5
HOSPITAL BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA AND DEDICATE TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF THE COMMUNITY. THE COMMUNITY BOARD STEERS THE ORGANIZATIONAL GOALS AND MISSION TOWARDS PROVIDING THE BEST HEALTHCARE FOR THE COMMUNITY. BINGHAM SUPPORTS A MULTITUDE OF PHYSICIAN SPECIALISTS IN THEIR EFFORTS TO PROVIDE CARE TO THE COMMUNITY ON A REGULAR SCHEDULE. WITH THIS ASSISTANCE, AND AN OPEN MEDICAL STAFF, NUMEROUS PHYSICIANS ARE ABLE TO PROVIDE OUR COMMUNITY WITH SPECIALIZED MEDICAL CARE, FROM NEUROLOGY TO PODIATRY. ANY SURPLUS FUNDS ARE REINVESTED INTO THE FACILITY, EQUIPMENT, AND EMPLOYEE EDUCATION ALLOWING THE HOSPITAL TO FOCUS ON MEETING THE HEALTH AND WELFARE NEEDS OF THE COMMUNITY. THE VARIOUS SEMINARS, CLASSES AND EVENTS WE PROVIDE TO THE COMMUNITY FREE OF CHARGE GIVES THE COMMUNITY OPPORTUNITIES TO EDUCATE THEMSELVES ABOUT SOME OF THE MAJOR HEALTH CONCERNS PEOPLE HAVE. COMMUNITY ACTIVITIES INCLUDE HEALTH FAIR, FREE FLU SHOT CLINICS, SKIN CANCER SCREENINGS, STUDENT ATHLETE PHYSICALS, AND NUMEROUS HEALTH, WELLNESS, AND EDUCATION ACTIVITIES TO PROMOTE HEALTH WITHIN THE COMMUNITY. IN ADDITION, OUR FINANCIAL ASSISTANCE POLICIES AND PROTOCOLS ALLOW THOSE COMMUNITY MEMBERS WHO MAY HAVE LESS ABILITY TO PAY RECEIVE THE MEDICAL ATTENTION THEY NEED TO LIVE A HEALTHY LIFE.