Community Benefit Insight - Tax-exempt hospital

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Touchette Regional Hospital

Touchette Regional Hospital

5900 Bond Street
Centreville, IL 62207

Bed count	109	Medicare provider number	140077	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 371305510

Display data for year:

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

10.23%

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	$ 2,501,656 3.36 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 5,110,471 6.87 %
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.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
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	$ 3,441,634 4.62 %
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	$ 818,466 23.78 %

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 $ 53257467 including grants of $ 0) (Revenue $ 50936809)
TOUCHETTE REGIONAL HOSPITAL PROVIDES CARE TO BOTH MEDICAID AND MEDICARE PATIENTS AT OR BELOW COST WHICH REPRESENTED 89% OF THE HOSPITAL'S DISCHARGES IN 2021. THE HOSPITAL ALSO PROVIDES SERVICES TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE OR FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES AS A PART OF ITS COMMUNITY BENEFITS. DURING 2021, THE HOSPITAL PROVIDED COMMUNITY BENEFITS OF APPROXIMATELY $6,900,000 WHICH CONSISTS OF THE COST OF CARE PROVIDED TO INDIGENT PATIENTS, SUBSIDIZED HEALTH SERVICES, UNCOMPENSATED COSTS OF GOVERNMENT SPONSORED INDIGENT HEALTH CARE AND OTHER FORGONE CHARGES AS WELL AS VARIOUS INITIATIVES. THESE COMMUNITY BENEFITS AMOUNT TO 9.3% OF THE HOSPITAL'S 2021 TOTAL COSTS.

4B (Expenses $ 6582384 including grants of $ 0) (Revenue $ 6295561)
THE PRIMARY MISSION OF TOUCHETTE REGIONAL HOSPITAL IS TO IMPROVE THE OVERALL HEALTH OF THE STATUS OF THE COMMUNITIES WE SERVE AS PART OF A COMPREHENSIVE NETWORK MEETING HEALTH NEEDS INCLUDING LIFESTYLE ISSUES, ENVIRONMENTAL ISSUES, EDUCATION, PREVENTION, PRIMARY CARE AND ALL OTHER ASPECTS OF HEALTHCARE. THE HOSPITAL ACCOMPLISHES THIS BY: A) SERVING AS PART OF A REGIONAL SAFETY NET HEALTHCARE SYSTEM BY PROVIDING ACCESS TO CARE FOR THE VULNERABLE POPULATION THAT HAVE LOW INCOME OR ARE EITHER UNINSURED OR UNDERINSURED; B) OPERATING AN EMERGENCY ROOM 24 HOURS EACH DAY OF THE YEAR FOR ALL PERSONS REGARDLESS OF ABILITY TO PAY; C) PARTICIPATING IN GOVERNMENT-SPONSORED HEALTHCARE PROGRAMS SUCH AS MEDICAID, MEDICARE, CHAMPUS AND TRICARE; D) PROVIDING STAFFING TO ASSIST PATIENTS IN APPLYING FOR CHARITY CARE BENEFITS AND FINANCIAL ASSISTANCE; AND E) REACHING BEYOND THE WALLS OF THE HOSPITAL AND OTHER FACILITIES WITH COMMUNITY BENEFIT INITIATIVES.DURING 2021, THE HOSPITAL CONTINUED ITS SAFETY NET ROLE IN BRINGING QUALITY HEALTH CARE TO THE UNDERSERVED COMMUNITIES BY PROVIDING 7,765 TOTAL PATIENT DAYS OF CARE, INCLUDING 6,120 BEHAVIORAL HEALTH DAYS, 20,017 OUTPATIENT VISITS, 5,379 HOME HEALTH ADMISSIONS AND 11,938 EMERGENCY ROOM VISITS.TOUCHETTE REGIONAL HOSPITAL HAS LONG BEEN AN ADVOCATE FOR THE NEEDS OF ITS PATIENTS. THE HOSPITAL WORKS HARD TO RAISE AWARENESS OF THE PROBLEM FACED BY POOR RESIDENTS IN UNDERSERVED COMMUNITIES WHO DO NOT HAVE ACCESS TO ADEQUATE HEALTH CARE PLANS.

4C (Expenses $ 1634272 including grants of $ 0) (Revenue $ 1204897)
SOUTHERN ILLINOIS HOME CARE DELIVERS SAFE AND SUPPORTIVE SERVICES RIGHT AT HOME TO RECOVERING, DISABLED, OR CHRONICALLY ILL PATIENTS IN MADISON, MONROE, AND ST. CLAIR COUNTIES. HOME CARE SERVICES ALLOW YOU OR YOUR LOVED ONE TO STAY IN THE COMFORT OF YOUR OWN HOME WHILE RECEIVING MEDICAL ATTENTION AND REHABILITATIVE SERVICES.AN INDIVIDUAL MAY RECEIVE A SINGLE TYPE OF HOME CARE SERVICE OR A COMBINATION OF SERVICES, DEPENDING ON THE COMPLEXITY OF THEIR NEEDS AND WHEN PRESCRIBED BY A PHYSICIAN. THOSE SERVICES INCLUDE: SKILLED NURSING, SOCIAL SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY.

Facility Information

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

TOUCHETTE REGIONAL HOSPITAL
PART V, SECTION B, LINE 5: TOUCHETTE REGIONAL HOSPITAL CONTINUES TO EMPLOY A COLLABORATIVE APPROACH TO ENSURE THE COMMUNITY HEALTH NEEDS ASSESSMENT IS COMPLETED THOROUGHLY. THEREFORE, WE REQUESTED INPUT FROM KEY STAKEHOLDERS IN THE COMMUNITY. STAKEHOLDER INPUT, ALONG WITH QUANTITATIVE DATA, WAS USED TO IDENTIFY PRIMARY COMMUNITY HEALTH NEEDS AND TO PRIORITIZE THESE ISSUES. THE EAST SIDE ALIGNED ROADMAP, EAST SIDE HEALTH DISTRICT NEEDS ASSESSMENT, AND ST. CLAIR COUNTY HEALTH DISTRICT INFORMATION WERE ALSO USED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT. EAST SIDE HEALTH DISTRICT'S POPULATION SERVED IS VIRTUALLY SYNONYMOUS WITH THE PRIMARY SERVICE AREA OF TOUCHETTE REGIONAL HOSPITAL. DATA ANALYSIS WAS PROVIDED BY PLANNING AND DEVELOPMENT STAFF AT THE LOCAL FEDERALLY QUALIFIED HEALTH CENTER (FQHC). THE FQHC IS RECOGNIZED FOR THEIR PROFICIENCY OF CONDUCTING SUCH ASSESSMENTS. FOR MANY YEARS, THE PLANNING AND DEVELOPMENT DEPARTMENT HAS COLLABORATED WITH SEVERAL LOCAL ORGANIZATIONS ASSISTING IN THE PERFORMANCE OF NEEDS ASSESSMENTS WITHIN THE COMMUNITY. THE FQHC IS ALSO NOTED FOR THEIR SUCCESS IN USING THESE ASSESSMENTS TO SECURE COMPETITIVE GRANT FUNDING FOR BOTH ONGOING AND NEW PROJECTS. ADDITIONALLY, EVERY THREE YEARS TOUCHETTE REGIONAL HOSPITAL HOSTS A COMMUNITY PARTNERS ROUND TABLE TO OBTAIN INPUT FOR THE COMMUNITY NEEDS ASSESSMENT. REPRESENTATIVES FROM AGENCIES THAT PROVIDE HEALTH AND SOCIAL SERVICES TO THE EAST ST. LOUIS AREA ARE INVITED TO PARTICIPATE. THE WORK BEING DONE IN THE COMMUNITY BY OTHER GROUPS AND INDIVIDUALS OFTEN REVEALS SIGNIFICANT NEEDS NOT ALWAYS OBSERVED BY THE HOSPITAL. THE PRIMARY GOAL OF THE MEETING IS TO GATHER INSIGHT AND PERSPECTIVES FROM THESE OUTSIDE RESOURCES. THE ROUNDTABLE PROVIDES A FORUM FOR KEY INFORMANTS AND HOSPITAL PERSONNEL TO EXPLORE AND IDENTIFY COMMUNITY HEALTH NEEDS. PARTICIPANTS IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INCLUDED A VARIETY OF GROUPS DEDICATED TO SERVING THE EAST ST. LOUIS POPULATION. THESE AGENCIES PROVIDE SERVICES IN AREAS OF HEALTHCARE, SOCIAL SERVICES, EDUCATION, AND MORE. FOR THE EAST ST. LOUIS COMMUNITY, THESE ARE IMPORTANT DETERMINANTS WHICH PLAY A SIGNIFICANT ROLE IN THE OVERALL QUALITY OF LIFE FOR THE POPULATION.AMONG THE STAKEHOLDERS, THERE WAS A GENERAL CONSENSUS OF AGREEMENT AROUND THE DATA REGARDING DEMOGRAPHICS, SOCIOECONOMIC FACTORS, AND HEALTH TRENDS. ADDITIONAL CONCERNS ABOUT PROBLEMS LIKELY CONTRIBUTING TO THE POOR HEALTH STATUS OF THE COMMUNITY WERE ALSO RAISED. DURING THE COMMUNITY ROUND TABLE, THE PARTIES PRESENT BRAINSTORMED DIFFERENT METHODS TO ADDRESS THESE HEALTH ISSUES. THE COMMUNITY AGENCIES PARTICIPATING IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS INCLUDE: HOYLETON MINISTRIES/PUENTES DE ESPERANZA, ST. CLAIR COUNTY MENTAL HEALTH BOARD, SIHF HEALTHCARE HEALTHY START INITIATIVE, WINDSOR HEALTH CENTER, CATHOLIC URBAN PROGRAMS, AND LESSIE BATES DAVIS NEIGHBORHOOD HOUSE.

TOUCHETTE REGIONAL HOSPITAL
PART V, SECTION B, LINE 11: 1) MENTAL HEALTH - TOUCHETTE REGIONAL HOSPITAL WILL ADDRESS ADULT AND YOUTH MENTAL HEALTH SERVICES. ADDITIONALLY, A CONTINUING FOCUS ON TRAUMA-INFORMED CARE WILL BE APPLIED DUE TO THE CONTINUED NEED FOR EDUCATION, TRAINING, AND SPECIFIED SERVICES RELATED TO THIS TOPIC. 2) SUBSTANCE USE DISORDERS - SUBSTANCE USE DISORDERS ARE OFTEN CATEGORIZED UNDER BEHAVIORAL HEALTH SERVICES. FOR THE 2020 COMMUNITY HEALTH NEEDS ASSESSMENT, THEY ARE PRIORITIZED UNDER A DISTINCT CATEGORY TO RECOGNIZE THE IMPACT THIS GROWING EPIDEMIC HAS ON THE HOSPITAL'S PRIMARY POPULATION. THE HOSPITAL ALSO RECOGNIZES THE LIKELIHOOD OF CO-OCCURRING MENTAL ILLNESS AND SUBSTANCE USE DISORDERS AND THE IMPORTANCE OF TRAUMA-INFORMED CARE WHEN TREATING BOTH. 3) CHRONIC DISEASES - CHRONIC DISEASES CAN BE SUCCESSFULLY CONTROLLED THROUGH DAILY MANAGEMENT ACTIVITIES SUCH AS MEDICATION MANAGEMENT, STEADY MONITORING OF APPROPRIATE MEASURES (I.E. GLUCOSE LEVELS FOR DIABETES PATIENTS), AND BEHAVIORAL MODIFICATIONS (I.E. BENEFITS OF ALTERING FOOD CONSUMPTION CHOICES BY OBESE INDIVIDUALS). AS PART OF THE 2020 COMMUNITY HEALTH NEEDS ASSESSMENT, TOUCHETTE REGIONAL HOSPITAL RECOGNIZES THAT FURTHER PATIENT EDUCATION ON CHRONIC DISEASES IS NECESSARY IF PATIENTS ARE EXPECTED TO UNDERSTAND AND APPLY DISEASE MANAGEMENT IN THEIR DAILY LIVES.4) SOCIAL DETERMINATS OF HEALTH - SOCIAL DETERMINANTS OF HEALTH DO NOT ADDRESS A SPECIFIC HEALTH ISSUE OR DISEASE, BUT RATHER ARE FACTORS THAT INFLUENCE THE OVERALL HEALTH OF THE PATIENT POPULATION. THE PRIMARY SERVICE AREA IS AFFECTED BY MANY OF THESE, INCLUDING POVERTY, FOOD INSECURITY, EDUCATIONAL ATTAINMENT, AFFORDABLE AND SAFE HOUSING, AND VIOLENCE AND CRIME. FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT, TOUCHETTE REGIONAL HOSPITAL RECOGNIZES THE SIGNIFICANT IMPACT ON THE PRIMARY PATIENT POPULATION OF SOCIAL DETERMINANTS OF HEALTH AND AIMS TO EXPLORE WAYS THE HOSPITAL CAN HAVE A SIGNIFICANT IMPACT IN THIS AREA. 5) COORDINATION OF SOCIAL SERVICES - BY COORDINATING SERVICES WITH OTHER AGENCIES IN THE COMMUNITY, TOUCHETTE REGIONAL HOSPITAL CAN PLAY AN IMPORTANT ROLE IN ENSURING PATIENTS CAN RECEIVE RESOURCES AFFECTING THEIR SOCIAL DETERMINANTS OF HEALTH. TOUCHETTE REGIONAL HOSPITAL RECOGNIZES THE IMPACT THAT SOCIAL DETERMINANTS HAVE ON PATIENTS' HEALTH AND THAT COORDINATION OF SOCIAL SERVICES CAN HAVE A SIGNIFICANT, POSITIVE IMPACT ON THE PRIMARY POPULATION'S HEALTH OUTCOMES.

PART V, SECTION B, LINE 22D
THE HOSPITAL FACILITY USES THE AVERAGE NEGOTIATED COMMERCIAL INSURANCE RATES FOR THEIR PRIMARY COMMERCIAL INSURANCE PAYORS.

SCHEDULE H, PART V, SECTION B, LINE 7A
THE HOSPITAL'S 2019 COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT:TOUCHETTE.ORG/MEDIA-LIBRARY/DOCUMENTS/TOUCHETTE_FILES/NEEDS_ASSESSMENT_BROCHURE.PDF

SCHEDULE H, PART V, SECTION B, LINE 10A
THE HOSPITAL'S 2019 IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTP://SIHF.ORG/MEDIA-LIBRARY/DOCUMENTS/NEEDS_ASSESSMENT_BROCHURE.PDF

SCHEDULE H, PART V, SECTION B, LINE 16A
THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT:HTTP://TOUCHETTE.ORG/MEDIA-LIBRARY/DOCUMENTS/BO1006_FAP_POLICY_(2018).PDF

SCHEDULE H, PART V, SECTION B, LINE 16B
THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND AT:HTTP://TOUCHETTE.ORG/MEDIA-LIBRARY/DOCUMENTS/TOUCHETTE_FILES/2016-FINANCIAL-ASSISTANCE-APP_ENGLISH.PDF

SCHEDULE H, PART V, SECTION B, LINE 16C
THE HOSPITAL'S PLAIN LANGUAGE SUMMARY OF ITS FAP CAN BE FOUND AT:HTTPS://TOUCHETTE.ORG/FINANCIAL-ASSISTANCE

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 7:
THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES INCLUDE OB, ER, PHYSICIAN CLINIC, HOME HEALTH AND BHU.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR THE PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,441,634. EVEN THOUGH THE IRS DOESN'T ALLOW SCHEDULE H, PART 1, LINE 7, COLUMN F TO BE A NEGATIVE PERCENTAGE, WE BELIEVE THAT REPORTING A NEGATIVE PERCENTAGE IN COLUMN F UNDERSTATES THE TRUE AMOUNT OF COMMUNITY BENEFIT/CHARITY CARE PROVIDED BY THE ORGANIZATION. FURTHERMORE, WE BELIEVE THAT COLUMN E, NET COMMUNITY BENEFIT EXPENSE, UNDERSTATES THE TRUE AMOUNT OF COMMUNITY BENEFIT EXPENSE.

PART III, LINE 3:
THE HOSPITAL UTILIZES PRESUMPTIVE CHARITY ELIGIBILITY HOWEVER BELIEVES THAT THE COMMUNITY BENEFIT OBTAINED FROM ITS CHARITY CARE IS UNDERSTATED DUE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT DO NOT APPLY OR PROVIDE INCOMPLETE INFORMATION. SOME CARE PROVIDED TO PATIENTS IS NOT CLASSIFIED AS CHARITY CARE DUE TO PATIENTS MISSING DOCUMENTATION THAT PROVES THEY QUALIFY FOR CHARITY CARE. THE HOSPITALS BAD DEBT DOES INCLUDE AMOUNTS THAT COULD BE CLASSIFIED AS CHARITY CARE IF THE PATIENTS WOULD APPLY OR PROVIDE THE APPROPRIATE INFORMATION TO COMPLETE THE CARE APPLICATION.

PART III, LINE 4:
THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THEIR HEALTH CARE EXPENSES AS DETERMINED BY THE HOSPITAL'S CRITERIA FOR FINANCIAL ASSISTANCE. IN SOME CASES, THE HOSPITAL DOES NOT RECEIVE THE AMOUNT BILLED FOR PATIENT SERVICES EVEN THOUGH IT DID NOT RECEIVE INFORMATION NECESSARY TO DETERMINE IF THE PATIENTS MET THE CRITERIA FOR FINANCIAL ASSISTANCE. BAD DEBTS EXPENSE IS THE ESTIMATED AMOUNT OF PATIENT REVENUE THAT THE HOSPITAL WILL NOT COLLECT.THE COSTING METHODOLOGY USED WAS THE RATIO OF PATIENT CARE COST-TO CHARGES, EXCEPT COST FOR THE MEDICARE PROGRAM WHICH IS OBTAINED FROM FILED COST REPORTS. NO BAD DEBT AMOUNTS WERE INCLUDED IN COMMUNITY BENEFIT. FOR PATIENTS WITH ONE OR MORE PAYOR SOURCES AND AFTER THE ACCOUNT IS FULLY ADJUDICATED BY THE PAYOR(S), WE ATTEMPT TO CONTACT THE PATIENT FOR 120 DAYS LISTING THE REMAINING AMOUNT DUE BY THE PATIENT. IF THE PATIENT DOES NOT RESPOND WITH 120 DAYS, THE ACCOUNT IS SENT TO COLLECTIONS FOR FURTHER FOLLOW-UP. IF THE PATIENT CANNOT BE CONTACTED OR IS UNRESPONSIVE, WE ADJUST THE ACCOUNT TO BAD DEBTS AFTER 120 DAYS. FOR PATIENTS WITHOUT A PAYOR SOURCE, WE NOTIFY THE PATIENT AT TIME OF REGISTRATION OUR CHARITY PROGRAM. IF THE PATIENT DOES NOT RESPOND WITH 90 DAYS, THE ACCOUNT IS SENT TO COLLECTIONS FOR FURTHER FOLLOW-UP AND THE CHARITY PROGRAM IS OFFERED AGAIN. IF THE PATIENT CANNOT BE CONTACTED OR IS UNRESPONSIVE, WE ADJUST THE ACCOUNT TO BAD DEBTS AFTER 120 DAYS.

PART III, LINE 8:
THE HOSPITAL'S OBJECTIVE IS TO PROVIDE COST EFFECTIVE CARE FOR ITS PATIENTS. THE MEDICARE PROGRAM, HOWEVER, DOES NOT PROVIDE PAYMENT THAT COVERS ALL OF THE COST OF THE CARE PROVIDED. MANAGEMENT ADVOCATES FOR IMPROVED MEDICARE PAYMENTS. THE HOSPITAL IS CONCERNED WITH THE COMMUNITY NEED AND WANTS TO BE SURE THAT QUALITY CARE TO THE PATIENTS IS NOT COMPROMISED. ALTHOUGH THE IRS DOES NOT CLASSIFY THE SHORTFALL OF MEDICARE REVENUE AS COMMUNITY BENEFIT, WE BELIEVE THAT IT IS IMPORTANT TO THE HEALTH OF THE COMMUNITY. EVEN IF WE ARE NOT PAID FOR IT WE BELIEVE THAT WE SHOULD PROVIDE QUALITY CARE TO ALL PATIENTS. THE COSTING METHODOLOGY USED WAS THE RATION OF PATIENT CARE COST-TO-CHARGES.

PART III, LINE 9B:
IF THE PATIENT WAS QUALIFIED FOR ANY PORTION OF CHARITY CARE AN ADJUSTMENT WILL BE MADE TO THE PATIENT'S ACCOUNT. IF THE PATIENT DID NOT QUALIFY FOR CHARITY AND DID NOT HAVE INSURANCE AT THE TIME, TOUCHETTE REGIONAL CHARGES WILL BE DISCOUNTED 30% PRIOR TO BILLING AND MAY BE ELIGIBLE FOR ADDITIONAL DISCOUNTS. ANY REMAINING BALANCE AFTER ALL CONSIDERATIONS BECOMES THE RESPONSIBILITY OF THE PATIENT.

PART VI, LINE 2:
TOUCHETTE REGIONAL HOSPITAL CONSIDERS THE COMMUNITY NEEDS EACH YEAR AS THE ORGANIZATION PERFORMS THEIR PLANNING/BUDGETING FOR THE NEXT YEAR. THIS PROCESS INCLUDES OBTAINING AND ANALYZING VARIOUS DATA AND MARKET DEMOGRAPHICS. THE DATA IS THEN SUPPLEMENTED WITH VIEWS AND CONCERNS FROM OUR COMMUNITY BOARD MEMBERS, OTHER COMMUNITY OUTREACH RELATIONSHIPS AND OTHER COMMON ORGANIZATIONS. ONE SUCH PROGRAM WHICH HAS BEEN DEVELOPED RECENTLY THROUGH THIS PROCESS IS THE BREAST AND CERVICAL CANCER PROGRAM WHERE THE COMMUNITY NEED BECAME APPARENT FOR THOSE THAT ARE UNINSURED. ALSO, THE BEHAVIORAL HEALTH SERVICES WERE EXPANDED. THE PLANNING FOR THIS WAS COMPLETED AND THE SERVICES WERE AWARDED A CON FOR IN 2014. CONSTRUCTION STARTED IN 2015 AND WAS COMPLETED DURING 2016.

PART VI, LINE 3:
UNINSURED PATIENTS AND PERSONS WHO SEEK AND/OR OBTAIN SERVICES FROM THE HOSPITAL, ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE VIA SIGNAGE THROUGHOUT THE PATIENT ACCESS AREAS OF THE FACILITY, BROCHURES, ADMISSION PACKETS, DISCLOSURE ON THE PATIENT BILL, IN PERSON AND TELEPHONE ASSISTED CUSTOMER SERVICE, AS WELL AS INFORMATION SUCH AS THE GUIDELINES AND APPLICATION BEING PREDOMINATELY POSTED ON THE HOSPITAL WEBSITE.

PART VI, LINE 4:
THE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF THE ILLINOIS ZIP CODES OF 62201-62207 AND THE CITIES WITHIN THESE ZIP CODES SUCH AS EAST ST. LOUIS, FAIRMOUNT CITY, CENTREVILLE, WASHINGTON PARK, CAHOKIA, SAUGET AND ALORTON. THESE COMMUNITIES ARE MEDICALLY VULNERABLE AND HAVE A LARGE INDIGENT POPULATION.

PART VI, LINE 5:
DESIGNATED AS A DISPROPORTIONATE SHARE HOSPITAL, THE HOSPITAL USES ANY LIMITED SURPLUS FUNDS TO FURTHER ITS EXEMPT PURPOSE BY PROVIDING PROGRAMS AND ACCESS AS NOTED IN FORM 990, PART III, LINE 1 AND 4A AND CONTINUED ON SCHEDULE O. THE BOARD OF DIRECTORS IS MADE UP FROM COMMUNITY LEADERS WITHIN ITS PRIMARY SERVICE AREA THAT ARE APPOINTED BY THE MEMBER ORGANIZATION.

PART VI, LINE 6:
"THE HOSPITAL IS PART OF A COMPREHENSIVE SAFETY NET NETWORK THAT INCLUDES SOUTHERN ILLINOIS HEALTHCARE FOUNDATION, ITS SOLE MEMBER, WHICH PROVIDES HEALTH AND SUPPORTIVE SERVICE TO THE COMMUNITIES THEY SERVE. MANY OF THE BENEFITS PROVIDED ARE REPORTED TO THE STATE OF ILLINOIS WITHIN THE ""ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT""."

PART VI, LINE 7, REPORTS FILED WITH STATES
IL

Operating expenses	$ 74,416,537
Total amount spent on community benefits as % of operating expenses	$ 7,612,127 10.23 %