4A (Expenses $ 433413692 including grants of $ 254139) (Revenue $ 541550608)
THE MISSION OF REID HOSPITAL AND HEALTH CARE SERVICES, INC. IS TO SERVE THE PEOPLE OF A MULTI-COUNTY SERVICE AREA IN REFERENCE TO THEIR CURRENT AND FUTURE NEEDS FOR HEALTH CARE SERVICES. IN FURTHERANCE OF THIS MISSION, REID HOSPITAL AND HEALTH CARE SERVICES, INC. PROVIDES QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. DURING 2021, REID HOSPITAL AND HEALTH CARE SERVICES, INC. ADMITTED APPROXIMATELY 14,338 PATIENTS FOR IN-PATIENT SERVICES REPRESENTING 66,635 PATIENT DAYS; 703 BIRTHS REPRESENTING 1,445 NEWBORN PATIENT DAYS AND PERFORMED APPROXIMATELY 1,543 IN-PATIENT SURGERIES. IN ADDITION, REID HOSPITAL AND HEALTH CARE SERVICES, INC. RECEIVED 317,304 OUT-PATIENT ENCOUNTERS FOR NON-EMERGENCY DIAGNOSTIC AND TREATMENT SERVICES INCLUDING 9,534 AMBULATORY SURGERIES AND 15,490 HOME HEALTH ENCOUNTERS. REID HOSPITAL AND HEALTH CARE SERVICES, INC. OFFERS EMERGENCY SERVICES 24 HOURS PER DAY, 365 DAYS EACH YEAR. IN 2021, 52,505 PATIENTS WERE TREATED THROUGH EMERGENCY SERVICES. IN KEEPING WITH REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S COMMITMENT TO SERVE ALL MEMBERS OF OUR MULTI-COUNTY SERVICE AREA, REID HOSPITAL AND HEALTH CARE SERVICES, INC. PROVIDES HEALTHCARE TO THE ELDERLY AND DISABLED COVERED UNDER MEDICARE AND MEDICAID PROGRAMS AT OR BELOW COST. IN ADDITION, REID HOSPITAL AND HEALTH CARE SERVICES, INC. HAS ESTABLISHED A FINANCIAL ASSISTANCE POLICY FOR THE POOR WHO DO NOT HAVE THE MEANS TO PAY FOR SERVICES. FOR 2021, THE TOTAL VALUE OF UNCOMPENSATED CARE AT COST FOR THE ELDERLY AND DISABLED WAS $3.9 MILLION AND FINANCIAL ASSISTANCE FOR THE POOR WAS $5.2 MILLION. TO ENSURE MEMBERS OF OUR SERVICE COMMUNITY HAVE ADEQUATE ACCESS AND RESOURCES AVAILABLE TO MEET THEIR HEALTHCARE NEEDS, REID HOSPITAL AND HEALTH CARE SERVICES, INC. HAS UNDERTAKEN A DELIBERATE PHYSICIAN RECRUITMENT PROGRAM CONSISTENT WITH IRS GUIDANCE. THIS PROGRAM PROVIDES ASSURANCE THAT OUR SERVICE COMMUNITY HAS ADEQUATE AND QUALIFIED PHYSICIAN RESOURCES COVERING VARIETY OF SPECIALTY AREAS. THE COST OF FUNDING THIS RECRUITMENT EFFORT WAS $988,624 FOR 2021. IN ADDITION, REID HOSPITAL AND HEALTHCARE SERVICES, INC. IS COMMITTED TO INITIATING, PARTICIPATING IN, OR COOPERATIVELY SUPPORTING COMMUNITY EFFORTS THAT ENHANCE THE GENERAL HEALTH STATUS, WELL-BEING AND TOTAL QUALITY OF LIFE IN OUR SERVICE COMMUNITY.

SCHEDULE H, PART V, SECTION B, LINE 5
CHNA COMMUNITY INPUT COMMUNITY INPUT WAS COLLECTED VIA AN ENGLISH LANGUAGE COMMUNITY SURVEY, KEY INFORMANT INTERVIEWS, AND FOCUS GROUPS. COMMUNITY SURVEY ONE FORM OF COMMUNITY INPUT COLLECTED WAS VIA AN ONLINE ENGLISH LANGUAGE COMMUNITY SURVEY. SURVEY MONKEY WAS THE TOOL USED TO DISTRIBUTE AND COLLECT RESPONSES FOR THE COMMUNITY SURVEY. PAPER SURVEYS WERE ALSO MADE AVAILABLE. ANSWERS TO THE PAPER SURVEY WERE INPUT INTO THE SURVEY MONKEY TOOL. THE COMMUNITY SURVEY WAS DISTRIBUTED ACROSS REID HEALTH'S ENTIRE SERVICE AREA FROM APRIL 10, 2019 TO MAY 20, 2019. A TOTAL OF 1,168 RESPONSES WERE COLLECTED. RESULTS IN THIS REPORT ARE BASED ON THE EIGHT COUNTIES THAT COMPRISE REID HEALTH'S SERVICE AREA. THIS WAS A CONVENIENCE SAMPLE, WHICH MEANS RESULTS MAY BE VULNERABLE TO SELECTION BIAS AND MAKE THE FINDINGS LESS GENERALIZABLE. ANOTHER LIMITATION TO THE SURVEY IS THAT IT WAS CONDUCTED ONLY IN ENGLISH. OUT OF THE 1,168 RESPONDENTS, 88.9% WERE FEMALE AND 10.86% WERE MALE. THEY WERE COMPRISED OF 73.16% HEALTH PROFESSIONALS. FOCUS GROUPS ANOTHER FORM OF COMMUNITY INPUT WAS COLLECTED VIA FIVE FOCUS GROUPS WITH THIRTY-THREE PARTICIPANTS TOTAL. THESE FOCUS GROUPS WERE HELD BETWEEN APRIL 29, 2019 AND MAY 2, 2019. THE FOCUS GROUP DISCUSSIONS LASTED BETWEEN 60-90 MINUTES IN LENGTH. THREE OF THE FIVE FOCUS GROUPS WERE HELD AT REID HEALTH. TWO ADDITIONAL FOCUS GROUPS WERE HELD IN THE COMMUNITIES OF CONNERSVILLE, INDIANA (FAYETTE COUNTY) AND EATON, OHIO (PREBLE COUNTY). DURING THE FOCUS GROUP DISCUSSIONS, QUESTIONS WERE ASKED TO LEARN MORE ABOUT THE COMMUNITY'S OVERALL HEALTH STATUS, HEALTH NEEDS, BARRIERS TO HEALTH, AND AVAILABLE COMMUNITY RESOURCES. NOTES FROM THE FOCUS GROUP DISCUSSIONS WERE TRANSCRIBED AND UPLOADED TO THE WEB-BASED QUALITATIVE DATA ANALYSIS TOOL, DEDOOSE. EXCERPTS WERE CODED BY RELEVANT TOPIC AREAS AND KEY HEALTH THEMES. THE FREQUENCY WITH WHICH A HEALTH TOPIC WAS DISCUSSED WAS USED TO ASSESS THE RELATIVE IMPORTANCE OF THAT HEALTH AND/OR SOCIAL NEED TO DETERMINE THE MOST PRESSING HEALTH NEEDS OF THE COMMUNITY. KEY INFORMANT INTERVIEWS HCI CONSULTANTS CONDUCTED KEY INFORMANT INTERVIEWS VIA A QUESTIONNAIRE IN ORDER TO COLLECT COMMUNITY INPUT. INTERVIEWEES WHO WERE ASKED TO PARTICIPATE WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS AND/OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL, AND/OR COULD SPEAK TO THE NEEDS OF MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS. FOURTEEN INDIVIDUALS AGREED TO PARTICIPATE AS KEY INFORMANTS. THE FOURTEEN KEY INFORMANT INTERVIEWS WERE HELD BETWEEN APRIL 11, 2019 AND MAY 17, 2019 VIA AN EMAIL QUESTIONNAIRE. THE QUESTIONNAIRE SOUGHT TO GAIN INFORMATION ABOUT THE INTERVIEWEE'S BACKGROUND AND ORGANIZATION, HEALTH NEEDS AND BARRIERS OF CONCERN IN THE COMMUNITY, AS WELL AS THE IMPACT OF HEALTH ISSUES ON VULNERABLE POPULATIONS.

SCHEDULE H, PART V, SECTION B, LINE 11
COMMUNITY HEALTH NEEDS THE FOLLOWING COMMUNITY HEALTH NEEDS, IDENTIFIED IN REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT, WERE ADDRESSED IN AN IMPLEMENTATION STRATEGY TO ADDRESS EACH COMMUNITY HEALTH NEED IDENTIFIED AND EXECUTING THE STRATEGY. A COMMUNITY BENEFIT SECTION IS INCLUDED WITHIN OPERATIONAL PLANS AND MONITORED BY THE CONTINUUM OF CARE COMMITTEE. PROVISIONS ARE BUDGETED EACH YEAR FOR SERVICES THAT ADDRESS THE IDENTIFIED NEEDS. THROUGH AN ANALYSIS OF THE PRIMARY AND SECONDARY DATA THE FOLLOWING TOP HEALTH NEEDS WERE DETERMINED: - ACCESS TO HEALTH SERVICES - CANCER - DIABETES - ECONOMY - EDUCATION - EXERCISE, NUTRITION AND WEIGHT - HEART DISEASE AND STROKE - MENTAL HEALTH AND MENTAL DISORDERS - OLDER ADULTS AND AGING - SUBSTANCE ABUSE - TRANSPORTATION ON JUNE 17, 2019, REID HEALTH'S COMMUNITY BENEFIT TEAM, OTHER MEMBERS FROM VARIOUS DEPARTMENTS IN THE HOSPITAL, AND REPRESENTATIVE MEMBERS OF THE COMMUNITY CAME TOGETHER TO PRIORITIZE THE SIGNIFICANT HEALTH NEEDS IN A SESSION LED BY CONSULTANTS FROM HEALTHY COMMUNITIES INSTITUTE. WHILE CONSIDERING SEVERAL PRIORITIZATION CRITERIA, THE FOLLOWING THREE TOPICS WERE IDENTIFIED AS PRIORITIES TO ADDRESS: - MENTAL HEALTH AND SUBSTANCE MISUSE - PHYSICAL ACTIVITY, NUTRITION AND WEIGHT - ADVERSE CHILDHOOD EXPERIENCES MENTAL HEALTH AND SUBSTANCE MISUSE GOAL PROMOTE MENTAL, EMOTIONAL, AND BEHAVIORAL WELL-BEING WITHIN THE COMMUNITIES WE SERVE BY IMPROVING MENTAL HEALTH AND REDUCING SUBSTANCE MISUSE. OBJECTIVES 1. IMPROVE OVERALL MENTAL HEALTH WITHIN THE COMMUNITY 2. REDUCE THE INCIDENCE AND COMPLICATIONS OF SUBSTANCE MISUSE INDICATORS 1. AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS 2. AGE-ADJUSTED DEATH RATE DUE TO SUICIDE 3. CHILD ABUSE RATE DEATH RATE DUE TO DRUG POISONING 4. MOTHERS WHO SMOKE DURING PREGNANCY 5. ADULTS WHO SMOKE 6. NON-FATAL ED VISITS DUE TO OPIOID OVERDOSE STRATEGIES 1. INITIATIVES - REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH AND SUBSTANCE MISUSE. - INCREASE ACCESS TO MENTAL HEALTH AND ADDICTION SERVICES - DEVELOP AND PARTNER WITH PROGRAMS THAT BUILD FAMILY SUPPORT - BUILD A STRONGER SENSE OF COMMUNITY SUPPORT SURROUNDING MENTAL HEALTH AND SUBSTANCE MISUSE 2. NEW TACTICS - COMMUNITY PLEDGE - COMMUNITY EDUCATION - INDIANA RECOVERY COUNCIL MESSAGING - FINANCIAL SUPPORT - PROMOTE CURRENT SERVICES AVAILABLE - DEVELOP HOSPITAL-ENTRY REFERRAL PROGRAM - WORKPLACE RECOVERY PROGRAMS - IDENTIFY WAYS TO ATTRACT PROVIDERS - IMPLEMENT A COMMUNITY SCREENING TOOL - SCHOOL PARTNERSHIPS - GRANDPARENT SUPPORT - HOME VISITING PROGRAMS - PREVENTION EDUCATION - COMMUNITY EVENTS - ORGANIZATIONAL COLLABORATION 3. CONTINUING TACTICS - OVERDOSE AWARENESS DAY - JACY HOUSE SUPPORT - DEPRESSION SCREENINGS - PSYCHIATRIC CARE - NARCAN PROGRAM - NEONATAL ABSTINENCE PROGRAM - DEPO-PROVERA PROGRAM - MATERNAL TREATMENT PROGRAM - MEDICATION ASSISTED TREATMENT - SUPPORT FOR DRUG FREE WAYNE COUNTY PARTNERSHIP - SUPPORT FOR REACH ALL RANDOLPH COUNTY - PROGRAMMATIC SUPPORT FOR SYRINGE EXCHANGE PROGRAMS - SUPPORT GROUPS PHYSICAL ACTIVITY, NUTRITION AND WEIGHT GOAL IMPROVE THE HEALTH OF THE COMMUNITY BY ENCOURAGING HEALTHY CHOICES AND REDUCING THE DISPARITIES RELATED TO ACTIVITY AND NUTRITION. OBJECTIVES 1. INCREASE PHYSICAL ACTIVITY AND REDUCE OBESITY 2. INCREASE THE AVAILABILITY OF HEALTHY FOODS WITHIN THE COMMUNITY INDICATORS 1. ACCESS TO EXERCISE OPPORTUNITIES 2. ADULTS 20+ WHO ARE OBESE 3. ADULTS 20+ WHO ARE SEDENTARY 4. CHILD FOOD INSECURITY RATE 5. FOOD INSECURITY RATE STRATEGIES 1. INITIATIVES - INCREASE ACCESS TO FRESH AND NUTRITIOUS FOODS - PROMOTE CURRENT RESOURCES AND PROGRAMS WHICH SUPPORT PHYSICAL ACTIVITY, NUTRITION AND WEIGHT - HOST COMMUNITY CLASSES FOR ALL AGES AND ABILITIES IN A VARIETY OF LOCATIONS - ENCOURAGE ORGANIZATIONAL PARTNERSHIPS TO SUPPORT PHYSICAL ACTIVITY, NUTRITION AND WEIGHT 2. NEW TACTICS - COMMUNITY GARDENS - MOBILE MARKETS - ENCOURAGE PARTNERSHIPS WITH GROCERY STORES - EMERGENCY FOOD FOR CHILDREN - ONLINE SUPPORT - INCENTIVIZE HEALTHY OPTIONS - INCREASE AWARENESS OF OPTIONS FOR PHYSICAL ACTIVITY - AFFORDABLE FITNESS OPPORTUNITIES - COOKING CLASSES IN THE COMMUNITY - COMMUNITY CHALLENGES - PORTION SIZE EDUCATION - INCENTIVIZE HEALTHY OPTIONS AMONG BUSINESSES - WORKPLACE FITNESS OPPORTUNITIES AND CHALLENGES - IMPROVED WALK-ABILITY/BIKE-ABILITY - SCHOOL-BASED PROGRAMS 3. CONTINUING TACTICS - LACTATION/BREASTFEEDING SUPPORT - FARMER'S MARKET SUPPORT - SUBSIDIZED SUMMER MEALS - MEALS FOR 3RD GRADE ACADEMY - ROCK SOLID MEALS - ALED/HEED CLASSES - DIABETES SUPPORT GROUP - CAMBRIDGE CITY PHYSICAL ACTIVITY CAMP - HEALTHY COOKING CLASSES - FITNESS CLASSES - REID HEALTHIER COMMUNITY DAY - REID RIDE - BABY BOOMERS FIGHT CLUB - HEALTHWORKS - WAYNE COUNTY FOOD COUNCIL - REID HEALTHIER CLUB - CITY FIT PARTICIPATION - FOOD RESCUE PROGRAM - ANGEL WISH BAGS - CIRCLE U HOLIDAY MEAL SUPPORT ADVERSE CHILDHOOD EXPERIENCES GOAL IMPROVE THE HEALTH OF THE COMMUNITY BY PREVENTING ADVERSE CHILDHOOD EXPERIENCES (ACES) AND REDUCING THE IMPACT OF ACES. OBJECTIVES 1. INCREASE COMMUNITY AWARENESS OF ACES AND POTENTIAL RISK 2. BUILD RESILIENCE AMONG YOUTH AND ADULTS IN OUR COMMUNITIES INDICATORS 1. DEATH RATE DUE TO DRUG POISONING 2. NON-FATAL ED VISITS DUE TO OPIOID OVERDOSE 3. CHILD ABUSE RATE 4. CHILD FOOD INSECURITY RATE 5. VIOLENT CRIME RATE 6. SINGLE PARENT HOUSEHOLDS 7. AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS 8. AGE-ADJUSTED DEATH RATE DUE TO SUICIDE 9. TEEN PREGNANCY RATE 10. CHILDREN LIVING BELOW POVERTY 11. FAMILIES LIVING BELOW POVERTY STRATEGIES 1. INITIATIVES - CONDUCT AN ACES AWARENESS CAMPAIGN - PROVIDE COMMUNITY-BASED TRAINING ON ACES - DEVELOP AN ACES TASK FORCE - IMPLEMENT PARENT CAFES - EXPAND EXISTING PROGRAMS THAT SUPPORT RESILIENCE 2. NEW TACTICS - HIGHLIGHT REAL STORIES OF PEOPLE WITH ACES - OVERALL MEDIA CAMPAIGN - ACES SCREENINGS - SOCIAL MEDIA CAMPAIGN - COMMUNITY SHOWINGS OF ACE RELATED FILMS - EDUCATION TO ALL PUBLIC SECTORS - EDUCATE ON IMPACT OF ACES - INCLUDE REPRESENTATION FROM ALL PUBLIC SECTORS - STRENGTHEN WORKFORCE PROGRAMS - PROMOTE SCHOOL RELATIONSHIPS WITH CMHCS - INITIATE TRAINING FOR PARENT CAFES - HOST PARENT CAFES WITH COMMUNITY PARTNERS - EDUCATE PARENTS - SUPPORT FOR TEEN PARENTS - FORMAL FOLLOW UP FOR CHALLENGE DAY - MENTORING PROGRAMS - HOME VISIT PROGRAMS 3. CONTINUING TACTICS - TRANSITION WTHR REID LEADS CAMPAIGN TO FOCUS ON ACES - SUPPORT FOR JACY HOUSE - WAYNE COUNTY FOOD COUNCIL SUPPORT - DRUG FREE WAYNE COUNTY SUPPORT - REACH ALL RANDOLPH COUNTY SUPPORT - PARENT CAFE EDUCATION AND SUPPLIES - CHALLENGE DAY - SUPPORT FOR FOOD INSECURITY PROGRAMS - MATERNAL TREATMENT PROGRAM - NARCAN PROGRAM - OVERDOSE AWARENESS DAY - NEONATAL ABSTINENCE PROGRAM - SUPPORT FOR SYRINGE EXCHANGE PROGRAMS - DEPO-PROVERA PROGRAM SIGNIFICANT HEALTH NEEDS NOT ADDRESSED IN AN EFFORT TO MAKE IMPROVEMENTS IN THE PRIORITIZED AREAS OF COMMUNITY HEALTH NEEDS, THERE ARE OTHER SIGNIFICANT NEEDS WHICH REID HEALTH WILL NOT ADDRESS THROUGH THE IMPLEMENTATION PLAN DUE TO RESOURCE CONSTRAINTS OR SCOPE OF SERVICES. THOSE INCLUDE THE FOLLOWING: 1. OLDER ADULTS & AGING 2. ECONOMY 3. DIABETES 4. ACCESS TO CARE 5. TRANSPORTATION 6. HEART DISEASE & STROKE 7. CANCER 8. LOW INCOME & UNDERSERVED

SCHEDULE H, PART III, SECTION A, LINE 2
BAD DEBT EXPENSE THE AMOUNT REPORTED ON PART III, LINE 2 IS CALCULATED BASED ON TOTAL BAD DEBT EXPENSE BASED ON CHARGES.

SCHEDULE H, PART III, SECTION A, LINE 3
BAD DEBT EXPENSE AN ALLOCATION PERCENTAGE WAS CALCULATED USING FY2021 BAD DEBT EXPENSE AND BAD DEBT ATTRIBUTED TO PATIENTS UNDER THE FINANCIAL ASSISTANCE POLICY. THIS PERCENTAGE WAS THEN APPLIED TO FY2021 BAD DEBT EXPENSE TO CALCULATE THE AMOUNT REPORTED ON LINE 3.

SCHEDULE H, PART III, SECTION A, LINE 4
BAD DEBT EXPENSE REID HOSPITAL AND HEALTH CARE SERVICES, INC. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, REID HOSPITAL AND HEALTH CARE SERVICES, INC. ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, REID HOSPITAL AND HEALTH CARE SERVICES, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), REID HOSPITAL AND HEALTH CARE SERVICES, INC. RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

SCHEDULE H, PART III, SECTION B, LINE 8
MEDICARE REID HOSPITAL AND HEALTH CARE SERVICES, INC. BELIEVES THAT ANY MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT BECAUSE OUR MISSION IS TO PROMOTE QUALITY HEALTHCARE AND HEALTH EDUCATION IN OUR SERVICE COMMUNITY REGARDLESS OF ONE'S ABILITY TO PAY. WE DO NOT LIMIT THE CARE AVAILABLE TO ANY PATIENTS, INCLUDING THOSE COVERED UNDER THE MEDICARE PROGRAM. WE ARE RELIEVING A GOVERNMENT BURDEN BY PROVIDING CARE TO MEDICARE PATIENTS BELOW COST. TAX-EXEMPT HOSPITALS ARE EXPECTED TO PARTICIPATE IN THE MEDICARE PROGRAM.

SCHEDULE H, PART III, SECTION C, LINE 9B
COLLECTION PRACTICES ANY INDICATION OF A PATIENTS INABILITY TO PAY FOR SERVICES IS TREATED AS A REQUEST FOR CHARITY CARE. THIS REQUEST CAN BE MADE BY, OR ON BEHALF OF AN INDIVIDUAL SEEKING SERVICE. REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE ANY COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK TO A COUNSELOR FOR ASSISTANCE AND REVIEW.

SCHEDULE H, PART VI, LINE 2
NEEDS ASSESSMENT A NEEDS ASSESSMENT IS CONDUCTED EVERY 3 YEARS IN ACCORDANCE WITH STATE AND FEDERAL REQUIREMENTS. THE LAST NEEDS ASSESSMENT OF REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S SERVICE AREA WAS CONDUCTED IN 2019. THE RESULTS OF THE NEEDS ASSESSMENT ARE POSTED ON REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S WEBSITE SO THAT COMMUNITY MEMBERS AND ORGANIZATIONS MAY USE THE INFORMATION AS NEEDED. FORMAL AND INFORMAL MEETINGS ARE WITH COMMUNITY STAKEHOLDERS TO SEEK THEIR INPUT ON THE RESULTS. HEALTHY COMMUNITIES INSTITUTE CONDUCTED THE NEEDS ASSESSMENT AND PROVIDED A COMPARISON TO THE 2016 NEEDS ASSESSMENT RESULTS. THE NEXT NEEDS ASSESSMENT WILL BE CONDUCTED IN 2022 AND WILL COMPLY WITH ALL REQUIREMENTS FOR COMMUNITY HEALTH NEEDS ASSESSMENTS UNDER THE AFFORDABLE CARE ACT AND CORRESPONDING REGULATIONS. IN ADDITION, ALL INDEPENDENT AND NON-INDEPENDENT VOTING MEMBERS OF THE BOARD ARE REQUIRED TO RESIDE WITHIN REID HOSPITAL AND HEALTH CARE SERVICES, INC.'S SERVICE AREA. THE DISTINCTION IS IMPORTANT BECAUSE THEY ARE INVOLVED AND BETTER AWARE OF THE HEALTH NEEDS OF THE COMMUNITY REID HOSPITAL AND HEALTH CARE SERVICES, INC. SERVES.

SCHEDULE H, PART VI, LINE 3
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE REID HOSPITAL AND HEALTH CARE SERVICES, INC. STAFF INFORMS ALL PATIENTS, AS THEY ARE ADMITTED, OF THE VARIOUS ASSISTANCE PROGRAMS AVAILABLE TO HELP THEM PAY THEIR BILL. WE HAVE COMMUNITY EDUCATION INITIATIVES (THAT INCLUDE THE DISTRIBUTION OF FLYERS AND CARDS IN PUBLIC PLACES, INSERTS IN BILLS, AND FLYERS FOR CHURCHES THAT PROMOTE THE PATIENT ADVOCATE PROGRAM) ASKING PEOPLE TO CONTACT A PATIENT ADVOCATE IF THEY, OR A LOVED ONE, DOES NOT HAVE HEALTH COVERAGE. REID HOSPITAL AND HEALTH CARE SERVICES, INC. USES TARGETED ADVERTISEMENTS IN AN EFFORT TO REACH PEOPLE BEFORE THEY ARE IN NEED OF CARE AND TO CONNECT THEM WITH OUR PATIENT ADVOCATES TO HELP DETERMINE ELIGIBILITY FOR INSURANCE COVERAGE. WE HAVE CONTRACTED WITH A THIRD PARTY VENDOR THAT SPECIALIZES IN HELPING PEOPLE WITH THE APPLICATION PROCESS FOR VARIOUS PROGRAMS. IN ADDITION, WE PROVIDE INFORMATION ABOUT FINANCIAL ASSISTANCE IN OUR MONTHLY STATEMENTS. WE CURRENTLY PROMOTE FREE SCREENING SERVICES DIRECTED TO SELF PAY PATIENTS. THOSE WHO RESPOND MAKE AN APPOINTMENT WITH OUR PATIENT ADVOCATES THEN RECEIVE THEIR FREE WELLNESS LAB TEST.

SCHEDULE H, PART VI, LINE 7
STATE FILING OF COMMUNITY BENEFIT REPORT INDIANA

SCHEDULE H, PART VI, LINE 4
COMMUNITY INFORMATION REID HOSPITAL AND HEALTH CARE SERVICES, INC. SERVES FIVE (5) COUNTIES IN INDIANA (WAYNE, UNION, RANDOLPH, HENRY, AND FAYETTE) AND TWO (2) COUNTIES IN OHIO (PREBLE AND DARKE)(SERVICE AREA). THE DEMOGRAPHICS OF A COMMUNITY SIGNIFICANTLY IMPACT ITS HEALTH PROFILE. DIFFERENT RACE/ETHNIC, AGE, AND SOCIOECONOMIC GROUPS MAY HAVE UNIQUE NEEDS AND REQUIRE VARIED APPROACHES TO HEALTH IMPROVEMENT EFFORTS. ALL DEMOGRAPHIC ESTIMATES ARE SOURCED FROM THE U.S. CENSUS BUREAU'S 2013-2017 AMERICAN COMMUNITY SURVEY UNLESS OTHERWISE INDICATED. POPULATION ACCORDING TO THE U.S. CENSUS BUREAU'S 2013-2017 AMERICAN COMMUNITY SURVEY, THE SERVICE AREA HAD A POPULATION OF APPROXIMATELY 285,267. REID HOSPITAL AND HEALTH CARE SERVICES, INC. IS GEOGRAPHICALLY LOCATED IN THE CENTER OF THEIR SERVICE AREA AND WITHIN THE MOST POPULATED COUNTY AND ZIP CODE. AGE THE AGE DISTRIBUTION OF THE SERVICE AREA WAS SIMILAR TO BOTH OHIO AND INDIANA WITH THE EXCEPTION OF SOME MINOR DIFFERENCES. PROPORTIONALLY THERE WERE SLIGHTLY LESS 18-44 YEAR OLDS, AND THERE WERE SLIGHTLY MORE 45-64 YEAR OLDS. THERE WAS, HOWEVER, A SIGNIFICANTLY LARGER PROPORTION OF OLDER ADULTS (AGE 65+) IN THE SERVICE AREA, WHEN COMPARED TO THE STATES OF INDIANA AND OHIO. RACE/ETHNICITY THE RACIAL AND ETHNIC MAKEUP OF THE SERVICE AREA WAS MORE HOMOGENOUS COMPARED TO THE STATE OF INDIANA AND THE STATE OF OHIO, WITH APPROXIMATELY 95.2% OF THE POPULATION IDENTIFYING AS WHITE. COMPARED TO INDIANA AND OHIO, THE SERVICE AREA HAD A SMALLER PROPORTION OF BLACK OR AFRICAN AMERICANS, ASIANS, THOSE WHO IDENTIFY AS TWO OR MORE RACES, AND HISPANIC OR LATINOS. IT WAS ESTIMATED THAT 1.8% OF THE SERVICE AREA POPULATION IDENTIFIES AS HISPANIC OR LATINO. SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH SOCIAL DETERMINANTS ARE THE CONDITIONS IN WHICH PEOPLE ARE BORN, GROW, WORK, LIVE, AND AGE, AND THE WIDER SET OF FORCES AND SYSTEMS SHAPING THE CONDITIONS OF DAILY LIFE. INCOME ALL COUNTIES IN THE SERVICE AREA HAD A MEDIAN HOUSEHOLD INCOME BELOW THE NATIONAL VALUE. FRANKLIN COUNTY, INDIANA HAD THE HIGHEST ESTIMATED MEDIAN HOUSEHOLD INCOME AT APPROXIMATELY $55,588, WHICH WAS JUST SLIGHTLY HIGHER THAN THE MEDIAN HOUSEHOLD INCOME FOR THE STATE OF INDIANA. BOTH FAYETTE COUNTY, INDIANA AND WAYNE COUNTY, INDIANA HAD THE LOWEST APPROXIMATE MEDIAN HOUSEHOLD INCOME AT JUST BELOW $42,000; NEARLY $15,000 LESS THAN THE NATIONAL VALUE. POVERTY OUT OF THE EIGHT COUNTIES IN THE SERVICE AREA, FAYETTE AND WAYNE COUNTIES HAD THE HIGHEST PROPORTION OF THE POPULATION LIVING BELOW POVERTY (18.2%). THIS VALUE IS HIGHER THAN BOTH THE INDIANA AND OHIO POVERTY RATE, 15.2% AND 15.8%, RESPECTIVELY. UNEMPLOYMENT THE UNEMPLOYMENT RATE IN THE SERVICE AREA RANGED FROM 3.5% IN DARKE COUNTY, OHIO, TO 4.9% IN FAYETTE COUNTY, INDIANA. ADDITIONALLY, SIX OUT OF EIGHT COUNTIES IN THE SERVICE AREA HAD HIGHER UNEMPLOYMENT RATES WHEN COMPARED TO THE U.S. VALUE FOR UNEMPLOYMENT (3.5%). EDUCATION HIGH SCHOOL DEGREE ATTAINMENT IS FAIRLY SIMILAR BETWEEN COUNTIES IN THE SERVICE AREA AND COMPARED TO THE INDIANA STATE VALUE (88.3%), THE OHIO STATE VALUE (89.8%), AND THE U.S. NATIONAL VALUE (87.3%). HOWEVER, FAYETTE, INDIANA HAD THE LOWEST HIGH SCHOOL ATTAINMENT IN THE SERVICE AREA AT APPROXIMATELY 82.0%. TRANSPORTATION THE PERCENT OF HOUSEHOLDS WITHOUT A VEHICLE IN THE SERVICE AREA RANGED FROM 6.7% TO 14.5%. OUT OF THE EIGHT COUNTIES IN THE SERVICE AREA, WAYNE COUNTY HAD THE HIGHEST PROPORTION OF HOUSEHOLDS WITHOUT A VEHICLE AT 10.1%. RESIDENTS IN THESE IMPACTED LOCATIONS MAY BE MORE LIKELY TO EXPERIENCE DIFFICULTIES ACCESSING SERVICES PROVIDED BY REID HOSPITAL AND HEALTH CARE SERVICES, INC.

SCHEDULE H, PART VI, LINE 5
PROMOTION OF COMMUNITY HEALTH REID HOSPITAL AND HEALTH CARE SERVICES, INC. SERVES AS A CORNERSTONE FOR THE COMMUNITY BY PROVIDING MANY AREAS OF OUTREACH AND COMMUNITY SERVICE. EXEMPT EMPLOYEES SERVE ON LOCAL BOARDS SUCH AS THE BOYS AND GIRLS CLUB, GIRLS, INC., UNITED WAY, ACHIEVA RESOURCES, THE CHAMBER OF COMMERCE, COMMUNITIES IN SCHOOLS, BIRTH TO FIVE, HEADSTART HEALTH AND EDUCATION ADVISORY COUNCIL AND MANY OTHER CIVIC ORGANIZATIONS. A COMMUNITY BENEFIT PAYROLL BUDGET IS ESTABLISHED EACH YEAR TO ALLOW HOURLY EMPLOYEES TO SERVE IN THE COMMUNITY (DURING WORKING HOURS) ON PROJECTS SUCH AS HABITAT FOR HUMANITY. AS OF 2021, A TOTAL OF 225 AED'S (AUTOMATED EXTERNAL DEFIBRILLATORS) WERE PLACED IN LOCAL SCHOOLS, NOT FOR PROFIT ORGANIZATIONS, FIRE AND POLICE, AND EMS SERVICES, TO SUPPORT THE HEALTH OF THE COMMUNITY. REID HOSPITAL AND HEALTH CARE SERVICES, INC. ALSO PROVIDES ASSISTANCE TO THESE PUBLIC DEPARTMENTS WITH CERTIFICATION AND RENEWAL OF REQUIRED AMERICAN HEART ASSOCIATION COURSES SUCH AS BLS (BASIC LIFE SUPPORT), ACLS (ADVANCED CARDIAC LIFE SUPPORT), AND PALS (PEDIATRIC ADVANCED LIFE SUPPORT). SUSTAINING A WELL-EDUCATED HEALTH CARE WORK FORCE IS PART OF THE OUTREACH OF REID HOSPITAL AND HEALTH CARE SERVICES, INC. MEDICAL GRAND ROUNDS ARE OFFERED WEEKLY AND ARE OPEN TO ALL PHYSICIANS IN THE COMMUNITY. EACH YEAR REID HOSPITAL AND HEALTH CARE SERVICES, INC., IVY TECH COMMUNITY COLLEGE AND INDIANA UNIVERSITY-EAST CAMPUS COLLABORATE ON A HEALTH CAREER CAMP WHICH PROVIDES HIGH SCHOOL STUDENTS AN OPPORTUNITY TO PARTICIPATE IN NURSING AND ALLIED HEALTH ACTIVITIES. STUDENTS FROM THE 7-COUNTY SERVICE AREA ARE INVITED TO ATTEND. THERE ARE SOCIAL DETERMINANTS OF HEALTH AND READING IS ONE OF THOSE ELEMENTS REID HOSPITAL AND HEALTH CARE SERVICES, INC. HAS CHOSEN TO SUPPORT. EACH YEAR THE THIRD GRADE READING ACADEMY WORKS WITH CHILDREN WHO ARE NOT READING AT GRADE LEVEL AND SPEND THE SUMMER IMPROVING THEIR READING SKILLS. REID HOSPITAL AND HEALTH CARE SERVICES, INC. HAS SUPPORTED THIS NOT FOR PROFIT ORGANIZATION SINCE IT BEGAN. THE GOVERNING BOARD OF REID HOSPITAL AND HEALTH CARE SERVICES, INC. AND ESPECIALLY THE COMMUNITY BENEFIT COMMITTEE OF THE BOARD GUIDE THE OUTREACH TO THE COMMUNITY TO MAKE CERTAIN THAT REID HOSPITAL AND HEALTH CARE SERVICES, INC. SERVES THE PATIENTS AND THE COMMUNITY WITH EQUAL CARE.