2025-05-13T09:35:58+00:00 2024-06-30 440160260 Forvis Mazars LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2023-07-01 440537826 Community Hospital Association Inc COMM 6606862320 26136 US 59 Fairfax MO 64446 Julie Jones CEO 6606862320 2025-05-13 true Michael Engle P00482834 8162216300 2025-05-13 2023 2025-03-06 01:10:19Z JULIE JONES 26136 US 59 Fairfax MO 64446 26055757 false X WWW.FAIRFAXMED.COM X 1976 MO TO PROVIDE QUALITY ACUTE CARE, EMERGENCY PRIMARY CARE AND OUTPATIENT SERVICES. 11 10 191 80 0 0 1004609 36242 24057515 25879355 63239 67182 298286 72978 25423649 26055757 0 0 0 0 11765225 12501173 0 0 11473 14032352 14221054 25797577 26722227 -373928 -666470 12508765 10915243 10376969 10730084 2131796 185159 TO BE THE HEALTHCARE PROVIDER OF CHOICE FOR THE COMMUNITIES WE SERVE. false false 22185276 0 25879355 COMMUNITY HOSPITAL-FAIRFAX (CH-F) PRIDES ITSELF IN PROVIDING ACCESS TO HEALTHCARE TO A REGION WHERE HEALTH SERVICES ARE SPARSE. WITH THE LOCAL PHYSICIAN RATIO THREE TIMES THE NATIONAL BENCHMARK. EMERGENCY SERVICES WOULD OTHERWISE BE 30 MILES OR MORE FROM THE POPULATION CENTERS. COMMUNITY HOSPITAL-FAIRFAX PROVIDES THE NORTHWEST MISSOURI AREA POPULATION OF 11,000 IN HOLT, ATCHISON AND WESTERN NODAWAY COUNTY WITH A 24-HOUR EMERGENCY ROOM, ACUTE CARE (INCLUDING OBSTETRICS) AND POST-ACUTE CARE SERVICES, PRIMARY CARE SERVICES, MANY OUTPATIENT SERVICES, SURGERY, ANCILLARY SERVICES, AND A FULL-SERVICE THERAPY DEPARTMENT. IN ADDITION TO SERVING THE HEALTH NEEDS OF A POPULATION THAT WOULD OTHERWISE NOT HAVE ACCESS TO CARE, COMMUNITY HOSPITAL-FAIRFAX CONTINUES TO INVEST IN A HEALTHY FUTURE FOR THE COMMUNITY. CH-F TRIES TO FOCUS ON THE GREATEST HEALTH NEEDS IN THE COMMUNITY WHICH TEND TO BE CHRONIC DISEASES SUCH AS HEART DISEASE, COPD AND ASTHMA, STROKE AND DIABETES. RISK FACTORS FOR THESE DISEASES ARE OBESITY, CIGARETTE SMOKING AND PHYSICAL INACTIVITY. NEARLY 30% OF THE CH-F SERVICE POPULATION IS OBESE, 35% REPORT PHYSICAL INACTIVITY AND 22% SMOKE. TO EDUCATE AND PROVIDE SERVICES TO A COMMUNITY WHERE THESE CHRONIC CONDITIONS PREVAIL, THE FOLLOWING ACTIVITIES ARE PART OF CH-F'S RESPONSE TO HEALTH NEEDS OF THE COMMUNITY: CH-F LAUNCHED A CHRONIC CARE MANAGEMENT PROGRAM BY DECEMBER 1, 2019. COMMUNITY HOSPITAL-FAIRFAX HIRED A NURSE TO BEGIN A CHRONIC CARE PROGRAM. FOR ALL OTHER ACTIVITIES AND STRATEGIES RELATED TO THE CHNA, SEE THE REPORT AND IMPLEMENTATION STRATEGY AT WWW.FAIRFAXMED.COM/CHHA. 22185276 true true false true false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true true false false true 4 0 true 191 true false false false false false false false false false false false false X 11 10 false false false false false true false true true false false true true true true true true true true false X JON DAVIS 6606862320 26136 US HIGHWAY 59 PO BOX 107 FAIRFAX MO 64446 AMY RYAN DIRECTOR/VICE-PRESIDENT 1.0 0.0 X X 0 0 0 REBEKAH GEBHARDS SECRETARY/TREASURER 1.0 0.0 X X 0 0 0 VIRGINIA LOW DIRECTOR/PRESIDENT/CHAIRMAN 1.0 1.0 X X 0 0 0 COREY HERRON DIRECTOR 1.0 0.0 X 0 0 0 GARRETT WOOD DIRECTOR 1.0 0.0 X 0 0 0 GLENN SCOTT DIRECTOR 1.0 0.0 X 0 0 0 RICHARD ARON BURKE MD DIRECTOR/CHIEF MEDICAL OFFICER 40.0 0.0 X 719096 0 41712 SUSAN NOLAND DIRECTOR 1.0 0.0 X 0 0 0 TERESA SMITH DIRECTOR 1.0 0.0 X 0 0 0 TIM UMBARGER DIRECTOR 1.0 0.0 X 0 0 0 TOM BULLOCK DIRECTOR 1.0 0.0 X 0 0 0 JON DAVIS CFO 40.0 1.0 X 155559 0 19308 JULIE JONES CEO 40.0 1.0 X 249842 0 31781 DR DUSTIN CARPENTER MD PHYSICIAN 40.0 0.0 X 259436 0 23941 KELLY OSBORN CRNA 40.0 0.0 X 201074 0 40224 MELISSA WILLIAMSON APRN MANAGER 40.0 0.0 X 160200 0 31470 REBECCA SCHLUETER COO 40.0 0.0 X 129502 0 28592 RENEE KREIFELS CRNA 40.0 0.0 X 211653 0 30000 2086362 0 247028 17 false true false INSPIRE REHABILITATION LLC 8181 ARISTA PLACE SUITE 100 BROOMFIELD CO 80021 REHAB SERVICES 1493902 PSYCHIATRIC MEDICAL CARE LLC PO BOX 734606 DALLAS TX 75373 SENIOR MENTAL HEALTH 652595 FOCUSONE SOLUTIONS PO BOX 850861 MINNEAPOLIS MN 55485 STAFFING SERVICES 431374 CPSI INC PO BOX 11407 BIRMINGHAM IL 35246 EHR SYSTEM 400468 DOCS WHO CARE 800 W FRONTIER LN OLATHE KS 66061 STAFFING SERVICES 262792 23 36242 36242 NET PATIENT SERVICE REVENUE 621990 24544136 24544136 340B REVENUE 621990 1335219 1335219 0 0 0 0 25879355 67182 67182 0 0 0 0 CAFETERIA 900099 52638 52638 OTHER REVENUE 900099 20340 20340 0 0 0 0 72978 26055757 25879355 0 140160 X 0 0 1232872 1002436 229783 653 170643 170643 9396602 7640283 1751339 4980 99728 81088 18587 53 771064 626944 143711 409 830264 675079 154745 440 373257 373257 109107 109107 8700 8700 3636155 3036294 598159 1702 31935 25966 5952 17 2300868 1870813 428836 1219 417278 339285 77772 221 119097 96837 22197 63 522474 424818 97379 277 783609 637145 146049 415 261872 212925 48808 139 BAD DEBT 1713304 1713304 MEDICAL SUPPLIES 1496905 1496905 REPAIRS & MAINTENANCE 781370 635324 145632 414 MEDICAID 777331 777331 887792 721856 165465 471 26722227 22185276 4525478 11473 14726 107651 3907742 1742760 2384678 2452362 0 0 0 0 551999 593414 116522 146230 24898653 21284319 3833185 3614334 0 0 1699913 2258492 12508765 10915243 2137405 3005818 0 0 7790187 7476514 449377 247752 10376969 10730084 X 2096796 173211 35000 11948 2131796 185159 12508765 10915243 X -666470 -1280167 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false true 8700 false false false 8700 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE LOBBYING EXPENSES RECORDED ARE A PORTION OF DUES PAID TO THE MISSOURI HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. 244304 244304 8003077 6777602 1225475 16186126 14506717 1679409 465146 465146 3614334 DUE FROM THIRD PARTY PAYORS 943000 OTHER RECEIVABLES 1196909 ROU ASSETS 118583 2258492 DUE TO THIRD PARTY 128000 ROU LIABILITY 119752 247752 24833422 490969 490969 24342453 1713304 1713304 26055757 25057925 49002 49002 25008923 1713304 1713304 26722227 Schedule D, Part X, Line 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 RELATED ORGANIZATION'S REVENUE - 467917 NET ASSETS RELEASED FROM RESTRICTION - 23052 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements BAD DEBT EXPENSE - 1713304 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 RELATED ORGANIZATION'S EXPENSES - 49002 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements BAD DEBT EXPENSE - 1713304 true true X true X 250 true X 500 true true true false true true 165244 0 165244 0.0066 2260213 1975062 285151 0.0114 6180 5211 969 0.0000 0 0 2431637 1980273 451364 0.0180 0 0 0 0.0 33292 18310 14982 0.0006 2029 0 2029 0.0001 0 0 0 0.0 0 0 0 0.0 0 0 35321 18310 17011 0.0007 0 0 2466958 1998583 468375 0.0187 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0.0 0 0 0 0 0 0.0 true 1713304 142778 11233465 11595930 -362465 X true true 1 1 COMMUNITY HOSPITAL-FAIRFAX 261136 US HWY 59 FAIRFAX MO 64446 WWW.FAIRFAXMED.COM/ 102-61 X X X X COMMUNITY HOSPITAL-FAIRFAX 1 false false true X X X X X X X X X 22 true false false true X HTTPS://FAIRFAXMED.COM/CHNA X true 22 true HTTPS://FAIRFAXMED.COM/CHNA false true X 250.0 500.0 X X X X true true X X X X true X HTTPS://FAIRFAXMED.COM/CHARITY-CARE/ X HTTPS://FAIRFAXMED.COM/CHARITY-CARE/ X HTTPS://FAIRFAXMED.COM/CHARITY-CARE/ X X X X X X true X false X X X X true X true false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL-FAIRFAX. CHF USED FOCUS GROUPS FROM LOCAL FOOD ASSISTANCE PROGRAMS, CLERGY, SCHOOL ADMINISTRATION, OTHER AREA HEALTHCARE PROVIDERS AND PUBLIC ADMINISTRATORS AS PART OF THE CHNA STUDY. THIS WAS DONE THROUGH PAID OUTREACH THROUGH SOCIAL MEDIA, WEBSITE POP-UP, MASS MAILING TO SENIOR ADULTS, PUBLIC SPEAKING ENGAGEMENTS, AND EMAIL DISTRIBUTION. OF THOSE WHO RESPONDED, NEARLY HALF REPRESENTED HOUSEHOLDS OF MORE THAN ONE PERSON, PRIMARILY WOMEN AND IN ATCHISON COUNTY. HALF WERE OF INCOMES LESS THAN $75,000 PER YEAR. OF THE SURVEYS, 250 WERE MAILED TO A RANDOM LIST OF INDIVIDUALS OVER 65, WITH 84 OF THOSE RESPONDING. OF THE TOTAL SURVEYS, 306 WERE COLLECTED ELECTRONICALLY. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL-FAIRFAX. THE SURVEY WAS ADOPTED BY THE BOARD OF DIRECTORS IN THE MAY 2022 BOARD OF DIRECTORS MEETING. STRATEGIES FOR IMPLEMENATION THAT WERE SPECIFICALLY IDENTIFIED OF AREAS OF CONCERN BY THE COMMUNITEE WERE TELEHEALTH MENTAL HEALTH SERVICES AND THE NEED FOR ADDITIONAL PRIMARY CARE PHYSICIAN SERVICES. THIRD ON THE LIST WERE DEALING WITH UNHEALTHY BEHAVIORS AND CHRONIC CARE MANAGEMENT. FINALLY, ACCESS TO HEALTHCARE WAS MENTIONED AS A MAJOR CONCERN WITH THE INABILITY TO GET A CONVENIENT APPOINTMENT AND AFFORDABILITY AS THE MOST COMMON RESPONSE. EACH OF THESE AREAS WERE GIVEN THE GREEN LIGHT BY THE BOARD TO ADD TO THE HOSPITAL'S STRATEGIC PLAN, AS WELL AS ADOPTING A BUDGET FOR EACH. IN RESPONSE TO WHETHER WE PROVIDE THE DESIRED SERVICES, URGENT CARE, CHEMOTHERAPY, ENT, PODIATRY, DERMATOLOGY AND PULMONOLGY WERE LISTED AS THE KINDS OF SERVICES THE RESPONDENTS WOULD LIKE TO HAVE ACCESS TO LOCALLY. Schedule H, Part V, Section B, Line 23 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL-FAIRFAX. COMMUNITY HOSPITAL ASSOCIATION INADVERTENTLY DID NOT CALCULATE THEIR AGB CORRECTLY BECAUSE THEY FAILED TO INCLUDE MEDICARE IN THE CALCULATION. AGB IS REQUIRED TO BE CALCULATED ONCE A YEAR, AND THIS INADVERTENT AND MINOR ERROR OCCURRED IN FISCAL YEARS 2022-2024. THE INADVERTENT AND MINOR ERROR WAS DISCOVERED IN FEBRUARY OF 2025 DURING THE PAID PREPARERS REVIEW FORM 990. THE HOSPITAL CORRECTED THIS MINOR AND INADVERTENT ERROR BY RECALCULATING AGB FOR FISCAL YEARS 2022-2024 IN ACCORDANCE WITH THE LOOK-BACK METHOD BASED ON CLAIMS ALLOWED BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE HOSPITAL FACILITY. THE CALCULATIONS WERE CORRECTED IN MARCH OF 2025. DUE TO THIS INADVERTENT AND MINOR ERROR, 11 INDIVIDUALS WERE BILLED AN AMOUNT GREATER THAN AGB AND ONLY 3 OF THOSE INDIVIDUALS PAID MORE THAN AGB OUT OF 1,277 APPLICATIONS. REFUNDS ARE BEING PROMPTLY ISSUED TO THREE INDIVIDUALS FOR THE AMOUNTS BILLED IN EXCESS OF AGB. .EIGHT OF THE INVIDIVIDUALS THAT WERE BILLED MORE THAN AGB WERE WRITTEN OFF BEFORE THE INADVERTENT AND MINOR ERROR WAS DISCOVERED. IT IS ANTICIPATED ALL REFUNDS WILL BE ISSUED BY APRIL 30, 2025 TO THREE INDIVIDUALS THAT PAID MORE THAN AGB. ADDITIONALLY, THE ORGANIZATION HAS DECIDED TO MOVE TO A 100% FREE CARE MODEL, USING THE PROSPECTIVE METHOD, AND WILL INCREASE ELIGIBILITY TO FREE CARE BY DETERMINING ELIGIBILITY BASED ON 300% OF THE FEDERAL POVERTY GUIDELINES INSTEAD OF 250%. THEREFORE, THE AGB LOOKBACK CALCULATION WILL NO LONGER NEED TO BE CALCULATED. 6 MOUND CITY FAMILY MEDICINE 514 STATE STREET MOUND CITY MO 64470 PROVIDER BASED RURAL HEALTH CLINIC WEST NODAWAY FAMILY MEDICINE 226 W MAIN STREET BURLINGTON JUNCTION MO 64428 PROVIDER BASED RURAL HEALTH CLINIC SOUTH HOLT FAMILY MEDICINE 101 SOUTH WASHINGTON OREGON MO 64473 PROVIDER BASED RURAL HEALTH CLINIC TARKIO FAMILY MEDICINE 102 S 6TH STREET TARKIO MO 64491 PROVIDER BASED RURAL HEALTH CLINIC FAIRFAX FAMILY MEDICINE 309 E MAIN STREET FAIRFAX MO 64446 PROVIDER BASED RURAL HEALTH CLINIC ROCK PORT FAMILY MEDICINE 100 E CASS STREET ROCK PORT MO 64482 PROVIDER BASED RURAL HEALTH CLINIC Schedule H, Part I, Line 3c ELIGIBILITY FOR FREE OR DISCOUNTED CARE ADDITIONAL FACTORS CONSIDERED IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE INCLUDE ASSET LEVELS, MEDICAL INDIGENCY, INSURANCE/UNDERINSURANCE STATUS AND RESIDENCY. Schedule H, Part I, Line 7 COSTING METHODOLOGY THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO. Schedule H, Part I, Line 7f BAD DEBT EXPENSE THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $1,713,304. Schedule H, Part V ADDITIONAL DISCLOSURE REGARDING 501(r) INADVERTENT AND MINOR ERRORS RELATED TO 501(R) COMPLIANCE DURING THE PREPARATION OF THE 2023 FORM 990, THE ORGANIZATION WAS ALERTED TO ANINADVERTENT AND MINOR ERROR OF NOT HAVING UPDATED THE PROVIDER LISTING ON A QUARTERLY BASIS. PRIOR TO FILING THE 2023 FORM 990, THE ORGANIZATION HAS RESOLVED THE DEFICIENCIES THROUGH THE FOLLOWING ACTION ITEMS: - PROVIDER LIST, INCLUDING THOSE COVERED AND NOT COVERED BY THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY HAS BEEN COMPLETED AND IS AVAILABLE ON THEIR WEBSITE AT THE FOLLOWING LOCATION: HTTPS://FAIRFAXMED.COM/WP-CONTENT/UPLOADS/2024/05/ADMIN2005-FINANCIAL-ASSISTANCEPOLICY-052224.PDF. A PAPER COPY OF THE LISTING IS ALSO AVAILABLE AT THE HOSPITAL'S REGISTRATION DESK. THE PROVIDER LIST IS REVIEWED AND UPDATED ON A QUARTERLY BASIS. IN ORDER TO ENSURE COMPLIANCE IN THE FUTURE, THE ORGANIZATION HAS IMPLEMENTED THE FOLLOWING PROCEDURES: - DURING QUARTER FINANCIAL CLOSE, STAFF WILL REVIEW WEBSITE LOCATIONS AND MATERIALS AT THE REGISTRATION DESK TO ENSURE ALL REQUIRED DOCUMENTS, APPLICATIONS, AND POLICIES ARE AVAILABLE ELECTRONICALLY AND IN PAPER FORMAT. - DURING QUARTER FINANCIAL CLOSE, THE PROVIDER LISTING WILL BE REVIEW AND UPDATED, INCLUDING AN UPDATED TIME AND DATE STAMP. - THE ORGANIZATION WILL CONTINUE TO IMPROVE LINES OF COMMUNICATIONS WITH THOSE RESPONSIBLE FOR WEBSITE MAINTENANCE AND PATIENT ACCOUNTS TO ENSURE THAT STAFF UNDERSTAND THE REQUIREMENTS OUTLINED IN THE 501(R) REGULATIONS Schedule H, Part I, Line 6a Community benefit report prepared by related organization Community Healthcare Foundation Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 1713304 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL 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 UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE AMOUNT OF ACCOUNT BALANCES WRITTEN OFF TO BAD DEBTS THAT POSSIBLY WOULD HAVE QUALIFIED FOR CHARITY HAD THEY BEEN WILLING TO PROVIDE THE NECESSARY INFORMATION, AND THE TOTAL OF BANKRUPTCIES THE HOSPITAL HAD TO WRITE OFF. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE IS IN NOTE 1 ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE HOSPITAL'S SERVICE AREA IS APPROXIMATELY 23% MEDICARE BENEFICIARIES WHO PREFER TO GET THEIR MEDICAL CARE LOCALLY. OUR CUSTOMER SERVICE SURVEYS RATE COMMUNITY HOSPITAL CONSISTENTLY OVER 90%, SHOWING THESE MEDICARE BENEFICIARIES APPRECIATE THE SERVICES COMMUNITY HOSPITAL PROVIDES AND HOW THE SERVICES ARE PROVIDED. THE COSTING SOURCE WAS THE FY2024 MEDICARE COST REPORT. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance COLLECTION POLICY STATES ALL UNINSURED AND INSURED PATIENTS ARE INFORMED ON THEIR FIRST STATEMENT OF SERVICES THAT COMMUNITY HOSPITAL HAS A GRANT PROGRAM (FOR FINANCIAL ASSISTANCE) FOR THOSE WHO QUALIFY. THIS SAME TYPE OF 'ASSISTANCE AVAILABLE' INFORMATION IS ALSO IN THE PATIENT INFORMATION BROCHURES IN THE PATIENT ROOMS AND WAITING AREAS. PATIENTS MAY QUALIFY FOR A CHARITY DISCOUNT OR A MEDICALLY INDIGENT DISCOUNT, DEPENDING ON THEIR FINANCIAL SITUATION AND USING THE FEDERAL POVERTY GUIDELINES. Schedule H, Part V, Section B, Line 16a FAP website - COMMUNITY HOSPITAL-FAIRFAX: Line 16a URL: HTTPS://FAIRFAXMED.COM/CHARITY-CARE/; Schedule H, Part V, Section B, Line 16b FAP Application website - COMMUNITY HOSPITAL-FAIRFAX: Line 16b URL: HTTPS://FAIRFAXMED.COM/CHARITY-CARE/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - COMMUNITY HOSPITAL-FAIRFAX: Line 16c URL: HTTPS://FAIRFAXMED.COM/CHARITY-CARE/; Schedule H, Part VI, Line 2 Needs assessment N THE MOST RECENT COMMUNITY NEEDS ASSESSMENT, COMMUNITY HOSPITAL FAIRFAX IDENTIFIED PRIMARY ACCESS TO HEALTHCARE AS CONTINUING TO BE THE MAIN DRIVER OF SIGNIFICANT HEALTH ISSUES IN OUR SERVICE AREA. RECENT SURVEYS SHOW THAT MANY HOUSEHOLDS DO NOT ACCESS HEALTHCARE AT A PRIMARY LEVEL EVEN WHEN A HEALTHCARE ISSUE REQUIRING PRIMARY CARE SERVICES IS NEEDED. INCREASED RISK FACTORS INCLUDE HEART DISEASE, CANCER, CHRONIC LOWER RESPIRATORY DISEASE, AND STROKE. I. ABILITY TO PAY FOR CARE - COMMUNITY HOSPITAL-FAIRFAX IDENTIFIED STRATEGIES TO ASSIST THOSE WITH NO INSURANCE OR HIGH DEDUCTIBLES TO ACCESS CARE THAT THEY NEED. TO ASSIST WITH THIS EFFORT, COMMUNITY HOSPITAL-FAIRFAX HAS SUCCESSFULLY IMPLEMENTED A STRATEGY TO NEGOTIATE PAYMENT STRUCTURES WHICH ARE FAVORABLE TO PATIENTS. IN ADDITION TO THIS STRATEGY, AN AGGRESSIVE FORGIVENESS PROGRAM FOR EXISTING DEBT WAS IMPLEMENTED IN FY2020 AND FY2021. II. PREVENTIVE CARE - COMMUNITY HOSPITAL-FAIRFAX ONBOARDED A CARECOORDINATOR/POPULATION HEALTH NURSE. THIS NURSE HAS BEEN VERY ACTIVE BUILDING AN ANNUAL WELLNESS VISIT AND CHRONIC CARE MANAGEMENT PROGRAM FOR PRIMARY CARE CLINIC PATIENTS. ANNUAL WELLNESS VISITS ARE A BENEFIT OFFERED TO MEDICARE PATIENTS AND ARE CRITICAL IN HELPING IDENTIFY HEALTH NEEDS AND OPPORTUNITIES IN THAT POPULATION. WITH LESS THAN A FULL YEAR OF ACTIVE ANNUAL WELLNESS VISIT PROGRAM, NEARLY 20% OF COMMUNITY HOSPITAL-FAIRFAX'S ATTRIBUTED MEDICARE POPULATION HAS RECEIVED AN ANNUAL WELLNESS VISIT WITH THE POPULATION HEALTH NURSE AND THEIR PROVIDER. CHRONIC CARE MANAGEMENT IS EQUALLY IMPORTANT TO PREVENTATIVE HEALTH AS ITS FOCUS IS TO PROVIDE EXTRA CARE FOR PATIENTS WITH MULTIPLE CHRONIC DISEASES. STRATEGIES ARE CURRENTLY IN DEVELOPMENT FOR THIS PROGRAM. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance COMMUNITY HOSPITAL BUSINESS OFFICE STAFF WILL DISCUSS WITH INPATIENTS AND OUTPATIENTS THE OPTIONS AVALIABLE TO HELP THE PATIENTS MEET THEIR FINANCIAL OBLIGATIONS TO COMMUNITY HOSPITAL. THEY DISCUSS THE FEDERAL/STATE GOVERNMENT PROGRAMS AVAILABLE AND THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEN INFORMATION IS INCLUDED IN THE STATEMENTS SENT TO PATIENTS (EXPLAINING THE AMOUNTS OWED BY THE PATIENT'S INSURANCE OR THE PATIENT), MUCH OF THE INFORMATION IS THE SAME AS THE INFORMATION DISCUSSED IN PERSON. Schedule H, Part VI, Line 4 Community information COMMUNITY HOSPITAL-FAIRFAX SERVES THE ATCHISON, HOLT AND WESTERN NODAWAY COUNTIES, POPULATION APPROXIMATELY 10,700. THERE ARE FIVE MAIN TOWNS IN ATCHISON AND HOLT, ALL WITH POPULATIONS BELOW 2,000. THE POPULATION IS ALL RURAL AND THE ECONOMY IS LARGELY DRIVEN BY AGRICULTURE. THE POPULATION IS AGING WITH A MEDIAN HOUSEHOLD INCOME OF $43,000 AND $46,000. Schedule H, Part VI, Line 5 Promotion of community health TO EDUCATE AND PROVIDE SERVICES TO ITS COMMUNITY, COMMUNITY HOSPITAL RESPONDS BY PROVIDING THE FOLLOWING ACTIVITES: AN ANNUAL HEART HEALTH SCREENING OFFERED FREE OF CHARGE, AND FREE BLOOD PRESSURE CHECKS; DIABETES COUNSELING CLASSES WITH A REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR; FREE GLUCOSE SCREENING, BMI CHECKS AND BLOOD PRESSURE CHECKS AT ANNUAL WOMEN'S EVENT; AN ANNUAL BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN AND HEALTHY EATING CHOICES ARE DISCUSSED; AN ANNUAL PROSTATE SCREENING WHICH INCLUDES A FREE EXAM FOR LOCAL RESIDENTS. IN ADDITION, THE HOSPITAL INITIATED A WORKPLACE WELLNESS PROGRAM WHERE SCREENINGS ARE OFFERED AT A REDUCED PRICE FOR EMPLOYEES. Schedule H, Part VI, Line 7 State filing of community benefit report MO X X false false false false false false false false false RICHARD ARON BURKE MD DIRECTOR/CHIEF MEDICAL OFFICER 717991 0 0 0 1105 0 22500 0 19212 0 760808 0 0 0 JON DAVIS CFO 154854 0 0 0 705 0 0 0 19308 0 174867 0 0 0 JULIE JONES CEO 247023 0 0 0 2819 0 25277 0 6504 0 281623 0 0 0 DR DUSTIN CARPENTER MD PHYSICIAN 259171 0 0 0 265 0 8101 0 15840 0 283377 0 0 0 KELLY OSBORN CRNA 200806 0 0 0 268 0 22500 0 17724 0 241298 0 0 0 REBECCA SCHLUETER COO 129426 0 0 0 76 0 10904 0 17688 0 158094 0 0 0 RENEE KREIFELS CRNA 211267 0 0 0 386 0 30000 0 0 0 241653 0 0 0 MELISSA WILLIAMSON APRN MANAGER 160200 0 0 0 0 0 6882 0 24588 0 191670 0 0 0 Schedule J, Part II CEO Compensation THE COMPENSATION FOR JULIE JONES IS PAID THROUGH A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC), AN UNRELATED 501(C)(3) HOSPITAL. JAMIE BURKE JAMIE BURKE IS THE DAUGHTER OF DR. RICHARD ARON BURKE, A DIRECTOR OF THE ORGANIZATION. 60306 JAMIE IS COMPENSATED AS AN LPN FOR THE ORGRANIZATION. false JOANNA BURKE JOANNA BURKE IS THE WIFE OF DR. RICHARD ARON BURKE, A DIRECTOR OF THE ORGANIZATION. 110337 JOANNA IS COMPENSATED AS A PEDIATRIC NURSE PRACTITIONER IN ONE OF OUR RELATED CLINICS. false Form 990, Part VI, Line 15a 15b: CEO AND OFFICER COMPENSATION THE ORGANIZATION USES COMPARABILITY DATA TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER OFFICERS. THE COMPENSATION OF THE CEO AND OTHER OFFICERS IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE LAST REVIEW WAS IN 2023. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE ORGANIZATION'S BY-LAWS STATE THAT THE BOARD OF DIRECTORS SHALL CONSIST OF AT LEAST ELEVEN MEMBERS AND NO MORE THAN FIFTEEN MEMBERS. TWO OF THE DIRECTORS SHALL BE INDIVIDUALS NOMINATED BY THE NEBRASKA MEDICAL CENTER (NMC), SUBJECT TO A MAJORITY VOTE OF THE BOARD. IF AN NMC DIRECTOR IS NOT ELECTED BY THE BOARD, NMC SHALL CONTINUE TO NOMINATE OTHER CANDIDATES UNTIL A NOMINEE IS ELECTED BY THE BOARD. Form 990, Part VI, Line 11b Review of form 990 by governing body AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE FORM 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S ADMINISTRATION. ANY QUESTIONS OR CONCERNS THE ORGANIZATION'S ADMINISTRATION HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS ARE MADE. THE 990 WITH ALL COMPLETED SCHEDULES IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION ANNUALLY OBTAINS WRITTEN AFFIRMATIONS FROM EACH OFFICER AND DIRECTOR AS TO THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IF A DISCLOSURE OCCURS, THE MATTER IS FORWARDED TO AN EXECUTIVE COMMITTEE OF THE BOARD OF DIRECORS TO REVIEW ALL CIRCUMSTANCES SURROUNDING THE CONFLICT OF INTEREST. THE DETERMINATION OF SUCH MATTERS IS DEEMED FINAL BY THE BOARD. THE CONFLICTED INDIVIDUAL MAY NOT VOTE OR PARTICIPATE IN DISCUSSIONS AND/OR DETERMINATIONS INVOLVING THE CONFLICT. IT IS NOTED IN THE BOARD MEETING MINUTES OF ANY INDIVIDUALS ABSTAINING FROM VOTING DUE TO ANY CONFLICT. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part IX, Line 11g Other Fees Physican Fees - Total Expense: 426804, Program Service Expense: 426804, Management and General Expenses: , Fundraising Expenses: ; Fees for Services - Total Expense: 2838749, Program Service Expense: 2308158, Management and General Expenses: 529086, Fundraising Expenses: 1505; Professional Fees - Total Expense: 348529, Program Service Expense: 283385, Management and General Expenses: 64959, Fundraising Expenses: 185; Consulting Fees - Total Expense: 22073, Program Service Expense: 17947, Management and General Expenses: 4114, Fundraising Expenses: 12; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER TO RELATED ORGANIZATION - -1280167; COMMUNITY HEALTHCARE FOUNDATION 26136 US HWY 59 FAIRFAX MO 64446 431757553 SUPPORT ORG MO 501(c)(3) Type I CHA true false false false false false false false false false false false false true true true false true true false COMMUNITY HEALTHCARE FOUNDATION R 1280167 FMV