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BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. 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X X X X X true true X X X X true X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 CH-F INVITED AREA COMMUNITY EXPERTS TO GATHER IN 3 DIFFERENT FOCUS GROUPS. THOSE IN ATTENDANCE INCLUDED AREA COUNSELORS, CLERGY MEMBERS, LAW ENFORCEMENT, ECONOMIC DEVELOPMENT PERSONNEL, NURSING HOME REPRESENTATIVES, SCHOOL FACULTY, COMMUNITY SERVICES STAFF AND OTHER COMMUNITY EXPERTS. FOCUS GROUP ATTENDEES WERE ASKED A VARIETY OF QUESTIONS. DIALOGUE WAS CANDID AND FOCUS GROUP ATTENDEES USED THEIR KNOWLEDGE OF THE CONSTITUENCY THEY REPRESENT TO HONESTLY EVALUATE THE HEALTH OF THE COMMUNITY. RESULTS FROM THOSE MEETINGS ARE SUMMARIZED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. CH-F STAFF ALSO PARTICIPATED IN THE FOCUS GROUPS. COMMUNITY HOSPITAL-FAIRFAX RELEASED A CHNA SURVEY TO THE PUBLIC. THE QUESTIONS ON THE SURVEY WERE DETERMINED THROUGH GUIDANCE PROVIDED BY THE MISSOURI HOSPITAL ASSOCIATION AND INFORMATION GATHERED THROUGH THE FOCUS GROUPS AND SECONDARY RESEARCH. THE SURVEY WAS OFFERED ONLINE. PAPER COPIES WERE PROVIDED IN LOCATIONS WHERE POPULATIONS MIGHT HAVE DIFFICULTY ACCESSING IT ONLINE. THIS INCLUDES NURSING HOMES, SENIOR HOUSING AND NUTRITION CENTERS. CH-F PROMOTED THE SURVEY USING FACEBOOK, BLAST EMAILS, NEWSPAPER AND THE CABLE CHANNEL. 556 SURVEYS WERE RETURNED. COMMUNITY HOSPITAL-FAIRFAX ALSO COLLABORATED WITH COMMUNITY SERVICES INC. OF ATCHISON AND HOLT COUNTY TO DISTRIBUTE SURVEYS. COMMUNITY SERVICES INC. IS THE LOCAL AGENCY EMPOWERED TO HELP PEOPLE IN NEED IN THE ATCHISON AND HOLT COUNTY COMMUNITIES. SCHEDULE H, PART V, SECTION B, LINE 11 IDENTIFIED NEEDS AND AREAS OF PRIORITY PRIMARY CARE ACCESS PROBLEM STATEMENT: PRIMARY CARE ACCESS WAS IDENTIFIED IN BOTH THE CHNA SURVEY AND THE FOCUS GROUPS AS A SIGNIFICANT ISSUE. ATCHISON AND HOLT COUNTIES ARE LOCATED IN A HPSA. BOTH ATCHISON AND HOLT COUNTIES ARE RANKED LOW FOR RATIOS OF POPULATION TO PRIMARY CARE PROVIDERS. THIS IS BECAUSE PRIMARY CARE PHYSICIANS ARE SCARCE AND DIFFICULT TO RECRUIT TO RURAL AREAS. COMMUNITY HOSPITAL-FAIRFAX STRATEGIES: COMMUNITY HOSPITAL-FAIRFAX HAS RECRUITED A THIRD PHYSICIAN TO THE AREA IN OCTOBER OF 2016. CH-F INTENDS TO OPEN A THIRD PRIMARY CARE CLINIC IN THE SERVICE AREA IN 2016. TWO PREVIOUS CLINICS WERE OPENED IN 2014 IN MOUND CITY AND IN 2016 IN OREGON. TIMELINE: OCTOBER 2016 ANTICIPATED IMPACT: CH-F BELIEVES THAT A NEW PRIMARY CARE PHYSICIAN WILL LESSEN THE BURDEN ON EXISTING PROVIDERS AND ALLOW FOR PATIENTS TO RECEIVE MORE CONVENIENT APPOINTMENTS. IT SHOULD ALSO ALLOW CLINICS MORE TIME TO SEE PATIENTS AND FURTHER DEVELOP THE WELLNESS INITIATIVE HIGHLIGHTED LATER IN THIS PLAN. MENTAL HEALTH PROBLEM STATEMENT: MENTAL HEALTH WAS IDENTIFIED AS A MAJOR PRIORITY AMONG NEEDS IDENTIFIED IN THE CHNA SURVEY AND IN FOCUS GROUPS. ATCHISON AND HOLT COUNTIES ARE BOTH IN A MENTAL HEALTH HPSA. ER UTILIZATION FOR AFFECTIVE DISORDERS IS INCREASING IN RURAL MISSOURI. LIKE PRIMARY CARE, MENTAL HEALTH PROVIDERS ARE EXTREMELY SCARCE AND DIFFICULT TO RECRUIT TO RURAL AREAS. COMMUNITY HOSPITAL-FAIRFAX STRATEGIES: - MAINTAIN SENIOR LIFE SOLUTIONS PROGRAM AND GROW TO A SECOND TRACK AS NEEDS SUGGEST. - RECRUIT AND RETAIN TELE-PSYCHIATRY AS AN ONGOING SPECIALIST CLINIC. - DEVELOP SUPPORT GROUPS FOR VARIOUS NEEDS SUCH AS GRIEF, DIVORCE AND SUBSTANCE ABUSE. - PARTNER WITH EXISTING RESOURCES TO BRING ADDITIONAL COUNSELING SERVICES TO THE COMMUNITY. TIMELINE: SENIOR LIFE SOLUTIONS SECOND TRACK BY JUNE OF 2018. TELE-PSYCHIATRY SPECIALTY CLINIC BY JUNE OF 2018. SUPPORT GROUP PROGRAM DEVELOPMENT BY JUNE OF 2017. ADDITIONAL COUNSELING RESOURCES TO THE COMMUNITY BY JUNE OF 2017. ANTICIPATED IMPACT: SLS WILL ACCOMMODATE TWICE AS MANY PATIENTS THAN ARE BEING CURRENTLY SERVED. TELE-PSYCHIATRY AND ADDITIONAL COUNSELING RESOURCES SHOULD EASE REFERRAL CHALLENGES FOR PRIMARY CARE PHYSICIANS AN INCREASE ACCESS FOR PATIENTS. SUPPORT GROUPS WILL GIVE UNMET NEEDS AN OUTLET FOR DEALING WITH SOME OF THESE CHALLENGES. ABILITY TO PAY FOR CARE PROBLEM STATEMENT: UNINSURED RATES CONTINUE TO STAGNATE INSTEAD OF IMPROVE. PER CAPITA INCOME REMAINS BELOW THE STATE AND NATIONAL AVERAGE. BAD DEBT AND CHARITY CARE ARE BECOMING A LARGER PERCENTAGE OF REVENUE EACH YEAR AT CH-F. COST OF CARE CONTINUES TO INCREASE MAKING HEALTHCARE LESS AND LESS AFFORDABLE. MISSOURI DID NOT EXPAND MEDICAID AND DESPITE ADDITIONAL INSURANCE OPTIONS BEING AVAILABLE, THEY ARE STILL LARGELY FINANCIALLY UNREACHABLE FOR MANY IN THE LOWER INCOME BRACKETS. COMMUNITY HOSPITAL-FAIRFAX STRATEGIES: COMMUNITY HOSPITAL-FAIRFAX IS COMMITTED TO EXPLORING A VARIETY OF STRATEGIES TO ASSIST THOSE WITH NO INSURANCE OR HIGH DEDUCTIBLES IN ACCESSING THE CARE THAT THEY NEED WITH OPTIONS TO MAKE IT AFFORDABLE. THESE STRATEGIES MAY INCLUDE TRAINING STAFF TO PROVIDE COUNSELING FOR PAYMENT OPTIONS, DEVELOPING DISCOUNTS FOR PRIVATE PAY PATIENTS, PROVIDING BETTER ESTIMATES FOR PRE-PAYMENT AND COPAYMENT, CREATING PROGRAMS FOR FORGIVENESS FOR OLD ACCOUNTS AND PROVIDING PAYMENT OPTIONS TO AVOID COLLECTIONS WHENEVER POSSIBLE. TIMELINE: PLANNING WILL OCCUR IN THE REMAINDER OF 2016 WITH DEPLOYMENT OF MOST STRATEGIES IN 2017. ANTICIPATED IMPACT: WE BELIEVE THAT THESE STRATEGIES WILL RELIEVE THOSE FACING DIFFICULT DECISIONS BETWEEN HEALTHCARE AND OTHER COMPETING FINANCIAL NEEDS. WE BELIEVE THAT WE WILL ALSO BE ABLE TO PROTECT A VULNERABLE POPULATION FROM ADDITIONAL FINANCIAL STRESS FROM THE COST OF CARE. PREVENTIVE CARE PROBLEM STATEMENT: NORTHWEST MISSOURIANS, INCLUDING ATCHISON AND HOLT RESIDENTS, HAVE OPPORTUNITIES FOR INCREASING ACCESS TO PREVENTIVE CARE. AREAS BELOW THE STATE AS A WHOLE INCLUDE ADULT IMMUNIZATIONS, ROUTINE CHECKUPS, COLONOSCOPIES, CLINICAL BREAST EXAMS, MAMMOGRAMS AND HEART DISEASE SCREENINGS. WITH HIGHER THAN STATE AVERAGE IN AVOIDABLE HOSPITALIZATIONS, PREVENTIVE CARE COULD PLAY AN IMPORTANT ROLE IN MAKING THE COMMUNITY HEALTHIER. THERE ARE A VARIETY OF FACTORS THAT CONTRIBUTE TO LACK OF PREVENTIVE CARE. OTHER DATA SUGGESTS THAT THE PRIMARY REASON IS COST. WITH CHANGES TO INSURANCE PLANS, ADDITIONAL WELLNESS VISITS ARE NOW COVERED WHICH SHOULD INCREASE UTILIZATION. COMMUNITY HOSPITAL-FAIRFAX STRATEGIES: COMMUNITY HOSPITAL-FAIRFAX WILL HAVE OPENED THREE PRIMARY CARE CLINICS SINCE AUGUST OF 2014. A NEW PROJECT WILL BE INITIATED TO INCREASE PREVENTIVE CARE VISITS IN THE POPULATION CARED FOR BY THESE CLINICS. THESE VISITS WILL INCLUDE TRADITIONAL SCREENINGS ALONG WITH DEPRESSION AND COUNSELING REGARDING ADVANCED DIRECTIVES. TIMELINE: JANUARY 2017 ANTICIPATED IMPACT: WE BELIEVE THAT INCREASING WELLNESS VISITS IN THIS POPULATION WILL INCREASE RATES OF IMMUNIZATIONS AND PREVENTIVE SCREENINGS. UNMET NEEDS CH-F RECOGNIZES THAT WE ARE UNABLE TO MEET EVERY NEED DISCOVERED IN THE CH-F CHNA. SOMETIMES RESOURCES ARE NOT AVAILABLE TO MEET THESE NEEDS OR THE HOSPITAL IS NOT THE BEST ORGANIZATION TO TAKE A LEADERSHIP ROLE. ADDITIONALLY, SOME ORGANIZATIONS ARE ALREADY WORKING ON SOLUTIONS FOR SOME OF THESE ISSUES. THE FOLLOWING DESCRIBES HOW WE INTEND TO MEET THE NEEDS WE IDENTIFIED AND, IF WE CHOSE NOT TO ADDRESS CERTAIN PROBLEMS, WHY. AREA OF CONCERN POPULATION LOSS - NO ATCHISON AND HOLT COUNTIES HAVE EXISTING ORGANIZATIONS TO MEET THESE NEEDS. AGING POPULATION - YES THIS CANNOT BE ADDRESSED; THE NEEDS CAN ONLY BE ANTICIPATED. THE WORK THAT CH-F IS DOING IN CARE TRANSITIONS, WELLNESS AND HOMECARE WILL PREPARE THE HOSPITAL TO MEET THE HEALTH NEEDS OF AN AGING POPULATION. ADDITIONAL PRIMARY CARE RESOURCES WILL ALSO MEET THIS NEED. CHILDREN IN POVERTY - NO CH-F IS NOT DIRECTLY ADDRESSING THIS NEED IN THIS CHNA IMPLEMENTATION PHASE. HOWEVER, THE HOSPITAL HAS ADDED SLIDING FEE SCALE CLINICS IN THE LAST 18 MONTHS WHICH HAVE SERVED THIS NEED. CH-F IS ALSO IN THE SIXTH YEAR OF PROVIDING THE BACK TO SCHOOL FAIRS WHICH INCLUDE FREE SCHOOL SUPPLIES AND SOME HEALTH SERVICES FOR UNDERPRIVILEGED CHILDREN. INADEQUATE SLEEP - NO CH-F DOES NOT HAVE THE RESOURCES TO MEET THIS NEED. HOWEVER, WELLNESS ISSUES ADDRESSING OVERALL HEALTH MAY ASSIST THIS ISSUE. ACCESS TO PRIMARY CARE - YES CH-F PLANS TO OPEN A 3RD CLINIC AND RECRUIT AN ADDITIONAL CLINIC IN THE FALL OF 2016. ACCESS TO SPECIFIC SPECIALISTS - YES CH-F INTENDS TO RECRUIT ADDITIONAL SPECIALISTS IDENTIFIED IN THE SURVEY. ACCESS TO MENTAL HEALTH PROVIDERS - YES CH-F INTENDS TO MAINTAIN AND EXPAND SENIOR LIFE SOLUTIONS. ADDITIONALLY, CH-F INTENDS TO BRING ADDITIONAL COUNSELING SERVICES TO THE AREA. STAGNANT AND BELOW NATIONAL AVERAGE INSURANCE COVERAGE - YES CH-F HAS IDENTIFIED THIS AS A MAJOR ISSUE IN THE COMMUNITY AND WILL BE DEVELOPING STRATEGIES TO ASSIST THE UNINSURED OR UNDERINSURED IN ACCESSING CARE. INABILITY TO PAY FOR CARE - YES SEE ABOVE. PHYSICAL INACTIVITY - YES CH-F IS EXPLORING OPPORTUNITIES TO INCORPORATE PHYSICAL ACTIVITY COACHING AND EDUCATION INTO THE WELLNESS INITIATIVE. PREVENTATIVE HEALTH - YES CH-F IS EXPLORING OPPORTUNITIES TO BUILD WELLNESS CARE THROUGH PRIMARY CARE CLINICS WHICH WILL INCLUDE IDENTIFICATION OF PREVENTIVE HEALTH OPPORTUNITIES. CHRONIC DISEASE - YES CH-F PLANS TO ADDRESS CHRONIC DISEASE CARE THROUGH THE WELLNESS INITIATIVE IN ADDITION TO THE CARE TRANSITIONS PROJECT. CANCER - NO CH-F DOES NOT HAVE THE RESOURCES TO ADDRESS THIS HEALTH ISSUE. CH-F WILL MAINTAIN ALL NECESSARY SERVICES. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C WWW.FAIRFAXMED.COM/CONTACTUS/PAYMENTS/CHARITY-CARE/ 3 MOUND CITY FAMILY MEDICINE 514 STATE STREET MOUND CITY MO 64470 PRIMARY CARE FACILITY WEST NODAWAY FAMILY MEDICINE 226 W MAIN STREET BURLINGTON JUNCTION MO 64428 PRIMARY CARE FACILITY SOUTH HOLT FAMILY MEDICINE 101 SOUTH WASHINGTON OREGON MO 64473 PRIMARY CARE FACILITY SCHEDULE H, PART I, LINE 3C 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 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 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $1,028,992. SCHEDULE H, PART II COMMUNITY HOSPITAL-FAIRFAX PARTICIPATES IN YEAR-ROUND COMMUNITY BUILDING ACTIVITES. IN FEBRUARY, OVER 200 COMMUNITY MEMBERS WERE SERVED IN A FREE HEART HEALTH SCREENING. IN THE SPRING, AREA FIRST GRADERS ENJOY PEDIATRIC ORIENTATION, A FUN FILLED TIME TO VISIT THE HOSPITAL AND LEARN MORE ABOUT BEING A PATIENT OR A HEALTHCARE WORKER. THE SUMMERTIME KICKS OFF A REDUCED PRICE SPEEED AND AGILITY CAMP FOR AREA ATHLETES WHERE THEY GET TO WORK OUT WITH PHYSICAL THERAPY STAFF AND LEARN HOW TO AVOID INJURY. THE ANNUAL BACK TO SCHOOL FAIRS ROUND OUT THE SUMMER WITH OVER 100 KIDS RECEIVING FREE SCHOOL SUPPLIES AND AN OPPORTUNITY TO SPEAK WITH A COUNSELOR ABOUT HEALTHY SCHOOL HABITS. IN THE FALL, BOTH MEN AND WOMEN PARTICIPATE IN HEALTHY EVENTS WITH AN ANNUAL PROSTATE SCREENING AND WOMENS EVENT WHERE FREE SCREENINGS AND HEALTH INFORMATION ARE OFFERED. THROUGHOUT THE YEAR, COMMUNITY MEMBERS HAVE AN OPPORTUNITY TO LEARN FROM HEALTHCARE PROFESSIONALS AT LUNCH AND LEARNS PROVIDED THROUGHOUT THE YEAR. STERLING CONNECTION, A FREE MEMBERSHIP SERVICE OFFERED TO THOSE 55 AND OLDER, ALSO PROVIDES CONNECTION POINTS TO THE HOSPITAL THROUGHOUT THE YEAR INCLUDING ICE CREAM SOCIALS, FREE SCREENINGS AND INFORMATIVE EVENTS. SIDELINE COVERAGE FOR LOCAL SPORTING EVENTS IS ALSO AN IMPORTANT PRIORITY AT COMMUNITY HOSPITAL-FAIRFAX. PHYSICIANS AND PHYSICAL THERAPISTS VOLUNTEER THEIR TIME EACH FALL TO AIDING STUDENT ATHLETES AT AREA FOOTBALL GAMES. SCHEDULE H, PART III, SECTION A, LINE 2 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, SECTION A, LINE 3 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, SECTION A, LINE 4 THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE IS IN NOTE 1 ON PAGE 8 OF THE ATTACHED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 8 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 FY16 MEDICARE COST REPORT. SCHEDULE H, PART III, SECTION A, LINE 9B 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 VI, LINE 2 A. COMMUNITY HOSPITAL-FAIRFAX IDENTIFIED THREE AREAS OF PRIORITY IN THE COMMUNITY NEEDS ASSESSMENT. I. PRIMARY CARE ACCESS PRIMARY CARE ACCESS WAS IDENTIFIED AS A SIGNIFICANT ISSUE. PRIMARY CARE PHYSICIANS ARE SCARCE AND DIFFICULT TO RECRUIT TO RURAL AREAS AND ACCESS TO APPOINTMENTS CAN BE LIMITED. AS A RESPONSE TO THIS IDENTIFIED NEED, COMMUNITY HOSPITAL-FAIRFAX RECRUITED A NEW PRIMARY CARE PHYSICIAN IN THE FALL OF 2016 AND ADDED AN ADDITIONAL NURSE PRACTITIONER IN THE SUMMER OF 2017. COMMUNITY HOSPITAL-FAIRFAX ALSO OPENED A NEW CLINIC SITE IN BURLINGTON JUNCTION IN THE FALL OF 2016 AND ANOTHER SITE IN FAIRFAX IN THE WINTER OF 2018. FINALLY, COMMUNITY HOSPITAL-FAIRFAX MERGED WITH TWO PRIVATELY RUN PHYSICIAN CLINICS IN JULY OF 2017. IN FY2016, 4,861 VISITS WERE MADE TO COMMUNITY HOSPITAL-FAIRFAX PRIMARY CARE CLINICS. IN FY2017, CLINIC VISITS WERE INCREASED TO 6,986. THIS INDICATES CH-F STRATEGIES TO INCREASE PRIMARY CARE ACCESS HAVE RESULTED IN MORE LOCAL APPOINTMENTS AVAILABLE FOR OUR POPULATION. II. MENTAL HEALTH ACCESS. COMMUNITY HOSPITAL-FAIRFAX IDENTIFIED STRATEGIES INCLUDED INCREASING OUR EXISTING SENIOR LIFE SOLUTIONS (GROUP THERAPY PROGRAM), RECRUITING A PSYCHIATRY PRESENCE, DEVELOPING SUPPORT GROUPS AND PARTNERING WITH EXISTING RESOURCES TO BRING COUNSELING TO THE COMMUNITY. IN FY2017, COMMUNITY HOSPITAL-FAIRFAX MOVED A MODULAR BUILDING ONTO THE CAMPUS TO FACILITATE EXPANDING SENIOR LIFE SOLUTIONS AND DOUBLING THE NUMBER OF PARTICIPANTS THAT COULD BE SERVED IN THIS GROUP THERAPY PROGRAM. ALSO, IN FY2017, COMMUNITY HOSPITAL-FAIRFAX ADDED A MONTHLY PSYCHIATRY SPECIALTY CLINIC WITH A PSYCHIATRIST ONSITE THAT TREATS ALL TYPES OF PATIENTS. WORK CONTINUES TO BOLSTER SUPPORT GROUPS AND TO RECRUIT COUNSELING RESOURCES (WHICH REMAIN SCARCE) TO THE AREA. III. 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 FY16 AND FY17. THIS WORK HAS RESULTED IN LOWERING COMMUNITY HOSPITAL-FAIRFAX BAD DEBT FROM 9% APPROXIMATELY TO LESS THAN 6%. IV. PREVENTIVE CARE COMMUNITY HOSPITAL-FAIRFAX IDENTIFIED A NEED FOR ADDITIONAL PREVENTIVE CARE IN OUR COMMUNITIES. OUR STRATEGY FIRST INCLUDED EXPANDING ACCESS TO PRIMARY CARE WHERE THESE OPPORTUNITIES COULD BE IDENTIFIED. NOW THAT WE HAVE SUCCEEDED IN INCREASING ACCESS TO PRIMARY CARE, WE HAVE LAUNCHED AN ACO STRATEGY IN OUR CLINICS TO ADOPT ADDITIONAL MEASURES FOR PREVENTATIVE CARE. A CARE COORDINATOR HAS BEEN HIRED AND AN AGGRESSIVE EFFORT TO SCHEDULE OUR MEDICARE PATIENTS FOR THEIR ANNUAL WELLNESS VISIT HAS RECENTLY BEEN INITIATED. SCHEDULE H, PART VI, LINE 3 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 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 $45,129. SCHEDULE H, PART VI, LINE 5 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. X X false false false false false false false true false ROGER STEINKRUGER CEO 203201 0 43260 0 3043 0 7955 0 20302 0 277761 0 DR DUSTIN CARPENTER MD DOCTOR 241756 0 0 0 905 0 0 0 6976 0 249637 0 RENEE KREIFELS CRNA 154772 0 0 0 1830 0 0 0 6157 0 162759 0 KELLY OSBORN CRNA 155420 0 0 0 120 0 0 0 1863 0 157403 0 HAROLD LAWRENCE PHARMACIST 133429 0 10025 0 964 0 9566 0 30846 0 184830 0 JULIE JONES CNO 161010 0 10000 0 2449 0 0 0 5614 0 179073 0 SCHEDULE J, PART I, LINE 7 BONUSES WERE PAID BASED ON A NUMBER OF PROFESSIONAL AND PERSONAL PERFORMANCE-RELATED CRITERIA. SCHEDULE J, PART II THE COMPENSATION FOR ROGER STEINKRUGER AND HAROLD LAWRENCE ARE PAID THROUGH A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC), AN UNRELATED 501(C)(3) HOSPITAL. SEE SUPPLEMENTAL INFORMATION SCHEDULE L , PART IV A) JAMIE BURKE B) JAMIE BURKE IS AN EMPLOYEE OF CH-F AND THE SISTER OF DR. RICHARD ARON BURKE, WHO IS A DIRECTOR OF CH-F. C) $46,705 D) COMPENSATION E) NO FORM 990, PART III, LINE 4A COMMUNITY HOSPITAL-FAIRFAX (CH-F) PRIDES ITSELF IN PROVIDING ACCESS TO HEALTHCARE TO A REGION WHERE HEALTH SERVICES ARE SPARSE, THE PHYSICIAN RATIO IS 2750:1 (NATIONAL BENCHMARK IS 631:1) AND 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, 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, 69% REPORT PHYSICAL INACTIVITY AND 26% 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: 1. FEBRUARY HEART HEALTHY SCREENING EVENT WITH 200 PLUS PARTICIPANTS. PARTICIPANTS RECEIVED FREE BLOOD PRESSURE, CHOLESTEROL, GLUCOSE AND BODY COMPOSITION ALONG WITH CARDIAC COUNSELING. HEART SCREENINGS ARE HELD IN CLINIC LOCATIONS IN ADDITION TO ONSITE AT THE HOSPITAL. 2. FREE GLUCOSE SCREENINGS, BMI CHECKS AND BLOOD PRESSURE CHECKS BIANNUALLY AT A WOMEN'S EVENT (ATTENDED BY 225 WOMEN). 3. ATTENDANCE AT AREA HEALTH FAIRS OFFERING FREE SCREENINGS. 4. CH-F IS STROKE READY AND HAS PROTOCOL IN PLACE TO RESPOND TO A STROKE WITHIN 60 MINUTES. 5. CH-F STAFF TEACHES HEALTHY EATING CHOICES AND GOOD HABITS FOR A HEALTHY SCHOOL YEAR AT THE AREA BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN. OVER 100 CHILDREN WERE REACHED THROUGH THIS ACTIVITY. 6. AN ANNUAL PROSTATE SCREENING IS HELD BY CH-F. A FREE EXAM WAS PROVIDED TO NEARLY 45 MEN THIS YEAR. IN ADDITION TO RESPONDING TO AREA HEALTH CONCERNS, CH-F ALSO WANTS TO ENSURE THAT THERE ARE HEALTHCARE PROVIDERS FOR FUTURE GENERATIONS IN NORTHWEST MISSOURI. SCHOLARSHIPS ARE AWARDED EACH YEAR TO STUDENTS ENROLLED IN A HEALTHCARE PROGRAM. A CAREER DAY WAS ALSO HOSTED FOR AREA 8TH GRADERS. 55 STUDENTS ATTENDED TO LEARN ABOUT HEALTH CAREERS THROUGH HANDS ON ACTIVITIES WITH PHYSICIANS, LABORATORY, RADIOLOGY, NURSING AND PHYSICAL THERAPY EMPLOYEES. CH-F ALSO HOSTS JUNIORS FOR A CAREER DAY AND OFFERS JOB SHADOWING FOR ALL STUDENTS 16 AND OLDER. CH-F CONTINUES TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE TO A POPULATION THAT WOULD NOT OTHERWISE HAVE ACCESS. RECRUITING PHYSICIANS, NURSES, THERAPISTS AND OTHER HEALTHCARE PROVIDERS IS ONGOING. PURCHASING STATE OF THE ART EQUIPMENT WHEN POSSIBLE AND MAKING SURE THAT EACH MEMBER OF OUR COMMUNITY HAS THE CARE THEY DESERVE IS NOT AN EASY TASK, BUT ONE CH-F IS PROUD TO DO. FORM 990, PART VI, SECTION A, LINE 3 COMMUNITY HOSPITAL ASSOCIATION, INC. HOLDS A MANAGEMENT CONTRACT WITH THE NEBRASKA MEDICAL CENTER (NMC). NMC APPOINTS A CHIEF EXECUTIVE OFFICER TO MANAGE DAY-TO-DAY OPERATIONS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S BY-LAWS STATE THAT THE BOARD OF DIRECTORS SHALL CONSIST OF AT LEAST ELEVEN MEMBERS AND NO MORE THAN FIFTEEN MEMBERS. ONE-HALF 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, SECTION B, LINE 11B 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, SECTION B, LINE 12C 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 VOTED ON BY THE BOARD OF DIRECTORS. IF A MAJORITY VOTE OCCURS THEN THE DISCLOSURE IS CONSIDERED A CONFLICT. THE CONFLICTED INDIVIDUAL MAY NOT VOTE OR PARTICIPATE IN THE MATTERS INVOLVING THE CONFLICT. IT IS NOTED IN THE BOARD MEETING MINUTES THAT THE INDIVIDUAL ABSTAINED FROM VOTING. FORM 990, PART VI, SECTION B, LINES 15A & 15B THE ORGANIZATION USES COMPARABILITY DATA TO DETERMINE THE COMPENSATION OF THE CEO AND OTHER OFFICERS. THE COMPENSATION OF THE CEO IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE COMPENSATION OF THE OTHER OFFICERS IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE MOST RECENT COMPENSATION REVIEW WAS PERFORMED IN 2017 BY SHARON GARDNER, INTERIM HR EXECUTIVE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A THE COMPENSATION FOR DR. ARON BURKE IS FOR SERVICES PERFORMED AS A PHYSICIAN, AND IS NOT COMPENSATION FOR BEING A DIRECTOR. FORM 990 PART IX LINE 11G DESCRIPTION:EMERGENCY ROOM PHYSICIAN FEES TOTAL FEES:451329 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES - PHARMACY TOTAL FEES:260881 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES - OTHER TOTAL FEES:299064 FORM 990 PART IX LINE 11G DESCRIPTION:HOUSEKEEPING TOTAL FEES:193350 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PHYSICIAN FEES TOTAL FEES:93745 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:1201541 COMMUNITY HEALTHCARE FOUNDATION 26136 US HWY 59 FAIRFAX MO 64446 431757553 SUPPORT ORG MO 501(C)(3) 12A CHA true false false true false false false false false false false false false true true true false true false false COMMUNITY HEALTHCARE FOUNDATION C 73028 FMV