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HOSPICE SELF PAY DISCOUNTS & UNCOMPENSATED CARE (CHARITY) POLICY POLICY: 1. PHILOSOPHY: IN KEEPING WITH SIERRA VISTA REGIONAL HEALTH CENTERS VISION TO BE A LEADER IN IMPROVING THE COMMUNITY'S HEALTH CARE STATUS, IT IS CONSIDERED NOT ONLY NECESSARY BUT ALSO APPROPRIATE TO MAKE ADJUSTMENT TO PATIENT CARE CHARGES UNDER CERTAIN CIRCUMSTANCES. IT IS NOT THE INTENT OF THIS POLICY TO RESTRICT THIS PRACTICE, BUT TO ESTABLISH CLEAR GUIDELINES BY WHICH TO ACCOMPLISH THE TASK. 2. DEFINITIONS: BECAUSE ADJUSTMENTS CAN OCCUR FOR SEVERAL REASONS, IT IS NECESSARY TO DEFINE CERTAIN TYPES OF ADJUSTMENTS. A. UNCOMPENSATED CARE: UNCOMPENSATED CARE/CHARITY CARE IS DEFINED AS SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE TO PAY BASED ON INCOME LEVEL, FINANCIAL ANALYSIS, DEMOGRAPHIC INDICATORS AND/OR FURTHER HEALTHCARE NEEDS BASED ON DIAGNOSIS OR CATASTROPHIC CIRCUMSTANCES. B. SELF-PAY DISCOUNT: A PAYMENT ADJUSTMENT MAY OCCUR WHEN THE PATIENT AGREES TO MAKE IMMEDIATE OR PROMPT PAYMENT IN RETURN FOR A REDUCTION IN THE AMOUNT DUE. C. PROCESS: ALL ADJUSTMENTS OF PATIENT CARE CHARGES REQUESTED SHALL BE APPROVED BY PERSONS DESIGNATED AS FOLLOWS: - $25,000 + CFO - $5,000 TO $24,999 DIRECTOR OF REVENUE MANAGEMENT - $101 TO $4999 ASSISTANT MANAGER OF A/R - $1.00 TO $100 A/R STAFF - SELF PAY DISCOUNTS. : A SELF PAY DISCOUNT OF 50% WILL BE APPLIED AT THE TIME OF BILLING. D. PLEASE NOTE ON SELF PAY AFTER INSURANCE, THERE IS NO DISCOUNT ON DEDUCTIBLES OR CO-PAYS AS THIS IS PART OF THE CONTRACTUAL RELATIONSHIP BETWEEN THE PAYER AND THE SUBSCRIBER. ONLY COINSURANCE BALANCES ARE ELIGIBLE FOR DISCOUNTS. E. A COINSURANCE DISCOUNT OF 30% WILL BE APPLIED AT THE TIME OF BILLING. F. UNCOMPENSATED CARE - CHARITY CARE POLICY REQUEST FOR CHARITY CARE (FINANCIAL ASSISTANCE): FINANCIAL ASSISTANCE REQUEST MAY BE MADE BY THE PATIENT, OUTSIDE HEALTH CARE PROVIDERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, FAMILY MEMBERS, AND SVRHC PERSONNEL. THE FINANCIAL COUNSELOR WILL KEEP ON FILE (AND FOR REFERENCE) AN ANNUAL "POVERTY GUIDELINES" AS PUBLISHED BY THE FEDERAL REGISTRY. 1. ELIGIBILITY CONSIDERATIONS FOR FINANCIAL ASSISTANCE: - FINANCIAL ASSISTANCE IS SECONDARY TO ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT INCLUDING INSURANCE, GOVERNMENT PROGRAMS, THIRD PARTY LIABILITY, AND PERSONAL ASSETS. - FULL FINANCIAL ASSISTANCE WILL BE PROVIDED TO A PATIENT/GUARANTOR WITH A GROSS FAMILY INCOME 200% OF THE FEDERAL POVERTY GUIDELINES. DEPENDENT UPON THE ELIGIBILITY CRITERIA FOR THE AHCCCS PROGRAMS - MOST PROGRAMS AHCCCS ELIGIBILITY 100% FPL (FEDERAL POVERTY LEVEL) - A PATIENT /GUARANTOR WILL BE GIVEN PARTIAL FINANCIAL ASSISTANCE BASED ON HIS OR HER INCOME LEVEL UP TO 800% OF THE POVERTY GUIDELINES. - COSMETIC AND OTHER SERVICES THAT ARE NOT MEDICALLY NECESSARY ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE - OTHER CATASTROPHIC CIRCUMSTANCES MAY BE CONSIDERED IN THE CHARITY DECISION. - AHCCCS ELIGIBILITY WITHIN 60 DAYS OF SERVICE WILL BE PROOF OF INDIGENCE - MEDICAL INDIGENCE -EVALUATE ADDITIONAL CIRCUMSTANCE - MEDICAL BILLS (COMBINED) GREATER THAN 1 YEAR TIMES ANNUAL INCOME - CATASTROPHIC EVENT/DIAGNOSIS - ASSET AVAILABILITY - PATIENTS/GUARANTORS WILL BE ASKED TO COMPLETE AN APPLICATION FOR ASSISTANCE AND PROVIDE PROOF OF INCOME SUCH AS EMPLOYER PAYMENTS STUBS, BANK STATEMENTS AND/OR TAX RETURN. 2. DETERMINATION: - PATIENTS/GUARANTORS WILL BE NOTIFIED OF FINANCIAL ASSISTANCE DETERMINATION BY PHONE OR IN WRITING. - PATIENTS/GUARANTORS MAY APPEAL A FINANCIAL ASSISTANCE DETERMINATION BY PROVIDING ADDITIONAL INFORMATION SUCH AS INCOME VERIFICATION OR AN EXPLANATION OF EXTENUATING CIRCUMSTANCES TO THE FINANCIAL COUNSELOR FOR REVIEW. - SVRHC'S DECISION TO PROVIDE FINANCIAL ASSISTANCE IN NO WAY AFFECTS THE PATIENTS/GUARANTOR FINANCIAL OBLIGATION TO THEIR PHYSICIAN OR OTHER HEALTH CARE PROVIDERS. THE COMMUNITY BENEFIT REPORT IS CONTAINED IN A SEPARATE REPORT, PREPARED BY AN UNRELATED ORGANIZATION. COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE IS PRIMARILY THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H. OTHER COSTS COME FROM OUR FY2010 COST REPORT. SVRHC PROVIDES SUBSIDIZED HEALTH SERVICES FOR NON-MEDICARE/MEDICAID CARDIAC CATH PATIENTS AT LESS THAN HOSPITAL COST. BAD DEBT INCLUDED ON PART IX LINE 25 IS $2,685,398. THIS AMOUNT HAS BEEN BACKED OUT OF TOTAL EXPENSE USED IN THE DENOMINATOR FOR THE PERCENTAGES IN COLUMN F. THE BAD DEBT EXPENSE (AT COST) WAS CALCULATED USING THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H. THE BAD DEBT EXPENSE IS RECORDED ON THE FINANCIALS AT GROSS CHARGES. EVERY EFFORT IS MADE TO IDENTIFY CHARITY PATIENTS AT THE POINT OF SERVICE SO NONE OF THE PATIENTS WRITTEN OFF TO BAD DEBT SHOULD HAVE BEEN ELIGIBLE FOR CHARITY CARE. IT IS POSSIBLE THAT SOME PATIENTS REFUSED TO COMPLETE THE CHARITY APPLICATION SO THAT NEED COULD NOT BE DETERMINED. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H. MEDICARE CHARGES FOR CATH LAB WERE EXCLUDED SINCE THEY WERE REPORTED AS PART OF THE SUBSIDIZED HEALTH SERVICES. EXPENSE FOR HEALTH PROFESSIONAL EDUCATION WAS THEN EXCLUDED FROM RESULTING COST. THE ENTIRE SHORTFALL CALCULATED SHOULD BE ATTRIBUTABLE TO COMMUNITY BENEFIT, SINCE THERE ARE NO OTHER HOSPITALS IN THE AREA THAT COULD PROVIDE CARE FOR THESE PATIENTS. BAD DEBT PROCESSING PROCEDURE: TO ENSURE THAT ALL UNCOLLECTIBLE AMOUNTS FROM MEDICARE BENEFICIARIES AS WELL AS ALL SELF PAY AFTER INSURANCE AND STRAIGHT SELF PAY HAVE MET THE 120 DAY COLLECTION TIME FRAME AND THAT REASONABLE COLLECTION EFFORTS HAVE BEEN MADE. BAD DEBT REVIEW: - HEALTH CARE OUT SOURCING NETWORK (HON) WILL PROVIDE A LISTING WEEKLY OF ACCOUNTS FOR POSSIBLE APPROVAL FOR BAD DEBT PROCESSING. - ALL ACCOUNTS WILL HAVE BEEN IN SELF PAY COLLECTIONS FOR 120 DAYS PRIOR TO ASSIGNMENT. - ALL ACCOUNTS WILL BE SCREENED TO ENSURE THAT THE CO-PAY AND OR DEDUCTIBLE AMOUNT IS CORRECT. - ALL ACCOUNTS WILL BE SCREENED PRIOR TO BAD DEBT PLACEMENT FOR POSSIBLE PAYMENTS, OTHER THIRD PARTY INSURANCE, AND/OR OTHER AGENCY. - A LISTING OF ANY ACCOUNTS TO BE PULLED FROM COLLECTIONS WILL BE PROVIDED BACK TO HON FOR FURTHER WORK UP. ALL LOCATIONS ARE LICENSED BY THE STATE. A COMMUNITY HEALTH ASSESSMENT WAS PERFORMED BY HMS ASSOCIATES, A NATIONAL COMPANY, FOR SIERRA VISTA REGIONAL HEALTH CENTER IN JULY, 2007. ANOTHER COMMUNITY HEALTH CARE NEEDS ASSESSMENT IS SCHEDULED FOR THE SUMMER OF 2011. THE COMPANY CONDUCTED THE SURVEY UTILIZING THREE TYPES OF INFORMATION: A. STATISTICS ON DEATHS, BIRTHS, SERVICE USE B. COMMUNITY SURVEYS C. OPINIONS OF KEY ORGANIZATIONS THE ASSESSMENT COVERED ALL OF THE HOSPITAL'S SERVICE AREAS WITHIN THE COUNTY AND KEY EFFORTS INCLUDED DURING THE ANALYSIS WERE: GATHERING DATA, ASSIGNING DATA TO HEALTHY PEOPLE PROGRAM CATEGORIES, COMPARING DATA TO BENCHMARKS, ANALYZING DATA AND SELECTING PRIORITIES, AND SUMMARIZING FINDINGS. THE ASSESSMENT WAS THE FOUNDATION FOR SVRHC'S COMMUNITY BENEFIT PLAN WHICH INCLUDES ACTIVITIES AND PROGRAMS TO IMPROVE THE COMMUNITY HEALTH OF OUR CITIZENS. COLLECTION METHODS: ASSESSMENT CAPITALIZED ON EXTENSIVE EXISTING INFORMATION ABOUT COCHISE COUNTY RESIDENTS' HEALTH RELATED NEEDS KEY EFFORTS INCLUDE: - GATHERING DATA - ASSIGNING DATA TO HEALTHY PEOPLE PROGRAM CATEGORIES - COMPARING DATA TO BENCHMARKS - ANALYZING DATA AND SELECTING PRIORITIES - SUMMARIZING FINDINGS THE ASSESSMENT COVERS THE COUNTY AS A WHOLE AND ALSO SIX DIFFERENT COMMUNITIES WITHIN THE COUNTY. OFTEN TIMES, COUNTY PROBLEMS ARE MORE RELATED TO SPECIFIC COMMUNITIES. COMMUNITY ANALYSES HELP TO PINPOINT PROBLEMS AS WELL AS TARGET AND DEFINE THE MOST APPROPRIATE INTERVENTIONS. FINDINGS OF THE COUNTY'S MOST IMPORTANT COMMUNITY NEEDS: NINETEEN HEALTH PROGRAM AREAS WERE CLOSELY STUDIED AND THREE LEVELS OF PRIORITIES EMERGED. ACCESS TO HEALTH CARE IN GENERAL WAS A SIGNIFICANT CONCERN AS WELL. COMMUNITY NEEDS HIGH PRIORITIES: - ACCESS TO CARE - CANCER - CHRONIC DISEASE - HEART DISEASE - INJURY PREVENTION - MATERNAL CHILD HEALTH - SUBSTANCE ABUSE-DRUGS COMMUNITY NEEDS MODERATE PRIORITIES: - DIABETES/OBESITY - HIV - MENTAL HEALTH - ORAL HEALTH - RESPIRATORY DISEASE - SUBSTANCE ABUSE - ALCOHOL - SUICIDE COMMUNITY NEEDS LOW PRIORITIES: - BLOOD RELATED ILLNESSES - CEREBROVASCULAR DISEASE - IMMUNIZATION OR VACCINATION PREVENTABLE DISEASES - NEPHRITIS - RESPONSIBLE SEXUAL BEHAVIOR - VIOLENCE PREVENTION - CANCER - CHRONIC DISEASE - HEART DISEASE - INJURY PREVENTION - MATERNAL CHILD HEALTH - SUBSTANCE ABUSE-DRUGS THE FEDERAL POVERTY GUIDELINES CAN BE FOUND AT: https://www.cms.gov/medicaideligibility/downloads/pov10combo.pdf. SIERRA VISTA REGIONAL HEALTH CENTER INFORMS AND EDUCATES OUR PATIENTS AND COMMUNITY MEMBERS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, AND LOCAL GOVERNMENT PROGRAMS AND UNDER THE HOSPITAL'S CHARITY CARE POLICY IN THE FOLLOWING WAYS: A. INFORMATION ON ELIGIBILITY ASSISTANCE IS PROVIDED ON THE WEBSITE, AT THE HOSPITAL'S WELLNESS DEPOT, AND IN PAMPHLETS. B. EACH PATIENT IS VISITED BY AN ELIGIBILITY SPECIALIST TO DISCUSS ONE-ON-ONE ELIGIBILITY ASSISTANCE. C. THERE ARE POSTED SIGNS WITHIN THE HOSPITAL NOTIFYING PATIENTS/COMMUNITY MEMBERS ON ASSISTANCE. D. FOR PATIENTS UNABLE TO INTERACT WITH AN ELIGIBILITY SPECIALIST AT THE TIME OF ARRIVAL THROUGH THE EMERGENCY ROOM, THE DEMOGRAPHICS AND INFORMATION SHEET IS VIEWED BY THE SPECIALIST AND CONTACT IS MADE WITH EACH ONE TO DISCUSS ELIGIBILITY. E. THERE IS A STATEMENT ON EACH BILL SENT TO ALL PATIENTS ABOUT ELIGIBILITY ASSISTANCE. THE HOSPITAL UTILIZED THE DEMOGRAPHIC INFORMATION PROVIDED BY THE ASSESSMENT ON THE POPULATIONS OF THE CITIES WITHIN COCHISE COUNTY AND INFUSED THESE FINDINGS INTO OUR PLAN. WE LOOKED AT THE POPULATION SIZE AND DENSITY, DISTRIBUTION, AND VITAL STATISTICS OF EACH CITY COUPLED WITH THE HEALTH NEED FINDINGS TO ESTABLISH EDUCATION AND PROGRAMS FOR THE POPULACE. SOME OF THE DEMOGRAPHIC INFLUENCES UNIQUE TO OUR SERVICE AREA INCLUDE THE FOLLOWING: A. DUE TO ANTICIPATED POPULATION GROWTH, THE NEED FOR SERVICES WILL GROW BY 50% OVER THE NEXT 20 YEARS B. THE POPULACE OF 50+ YEARS IS PROJECTED TO GROW BY 54% OVER THE NEXT 20 YEARS C. RETIREE GROWTH IS ALSO PROJECTED TO GROW BY 18% OVER THE NEXT 20 YEARS D. POPULATIONS DENSITY VARIES (FROM 500 TO 65,000) DUE TO MOST OF OUR SERVICE AREA BEING RURAL E. ALL OF OUR SERVICE AREA HAS CULTURAL SENSITIVITY CHARACTERISTICS F. THE POPULACE HAS SPECIAL POPULATIONS WITHIN OF GROUP HOMES, ARMED FORCES, CIVILIAN VETERANS (TWO AGE GROUPS - 18 TO 64 AND OVER 64) G. DEMOGRAPHICS SHOW HIGH HEALTH RISK BEHAVIOR LEVELS, POOR HEALTH STATUS, AND CONSIDERABLE CONCERN BY COMMUNITY LEADERS AND KEY HEALTH CARE PROVIDERS WITHIN THE COUNTY H. ACCESS TO CARE WAS A MAJOR CONCERN IDENTIFIED FOR THE COUNTY I. THE COUNTY RELIES ON THE EMERGENCY ROOM FOR CARE MORE THAN ANY OTHER COUNTY IN THE STATE IN ACCORDANCE WITH OUR MISSION AND PHILOSOPHY, SIERRA VISTA REGIONAL HEALTH CENTER COMMITS SUBSTANTIAL RESOURCES TO SPONSOR A BROAD RANGE OF SERVICES TO BOTH THE POOR AND UNDERSERVED. OUR COMMUNITY BENEFIT INCLUDES THE COST OF PROVIDING SERVICES TO PERSONS WHO CANNOT AFFORD HEALTH CARE DUE TO INADEQUATE RESOURCES, UNDOCUMENTED PATIENTS, AND/OR WHO ARE UNINSURED OR UNDERINSURED. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COST OF TRADITIONAL CHARITY CARE, UNPAID PORTIONS OF ACCHHS AND SUPPLIES OR STAFF TIME VOLUNTEERED ON BEHALF OF THE COMMUNITY. COMMUNITY BENEFIT PROVIDED TO THE COMMUNITY INCLUDES THE COST OF PROVIDING SERVICES TO OTHER POPULATIONS WHO MAY NOT QUALIFY AS POOR; BUT MAY NEED SPECIAL SERVICES AND SUPPORT. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COST OF UNPAID PORTIONS OF MEDICARE AND OTHER PROGRAMS FOR SENIOR CITIZENS SUCH AS HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS, AND SCREENINGS. ALL OF THESE ARE NOT BILLED OR CAN BE PROVIDED ON A DEFICIT BASIS. IT ALSO INCLUDES UNPAID PORTIONS OF TRAINING HEALTH PROFESSIONALS SUCH AS MEDICAL RESIDENTS, NURSING STUDENTS, AND STUDENTS IN ALLIED HEALTH PROFESSIONALS. SIERRA VISTA REGIONAL HEALTH CENTER ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE FINANCIALLY VIABLE. THE DEVELOPMENT OF THESE PROGRAMS IS BASED ON A COMMUNITY HEALTH CARE ASSESSMENT PERFORMED BY AN INDEPENDENT COMPANY. THE CURRENT COMMUNITY OUTREACH PROGRAMS ARE: - FOOD DRIVES - HEALTH FAIRS - HOSPICE BEREAVEMENT GROUP - MALL WALKERS PROGRAM - PARISH NURSE PROGRAM - PERINATAL GRIEF SUPPORT - POISON - SAFETY CLASSES - POSTPARTUM DEPRESSION INFORMATION - POWER OF PINK BREAST CANCER - PRENATAL CLASSES - PULMONARY REHABILITATION - SPEAKERS BUREAU - SMART TEEN EATING PROGRAM - SMOKE SUPPORT GROUP - TELECARE HOME BOUND - VIRTUAL TOUR KITS FOR ALL SCHOOLS - WEIGHT MANAGEMENT PROGRAM - CHOLESTEROL TESTING - WELLNESS DEPOT - OLD MEDICATION DISPOSAL - H1N1 AWARENESS - VICAP - SPACE AND SUPPLIES - CHAIR YOGA - ARTHRITIS PROGRAMS - WATER SAFETY - MRSA AWARENESS - FLU PRECAUTION PROGRAMS - KIDS SPORTS TEAMS 1ST AIDE KITS - MUSIC THERAPY - LIVING WILLS - ADVANCED DIRECTIVES - SUN SAFETY - IMMUNIZATION INFORMATION - BONE MARROW COLLECTION - PULSE OXYGEN TESTS - BODY MASS INDEX - SW SNAKE SAFETY - SW INSECT SAFETY - ARRHYTHMIC DEATH SYNDROME - HEART SAFETY THE HOSPITAL ALSO SPONSORS EVENTS IN THE COMMUNITY WHICH PROMOTE HEALTHY LIFE STYLES AND/OR DISEASE PREVENTION/INFORMATION. THESE EVENTS ARE: - AMERICAN CANCER SOCIETY - FORGACH HOUSE (BATTERED WOMEN/CHILDREN) - LITTLE LEAGUE - GOOD NEIGHBOR ALLIANCE (MEN'S SHELTER) - UNITED WAY (NUMEROUS PROGRAMS) - MARCH OF DIMES - JUST KIDS (CLOTHING PROGRAM) - RUNNING CLUB - YOUTH SOCCER CLUB - SENIOR OLYMPICS - HIGH SCHOOL SCHOLARSHIPS - COLLEGE SCHOLARSHIPS - STATE OF ARIZONA KIDS CARE - AMERICAN HEART ASSOCIATION - AMERICAN RED CROSS BLOOD DRIVES - VICAP - PROJECT GRADUATION (DRUG/ALCOHOL FREE EVENING FOR GRADUATING SENIORS) SIERRA VISTA REGIONAL HEALTH CENTER PROVIDES MANY OPPORTUNITIES FOR COMMUNITY MEMBERS TO PROVIDE US FEEDBACK ON THE PROGRAMS AND SERVICES DELIVERED BY THE HOSPITAL. THESE PROGRAMS INCLUDE: - SVRHC AUXILIARY - SVRHC FOUNDATION - FOCUS GROUPS - FACILITY TOURS - VOLUNTEER SERVICES - COMMUNITY BREAKFASTS - ON LINE SURVEYS - PRESS GANEY SURVEYS - COMMUNITY ASSESSMENTS - WEB SITE - HEALTH BEAT COMMUNICATION IN ADDITION, THE HOSPITAL HOSTS EMT, NURSING, REHABILITATION, PHARMACY, LABORATORY, DIAGNOSTIC IMAGING, NUTRITION, AND RESIDENT STUDENTS. THESE STUDENTS RECEIVE FREE MEALS IN OUR CAFETERIA. THE REHAB AND RESIDENT STUDENTS RECEIVED "DORM" TYPE HOUSING FOR $100 PER MONTH. IN ADDITION, THE HOSPITAL HAS A RESIDENT PROGRAM. THE RESIDENTS RECEIVE FREE MEALS IN THE CAFETERIA AND FREE HOUSING WHEN THEY TRAVEL TO TUCSON FOR CERTAIN ROTATIONS. THE HOSPITAL ALSO SPONSORS A COMPASSION FUND WHICH ALLOWS US TO PURCHASE CLOTHING OR PAY FOR RIDES FOR PATIENTS THAT NEED THESE ITEMS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF AND A COMMUNITY BOARD OF TRUSTEES. THE HOSPITAL PLACES SURPLUS FUNDS BACK INTO THE ORGANIZATION THROUGH OPERATIONS AND ALSO THROUGH THE MANY COMMUNITY BENEFIT PROGRAMS AND CLASSES PROVIDED TO THE COMMUNITY MEMBERS WE SERVE. FROM APRIL 17, 2010 THROUGH JUNE 30, 2010 FOR FISCAL YEAR 6-30-10, THE HOSPITAL WAS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE HOSPITAL DID ENJOY AN INTEGRATIVE NETWORK AGREEMENT WITH CARONDELET HEALTH NETWORK TO FACILITATE WORKING ON PROJECTS. BOTH ORGANIZATIONS RAN COMPLETELY SEPARATE AND THERE WERE NO FINANCIAL COLLABORATIONS. THE AGREEMENT IS NO LONGER IN FORCE. LINE 8: THE ORGANIZATION OPERATES SOLELY IN ARIZONA. ARIZONA DOES NOT CURRENTLY REQUIRE COMMUNITY BENEFIT REPORTING. false SCHOLARSHIPS 13500 PROCEDURES FOR MONITORING FUNDS PART I, LINE 2 SCHOLARSHIP FUNDS (<$5,000) ARE PROVIDED TO COCHISE COLLEGE, AND THE COLLEGE ADMINISTERS THE PROGRAM. X X X false false false false false false false true false MARGARET HEPBURN 385902 0 135505 0 40248 0 28302 0 25458 0 615415 0 0 0 BRUCE NORTON 209583 0 47222 0 3804 0 29444 0 23142 0 313195 0 0 0 REBECCA MCCALMONT 130045 0 33599 0 2065 0 15385 0 19909 0 201003 0 0 0 MARIE WURTH 150589 0 35401 0 1938 0 0 0 19401 0 207329 0 0 0 SCHEDULE J, PART I, LINE 7 BONUS PROGRAM THE EXECUTIVE TEAM, WHICH CONSISTS OF THE CEO, CFO, VICE PRESIDENTS, DIRECTORS, AND MANAGERS, ARE ELIGIBLE FOR PARTICIPATION IN THE BONUS PROGRAM. THE AMOUNT OF BONUS IS DETERMINED BY A BONUS MATRIX, ONE OF THE COMPONENTS OF WHICH IS AN EARNINGS TRIGGER. THE INDUSTRIAL DEV AUTHORITY OF COUNTY OF COCHISE 860445518 191320BL3 2003-06-05 2670000 REFUND BONDS ISSUED ON 12/31/1996 false false 2670000 0 0 0 53400 0 0 2003 true false true true false false false false false true OFFICE SMART TRUSTEE MCDANIEL, OWNER 323936 PURCHASE/SALE OF GOODS false FORM 990, PART I, LINE 6 VOLUNTEER SERVICES VOLUNTEERS IMPACT EVERY DEPARTMENT AND ARE A SOURCE OF COMFORT TO PATIENTS AND FAMILY MEMBERS. THE QUALITY OF CARE THAT SVRHC PROVIDES IS NOT JUST A RESULT OF THE OUTSTANDING STAFF AND PHYSICIANS, BUT ALSO A DIRECT IMPACT FROM THE FRIENDLINESS AND CHEERY ATTITUDES EACH VOLUNTEER GIVES TO THE HOSPITAL. VOLUNTEERS SACRIFICE THEIR TIME AND ENERGY AS AMBASSADORS FOR SVRHC AND ARE TRUE GEMS IN THE COMMUNITY. WE UTILIZE VOLUNTEERS IN MOST OF THE DEPARTMENTS HERE AT THE HOSPITAL. THESE AREAS INCLUDE CLINICAL DEPARTMENTS SUCH AS MATERNAL CHILD, MED. SURGICAL, ICU/TELE, EMERGENCY DEPARTMENTS AND REHABILITATION SERVICES. OUR VOLUNTEERS WORK CLOSELY WITH OUR NURSING STAFF AND TECHNICIANS TO LEND ASSISTANCE WHENEVER NEEDED. THEY HELP GREET PATIENTS AND FAMILY MEMBERS, ANSWER PHONES, STOCK SMALL SUPPLIES, CREATE PACKETS, HELP WITH CHARTS AND TAKE ITEMS TO PATIENTS' ROOMS SUCH AS FLOWERS OR MAIL. OUR NON-CLINICAL DEPARTMENTS INCLUDE MEDICAL RECORDS, CLIENT SERVICES, HUMAN RESOURCES, PATIENT ACCOUNTS AND NUTRITION & FOOD SERVICES. OUR VOLUNTEERS HELP OUT IN THESE AREAS BY MAKING COPIES, DATA ENTRY, PUTTING TOGETHER PACKETS, ANSWERING PHONES, COVERING THE OFFICE FOR MEETINGS, MAKING FILES AND DOING FOOD PREPARATION. TRAINING IS REQUIRED WHICH PROVIDES VOLUNTEERS THE NECESSARY TRAINING AND TOOLS TO ASSIST THESE SPECIAL CLIENTS IN THEIR DAILY LIVES. WE ARE REQUIRED TO HAVE A CERTAIN PERCENTAGE OF VOLUNTEER HOURS TO STAFF HOURS TO MAINTAIN OUR STATUS AND MEET MEDICARE GUIDELINES. FORM 990, PART III, LINE 4A EXEMPT PURPOSE ACHIEVEMENTS SIERRA VISTA REGIONAL HEALTH CENTER (SVRHC) OPERATES AN 84 BED SHORT-TERM PRIMARY CARE FACILITY IN RURAL ARIZONA. SVRHC PROVIDES A FULL RANGE OF INPATIENT, OUTPATIENT, DIAGNOSTIC AND REHABILITATION SERVICES. SERVICES PROVIDED FOR YEAR ENDED JUNE 30, 2010 INCLUDED 17,845 INPATIENT PATIENT DAYS, 96,199 OUTPATIENT REGISTRATIONS AND 25,268 EMERGENCY ROOM VISITS. IN SUPPORT OF ITS MISSION AND PHILOSOPHY THE HOSPITAL PROVIDES CARE TO ALL PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE AND ACCORDINGLY THEY ARE NOT RECORDED AS REVENUE. CHARITY CARE SERVICES TOTALED APPROXIMATELY $1,166,000 WHEN MEASURED AT THE HOSPITAL'S ESTABLISHED RATES. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO HAVE ENTERED THE COMMUNITY ILLEGALLY. THE CHARGES FOR THESE PATIENTS ARE PARTIALLY REIMBURSED UNDER SECTION 1011 OF THE MEDICARE PRESCRIPTION DRUG IMPROVEMENT AND MODERNIZATION ACT OF 2003. THE UNREIMBURSED COSTS FOR SERVING THESE PATIENTS WERE APPROXIMATELY $49,000. PUBLIC PROGRAMS SUCH AS AHCCCS AND MEDICARE PROVIDE FOR THE POOR, INDIGENT AND ELDERLY. PUBLIC PROGRAMS DO NOT ALWAYS COVER THE COSTS OF PROVIDING THESE SERVICES; THE UNREIMBURSED COSTS OF THE MEDICARE PROGRAM WERE APPROXIMATELY $10,789,000. BENEFITS PROVIDED TO THE COMMUNITY INCLUDE THE COST OF PROVIDING SERVICES TO OTHER POPULATIONS WHO MAY QUALIFY AS POOR BUT MAY NEED SPECIAL SERVICES AND SUPPORT. THIS TYPE OF COMMUNITY BENEFIT INCLUDES THE COST OF PROGRAMS FOR SENIOR CITIZENS SUCH AS HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, IT ALSO INCLUDES COSTS INCURRED BY THE HOSPITAL FOR TRAINING HEALTH PROFESSIONALS SUCH AS MEDICAL RESIDENTS, NURSING STUDENTS IN ALLIED HEALTH PROFESSIONALS. THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE FINANCIALLY VIABLE. THE DEVELOPMENT OF THESE PROGRAMS IS BASED UPON A COMMUNITY ASSESSMENT PERFORMED BY AN INDEPENDENT COMPANY. SUCH ENDEAVORS INCLUDE LOCAL CHARITIES, NOT-FOR-PROFIT ORGANIZATIONS, YOUTH GROUPS AND OTHER PATIENT SUPPORT GROUPS SUCH AS BUT NOT INCLUSIVE OF: HEALTH SCREENINGS AND ASSESSMENTS, CANCER AND OTHER SUPPORT GROUPS, FREE TRANSPORTATION, MEALS AND MEDICATIONS FOR TRANSIENT PATIENTS WHEN NEEDED, THE AMERICAN HEART ASSOCIATION, MARCH OF DIMES, CANCER SOCIETY, AMERICAN RED CROSS, PRENATAL CLASSES, SENIOR OLYMPICS, HEALTH FAIRS, BLOOD PRESSURE CHECKS, HEALTH CAREER SCHOLARSHIPS FOR HIGH SCHOOL AND COLLEGE STUDENTS, BOY SCOUTS OF AMERICA, LITTLE LEAGUE AND PARTICIPATION IN REGULAR BLOOD DRIVES. FORM 990, PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS DIANE MCDANIELS, TRUSTEE, AND MARI PETERSON, TRUSTEE, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, LINE 11A PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE 990 IS PREPARED BY THE CONTROLLER CAREFULLY CONSIDERING THE ORGANIZATION'S ENTRIES ON THE RETURN. THOSE QUESTIONS CONCERNING COMPENSATION HAVE BEEN REVIEWED WITH THE VICE PRESIDENT OF HUMAN RESOURCES AND ALL COMPENSATION HAS BEEN SUPPLIED BY THE HUMAN RESOURCES DEPARTMENT. THE ENTIRE RETURN HAS BEEN REVIEWED FOR CORRECTNESS WITH THE CFO. ONCE COMPLETED THE RETURN WAS THEN REVIEWED BY ERNST AND YOUNG TAX DEPARTMENT. BEFORE THE FINAL RETURNS ARE FILED, THE COMPLETED 990 AND 990-T ARE REVIEWED WITH THE AUDIT COMMITTEE OF THE BOARD HIGHLIGHTING THE AREAS OF INTEREST TO A GOVERNING BODY. A COMPLETED COPY IS MADE AVAILABLE FOR ALL TRUSTEES TO REVIEW PRIOR TO FILING. ANSWERS ARE PROVIDED TO ANY QUESTIONS OR CONCERNS. FORM 990, PART VI, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICT OF INTEREST THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. THE FOLLOWING PROCEDURES ARE EMPLOYED. ALL OFFICERS, LEADERS OR IDENTIFIED OTHERS SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND SUBMIT IT TO THE HOSPITAL ANNUALLY. THE TERM "CONFLICT OF INTEREST" MEANS THOSE CIRCUMSTANCES WHERE THE BEST INTERESTS OF SIERRA VISTA REGIONAL HEALTH CENTER (SVRHC) CONFLICT WITH EITHER THE ECONOMIC, PROFESSIONAL, POLITICAL OR PERSONAL INTERESTS OF ONE OR MORE OFFICERS, LEADERS OR IDENTIFIED OTHER OF SVRHC. THE RELATIONSHIP BETWEEN SVRHC AND ITS OFFICERS, LEADERS AND IDENTIFIED OTHERS IS ONE WHICH IS COMPLEX AND CHANGING. THERE ARE CIRCUMSTANCES WHICH MAY EXIST WHICH MAY INTERTWINE THE INTERESTS OF SVRHC AND ITS OFFICERS, LEADERS AND IDENTIFIED OTHERS. IN ORDER TO RECOGNIZE AND EFFECTIVELY DEAL WITH CIRCUMSTANCES OF THIS NATURE THE FOLLOWING POLICY HAS BEEN ADOPTED. ANY AND ALL CONFLICTS OF INTEREST SHALL BE DISCLOSED TO THE HOSPITAL EITHER AT THE TIME OF HIRE, INCEPTION OF RELATIONSHIP AND/OR AT THE TIME OF AN INITIAL AGREEMENT/CONTRACT OR AT ANY TIME A CONFLICT OF INTEREST OCCURS. A CONFLICT OF INTEREST QUESTIONNAIRE IS SUBMITTED TO THE HOSPITAL. FAILURE TO COMPLETE AND SUBMIT A QUESTIONNAIRE WILL RESULT IN THE OFFICER, LEADER OR IDENTIFIED OTHER BEING REMOVED FROM THEIR RELATIONSHIP WITH THE HOSPITAL. WHILE THIS IS AN ANNUAL REQUIREMENT, IT IS NOT MEANT TO TAKE THE PLACE OF IMMEDIATE AND APPROPRIATE DISCLOSURE OF A CONFLICT OF INTEREST BY AN OFFICER, LEADER OR IDENTIFIED OTHER TO THE HOSPITAL WHEN CIRCUMSTANCES OCCUR. ANY POTENTIAL CONFLICT OF INTEREST SHALL BE DISCLOSED TO THE HOSPITAL. THE POTENTIAL CONFLICT WILL BE REVIEWED EITHER BY THE CEO/PRESIDENT OR HIS/HER DESIGNEE(S) OR BY THE BOARD OF TRUSTEES' CHAIRPERSON OR HIS/HER DESIGNEE(S) DEPENDING ON THE NATURE OF THE POTENTIAL CONFLICT. A DECISION PERTAINING TO THE CONFLICT OF INTEREST AND THE OFFICER'S, LEADER'S AND IDENTIFIED OTHER'S ABILITY TO CONTINUE IN HIS/HER POSITION AND/OR RELATIONSHIP WILL BE DETERMINED AND SHARED WITH THE OFFICER, LEADER OR IDENTIFIED OTHER. FORM 990, PART VI, LINES 15A AND 15B PROCEDURES USED TO DETERMINE COMPENSATION IT IS THE POLICY OF SIERRA VISTA REGIONAL HEALTH CENTER THAT AN EXECUTIVE'S BASE SALARY WILL BE MAINTAINED AT OR ABOVE THE 50TH PERCENTILE AND THAT ANNUALLY THE BOARD OF TRUSTEES WILL DEVELOP A COMPENSATION PLAN UTILIZING A THIRD PARTY CONSULTANT AND CURRENT MARKET DATA. IT IS THE POLICY OF SIERRA VISTA REGIONAL HEALTH CENTER THAT EXECUTIVES WILL BE PAID AN INCENTIVE BONUS BASED UPON AN ANNUAL PLAN COMPRISED OF FINANCIAL AND NON-FINANCIAL METRICS APPROVED BY THE BOARD OF TRUSTEES, THE PLAN WILL BE APPROPRIATELY ALIGNED WITH THE PROBABILITY OF ACHIEVEMENT. PROCEDURE: - ENGAGE AN INDEPENDENT COMPANY TO CONDUCT A COMPENSATION VALUATION STUDY OF COMPENSATION ARRANGEMENTS IN TAX- EXEMPT ORGANIZATIONS UNDER THE INTERMEDIATE SANCTIONS LEGISLATION. - THE INDEPENDENT COMPANY WILL PROVIDE THE SVRHC BOARD OF TRUSTEES' EXECUTIVE COMPENSATION COMMITTEE COMPETITIVE MARKET DATA TO INCLUDE: A CONFIRMATION OF THE SCOPE, DATA CUTS AND SURVEY SOURCES WITH THE HUMAN RESOURCE TEAM. PROVIDE MARKET COMPARABILITY DATA IN ORDER TO REVIEW THE COMPETITIVENESS OF SVRHC'S PROGRAM. RESEARCH MARKET PRACTICES FOR BOTH SHORT AND LONG TERM PLANS TO DETERMINE ALIGNMENT. REVIEW EXECUTIVE BENEFIT AND PERQUISITE PREVALENCE DATA. - THE INDEPENDENT COMPANY WILL SELECT RELEVANT DATA AND ADJUST THE DATA TO ACCURATELY REFLECT THE SIZE AND SCOPE OF SVRHC'S ROLES AND MEDIAN REVENUE SIZE. - THE INDEPENDENT COMPANY WILL UTILIZE THE SAME METHODOLOGY TO CONDUCT A REVIEW OF INCENTIVE BONUS PLANS FOR THE EXECUTIVE STAFF. - THE INDEPENDENT COMPANY WILL CONSIDER THE FOLLOWING WHEN REVIEWING A PARTICULAR INDIVIDUAL'S COMPENSATION: PRIOR SKILLS AND EXPERIENCE OF INCUMBENTS IN THE ROLE. THE MIX OF COMPENSATION ELEMENTS AND OTHER REWARD COMPONENTS. THE HOSPITAL'S PERFORMANCE VERSUS COMPARABLE PEER PERFORMANCE. THE ABILITY OF THE HOSPITAL TO PAY AT COMPETITIVE LEVELS. - THE INDEPENDENT COMPANY WILL MAKE RECOMMENDATIONS FOR COMPENSATION AND BONUS PERCENTAGES FOR THE EXECUTIVE STAFF TO THE SVRHC BOARD OF TRUSTEES EXECUTIVE COMPENSATION COMMITTEE. - THE COMMITTEE WILL REVIEW THE RECOMMENDATIONS AND FORWARD THEM TO THE ENTIRE SVRHC BOARD OF TRUSTEES FOR APPROVAL. FORM 990, PART VI, LINE 19 AVAILABILITY OF CERTAIN DOCUMENTS TO GENERAL PUBLIC THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. SVRHC PROPERTIES LLC 300 EL CAMINO REAL SIERRA VISTA AZ 85635 860186064 MOB AZ 0 0 NA SVRHC FOUNDATION 300 EL CAMINO REAL SIERRA VISTA AZ 85625 860729397 FUND RAISING AZ 9 509 (A)(2) NA SIERRA VISTA COMMUNITY HOSPITAL AUX INC 300 EL CAMINO REAL SIERRA VISTA AZ 85625 860431251 FUND RAISING AZ 9 509 (A)(2) NA ARIZONA FAMILY CARE ASSOCIATES 6 SOUTH 2ND ST SIERRA VISTA AZ 85635 PHYSICIANS GROUP AZ NA C CORP 0 0 0.58140 false false true false false false false false false false false false true false false false false true SVRHC FOUNDATION C 230060