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X X X true true 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 LINE 3E: PLEASE SEE THE RESPONSE TO SCHEDULE H, PART V, LINE 11 BELOW FOR AN EXPLANATION OF HOW THE HEALTH NEEDS IDENTIFIED IN THE CHNA WERE PRIORITIZED. LINE 5: INPUT FROM INDIVIDUALS IN THE COMMUNITY FOR THE 2018-2021 CHNA, AN EXTENSIVE SURVEY WAS DEPLOYED FOLLOWING THIS PROCESS AND METHODOLOGY: TO COLLECT PRIMARY DATA FROM THE HOSPITAL'S SERVICE AREA POPULATION, A SURVEY WAS DESIGNED, FIELDED, AND ANALYZED TO ENSURE THAT THE PERSPECTIVES OF THE RESIDENTS OF THE SERVICE AREA WERE INCLUDED IN THIS ASSESSMENT, THE HOSPITAL USED A RIGOROUS POPULATION-BASED METHODOLOGICAL APPROACH TO COVER THE SERVICE AREA. TO DEVELOP THE SURVEY USED FOR THE CHNA, THE HOSPITAL PARTNERED WITH FACULTY FROM INDIANA-BASED UNIVERSITIES WHO HAD PARTICULAR EXPERTISE IN COMMUNITY-BASED SURVEY RESEARCH. DR. WILLIAM MCCONNELL OF THE UNIVERSITY OF EVANSVILLE SERVED AS THE LEAD RESEARCHER ON THE PROJECT, IN PARTNERSHIP WITH DR. MICHAEL REECE AND DR. CATHERINE SHERWOOD-LAUGHLIN (BOTH OF THE INDIANA UNIVERSITY SCHOOL OF PUBLIC HEALTH). THE UNIVERSITY OF EVANSVILLE CONTRACTED WITH THE CENTER FOR SURVEY RESEARCH (CSR) AT INDIANA UNIVERSITY TO ADMINISTER THIS SURVEY IN TWO PHASES: PHASE I WAS CONDUCTED AS A PAPER SURVEY MAILED TO A RANDOM ADDRESS-BASED SAMPLE AND PHASE II WAS CONDUCTED AS A PAPER SURVEY ADMINISTERED BY THE HOSPITALS TO A CONVENIENCE SAMPLE OF THEIR CHOOSING. THE SURVEY WAS CONDUCTED WITH APPROVAL OF THE INSTITUTIONAL REVIEW BOARD (IRB) OF THE UNIVERSITY OF EVANSVILLE. PLANNING AND DEVELOPMENT FOR THE SURVEY BEGAN IN THE WINTER OF 2017. USING A CONSTRUCT-BASED APPROACH THAT IDENTIFIED THE LEADING AREAS TO BE INCLUDED ON THE SURVEY, THE HOSPITALS AND FACULTY DEVELOPED A SURVEY. THE SURVEY INCLUDED MEASURES THAT HAD BEEN VALIDATED FOR USE IN SIMILAR PROJECTS BY OTHER RESEARCHERS AND ADDITIONAL MEASURES THAT WERE DEVELOPED BY THE PARTNERS FOR SPECIFIC NEEDS OF THIS CHNA. THE SURVEY COVERED TEN MAJOR AREAS. TWO WEIGHTING ADJUSTMENTS WERE MADE TO ENHANCE CONSISTENCY BETWEEN THE SURVEY SAMPLE AND THE CHARACTERISTICS OF THE HOSPITAL'S SERVICE POPULATION. THE FIRST WAS A BASE WEIGHT ADJUSTMENT TO ACCOUNT FOR UNEQUAL PROBABILITIES OF SELECTION WITHIN HOUSEHOLD. THE SECOND WAS A POSTSTRATIFICATION ADJUSTMENT TO THE U.S. CENSUS BUREAU 2012-2016 AMERICAN COMMUNITY SURVEY FIVE-YEAR POPULATION ESTIMATES. THE TWO WEIGHTING ADJUSTMENTS WERE MULTIPLIED TO CALCULATE A PRELIMINARY FINAL WEIGHT FOR EACH HOSPITAL'S CATCHMENT AREA. THESE PRELIMINARY WEIGHTS WERE THEN TRIMMED AND SCALED SO THAT THE FINAL WEIGHTS SUMMED TO THE NUMBER OF RESPONDENTS IN EACH CATCHMENT AREA. DUE TO THE SCIENTIFIC RIGOR OF THIS SURVEY, IN PREPARATION FOR THE 2022-2024 CHNA, THE SAME SURVEY WAS SENT TO RESIDENTS USING CONVENIENCE SAMPLING TO VERIFY THAT THE RESULTS OF THE SURVEY WERE ACCURATE. ADDITIONAL QUESTIONS WERE ADDED RELATED TO COVID TO ASSIST IN UNDERSTANDING ANY DIFFERENCE DUE TO THE PANDEMIC. BECAUSE DATA COLLECTION OCCURRED DURING THE PANDEMIC, FOCUS GROUPS WERE UNABLE TO BE HELD. TO GAIN A FURTHER UNDERSTANDING OF COMMUNITY NEEDS, A SURVEY TO COMMUNITY PARTNERS, SUCH AS THE ONES LISTED BELOW, WAS ADMINISTERED. THE SURVEY MIRRORED THE RESIDENT SURVEY, WITH THE INCLUSION OF QUESTIONS RELATED TO COVID AND RECOVERY. SAMPLE OF PARTICIPATING ORGANIZATIONS - PURDUE EXTENSION (3) - YOUTH SERVICES BUREAU - CRAWFORDSVILLE COMMUNITY SCHOOL CORPORATION - CRAWFORDSVILLE FIRE DEPARTMENT - NURSE FAMILY PARTNERSHIP (2) - WABASH COLLEGE - CRAWFORDSVILLE PARKS DEPARTMENT - CRAWFORDSVILLE PUBLIC LIBRARY - MONTGOMERY COUNTY HEALTH DEPARTMENT - FRANCISCAN HEALTH (3) - WABASH VALLEY ALLIANCE - COMMUNITY HEALTHNET - COVERING KIDS AND FAMILIES - METHODIST HOSPITALS - COMMUNITY HEALTH CARE - FRANCISCAN HEALTH (2) - PURDUE UNIVERSITY NORTHWEST - NORTHWEST INDIANA COMMUNITY ACTION - NURSE FAMILY PARTNERSHIP (2) - CROWN POINT SCHOOLS - HEALTHY START - MUNSTER PARKS AND RECREATION - PURDUE EXTENSION (2) - THE INTREPID PHOENIX - FOOD BANK OF NORTHWEST INDIANA (2) - AREA HEALTH EDUCATION CENTER - INDIANA UNIVERSITY NORTHWEST (2) - GIRLS ON THE RUN - HOPE CHRISTIAN CHURCH - INDIANA PARENTING INITIATIVE (2) - COMMUNITY HEALTH NETWORK (2) - ANTHEM - NURSE FAMILY PARTNERSHIP - WINDROSE HEALTH - INDY SOUTHSIDE QUALITY OF LIFE - YMCA - CITY OF GREENWOOD - INDIANA YOUTH INSTITUTE - AREA HEALTH EDUCATION CENTER - GREATER SOUTHSIDE BUSINESS ALLIANCE - NURSE FAMILY PARTNERSHIP - THE VILLAGES - PURDUE UNIVERSITY SCHOOL OF NURSING - AREA IV AGENCY (2) - BOY SCOUTS - NORTH CENTRAL HEALTH SERVICES - PURDUE EXTENSION (3) - RIGGS COMMUNITY HEALTH CENTER - INDIANA UNIVERSITY HEALTH - FRANCISCAN HEALTH (4) - YWCA - BAUER SERVICES - LOCAL WOMEN INFANT CHILDREN'S ("WIC") AGENCY - HEALTHY COMMUNITIES OF CLINTON COUNTY/COVERING KIDS AND FAMILIES - INDIANA YOUTH INSTITUTE - PURDUE EXTENSION-4-H - FOOD FINDERS - LTHC HOMELESS SERVICES - UNITED WAY OF LAPORTE COUNTY - DUNEBROOK - PURDUE EXTENSION (2) - OPEN DOOR (2) - SOUTH CENTRAL SCHOOL DISTRICT - SWANSON CENTER - IVY TECH - BOYS AND GIRLS CLUB - YMCA (2) - FRONTLINE FOUNDATION - WALKER MEDICAL - AREA HEALTH EDUCATION CENTER - UNITY FOUNDATION - LAPORTE COUNTY HEALTH DEPARTMENT - HEALTHIER MORGAN COUNTY INITIATIVE - PURDUE GLOBAL - BRIDGES OF HOPE - IVY TECH - LIFE SMART YOUTH - UNITED WAY - MDWISE - BOYS AND GIRLS CLUB - MOORESVILLE PARKS DEPARTMENT - MOORESVILLE SCHOOLS YMCA - MORGAN COUNTY SUBSTANCE ABUSE COUNCIL (2) - MORGAN COUNTY HEALTH DEPARTMENT - PEACE RESTORED - JACKSON CENTER - MOORESVILLE CHAMBER OF COMMERCE - REACH FOR YOUTH - GIRL SCOUTS - BLOOM TOWNSHIP HIGH SCHOOL - GOVENORS STATE UNIVERSITY (2) - PARK FOREST POLICE - PRAIRIE STATE COLLEGE - SOUTH SUBURBAN FAMILY SHELTER - DISTRICT 163 SCHOOLS (2) - FRANCISCAN HEALTH (3) - DISTRICT 227 SCHOOLS - PREVENT CHILD ABUSE - SOUTH SUBURBAN PADS - RESPOND NOW (2) - FRANCISCAN HEALTH (3) - DISTRICT 227 SCHOOLS (2) - JONES CENTER LINE 7: ALL CHNA REPORTS ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT HTTPS://FRANCISCANBEACONHOSPITAL.ORG/COMMUNITY-HEALTH-RESOURCES. IN ADDITION, A PRINT COPY IS AVAILABLE FREE OF CHARGE IN THE HOSPITAL'S ADMINISTRATIVE OFFICE. LINE 10: ALL IMPLEMENTATION PLANS ARE CONTAINED IN THE CHNA AS 'CHAPTER 6: CALL TO ACTION.' THE REPORTS ARE AVAILABLE ON THE HOSPITAL'S WEBSITE AT HTTPS://FRANCISCANBEACONHOSPITAL.ORG/COMMUNITY-HEALTH-RESOURCES. LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT THE TOP HEALTH NEEDS IN A COMMUNITY IS A DIFFICULT PROCESS. MANY POOR HEALTH OUTCOMES, HEALTH DISPARITIES, AND POOR SOCIAL DETERMINANTS OF HEALTH WEIGH HEAVILY ON SEGMENTS OF OUR COMMUNITY. WE ALSO ACKNOWLEDGE THAT THERE ARE MANY STRENGTHS AND POSITIVE GROWTH THAT BALANCE SOME OF THESE CHALLENGES. FRANCISCAN HEALTH DETERMINED THE TOP HEALTH NEEDS BY REVIEWING SECONDARY DATA, SURVEY RESPONSES, AND FEEDBACK FROM INPUT MEETINGS. A CORE TEAM OF SIX STAFF MEMBERS WITH EDUCATION AND EXPERIENCE IN PUBLIC HEALTH WORKED WITH STAFF IN EACH COMMUNITY TO COME TO A CONSENSUS ON THE TOP ISSUES. A COMBINATION OF MULTIVOTE RANKING AND THE HANLON METHOD WERE USED. ONCE A REFINED LIST OF THE TOP TEN ISSUES WAS BROUGHT TO CONSENSUS, EACH STAFF MEMBER RANKED HEALTH ISSUES BASED ON SIZE, SERIOUSNESS, EQUITY, TYPES OF INTERVENTION, AND URGENCY. TO ASSIST WITH INTERVENTION PLANNING, A SECOND SCORE ON THE POTENTIAL FOR FRANCISCAN HEALTH TO PRIORITIZE THE HEALTH ISSUE WAS DETERMINED. SCORING CRITERIA INCLUDED INTERNAL CAPACITY, COMMUNITY ACCEPTABILITY, SUSTAINABILITY, AND LONG-TERM IMPACT. USING A MIX OF HANLON AND PEARL TECHNIQUES, THE FRANCISCAN HEALTH COMMUNITY HEALTH TEAM SCORED THE SECONDARY DATA, FEEDBACK MEETING COMMENTS, AND SURVEY DATA TO PRODUCE THE LIST OF TOP HEALTH NEEDS IN THE COMMUNITY. IN DETERMINING COMMUNITY HEALTH INTERVENTIONS FOR THE SELECTED PRIORITY HEALTH NEEDS, HEALTH EQUITY, SUSTAINABILITY, AND AN EMPHASIS ON SOCIAL DETERMINANTS OF HEALTH WERE HEAVILY WEIGHTED. WHILE MOST INTERVENTIONS FOCUS ON INDIVIDUAL LIFESTYLE FACTORS, KNOWLEDGE, SKILLS, AND BEHAVIORS, CONSIDERATION OF THE CULTURAL AND ENVIRONMENTAL CONTEXTS ARE JUST AS IMPORTANT. FRANCISCAN ALLIANCE ACKNOWLEDGES THAT TRUE CHANGE COMES WITH MAJOR SHIFTS IN ALL AREAS. THE FIRST CRITERIA USED TO DETERMINE IMPLEMENTATION STRATEGIES IS THE CONNECTION TO THE SOCIO-ECOLOGICAL MODEL AND SOCIAL DETERMINENTS OF HEALTH. INTERVENTIONS IMPLEMENTED BY FRANCISCAN ALLIANCE ARE PERSON-CENTERED AND DESIGNED TO CREATE LASTING CHANGE. MALCOLM KNOWLES' PRINCIPLES OF ANDRAGOGY PROVIDED THE FRAMEWORK. WHILE THIS MODEL IS BASED ON EDUCATIONAL PROGRAMMING, IT APPLIES TO ALL TYPES OF INTERVENTIONS. FOR EXAMPLE, IN THE PROVISION OF CLINICAL CARE OR MEDICATION ASSISTANCE, PARTICIPANTS NOT ONLY RECEIVE THE CARE OR MEDICATION, THEY ALSO LEARN TO BETTER MANAGE THEIR OWN HEALTH OR ACCESS COMPONENTS OF THE HEALTH SYSTEM OR ASSISTANCE PROGRAM. REFLECTION, TEACH-BACK, AND COMMUNICATION TECHNIQUES ARE UTILIZED TO EMPOWER THE PARTICIPANT TO MOVE BEYOND A ONE-TIME INTERACTION OR ASSISTANCE. FRANCISCAN ALLIANCE USES EVIDENCE-BASED PRACTICES IN PLANNING INTERVENTIONS WHENEVER POSSIBLE, AS THESE PROGRAMS HAVE BEEN THOROUGHLY TESTED AND HAVE PROVEN EFFICACY. WHEN EVIDENCE-BASED PROGRAMS ARE NOT AVAILABLE, BEST PRACTICES AND DOCUMENTED RESEARCH GUIDES THE DEVELOPMENT AND IMPLEMENTATION OF THE INTERVENTION. IMPLEMENTATION ACTIVITIES WILL BE EVALUATED TO THE FULLEST EXTENT. USING THE KIRKPATRICK MODEL (A STANDARDIZED EVALUATION SYSTEM BASED ON REACTION, LEARNING, BEHAVIOR, AND RESULTS) AS A GUIDE, EVALUATION OF NOT ONLY THE PROGRAM, BUT ITS IMPACT AND RESULTS WILL BE REVIEWED. THIS PROCESS ALLOWS FOR CHANGES TO BE MADE TO IMPROVE THE PROGRAM ON AN ONGOING BASIS. WHILE IT CAN BE DIFFICULT TO DETERMINE THE EXACT CAUSE OF INDIVIDUAL BEHAVIORAL CHANGE, BIOMETRICS, POST-FOLLOW UP SURVEYS, AND OTHER METHODS WERE USED TO CAPTURE QUALITATIVE AND QUANTITATIVE DATA. LINE 11: COMMUNITY HEALTH NEEDS ASSESSMENT CON'T THE FOLLOWING SHOWS THE TOP HEALTH NEEDS IN THREE CATEGORIES: SOCIAL NEED, POOR HEALTH BEHAVIORS, AND POOR HEALTH OUTCOMES. THIS TAKES INTO ACCOUNT THE COMPLEXITY OF SOCIAL DETERMINANTS OF HEALTH AND THE MANY FACTORS THAT MAKE UP INDIVIDUAL HEALTH. IN SOME CASES, ONE WILL NOTICE A CLEAR PATH BETWEEN SOCIAL NEED, POOR BEHAVIORS, AND THE RESULTING OUTCOME. MANY NEEDS ARE SELF-EXPLANATORY OR BASED ON COMMONLY UNDERSTOOD DEFINITIONS. HOWEVER, SOME ISSUES ARE A BIT NUANCED OR EMERGING COMMUNITY TRENDS. THE DEPARTMENT OFFERS THESE DEFINITIONS TO AID IN UNDERSTANDING IDENTIFIED ISSUES: SOCIAL COHESION - INCLUDES OVERALL SENSE OF COMMUNITY, SOCIAL BONDING, BRIDGING, CONNECTEDNESS, SUPPORT NETWORKS, FAMILY BUILDING, "WARM HAND-OFF" FOR RESOURCES, UNDERSTANDING OF OTHERS, COMMUNICATION AND CONFLICT SKILL DEVELOPMENT - HOW WE KNOW: VICTIMIZATION RATES, BEHAVIORAL HEALTH ISSUES, SOCIAL SERVICE AGENCIES REPORT/SURVEY, SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO), PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA VICTIMS OF VIOLENCE - INCLUDES DOMESTIC AND INTERPERSONAL VIOLENCE, CHILD ABUSE/NEGLECT, HUMAN TRAFFICKING, VIOLENT CRIME, ELDER ABUSE/NEGLECT - HOW WE KNOW: MORTALITY RATES, PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATE, LACK OF SERVICE PROVIDER CAPACITY; CHINS CASES, DCS/DCFS SUBSTANTIATED ABUSE CASES, VIOLENT CRIME RATES, ED DATA, HATE CRIME RATES BEHAVIORAL HEALTH - INCLUDES DIAGNOSED AND UNDIAGNOSED MENTAL HEALTH ISSUES, SUICIDE, SELF-HARM, DEPRESSION, ANXIETY - HOW WE KNOW: SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO), SUICIDE RATES, SELF-HARM RATES, POOR MENTAL HEALTH DAYS, PROFESSIONAL SURVEY DATA, PUBLIC SURVEY DATA, LACK OF RESOURCES SUBSTANCE ABUSE - INCLUDES ILLEGAL DRUGS, PRESCRIPTION ABUSE, ALCOHOL - HOW WE KNOW: MORTALITY RATES, OVERDOSE RATES, DUI, ED/PATIENT DATA, PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA ACCESS TO HEALTH CARE - INCLUDES BARRIERS THAT PREVENT OR LIMIT ACCESS TO NEEDED HEALTH CARE SERVICES, NO TRANSPORTATION, LACK OF INSURANCE, UNDERINSURED, TRANSPORTATION, AVAILABILITY OF PROVIDERS AND SERVICES - HOW WE KNOW: PUBLIC SURVEY DATA, PROFESSIONAL SURVEY DATA, INSURANCE RATES, SERVICE PROVIDER RATES (PATIENT:PROVIDER RATIO) THE HOSPITAL MADE THE FOLLOWING PROGRESS DURING 2022 IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS FROM ITS MOST RECENT CHNA: TOP HEALTH NEEDS INCLUDE (TOP NEEDS FIRST): - FOOD INSECURITY - POVERTY - BEHAVIORAL HEALTH - SOCIAL COHESION - NUTRITION - SUBSTANCE ABUSE - PHYSICAL ACTIVITY - CANCER - CARDIOVASCULAR DISEASES - DIABETES - INFANT MORTALITY - TEEN PREGNANCY 'HEALTHY BODIES, HEALTHY MINDS, AND HEALTHY CONNECTIONS' TO DESCRIBE A COMPREHENSIVE APPROACH TO THESE TOP HEALTH NEEDS, THE FOLLOWING INTERVENTIONS WERE PROVIDED: -FREE PHYSICAL ACTIVITY PROGRAMMING, INCLUDING 'FIT TOGETHER' FOR FAMILIES AND 'WALK WITH A DOC' -EDUCATION ON HEALTHY FOOD/NUTRITION, 'EAT SMART, MOVE MORE' -SUICIDE PREVENTION COURSES, INCLUDING QPR AND ASIST -FACILITATION OF A COMMUNITY WIDE RESILIENCE COALITION -PROFESSIONAL TRAINING ON TRAUMA INFORMED CARE, RESILIENCE AND MINDFULNESS FOR NON-PROFITS -ADOPTION OF THE NATIONAL 'REACH OUT AND READ' PROGRAM -OPENING OF A DIAPER PANTRY -EXPANSION OF THE PRENATAL ASSISTANCE PROGRAM -OFFERING OF YOUTH MENTAL HEALTH FIRST AID COURSE -OFFERING OF YOUTH MENTAL HEALTH FIRST AID COURSE LINE 15 AND 16: THROUGH FRANCISCAN ALLIANCE, INC. ("FRANCISCAN"), WE CONTINUE THE HEALING MINISTRY OF CHRIST IN A CATHOLIC HEALTH CARE SYSTEM THAT UPHOLDS THE MORAL VALUES AND TEACHINGS OF THE CATHOLIC CHURCH. CENTRAL CONCERNS OF THIS CORPORATE MINISTRY INCLUDE COMPASSION FOR THOSE IN NEED, RESPECT FOR LIFE AND THE DIGNITY OF PERSONS. FRANCISCAN BELIEVES IN THE DIGNITY, UNIQUENESS, AND WORTH OF EACH INDIVIDUAL AND, WITHIN THE LIMITS OF OUR RESOURCES, FRANCISCAN OFFERS A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES TO ALL REGARDLESS OF RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, HANDICAP OR AN INDIVIDUAL'S FINANCIAL CAPABILITY. IN LIGHT OF THIS BELIEF, WE CONSIDER OUR HEALTH CARE SERVICES TO BE REACHING OUT AND RESPONDING, IN A CHRIST-LIKE MANNER, TO THOSE WHO ARE PHYSICALLY, MATERIALLY, OR SPIRITUALLY IN NEED. FRANCISCAN IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE, IN THE FORM OF CHARITY CARE OR UNINSURED DISCOUNTS, TO PERSONS WHO ARE UNINSURED OR UNDERINSURED, WHO ARE INELIGIBLE FOR GOVERNMENTAL OR SOCIAL SERVICE PROGRAMS, AND WHO OTHERWISE ARE UNABLE TO PAY FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. CONSISTENT WITH OUR MISSION TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE AND TO ADVOCATE FOR THOSE WHO ARE POOR AND DISENFRANCHISED, FRANCISCAN STRIVES TO ENSURE THE FINANCIAL CAPACITY OF PEOPLE WHO NEED MEDICALLY NECESSARY HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING THAT CARE. FRANCISCAN'S FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ALLOW RELIEF FROM ALL OR PART OF THE CHARGES RELATED TO EMERGENCY OR MEDICALLY NECESSARY HEALTH CARE SERVICES THAT EXCEED A PATIENT'S REASONABLE ABILITY TO PAY. IN ORDER TO ENSURE TRANSPARENCY, CONSISTENCY AND FAIRNESS, WE ASK PATIENTS TO COOPERATE BY PROVIDING NECESSARY INFORMATION TO DETERMINE THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, OUTPATIENT SERVICE SETTINGS, AND ON OUR HOSPITALS' WEBSITES. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT EACH FRANCISCAN HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE, AND HEALTH INSURANCE EXCHANGE PROGRAMS AND FRANCISCAN'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE FRANCISCAN BILLING OFFICE OR DOWNLOADING A COPY AT NO COST FROM FRANCISCAN HOSPITAL'S WEBSITES. 6. PATIENTS/GUARANTORS CAN REQUEST FINANCIAL ASSISTANCE INFORMATION BY CALLING FRANCISCAN'S BILLING OFFICE PHONE LINE ON A 24-HOUR BASIS. 7. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMIHLY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 8. PRIOR TO TRANSFER TO A COLLECTION AGENCY, FRANCISCAN SENDS A MINIMUM OF 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. A PATIENT'S QUALIFICATION FOR CHARITY CARE IS DETERMINED THROUGH A FINANCIAL ASSISTANCE APPLICATION AND SCREENING PROCESS. PATIENTS WHO MAY QUALIFY FOR MEDICAID OR ANY OTHER GOVERNMENTAL ASSISTANCE MUST BE DENIED COVERAGE OR ASSISTANCE FROM THOSE GOVERNMENTAL PROGRAMS PRIOR TO RECEIVING APPROVAL FOR CHARITY CARE. AS SUCH, FRANCISCAN OFFERS PATIENTS ASSISTANCE IN APPLYING OR ENROLLING IN SUCH PROGRAMS. A PATIENT WILL NEED TO FILL OUT, SIGN, AND SUBMIT THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH ALL REQUESTED DOCUMENTATION OF INCOME, EXPENSES, ASSETS, AND LIABILITIES. FRANCISCAN'S BILLING OFFICE WILL PLACE THE PATIENT'S ACCOUNT ON HOLD ONCE A FINANCIAL ASSISTANCE APPLICATION HAS BEEN REQUESTED AND UNTIL A FINANCIAL ASSISTANCE DETERMINATION IS MADE. APPLICANTS ARE TREATED WITH DIGNITY AND RESPECT THROUGHOUT THE FINANCIAL ASSISTANCE PROCESS AND ALL INFORMATION/MATERIALS RECEIVED ARE CONFIDENTIALLY MAINTAINED. FRANCISCAN ALSO UTILIZES AN EXTERNAL VENDOR, SERVICE, OR DATA SOURCE THAT PROVIDES INFORMATION ON A PATIENT'S OR GUARANTOR'S ABILITY TO PAY (I.E. CREDIT SCORING). ELIGIBILITY FOR CHARITY CARE MAY BE DETERMINED AT ANY POINT IN THE COLLECTIONS CYCLE (I.E. PRIOR TO THE PROVISION OF SERVICES, DURING THE NORMAL COLLECTIONS CYCLE, OR MAY BE USED TO RE-CLASSIFY ACCOUNTS AFTER THEY HAVE BEEN DEEMED UNCOLLECTIBLE AND SUBSEQUENTLY RETURNED FROM A THIRD PARTY COLLECTION AGENCY). ONCE APPROVED, THE PATIENT WILL REMAIN ELIGIBLE FOR CHARITY CARE FOR A MAXIMUM OF FOUR MONTHS. THE ELIGIBILITY PERIOD WILL BEGIN FROM THE DATE OF THE PATIENT'S APPROVAL OF CHARITY CARE. CHARITY CARE DISCOUNTS WILL BE GIVEN FOR CURRENT OPEN ACCOUNTS AND THE FOLLOWING FOUR MONTHS OF EMERGENCY SERVICES OR MEDICALLY NECESSARY CARE. AFTER THE ELIGIBILITY PERIOD HAS ELAPSED, THE PATIENT MUST REAPPLY FOR FINANCIAL ASSISTANCE. LINES 16A, 16B, AND 16C: THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE AVAILABLE AT THE FOLLOWING ADDRESS: HTTPS://FRANCISCANBEACONHOSPITAL/ORG/PAY-YOUR-BILL/. SCHEDULE H, PART VI, ITEM 2 FRANCISCAN BEACON HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE BY COLLABORATING WITH PUBLIC AND PRIVATE AGENCIES TO DETERMINE COMMUNITY HEALTH NEEDS AND HOW BEST TO ADDRESS THEM. FRANCISCAN BEACON HOSPITAL'S CORPORATE COMMUNITY BENEFIT COMMITTEE, AS WELL AS COMMITTEES IN THE LOCAL FACILITY, COMMITTED TO AN ONGOING ASSESSMENT OF COMMUNITY HEALTH NEEDS AND PRIORITIES BASED UPON HEALTH INITIATIVES OF THE MUNICIPAL, COUNTY, AND STATE HEALTH DEPARTMENTS, COMMUNITY-BASED ASSESSMENTS BY OTHER PUBLIC SECTOR PARTNERS, PROFESSIONAL RESEARCH CONSULTANT REPORTS, AND FAITH-BASED PARTNERS WITHIN THE COMMUNITIES SERVED. IN ADDITION, OUR HOSPITALS ADDRESSES PUBLIC AGENCY AND COMMUNITY GROUP REQUESTS TO PROVIDE COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS THAT MEET CERTAIN SPECIALTY OR HYBRID NEEDS OR POPULATIONS. SCHEDULE H, PART VI, ITEM 3 FINANCIAL ASSISTANCE POLICY FRANCISCAN BEACON HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER FRANCISCAN BEACON HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICY. FOR PATIENTS NOT INITIALLY IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, FRANCISCAN BEACON HOSPITAL COMMUNICATES THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN THE APPLICABLE LANGUAGES OF THE HOSPITAL COMMUNITY THROUGH THE FOLLOWING MEANS: 1. FRANCISCAN BEACON HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE IN APPROPRIATE CARE SETTINGS SUCH AS EMERGENCY DEPARTMENTS, ADMITTING/REGISTRATION AREAS, BILLING OFFICES, AND OUTPATIENT SERVICE SETTINGS. SIGNS/POSTINGS INFORM PATIENTS THAT FREE OR REDUCED COST CARE MAY BE AVAILABLE TO QUALIFYING PATIENTS WHO COMPLETE A FINANCIAL ASSISTANCE APPLICATION. 2. BROCHURES SUMMARIZING OUR FINANCIAL ASSISTANCE PROGRAMS ARE AVAILABLE THROUGHOUT THE HOSPITAL. 3. FINANCIAL COUNSELORS AND BUSINESS OFFICE PERSONNEL ARE AVAILABLE TO HELP PATIENTS UNDERSTAND AND APPLY FOR LOCAL, STATE, FEDERAL HEALTH CARE PROGRAMS; HEALTH INSURANCE EXCHANGES; AND FRANCISCAN BEACON HOSPITAL'S FINANCIAL ASSISTANCE PROGRAMS. 4. ALL BILLS AND STATEMENTS FOR SERVICES INFORM UNINSURED PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE. 5. PATIENTS/GUARANTORS MAY REQUEST A COPY OF THE FINANCIAL ASSISTANCE APPLICATION BY CALLING THE BILLING OFFICE. 6. INDIVIDUALS OTHER THAN THE PATIENT, SUCH AS THE PATIENT'S PHYSICIAN, FAMILY MEMBERS, COMMUNITY OR RELIGIOUS GROUPS, SOCIAL SERVICES, OR HOSPITAL PERSONNEL MAY MAKE REQUESTS FOR FINANCIAL ASSISTANCE ON THE PATIENT'S BEHALF, SUBJECT TO APPLICABLE PRIVACY LAWS. 7. FRANCISCAN BEACON HOSPITAL SENDS 4 STATEMENTS AND MAKES 6 PHONE CALL ATTEMPTS TO CONTACT THE PATIENT/GUARANTOR AT THE ADDRESS AND PHONE NUMBER PROVIDED BY THE PATIENT/GUARANTOR. STATEMENTS AND COMMUNICATIONS INFORM THE PATIENT OF THE AMOUNT DUE AND IF THEY CANNOT PAY THEIR BALANCE THE AVAILABILITY OF FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, ITEM 4 COMMUNITY INFORMATION FRANCISCAN BEACON SERVES A GEOGRAPHIC AREA WHICH INCLUDES LAPORTE COUNTY IN INDIANA. THE POPULATION OF THE COMMUNITIES THAT WE SERVE AS ESTIMATED CLOSE TO 110,000 PEOPLE. SCHEDULE H, PART VI, ITEM 5 & PART I, LINE 6A OTHER INFORMATION WWW.FRANCISCANBEACONHOSPITAL.ORG REFLECTS FRANCISCAN BEACON'S MISSION TO "PROMOTE HEALING THROUGH COMPASSIONATE CARE FOR THE COMMUNITIES WE SERVE." ALTHOUGH IT IS NOT ALL INCLUSIVE OF THE MANY BENEFITS PROVIDED BY FRANCISCAN BEACON IT DOES PORTRAY THE SIGNIFICANT BENEFITS THAT REFLECT OUR COMMITMENT TO HEALTHCARE AND THE COMMUNITIES WE ARE PRIVILEGED TO SERVE. THE FOLLOWING IS A SUBSET OF THE MANY CLINICAL SERVICES AS WELL AS POPULATION HEALTH IMPROVEMENT AND COMMUNITY OUTREACH ACTIVITIES OFFERED: - INPATIENT HOSPITAL SERVICES INCLUDING: MEDICAL SERVICES, TELEMETRY SERVICES - EMERGENCY SERVICES INCLUDING: 24 HOUR EMERGENCY ROOM SERVICES, AMBULANCE SERVICES, IMMEDIATE CARE SERVICES, ADVANCED LIFE SUPPORT SERVICES, BASIC LIFE SUPPORT SERVICES, BEHAVIORAL HEALTH EMERGENCY CONSULTATION SERVICES, 24-HOUR CRISIS AND REFERRAL HOTLINE, TRAUMA SERVICES, ETC. - PRIMARY CARE AND SPECIALTY CARE PHYSICIAN CLINICS SUBSIDIZED HEALTHCARE SERVICES OFFERED BY FRANCISCAN BEACON: - FRANCISCAN BEACON (THROUGH FRANCISCAN AND BEACON HEALTH) HAS NEIGHBORHOOD HEALTH CLINICS THAT OFFER FAMILY PRACTICE SERVICES DESIGNED FOR FAMILIES WITHOUT ACCESS TO AFFORDABLE HEALTH CARE. THE FOCUS IS ON PROVIDING PRIMARY AND PREVENTIVE CARE AS WELL AS HEALTH EDUCATION. THESE CLINICS OFFER FREE IMMUNIZATIONS - AMBULANCE SERVICE - PHYSICIAN SERVICES SCHEDULE H, PART I, LINE 3B IN ADDITION TO USING FEDERAL POVERTY GUIDELINES AS A FACTOR IN DETERMINING ELIGIBILITY FOR DISCOUNTED CARE, FOR UNINSURED PATIENTS, FRANCISCAN BEACON WILL PROVIDE AN UNINSURED PATIENT DISCOUNT FOR EMERGENCY SERVICES OR MEDICALLY NECESSARY SERVICES PERFORMED AT ITS HOSPITAL LOCATION. FRANCISCAN BEACON MAY OFFER ADDITIONAL DISCOUNTS BASED ON THE FACTS AND CIRCUMSTANCES UNIQUE TO THEIR LOCAL MARKETS. THIS DISCOUNT SHALL NOT BE COMBINED WITH OTHER FACILITY DISCOUNTS, EXCEPT FOR A PROMPT PAY DISCOUNT, IF AVAILABLE. NO DISCOUNT SHALL BE PROVIDED THAT VIOLATES ANY LAWS OR GOVERNMENT REGULATIONS. FRANCISCAN BEACON WILL IDENTIFY UNINSURED PATIENTS DURING THE REGISTRATION AND/OR ADMISSIONS PROCESS. THE UNINSURED DISCOUNT IS APPLIED AUTOMATICALLY BY THE RECEIVABLE SYSTEM AT THE TIME OF INITIAL BILL. ALL STATEMENTS TO PATIENTS WILL INDICATE THE ADJUSTMENT AND THE REVISED PATIENT BALANCE. THE UNINSURED DISCOUNT IS A CONTRACTUAL DISCOUNT AND IS NOT CONSIDERED A CHARITY CARE WRITE OFF UNLESS THE PATIENT ALSO QUALIFIES FOR CHARITY CARE. UNINSURED PATIENT DISCOUNTS WILL NOT BE REVERSED DUE TO NONPAYMENT OF AN ACCOUNT. IF, AT ANY TIME, FRANCISCAN BECOMES AWARE THAT A PREVIOUSLY IDENTIFIED UNINSURED PATIENT WAS IN FACT COVERED BY INSURANCE AT THE TIME OF SERVICE, FRANCISCAN BEACON WILL REVOKE THE UNINSURED DISCOUNT AND ISSUE A REVISED STATEMENT TO THE PATIENT AND THE ASSOCIATED INSURANCE PROVIDER. PATIENTS THAT ARE STILL NOT ABLE TO PAY THE BALANCE AFTER THE UNINSURED DISCOUNT ARE ABLE TO APPLY FOR A CHARITY CARE WRITE OFF OR A MEDICAL FINANCIAL HARDSHIP ADJUSTMENT. SCHEDULE H, PART I, LINE 3C FACTORS TO BE CONSIDERED FOR FINANCIAL ASSISTANCE HOUSEHOLD SIZE AND INCOME THE FOLLOWING FACTORS MAY BE CONSIDERED IN DETERMINING THE ELIGIBILITY OF THE PATIENT FOR ASSISTANCE AND MUST BE PROVIDED BY ALL INCOME EARNING RESIDENTS IN THE COUNTABLE HOUSEHOLD UNIT UNLESS THEY ARE NOT DEPENDENTS BASED ON IRS GUIDELINES FOR DETERMINING WHETHER A HOUSEHOLD MEMBER CAN BE CONSIDERED A DEPENDENT: (1) INDIANA WORKFORCE WAGE REPORT FOR LAST 2 QUARTERS (UNEMPLOYMENT INCOME); (2) LAST 3 PAY STUBS OR A LETTER OR PRINTOUT FROM EMPLOYER(S) PROVIDING VERIFICATION OF GROSS INCOME IF CURRENTLY EMPLOYED (THIS DOCUMENTATION SHOULD NOT BE MORE THAN 30 DAYS OLD FROM DATE OF ISSUE AND INCLUDE YEAR-TO-DATE INFORMATION); (3) LAST 3 BANK STATEMENTS (INCLUDING EXPLANATIONS OF REGULAR DEPOSITS NOT EXPLAINED BY PAY STUBS); (4) SOCIAL SECURITY AWARD OR ENTITLEMENT LETTER OR OTHER PROOF OF GROSS MONTHLY AWARD; (5) RETIREMENT INCOME; (6) INVESTMENT INCOME; (7) STATEMENT FROM PERSON(S) THAT ARE PROVIDING DIRECT SUPPORT; (8) NUMBER OF DEPENDENTS; (9) MOST RECENT TAX RETURN (INCLUDING W2 AND ALL SUPPORTING SCHEDULES); (10) OTHER FINANCIAL OBLIGATIONS; (11) THE AMOUNT AND FREQUENCY OF HOSPITAL/MEDICAL BILLS; (12) OTHER FINANCIAL RESOURCES THAT PRODUCE INCOME; AND (13) IF SELF-EMPLOYED, GROSS INCOME LESS COST OF GOODS SOLD AND EMPLOYEE SALARIES. FINANCIAL CAPACITY WILL ALSO BE CONSIDERED INCLUDING: (1) INDIVIDUALS WITH THE FINANCIAL CAPACITY TO PURCHASE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE MAY BE REQUIRED TO PURCHASE AND WILL BE PROVIDED ACCESS TO MEET WITH AN INDIANA CERTIFIED NAVIGATOR AS A MEANS OF ASSURING ACCESS TO HEALTHCARE SERVICES, FOR THEIROVERALL PERSONAL HEALTH, AND FOR THE PROTECTION OF THEIR INDIVIDUAL ASSETS; (2) INDIVIDUALS FOUND TO BE INELIGIBLE FOR MEDICAID O R OTHER AFFORDABLE HEALTH CARE COVERAGE MUST PROVIDE PROOF OF DENIAL; (3) FOOD STAMPS OR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) WILL NOT BE COUNTED AS INCOME; AND (4) COSMETIC SERVICES ARE NOT ELIGIBLE FOR ANY TYPE OF ASSISTANCE AND CANNOT BE INCLUDED IN THE AMOUNT OF HOSPITAL/MEDICAL BILLS OWED. SCHEDULE H, PART III, LINE 2 THROUGHOUT THE YEAR, THE CORPORATION ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ITS PATIENT ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE, AND OTHER RELEVANT FACTORS. THESE FACTORS INCLUDE CHANGES IN THE ECONOMY AND UNEMPLOYMENT RATES, WHICH HAS AN IMPACT ON THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, AS WELL AS TRENDS IN HEALTH CARE COVERAGE, SUCH AS THE INCREASED BURDEN OF DEDUCTIBLES, COPAYMENTS, AND COINSURANCE PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED PROCEDURES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS AND CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE CORPORATION. SCHEDULE H, PART III, LINE 3 THE CORPORATION HAS A SYSTEM-WIDE CHARITY CARE AND UNINSURED DISCOUNT POLICY; HAS DETAILED ADMINISTRATIVE PROCEDURES ESTABLISHED FOR QUALIFYING AND ENROLLING PATIENTS FOR CHARITY CARE OR UNINSURED/UNDERINSURED DISCOUNTS; USES VARIOUS ANALYTICAL PROGRAMS INCLUDING SOFT CREDIT INQUIRIES THAT DO NOT AFFECT CREDIT SCORES TO HELP ASSESS A PATIENT'S ABILITY TO PAY; AND UTILIZES NUMEROUS MECHANISMS TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE WHICH ARE DETAILED UNDER SCHEDULE H, PART VI, ITEM 3. DESPITE THESE RIGOROUS EFFORTS, PATIENTS WHO NEED SUBSIDIZED CARE MAY NOT SEEK THIS ASSISTANCE NOR CHOOSE TO ENROLL IN THE STATE'S MEDICAID PROGRAM. ALSO, AS FURTHER DESCRIBED IN HFMA STATEMENT NO. 15, THE APPROPRIATE CLASSIFICATION OF CHARITY CARE AND BAD DEBT IS OFTEN DIFFICULT. THE URGENCY OF SOME TREATMENTS, AS WELL AS CERTAIN FEDERAL REGULATIONS, OFTEN REQUIRES THE PROVISION OF SERVICE WITHOUT CONSIDERATION OF THE PATIENT'S ABILITY TO PAY. SOME PATIENTS HAVE COMPLEX MEDICAL CONDITIONS WITH UNPREDICTABLE TREATMENT NEEDS. FOR THESE AND OTHER REASONS, FRANCISCAN BELIEVES, A PORTION OF ITS BAD DEBT EXPENSE AS REPORTED ON LINE 2 OF PART III REPRESENTS CHARITY CARE DELIVERED TO INDIVIDUALS IN THE COMMUNITIES IT SERVES CONSISTENT WITH ITS CHARITABLE HEALTHCARE MISSION. SCHEDULE H, PART III, LINE 8 CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF FRANCISCAN BEACON AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545 AND THE REQUIREMENTS OF IRC SECTION 501(R), FRANCISCAN BEACON PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT FRANCISCAN. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY FRANCISCAN TO PROVIDE SUCH SERVICES. LIKE MEDICAID, PAYMENT RATES FOR MEDICARE ARE SET BY LAW RATHER THAN THROUGH A NEGOTIATION PROCESS AS WITH PRIVATE INSURERS. THESE PAYMENT RATES ARE CURRENTLY SET BELOW THE COSTS OF PROVIDING CARE RESULTING IN UNDERPAYMENTS. MEDICARE RATES ARE DETERMINED WITHIN THE CONTEXT OF ALL THE BUDGETARY NEEDS OF THE FEDERAL GOVERNMENT AND MEDICARE PAYMENTS HAVE HISTORICALLY BEEN SET BELOW THE COSTS OF PROVIDING CARE TO MEDICARE PATIENTS THOUGH HOW FAR BELOW VARIES OVER TIME AND BY SERVICE. EACH YEAR MEDICARE IS SUPPOSED TO PROVIDE HOSPITALS AN INCREASE IN BOTH INPATIENT AND OUTPATIENT PAYMENTS TO ACCOUNT FOR INFLATION IN THE PRICES FOR GOODS AND SERVICES HOSPITALS MUST PURCHASE IN ORDER TO PROVIDE PATIENT CARE. FILING OF COMMUNITY BENEFIT REPORT IN FORM 990, PART VI, LINE 6 FRANCISCAN BEACON HOSPITAL, LLC HAS TWO MEMBERS, FRANCISCAN ALLIANCE, INC. AND BEACON HEALTH SYSTEM, INC. FORM 990, PART VI, LINE 7A EACH MEMBER OF FRANCISCAN BEACON HOSPITAL, LLC APPOINTS 3 MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, LINE 7B CERTAIN POWERS HAVE BEEN RESERVED TO THE MEMBERs. THOSE POWERS INCLUDE: - ANNUAL CAPITAL AND OPERATING BUDGETS OF THE COMPANY; PROVIDED, THAT IN THE EVENT THE MEMBERS ARE UNABLE TO APPROVE SUCH BUDGETS BY THE BEGINNING OF A FISCAL YEAR, UNTIL SUCH APPROVAL IS OBTAINED, THE OPERATING BUDGET FOR THE PRIOR YEAR SHALL BE DEEMED TO BE ADOPTED AS THE OPERATING BUDGET FOR THE CURRENT YEAR; - ADOPTION OF, AND ANY AMENDMENT TO, THE STRATEGIC BUSINESS PLAN FOR THE COMPANY; - MANDATORY CAPITAL CONTRIBUTIONS; - THE SALE OF THE COMPANY OR SUBSTANTIALLY OF ALL ITS ASSETS; - ANY PLAN TO CONSUMMATE A MERGER, CONSOLIDATION, UNIT EXCHANGE OR SIMILAR TRANSACTION INVOLVING THE COMPANY; - THE ADMISSION OF NEW MEMBERS TO THE COMPANY OR THE SALE OF ADDITIONAL INTEREST IN THE COMPANY; - ANY AMENDMENT OR REPEAL OF THE COMPANY'S ARTICLES OF ORGANIZATION OR OPERATING AGREEMENT - THE ACQUISITION BY THE COMPANY OF SUBSTANTIALLY ALL OF THE ASSETS OR ANY MEMBERSHIP INTERESTS, STOCK OR OTHER OWNERSHIP INTERESTS OF ANOTHER ENTITY; - ANY PLEDGE OF THE COMPANY'S ASSETS, OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; - VOLUNTARY DISSOLUTION OF THE COMPANY; - APPOINTMENT, REMOVAL AND REPLACEMENT OF INDIVIDUALS WHO WILL SERVE AS EXECUTIVE DIRECTOR OF THE COMPANY; - SELECTION OR DISMISSAL OF THE INDEPENDENT PUBLIC ACCOUNTANTS FOR THE COMPANY; - A DECISION TO REQUIRE MEMBERS TO GUARANTEE DEBT PURSUANT TO SECTION 2.8 OF THE COMPANY'S OPERATING AGREEMENT; - THE ESTABLISHMENT OF ANY SUBSIDIARIES OR AFFILIATES OF THE COMPANY APPROVED BY THE BOARD OF MANAGERS OR THE ENTRY INTO ANY JOINT VENTURE ARRANGEMENTS INVOLVING THE COMPANY APPROVED BY THE BOARD OF MANAGERS; - ADOPTION, AMENDMENT OR TERMINATION OF ANY EMPLOYEE RETIREMENT PLAN OR ANY OTHER WELFARE BENEFIT PLAN OR POLICY OF THE COMPANY OR ANY MODIFICATIONS THERETO; AND - ANY CHANGE IN THE STATUS OF THE COMPANY FOR FEDERAL TAX PURPOSES OR MAKE ANY STATE OR FEDERAL ELEXTION ON BEHALF OF THE COMPANY APPROVED BY THE BOARD OF MANAERS OR THE PARTNERSHIP REPRESENTATIVE. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATION TO PREPARE THE FORM 990 IS GATHERED BY FINANCE STAFF AND MISSION REPRESENTATIVES AND PROVIDED TO ITS ACCOUNTING FIRM WHO PREPARES THE RETURN. SENIOR MANAGEMENT THEN REVIEWS THE RETURN PRIOR TO FILING. THE FORM 990 IS ALSO MADE AVAILABLE TO FRANCISCAN BEACON HOSPITAL'S BOARD OF TRUSTEES AND BOARD FINANCE COMMITTEE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, ANY BOARD MEMBER, BOARD COMMITTEE MEMBER, CORPORATE OFFICER OR EXECUTIVE STAFF OF FRANCISCAN BEACON HOSPITAL MUST DISCLOSE THE EXISTENCE OF A FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION, ARRANGEMENT OR ANY BUSINESS RELATIONSHIP WITH A COMPETITOR OF THE CORPORATION. DISCLOSURES ARE GENERALLY MADE IN THE FOLLOWING METHODS: (A) DISCLOSURE ON THE ANNUAL SURVEY OR WEB BASED DUALITY STATEMENT OR OTHER PROSCRIBED MEANS. TO ENSURE THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, PERIODIC REVIEWS SHALL BE CONDUCTED UNDER THE CONFLICTS OF INTEREST POLICY. THE PERIODIC REVIEW SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: (A.) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING; AND (B.) WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ORGANIZATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES, AND DO NOT RESULT IN INUREMENT. FORM 990, PART VI, SECTION B, LINE 15 FRANCISCAN BEACON HOSPITAL, LLC. DOES NOT COMPENSATE ITS OFFICERS. FORM 990, PART VI, SECTION C, LINE 19 FRANCISCAN BEACON HOSPITAL, LLC.'S ARTICLES OF INCORPORATION ARE AVAILABLE ON THE INDIANA SECRETARY OF STATE WEBSITE. THE BYLAWS AND CONFLICTS OF INTEREST POLICY ARE AVAILABLE UPON WRITTEN REQUEST.