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Ascension Standish Hospital

Ascension Standish Hospital
805 West Cedar Street
Standish, MI 48658
Bed count25Medicare provider number231305Member of the Council of Teaching HospitalsNOChildren's hospitalNO
EIN: 381671120
Display data for year:
Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
1.37%
Spending by Community Benefit Category- 2021
(as % of total functional expenses)
* = CBI denoted preventative categories
Community Benefit Spending Compared to Functional Expenses, 2010-2021
Additional data

Community Benefit Expenditures: 2021

  • All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.

    • Operating expenses$ 25,253,117
      Total amount spent on community benefits
      as % of operating expenses
      $ 346,606
      1.37 %
  • Amount spent in the following IRS community benefit categories:
      • Financial Assistance at cost
        as % of operating expenses
        $ 282,121
        1.12 %
        Medicaid
        as % of operating expenses
        $ 0
        0 %
        Costs of other means-tested government programs
        as % of operating expenses
        $ 0
        0 %
        Health professions education
        as % of operating expenses
        $ 778
        0.00 %
        Subsidized health services
        as % of operating expenses
        $ 0
        0 %
        Research
        as % of operating expenses
        $ 0
        0 %
        Community health improvement services and community benefit operations*
        as % of operating expenses
        Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.
        $ 58,104
        0.23 %
        Cash and in-kind contributions for community benefit*
        as % of operating expenses
        $ 5,603
        0.02 %
        Community building*
        as % of operating expenses
        $ 0
        0 %
    • * = CBI denoted preventative categories
    • Community building activities details:
        • Did tax-exempt hospital report community building activities?NO
          Number of activities or programs (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Persons served (optional)0
          Physical improvements and housing0
          Economic development0
          Community support0
          Environmental improvements0
          Leadership development and training for community members0
          Coalition building0
          Community health improvement advocacy0
          Workforce development0
          Other0
          Community building expense
          as % of operating expenses
          $ 0
          0 %
          Physical improvements and housing
          as % of community building expenses
          $ 0
          Economic development
          as % of community building expenses
          $ 0
          Community support
          as % of community building expenses
          $ 0
          Environmental improvements
          as % of community building expenses
          $ 0
          Leadership development and training for community members
          as % of community building expenses
          $ 0
          Coalition building
          as % of community building expenses
          $ 0
          Community health improvement advocacy
          as % of community building expenses
          $ 0
          Workforce development
          as % of community building expenses
          $ 0
          Other
          as % of community building expenses
          $ 0
          Direct offsetting revenue$ 0
          Physical improvements and housing$ 0
          Economic development$ 0
          Community support$ 0
          Environmental improvements$ 0
          Leadership development and training for community members$ 0
          Coalition building$ 0
          Community health improvement advocacy$ 0
          Workforce development$ 0
          Other$ 0

    Other Useful Tax-exempt Hospital Information: 2021

    • In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

      • Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt
        as % of operating expenses
        $ 507,121
        2.01 %
        Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?NO
    • Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy

      The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2022 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

      • Does the organization have a written financial assistance (charity care) policy?YES
        Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?YES
        Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy
        as % of operating expenses
        $ 0
        0 %
    • Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
      • Reported to credit agencyNot available
    • Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.

      • After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid?YES
    • The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.

      • If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines?Not available
    • In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

      • Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute?NO

    Community Health Needs Assessment Activities: 2021

    • The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

      • Did the tax-exempt hospital report that they had conducted a CHNA?YES
        Did the CHNA define the community served by the tax-exempt hospital?YES
        Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?YES
        Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?YES
        Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?YES

    Supplemental Information: 2021

    This section presents qualitative information submitted by the hospital, verbatim from the 990H record.
    • Statement of Program Service Accomplishments
      Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
    • 4A (Expenses $ 18220489 including grants of $ 0) (Revenue $ 24765470)
      ASCENSION STANDISH HOSPITAL is a 54-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2022 Ascension Standish Hospital treated 647 adults and children for a total of 9,908 patient days of service. The hospital also provided services for 45,481 outpatient visits, including 8,790 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. As part of the Ascension Catholic health ministry, the filing organization served in support of Ascension's commitment to both care for patients and communities and support caregivers and other associates through the challenges of the COVID-19 global pandemic in FY22.
      Facility Information
      Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.
      Schedule H, Part V, Section B, Line 3E
      TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.
      Schedule H, Part V, Section B, Line 5 Facility , 1
      "Facility , 1 - ASCENSION STANDISH HOSPITAL. In Ascension Standish Hospital's tax year 2021 CHNA, community input was obtained through the following methods: Recognizing the vital importance of understanding the health needs and assets of the community, Mary Kushion Consulting, LLC. consulted with a range of public health and social service providers that represent the broad interest of Arenac County. A concerted effort was made to ensure that the individuals and organizations represented the needs and perspectives of: 1) public health practice and research; 2) individuals who are medically underserved, are low-income, or considered among the minority populations served by the hospital; and 3) the broader community at large and those who represent the broad interests and needs of the community served. Multiple methods were used to gather community input. To avoid duplication of effort and ""survey fatigue"", Ascension Standish Hospital promoted the community pulse surveys and provider surveys developed and disseminated by the MiTHRIVE assessment process. A large community forum was held to share the data generated at both the regional (MiTHRIVE) and county-specific level. The draft of the Arenac County CHNA was sent to the participants of the community forum and other stakeholders within the county with a feedback survey to gather the community's input prior to finalizing the CHNA for board approval. A summary of the process and results is outlined below. *Community Forum - In addition to the MiTHRIVE ""data walk"" to review and provide input on a regional level, Ascension Standish Hospital also hosted a large public forum in February 2022 to gather feedback from community members on the health needs and assets of Arenac County. 36 community members participated in the forum with participants representing various populations including the medically underserved and low-income. In addition, business, economic development, education, government, healthcare, mental health, public health, and substance misuse as well as the broader community were represented at the forum. *Survey - A survey was conducted between March-April 2022 by Ascension Standish Hospital to gather the perceptions, thoughts, opinions, and concerns of the community regarding the draft CHNA. The questions posed were related to the draft report's accuracy of content, the community perceptions related to its challenges, the assets and resources available, and the participant's vision for the Arenac County community. Eight community stakeholders and residents participated in the survey which provided valuable insight into the issues of importance to the community. The following list represents the CHNA participating organizations: *Arenac County EMC *Arenac Conservation District *Arenac County Sheriff *Ascension Standish Hospital *Bay-Arenac ISD *Bay-Arenac Great Start *Central Michigan District Health Department *City of Standish *Main Street Lanes *Ogemaw Hills Free Clinic *Stage Right Performing Arts Studio *Standish Family Medicine Clinic *Sterling Area Health Center *Ten 16 *The WELL Outreach *81st District Court"
      Schedule H, Part V, Section B, Line 6b Facility , 1
      Facility , 1 - ASCENSION STANDISH HOSPITAL. THE NON-HOSPITAL ORGANIZATIONS WITH WHICH ASCENSION STANDISH HOSPITAL CONDUCTED ITS tax year 2021 CHNA IS: -Northern Michigan Community Health Innovation Region -District Health Department #2 -Central Michigan District Health Department
      Schedule H, Part V, Section B, Line 11 Facility , 1
      Facility , 1 - ASCENSION STANDISH HOSPITAL - PART 1. Ascension Standish's tax year 2018 CHNA implementation strategy was completed June 2022 and has addressed the following priority health needs: Healthcare Access, Obesity Related Adverse Health Conditions, Adverse Childhood Experiences (ACEs), and Human Trafficking. Highlights from the Ascension Standish Hospital's previous implementation strategy include: *Healthcare Access - Ascension Standish Hospital's goal to increase access to healthcare services in Arenac County through the implementation of a tele-behavioral health clinic was achieved in November 2020. The clinic was marketed to surrounding physicians, Ascension Standish Family Medicine, Bay Arenac Behavioral Health, and Northern Michigan Opioid Response Consortium (NMORC) as a resource for substance use disorder (SUD) and opioid use disorder (OUD). Additionally, Administrator Rose Goick-Saddler participated in a legislative panel on March 25, 2021, to introduce a bipartisan bill sponsored by U.S. Representatives Dan Kildee (D-MI) and Brad Wenstrup (R-OH) - The Rural Behavioral Health Access Act of 2021 - that would ensure that Critical Access Hospitals (CAHs) retain important flexibility to provide behavioral health services through telehealth technology. Further information on the actions undertaken are outlined below: Implement a Tele-Behavioral Health Clinic - Secured Small Rural Hospital Improvement Program (SHIP) grant from Michigan Center for Rural Health (RCRH) for implementation; Launched clinic in November 2020 Partner with community organizations to increase mental health awareness by expanding mental health education, training capacity and support for community-driven initiatives - Hosted one (1) Mental Health First Aid training in partnership with the Northern Michigan Opioid Response Consortium; Established partnership with Ascension Brighton Center for Recovery to provide acute Emergency Department (ED) visits for SUD and OUD patients; Partnered with Cathoic Human Services to provide Project ASSERT, a program that helps Emergency Department patients who demonstrate risky alcohol and drug use behavior with access to treatment and the appropriate level of care *Adverse Childhood Experiences (ACES) - Ascension Standish Hospital achieved its goal to increase awareness of Adverse Childhood Experiences (ACEs) in Arenac County by both educating staff and screening Ascension Medical Group (AMG) outpatient clinic patients. Through a collaboration with the Ascension Clinical Professional Development department, a standardized ACEs module for internal education was developed; over 97% of staff have completed the annual module following its launch in 2020. Additionally, by July 2020, 100% of new patients seen at Ascension Standish Family Medicine completed the ACEs Universal Screening, an age-specific questionnaire that provides a score that can be an indicator to the care team that further mental health services may be needed based on current or past experience, and referrals made to the tele-behavioral clinic as appropriate. Further information on the actions undertaken are outlined below: Provide trauma informed care / ACEs educational module to internal staff - Developed standardized ACEs module for internal education; 97% of staff completed the annual module following launch in 2020 Implement ACEs Universal Screening protocol at Ascension Standish Family Medicine - Developed protocol for ACEs screening and referral process for new patients at Ascension Standish Family Medicine; 100% of new patients seen at Ascension Standish Family Medicine completed the ACEs Universal Screening and referrals made as appropriate *Obesity Related Adverse Health Conditions - Ascension Standish Hospital set forth to address obesity related adverse health conditions by focusing on reducing A1C levels for individuals in Arenac County at risk of developing Type 2 diabetes. Eight (8) patients participated in Canary Health's Diabetes Prevention Program (DPP), an evidence-based lifestyle change program that helps prevent type 2 diabetes, through a partnership with the Michigan Health Improvement Alliance, Inc. (MiHIA). Through March 2020, Ascension Standish Family Medicine providers referred patients to virtual DPP during in-person clinical visits; however, referral and awareness efforts were halted per transition from predominantly in-person clinical visits to virtual due to an operational shift caused by the COVID-19 pandemic. In Spring 2021, the Ascension Standish Hospital team re-launched virtual DPP focusing on associates and in-patient population. Unfortunately, notification was received by Canary Health that it was closing its DPP arm of the company; no new registrations were accepted after October 8, 2021, and current participants would be supported through January 31, 2022. Further information on the actions undertaken are outlined below: Provide education to clinical team Ascension Standish Family Medicine on virtual Diabetes Prevention Program - One (1) training session held in October 2019 to teach about the program and how to refer patients Implement virtual Diabetes Prevention Program referral protocol - Referral protocol implemented at Ascension Standish Family Medicine, however, referral and awareness efforts were halted per transition from predominantly in-person clinical visits to virtual due to an operational shift caused by the COVID-19 pandemic; Eight (8) patients participated in Canary Health's Diabetes Prevention Program (DPP) *Human Trafficking - Due to delays caused by the COVID-19 pandemic, Ascension Standish Hospital and Ascension St. Joseph Hospital collaborated and intended to host a human trafficking awareness event for Arenac and Iosco Counties residents in spring 2022. The event aimed to increase awareness and encourage action with special focus on parents, school staff, as well as the general community. Ascension Standish Hospital continues to utilize an established protocol to identify, assess, treat and refer victims of Human Trafficking (HT) to supportive community services who present for care in the Emergency Department or who are identified while receiving inpatient services. Additionally, Ascension Standish Hospital has combined efforts with Ascension Southwest Michigan Community Health and other Ascension hospitals throughout Michigan to offer hospital-wide associate education with an Ascension internal MyLearning education module to increase awareness and recognition of the signs and symptoms of Human Trafficking via the lens of Trauma Informed Care, and community resources to support victims. Further information on the actions undertaken are outlined below: Provide human trafficking awareness education to staff - Internal MyLearning education module available focused on the signs and symptoms of Human Trafficking via the lens of Trauma Informed Care; 92% of Standish associates and 100% of providers have completed module The Ascension Standish Hospital's Implementation Strategy for the tax year 2021 CHNA will address the following prioritized needs: *Mental and Behavioral Health, including substance use disorder: Strategy 1.1: Increase awareness, access, and referrals to Project ASSERT (Alcohol & Substance Abuse Services, Education, and Referral to Treatment) for patients who present to Ascension Standish Hospital and Ascension Medical Group outpatient clinics. Strategy 1.2: Through a coordinated and transformational approach, Ascension Michigan hospitals will improve access to mental and behavioral health for vulnerable populations. Strategy 1.3: Increase involvement in and support of community health activities to address mental health-focused needs. *Chronic Disease - It's important to note that 'Obesity' will also be addressed within the activities conducted through the Chronic Disease action plan. Strategy 2.1: Provide cancer (lung and breast) preventative screenings for underserved populations to improve early detection rates Strategy 2.2: Improve collaboration and coordination between Ascension Standish Hospital providers, including Ascension Medical Group outpatient clinics, and Ascension St. Mary's Diabetes Education Center through a diabetic & prediabetic referral protocol. Strategy 2.3: Increase involvement in and support of community health activities to address chronic disease-focused needs *Healthy Behaviors Strategy 3.1: Provide holistic health education and programs that support Arenac County resident's physical, mental, emotional, social, intellectual, and spiritual wellbeing. Strategy 3.2: Increase involvement in and support of community health activities to address healthy behavior-focused needs.
      Schedule H, Part V, Section B, Line 11 Facility , 2
      Facility , 2 - ASCENSION STANDISH HOSPITAL - PART 2. Child Health and Development, Education, and Income were not selected by Ascension Standish Hospital as prioritized needs in this CHNA cycle. While critically important to overall community health, these specific needs did not meet internally determined criteria that prioritized needs by either continuing or expanding current programs, services and initiatives to steward resources and achieve the greatest community impact. For the areas not chosen, there are other service providers in the community better resourced to address these priorities. Ascension Standish Hospital will work collaboratively with these organizations as appropriate to ensure optimal service coordination and utilization.
      Supplemental Information
      Schedule H (Form 990) Part VI
      Schedule H, Part I, Line 3c factors other than fpg
      "IN ADDITION TO FPG, THE ORGANIZATION USES MEDICAL INDIGENCY, ASSET TEST, INSURANCE STATUS AND RESIDENCY AS OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A Patient may not be eligible for the financial assistance if such Patient is deemed to have sufficient assets to pay pursuant to an ""Asset Test."" The Asset Test involves a substantive assessment of a Patient's ability to pay based on the categories of assets measured in the FAP Application. A Patient with such assets that exceed 250% of such Patient's FPL amount may not be eligible for financial assistance. AN ASSET TEST APPLIES IF A PATIENT HAS ELIGIBLE LIQUID ASSETS THAT EXCEED 250% OF THE PATIENT'S FPG LEVEL FOR CONSIDERATION OF FINANCIAL ASSISTANCE ELIGIBILITY. LIQUID ASSETS INCLUDE ASSETS THAT CAN BE CONVERTED TO CASH WITHIN 1 YEAR. THESE INCLUDE ITEMS SUCH AS CHECKING ACCOUNTS, SAVINGS ACCOUNTS, TRUST FUNDS AND LUXURY ITEMS SUCH AS RECREATIONAL VEHICLES, BOATS, A SECOND HOME, ETC."
      Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
      "THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (""CHA"") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED."
      Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
      After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2022 was $1,142,458 at charges, ($507,121 at cost).
      Schedule H, Part III, Line 3 Bad Debt Expense Methodology
      BASED ON THE ORGANIZATION'S ADMINISTRATION OF ITS FINANCIAL ASSISTANCE PROGRAM, NO ESTIMATE FOR BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DEEMED APPLICABLE TO HOSPITAL OPERATIONS.
      Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
      THE ORGANIZATION IS PART OFASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSESBAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 17-20, OF THE AUDITED FINANCIAL STATEMENTS.
      Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
      A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE GROSS CHARGES TO CALCULATE MEDICARE COSTS, WHICH ARE THEN COMPARED TO MEDICARE PAYMENTS RECEIVED, TO DETERMINE A MEDICARE GAIN OR LOSS. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT A MEDICARE SHORTFALL (LOSS) IS NOT TREATED AS COMMUNITY BENEFIT, EVEN THOUGH THE HOSPITAL HAS INCURRED LOSSES IN PROVIDING CARE TO MEDICARE PATIENTS. THEREFORE, NONE OF THE AMOUNT ON LINE 7 IS TREATED AS COMMUNITY BENEFIT.
      Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
      ASCENSION STANDISH HOSPITAL FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED IF ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED FOR THE AMOUNTS FOR WHICH THE PATIENT QUALIFIES.
      Schedule H, Part V, Section B, Line 16a FAP website
      - ASCENSION STANDISH HOSPITAL: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;
      Schedule H, Part V, Section B, Line 16b FAP Application website
      - ASCENSION STANDISH HOSPITAL: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance;
      Schedule H, Part V, Section B, Line 16c FAP plain language summary website
      - ASCENSION STANDISH HOSPITAL: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance;
      Schedule H, Part VI, Line 4 Community information
      Ascension Standish Hospital is located in Arenac County. The total population of Arenac county is estimated to be 13,320 residents in calendar year 2023 and is estimated to decrease by 242 residents or -1.82% over the next five years (Sg2/Claritas Pop-Facts 2023). There are an estimated 6,585 households. The county is rural and is a federally designated medically underserved area. The median household income in Arenac county is $45,679, based on the United States Census Bureau (in 2020 dollars, 2016-2020). Approximately 12.8% of the service area persons live below the poverty line. There are no other acute care hospitals located in Arenac County and Ascension Standish Hospital is a Critical Access Hospital.
      Schedule H, Part VI, Line 5 Promotion of community health
      ASCENSION STANDISH HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING ASCENSION MICHIGAN'S SERVICE AREAS AND INCLUDES MEMBERS WITH DIVERSE ASPECTS AND INTERESTS OF THE SERVICE AREA. MEMBERS OF THE GOVERNING BODY RESIDE IN THE ORGANIZATION'S SERVICE AREA AND ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. ASCENSION STANDISH HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. ASCENSION STANDISH HOSPITAL APPLIES SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE.
      Schedule H, Part VI, Line 2 Needs assessment
      Ascension Standish Hospital uses internal and external data and reports from third parties, including government sources, to assess the healthcare needs of the communities we serve. These reports provide key information about health, socioeconomic, demographic factors that identify areas of need and inform our strategies that help to meet those needs of our community. These reports include, but are not limited to: *Sg2 Healthcare Intelligence *State Datasets *Internal Data Sets Ascension Standish Hospital utilizes information from these secondary sources to develop programs and provide appropriate services needed throughout the region. In addition, Ascension Standish Hospital considers the health care needs of the overall community when evaluating internal financial and operational decisions.
      Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
      ASCENSION STANDISH HOSPITAL IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, ASCENSION STANDISH HOSPITAL'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; ASCENSION STANDISH HOSPITAL PROVIDES FULL FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 250% OF THE FEDERAL POVERTY LEVEL AND SLIDING SCALE ASSISTANCE FOR THOSE UP TO 400% OF THE FEDERAL POVERTY LEVEL. ASCENSION STANDISH HOSPITAL WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://healthcare.ascension.org/locations/michigan/misag/standish-ascension-standish-hospital/financial-assistance ASCENSION STANDISH HOSPITAL MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. ASCENSION STANDISH HOSPITAL INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. ASCENSION STANDISH HOSPITAL INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.
      Schedule H, Part VI, Line 6 Affiliated health care system
      ASCENSION STANDISH HOSPITAL IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. ASCENSION STANDISH HOSPITAL OPERATES A HOSPITAL FACILITY IN ARENAC COUNTY MICHIGAN AND IS PART OF ASCENSION HEALTH. ASCENSION ALSO OPERATES HOSPITALS IN THE EASTERN PORTION OF THE STATE INCLUDING ASCENSION ST. JOHN HOSPITAL, ASCENSION RIVER DISTRICT HOSPITAL, ASCENSION MACOMB OAKLAND HOSPITAL WARREN CAMPUS, ASCENSION MACOMB OAKLAND HOSPITAL MADISON HEIGHTS CAMPUS, ASCENSION PROVIDENCE HOSPITAL SOUTHFIELD CAMPUS, ASCENSION PROVIDENCE HOSPITAL NOVI CAMPUS, ASCENSION PROVIDENCE ROCHESTER HOSPITAL, ASCENSION ST. MARY'S HOSPITAL, ASCENSION GENESYS HOSPITAL, ASCENSION ST. JOSEPH HOSPITAL AND ASCENSION BRIGHTON CENTER FOR RECOVERY. ASCENSION ALSO OWNS AND OPERATES OTHER HEALTH CARE RELATED ENTITIES IN SOUTHWEST MICHIGAN INCLUDING ASCENSION BORGESS ALLEGAN HOSPITAL, ASCENSION BORGESS PIPP HOSPITAL, ASCENSION BORGESS LEE HOSPITAL AND ASCENSION BORGESS HOSPITAL. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF ASCENSION STANDISH HOSPITAL'S SERVICE AREA IN MID-MICHIGAN.