4A (Expenses $ 212116725 including grants of $ 152771) (Revenue $ 249643141)
PERSONAL APPROACH TO CARE THROUGH MORE THAN 25 SPECIALTIES. ALL OF OUR SPECIALTY SERVICES COMPLIMENT PRIMARY CARE AND OFFER PATIENTS GREATER CONVENIENCE AND PEACE OF MIND. WE CONTINUE TO WORK TO POSITION OMC AS A PREFERRED HEALTHCARE PROVIDER FOR PRIMARY AND SECONDARY CARE AMONG SOUTHEASTERN MINNESOTA RESIDENTS. OMC'S 193 CLINICIANS AND 1,000 HEALTHCARE PROFESSIONALS SERVE AT 25 LOCATIONS, INCLUDING PHYSICAL/OCCUPATIONAL THERAPY, TWO MULTI-SPECIALTY CLINICS, SPORTS MEDICINE FACILITIES, A LEVEL IV TRAUMA HOSPITAL WITH 24-HOUR EMERGENCY ROOM AND BIRTHCENTER, A WALK-IN FASTCARE RETAIL CLINIC, A SKYWAY CLINIC IN DOWNTOWN ROCHESTER, AND 11 COMMUNITY BRANCH CLINICS. IN 2021, OMC HAD 330,138 PATIENT VISITS SERVING 78,200 UNIQUE PATIENTS. THE HOSPITAL PROVIDED CARE FOR 2,984 PATIENT ADMISSIONS RESULTING IN 7,144 PATIENT DAYS INCLUDING 921 BIRTHS.

4B (Expenses $ 256950 including grants of $ 0) (Revenue $ 0)
OMC WELCOMES ITS MANY OPPORTUNITIES TO BE AN ACTIVE, CONTRIBUTING PARTNER TO SOUTHEASTERN MINNESOTA'S HEALTH AND WELLNESS EFFORTS. AS A 501(C)(3) NON-PROFIT ORGANIZATION, OMC ACTIVELY SUPPORTS SOUTHEASTERN MINNESOTA'S HEALTH AND WELLNESS EFFORTS THROUGH THE CONTRIBUTION OF STAFF TIME/TALENT, IN-KIND RESOURCES, AND FINANCIAL ASSISTANCE. IN 2021, OUR COMMUNITY CONTRIBUTIONS MADE UP 28.66% OF OUR ANNUAL OPERATING EXPENSE - MORE THAN $68,227,000 IN SUPPORT OF OUR COMMITMENT TO BE AN ACTIVE, CONTRIBUTING PARTNER IN THE COMMUNITIES WE SERVE. ANOTHER WAY OMC ACTIVELY SUPPORTS COMMUNITY HEALTH IS THROUGH ITS PARTNERSHIP WITH MAYO CLINIC, OLMSTED COUNTY PUBLIC HEALTH, AND SEVERAL OTHER COMMUNITY-SERVICE ORGANIZATIONS AS TOGETHER WE IMPLEMENTED THE YEAR-THREE ACTION PLAN BASED ON OUR COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). OVER THE PAST YEAR, WE CONTINUED TO MAKE IT EASIER FOR COMMUNITY MEMBERS TO DONATE THEIR TIME AND TALENT TO OMC. IN ADDITION TO ADDING AN ONLINE VOLUNTEER APPLICATION FORM TO OUR WEBSITE, WE EXPANDED OUR VOLUNTEERS IN PATIENT CARE OPPORTUNITIES LIKE CANINE COMPANIONS AND ESCORT/GREETER ROLES TO HELP PATIENTS NAVIGATE OUR EXPANDING HOSPITAL CAMPUS.

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 5: OLMSTED MEDICAL CENTER LAUNCHED A COLLABORATIVE EFFORT WITH OLMSTED COUNTY, MAYO CLINIC, MANY OF THE COMMUNITY BENEFIT NON-PROFIT ORGANIZATIONS, AND THE PUBLIC TO IDENTIFY THE COMMUNITY NEEDS.

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 6A: OLMSTED MEDICAL CENTER COLLABORATED WITH MAYO CLINIC.

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 6B: OLMSTED MEDICAL CENTER COLLABORATED WITH OLMSTED COUNTY HEALTH SERVICES TO PRODUCE THE COMMUNITY HEALTH NEEDS ASSESSMENT.

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON OUR WEBSITE AT:HTTPS://WWW.OLMMED.ORG/ABOUT/COMMUNITY-INVOLVEMENT/AND ON THE COUNTY'S WEBSITE AT:HTTPS://WWW.OLMSTEDCOUNTY.GOV/SITES/DEFAULT/FILES/2020-11/2019CHNA.PDF

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 11: A PRIORITIZATION PROCESS CONDUCTED BY OLMSTED COUNTY PUBLIC HEALTH ALLOWED MAYO CLINIC, OLMSTED MEDICAL CENTER, THE CHNA CORE GROUP, THE CHIP MEMBERS, AND OTHER COMMUNITY AGENCY GROUPS RESULTED IN THE LIST OF TOP FIVE COMMUNITY HEALTH NEEDS: OBESITY, MENTAL HEALTH, IMMUNIZATIONS, INJURY PREVENTION, AND HOMELESSNESS/FINANCIAL STRESS.OMC REMAINS COMMITTED TO WORKING WITH THE CHNA CORE GROUP AND ITS COLLABORATING PARTNERS TO DEVELOP AND IMPLEMENT A COMMUNITY HEALTH IMPROVEMENT PLAN. THE CHNA CORE GROUP WILL CONTINUE TO COORDINATE THE EFFORTS OF ALL OF THE INVOLVED HEALTH PROVIDERS AND AGENCIES IN THEIR WORK ON THE FIVE MAJOR COMMUNITY HEALTH PRIORITIES AS DETERMINED BY THE HEALTH NEEDS ASSESSMENT. A KEY GOAL WILL BE TO INTEGRATE MENTAL HEALTH, MEDICAL CARE, AND SOCIAL SERVICES FOR THOSE PARTICULARLY NEEDY INDIVIDUALS WHO HAVE MULTIPLE CHRONIC MEDICAL AND MENTAL HEALTH PROBLEMS AND WHO ARE FREQUENT AND HIGH-COST VISITORS TO EMERGENCY DEPARTMENTS, HOSPITALS, AND CLINICS.OMC'S COMMUNITY HEALTH NEEDS ASSESSMENT STEERING GROUP COMPRISED OF CLINICIANS, NURSES, DIETITIANS, AND ADMINISTRATORS HAS COMMITTED TO CONTINUING TO ENGAGE OUR STAFF IN THE VARIOUS COMMUNITY-LED EFFORTS THROUGH CHNA AND CHIP. IN ADDITION, THIS STEERING GROUP HAS DEVELOPED AN ACTION PLAN SPECIFIC TO OUR PATIENT BASE TO ADDRESS THESE SAME PRIORITIES. WHILE HOMELESSNESS AND FINANCIAL STRESS IS AN ISSUE BEYOND THE SCOPE OF OMC'S MISSION AND RESOURCES, OMC HAS ESTABLISHED SOME GOALS FOR THIS ISSUE AND INTENDS TO PARTICIPATE IN ANY COMMUNITY-WIDE EFFORTS TO ADDRESS THIS MOST DIFFICULT ISSUE. FOR ALL OF THE GOALS THAT FOLLOW, THE SPECIFIC NEEDS OF OMC PATIENTS, FEASIBILITY AND POTENTIAL IMPACT OF THE PLANS, FINANCIAL IMPLICATIONS, AND OPPORTUNITIES TO WORK WITH COMMUNITY ORGANIZATIONS WILL CONTINUE TO BE EVALUATED.

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 13H: OMC UTILIZES A THIRD PARTY TO CONDUCT AN ELECTRONIC REVIEW FOR PRESUMPTIVE ELIGIBILITY OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED THROUGH TRANSUNION / EBUREAU. ACCOUNTS THAT HAVE BEEN APPROVED UNDER THIS PROCESS WILL BE APPLIED TO THE FINANCIAL ASSISTANCE PROGRAM AND FURTHER COLLECTION ACTION WILL NOT TAKE PLACE.

OLMSTED MEDICAL CENTER
PART V, SECTION B, LINE 20E: MEETING WITH PATIENTS UPON THEIR REQUEST.

PART I, LINE 3C:
ELIGIBILITY IS DETERMINED BY MEASURING INCOME, HOME EQUITY ASSETS BASED ON THE FEDERAL POVERTY GUIDELINES, AND PRESUMPTIVE DETERMINATION. BOTH INCOME AND ASSETS (SEPARATELY) HAVE TO FALL BELOW THE ANNUAL GROSS INCOME/ASSET MAXIMUM VALUES IN OMC'S FINANCIAL ASSISTANCE POLICY TO QUALIFY.

PART I, LINE 6A:
THE OLMSTED MEDICAL CENTER ANNUAL REPORT IS MADE WIDELY AVAILABLE AND IS AVAILABLE ON THE WEBSITE.

PART I, LINE 7:
THE AMOUNTS REPORTED ON PART I, LINES 7A-C ARE DERIVED USING THE COST-TO-CHARGE RATIO CALCULATION BASED ON WORKSHEET 2 OF THE IRS INSTRUCTIONS. THE AMOUNTS REPORTED ON PART I, LINES 7E-7I ARE DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES INCLUDED IN PART I, LINE 7G INCLUDE ACTIVITIES FROM THREE OF OMC'S CLINIC LOCATIONS.

PART I, LN 7 COL(F):
$5,985,567 OF BAD DEBT EXPENSE WAS EXCLUDED IN CALCULATING THE PERCENTAGES REPORTED IN PART I, LINE 7, COLUMN F.

PART III, LINE 2:
PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENTS ARE CARRIEDAT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVEREDBY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFULRECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTSBY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIEDTO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLEPREVIOUSLY WRITTEN OFF ARE RECORDED WHEN RECEIVED.

PART III, LINE 3:
THE ORGANIZATION HAS NOT IDENTIFIED A METHODOLOGY UNDER WHICH IT CAN REASONABLY ESTIMATE THE PORTION OF BAD DEBT EXPENSE ATTRIBUTABLE TO INDIVIDUALS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE AN APPLICATION.

PART III, LINE 1:
THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HFMA STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.

PART III, LINE 4:
"SEE THE ""PATIENT ACCOUNTS RECEIVABLE NOTE ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS."

PART III, LINE 8:
THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THEMEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COSTREPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINEDTHROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICECENTER COSTS TO REVENUE DEPARTMENTS. THE METHODOLOGY DESCRIBED IN THEINSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTOACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THETOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA.THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALSWOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENTPROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THEBURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS;THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION INREIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESEINDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS, THE COMMUNITY BENEFIT OF COSTS IN EXCESS OF MEDICARE PAYMENTS WAS $31,271,884.

PART III, LINE 9B:
PATIENT FINANCIAL HARDSHIP POLICY: TO SUPPORT THE ORGANIZATION'S MISSIONAND PHILOSOPHY IN THAT THE PATIENT COMES FIRST AND PROVIDE A GUIDELINE INIDENTIFYING PATIENTS WHO HAVE AN EXCEPTIONAL PERSONAL FINANCIAL HARDSHIPAND REQUIRED NEEDED AND NECESSARY MEDICAL CARE AND THERE IS REMOTE ORNEGLIBLE CHANCE THAT THE INDIVIDUAL WILL BE ABLE TO REPAY.PROCEDURE: FACTORS THAT MAY CONTRIBUTE TO EXCEPTIONAL FINANCIAL HARDSHIPINCLUDE:1) UNEMPLOYMENT OR UNDEREMPLOYMENT THROUGH NO FAULT OF THE PATIENT AND/ORFAMILY; 2) THREATENED LOSS OF SHELTER THROUGH FORECLOSURE, ETC; 3) LOSS OFINCOME FROM FEDERAL, STATE OR OTHER GOVERNMENT BENEFITS INCLUDING, BUT NOTLIMITED TO SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLICASSISTANCE, ETC; 4) LOSS OF INCOME DUE TO DEATH OR DISABILITY; 5)EXCEPTIONAL EXPENSES INCURRED BECAUSE OF UNINSURED PROPERTY DAMAGE ORCOSTLY REPAIRS TO PRINCIPAL RESIDENCE; 6) EXCEPTIONAL EXPENSES DUE TOTEMPORARY OR CHRONIC ILLNESS; 7) EXCEPTIONAL EXPENSES DUE TO INCREASE INLIVING EXPENSES BECAUSE OF A DIVORCE, ABANDONMENT OR SEPARATION FROMSPOUSE OR INCOME EARNER; 8) LOSS OF INCOME DUE TO DECLARATION OFINCOMPETENCE OR IN PROCESS OF BEING DECLARED INCOMPETENT; 9) PATIENT ORFAMILY MEMBER IS CONFINED TO A CONVALESCENT HOME OR OTHER RESIDENCE OTHERTHAN THEIR PRINCIPAL RESIDENCE; 10) NATURAL DISASTERS SUCH AS FLOODS,FIRES, HURRICANES AND EARTHQUAKES; 11) EVICTION, HOMELESSNESS, LOSS OFOWNED RESIDENCE, ARSON, THEFT, ETC; 12) DISCONTINUANCE OF UTILITIES ORHEAT, OR UNSAFE OR UNHEALTHY LIVING CONDITIONS; 13) ANY OTHER CONDITIONCONSIDERED LIFE THREATENING DUE TO EXCEPTIONAL FINANCIAL HARDSHIP.APPLICATION PROCESS: THE FINANCIAL HARDSHIP APPLICATION, UTILIZING OMC'S FINANCIAL ASSISTANCE APPLICATION, CONTAINS THE NECESSARY INFORMATION TODETERMINE ELIGIBILITY FOR THE OMC FINANCIAL HARDSHIP PROGRAM. NO SEPARATEAPPLICATION IS NECESSARY. SUPPORTING DOCUMENTATION REQUIRED TO MAKE ANELIGIBILITY DETERMINATION ARE: 1) MOST RECENT TAX RETURNS; 2) CURRENTFAMILY PAYROLL STUB SHOWING YEAR-TO-DATE INCOME; 3) CURRENT TRANSUNIONCREDIT REPORT AND OTHER FINANCIAL HARDSHIP DOCUMENTATION TO SUPPORTHARDSHIP; AND 4) EXPLANATION OF HARDSHIP SITUATION/NECESSITY AND RARECOMPLICATIONS.ELIGIBILITY DETERMINATION: BASED UPON PATIENT'S/FAMILY'S INCOME ANDASSETS AND COMPLETED FINANCIAL ASSISTANCE APPLICATION. BASED UPON TAKINGINTO CONSIDERATION ALL PERSONAL FACTORS IN DETERMINING EXCEPTIONALFINANCIAL HARDSHIP. THE BUSINESS SERVICES DEPARTMENT EVALUATES THEAPPLICATIONS MEETING THE CRITERIA AND PRESENTS TO ADMINISTRATION FORAPPROVAL. OMC RESERVES THE RIGHT TO MAKE ADJUSTMENT DETERMINATIONS ON ACASE-BY-CASE BASIS.

PART VI, LINE 2:
OMC ACTIVELY WORKS WITH LOCAL GOVERNMENT IN ASSESSING AND ADDRESSINGCOMMUNITY NEEDS THROUGH MEETINGS, WORKSHOPS, AND COMMUNITY INPUT. INADDITION, OMC IS ACTIVELY INVOLVED WITH LOCAL GOVERNMENTS IN EMERGENCYPREPAREDNESS AND DISEASE MANAGEMENT.

PART VI, LINE 4:
OMC IS A REGIONAL HEALTH CARE FACILITY SERVING PATIENTS WITHIN A SIXTYMILE RADIUS OF ROCHESTER, MN.

PART VI, LINE 5:
THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. MEDICAL STAFF PRIVILEGES ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE ORGANIZATION UTILIZES ITS SURPLUS FUNDS TO INCREASE THE SERVICES OFFERED TO ITS PATIENTS.

PART VI, LINE 6:
N/A

PART VI, LINE 3:
OMC INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE ANDASSISTS PATIENTS WHO INDICATE AN INABILITY TO PAY. OMC INFORMS PATIENTSOF THE FINANCIAL ASSISTANCE PROGRAMS BY PROVIDING THE FINANCIAL ASSISTANCEPOLICY ON BROCHURES IN THE NEW PATIENT PACKET AND AT THE FRONT DESK FORALL PATIENTS. THE POLICY IS ALSO PROVIDED ON THE BACK OF THE HOSPITALBILL STATEMENTS, ON THE HOSPITAL WEBSITE AND ON THE HOSPITAL'S ONLINEBILL-PAY SYSTEM.OMC PATIENT FINANCIAL COUNSELORS PROVIDE INFORMATION TO PATIENTS REGARDINGAVAILABLE HEALTHCARE FINANCIAL COVERAGE OPTIONS, SUCH AS: 1) MEDICALASSISTANCE, 2) MINNESOTA CARE, 3) OTHER FINANCIAL SERVICES AVAILABLE FORLOW INCOME FAMILIES IN THE COMMUNITY, 4) OMC'S FINANCIAL ASSISTANCEPROGRAM.THE PATIENT FINANCIAL COUNSELORS ASSIST OMC PATIENTS IN THE APPLICATION PROCESS. ALL APPLICATIONS ARE PROCESSED IN A TIMELY MANNER. PATIENT APPLICATIONS ARE CONSIDERED FOR CURRENT PATIENT RESPONSIBLE BALANCES, AS WELL AS NEAR FUTURE SCHEDULED MEDICAL SERVICES. PATIENTS MAY QUALIFY FOR FULL OR PARTIAL FINANCIAL ASSISTANCE. PATIENT FINANCIAL COUNSELORS NOTE PATIENT'S ACCOUNT VIA ON-LINE NOTES REGARDING APPLICATIONS SENT, APPLICATIONS IN PROCESS, AND WHETHER APPLICATIONS HAVE BEEN APPROVED, DENIED, OR ADDITIONAL INFORMATION IS REQUIRED. THE PATIENT FINANCIAL COUNSELORS INFORM THE PATIENT VIA A LETTER REGARDING THE DETERMINATION (APPROVED, DENIED, OR PARTIAL COVERAGE APPROVED) OF THE RECEIVED AND COMPLETED APPLICATION. PRIOR TO TURNING ACCOUNTS OVER THE THIRD PARTY COLLECTION, THE ACCOUNT WILL BE REVIEWED FOR POSSIBLE FINANCIAL ASSISTANCE PROGRAM QUALIFICATION THROUGH THE E-BUREAU PROCESS.