4A (Expenses $ 38174480 including grants of $ 25860) (Revenue $ 45441915)
"Stevens Community Medical Center is a not-for-profit integrated health care system. The mission of the Medical Center is to make available high-quality health care. The Medical Center serves the population of West Central Minnesota and is becoming a regional health care center.""CARING IS OUR REASON FOR BEING""SCMC provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of SCMC, it is recognized that not all individuals possess the ability to purchase essential medical services. To further that, our mission is to serve the community with respect to providing health care services and health care education. For example, the Medical Center is committed to provide medical services to all members of its community, provide free care and/or subsidized care, promote health activities and programs to support the community, and provide care to persons covered by governmental programs at below cost. Therefore, financial assistance will be considered where the need and/or an individual's inability to pay exists. SCMC had 41,208 hospital outpatient visits, 43,507 clinic and urgent care visits, 1,268 inpatient days, 7,037 outpatient counseling visits, 84 deliveries, 532 surgeries, 2,394 emergency room visits, and 21,476 therapy treatments in 2021. SCMC also owns and operates the Courage Cottage, an assisted living facility specializing in care for the terminally ill. In 2021, 11 residents were served, and the cost to provide their care was subsidized by community donations.Recognizing its mission to the community, SCMC provides services to Medicare, Medicaid, and other patients covered by governmental programs, sometimes at a reimbursement below cost. The total discounts accepted for providing care to patients was $33,765,552 in 2021. The charges foregone for services supplied under SCMC's charity care policy (free and/or subsidized care) was $1,041,783 in 2021.Charity care is also provided through many reduced price services and free SCMC programs and information offered throughout the year based on activities and services which SCMC believes will serve a bona fide community need. These include: various brochures to educate patients; staff speaking for a variety of community events including SCMC sponsored ""health nights,"" elderly and adult education; sponsoring a smoking cessation program and a variety of other ""wellness"" type programs at subsidized cost; providing meeting facilities for various community groups; offering support groups; and providing assistance to educators through our work with student nurses."

Stevens Community Medical Center
"Part V, Section B, Line 5: SCMC conducted a community conversation on November 12, 2019 as part of the Community Health Needs Assessment. The meeting consisted of 26 individuals from specific stakeholder groups in the community. These people represented organizations in the community and individual interests in the overall health of the community. Representatives included local school and college officials, public health staff, health and wellness providers, local business representatives and owners, and community leaders. The conversation was specifically designed for discussion and data collection. Tobias Spanier from the University of Minnesota Extension Service facilitated the ""World Cafe"" format discussion. The group was divided into smaller discussion groups to answer four specific questions. Each group reported back after each question to help with further discussion and data collection."

Stevens Community Medical Center
Part V, Section B, Line 11: Community Health Needs Assessment 2021 Efforts in Addressing the Significant Needs Identified in 2019 CHNAThe 2019 Community Health Needs Assessment conducted by the Stevens Community Medical Center (SCMC) identified a wide range of current issues in the county, as well as the residents and community leaders' concerns for the future. Included in those issues are increased transportation options for the population. This includes transportation options that can serve patients outside of the Morris city limits and patients that require non-ambulatory transport after regular weekday business hours, the lack of child care options available, and the lack of an online central community communication hub for events and updates.1. TransportationSCMC continues to cover the cost of transit for area residents to travel to SCMC for appointments using either the Morris Transit or Rainbow Rider services. Signage and a phone were added to the front entrance to help assist patients and guests to contact local transportation. We added a transportation service called Julia's Place that will provide transport from the city of Hancock to Morris and outside of the Stevens County line into Swift County. Julia's Place can bill MA which allows for more payment flexibility in patient transport. The SCMC marketing department has added links directly to the SCMC website to enable patients with transportation options and gain access to transportation resources.2. Child CareIn June of 2021 a representative of SCMC attended the meeting hosted by the Stevens County Board of Commissioners. State funds had recently been awarded to Stevens County by the federal American Rescue Act 2021 for the Commissioners to allocate to community programs. SCMC commented during the meeting that they support the effort for increasing child care capacity and would like to see funds allocated to this area of need. Specifically, Kerrie McEvilly, CEO of SCMC issued a letter to the commissioners with the request for them to fund the Hancock community child care center building plans, allow for grant request proposals to be submitted by current care providers for their needs, and for the commissioners to provide funding for a local provider recruitment program. To date $50,000 has been allocated and awarded in the form of an RFP for local daycare providers to directly apply grant funds to their daycare businesses in the form of structural upgrades, site improvements, and training reimbursements. Ongoing county daycare subcommittee meetings continue and focus on the remaining funds being used for a new construction build that will increase daycare capacity in Stevens County. This structure is hopeful to be in operation and occupied by independent providers in 2023.3. Community CommunicationsSCMC collaborated with the Morris Area Chamber of Commerce and the Stevens County Building Resilience committee to apply for a community resilience initiative micro grant. We received the grant and hired a student to perform the necessary work for building out a communication tool. This project has resulted in a community calendar for all individuals in Stevens County to post meetings and events as well as a community resource page. This tool is active and is being used by SCMC to promote its classes, activities, and current events. A promotional magnet was designed and purchased with remaining grant funds to communicate out the resource to community members. The magnets are available for free at community social events, the Morris Chamber, and Horizon Public Health buildings. In addition, SCMC launched a new website in April of 2021 that hosts a facility calendar which is continually updated to include all community impacting events. Since 2019 a strategic effort has been made to utilize the SCMC Facebook page to promote all COVID communications, facility updates, job postings, and community sponsored events. The page has over 5000 followers to date that can receive the communication. Increased awareness is being brought directly to the business community by having a hospital representative participate in The Chamber Connection group activities hosted by the Morris Area Chamber. This outlet gives SCMC the opportunity to speak directly to the business leaders of our community and provide updates on the community health needs strategic plan and responses from our facility. This includes updates on providers, equipment, services, and employment opportunities.

Stevens Community Medical Center
Part V, Section B, Line 13b: The organization considers the patient's ability to make reasonable monthly payments on a balance owed. When income and expense documentation (such as pay stubs and tax returns) doesn't reflect an accurate picture of a patient's ability to pay, additional considerations are made.

Stevens Community Medical Center
Part V, Section B, Line 13h: Federal guidelines and Minnesota Attorney General agreement percentage discounts were used to determine eligibility for discounts.

Stevens Community Medical Center
Part V, Section B, Line 15e: We send MNSure applications and assist patients in applying for programs where there is a need and possibility for basis of eligibility. We are also an HPE (Hospital Presumptive Eligibility) site and provide and screen for short term medical assistance approvals.

Schedule H, Part V, Section B, line 7a:
https://www.scmcinc.org/about/community-health-needs-assessment/

Schedule H, Part V, Section B, line 10a:
https://www.scmcinc.org/about/community-health-needs-assessment/

Part I, Line 3c:
The following factors are used by the organization to help determine eligibility for Financial Assistance: * Proof of household income (such as social security award letters, pay stubs and tax returns).* Assessing the patient's ability to make reasonable monthly payments on balance owed (expense form reflecting household income and expenses).* When income and expense documentation doesn't reflect an accurate picture of a patient's ability to pay, additional considerations are made (e.g. wages have changed since the last filed tax return).*Medical Indigency is also considered.* SCMC provides assistance in applying for healthcare programs where applicable. Status of insurance is reviewed at application. * SCMC does not consider assets in the determination of eligibility for Financial Assistance.Along with the above considerations, the Federal Poverty Guidelines (FPG) are reviewed and the most appropriate discount is offered. The organization provides a 40% discount to 80% discount when income levels meet 170% down to 101% of the FPG. For example, an 80% discount is given for income ranges from 101% to 120% of the FPG. Outside of the FPG and FAP application process we standardly apply the 23% self-pay discount which is based off our Amounts Generally Billed (AGB) for all self-pay patients with qualifying services (i.e. medical necessary services which are not cosmetic or elective).

Part I, Line 6a:
The organization's community benefit report is available to the public upon request.

Part I, Line 7:
Charity care expense was converted to cost based on an overall cost-to-charge ratio addressing all patient segments. Medicaid and Other Mean's Tested was converted to cost using the cost-charge-ratio derived from Worksheet 2. Community health improvement services, health professions education, and cash and in-kind contributions are reported based on actual expenses recorded to the general ledger.

Part II, Community Building Activities:
In 2021 SCMC supported several significant health related community initiatives such as the Regional Fitness Center, Habitat for Humanity, and the local chapter of the American Cancer Society to name just a few. We also paid over $61,292 in local real estate taxes for our two medical clinics, which would certainly have a positive impact on the health of the communities we serve.

Part III, Line 2:
The amount reported on line 2 represents implicit price concessions. The Medical Center determines its estimate of implicit price concessions based on its historical collection experience with this class of patients.

Part III, Line 3:
The Hospital does not have a way to reasonably estimate the amount of implicit price concessions that are attributable to patients who would qualify for financial assistance.

Part III, Line 4:
The footnote to the organization's financial statements addressing implicit price concessions may be found on page 9 and 10 of the attached audited financial statements.

Part III, Line 8:
Medicare allowable cost is based on the Medicare Cost Report. The Medicare Cost report is completed based on the rules & regulations set forth by Centers for Medicaid and Medicare Services.

Part III, Line 9b:
Patients that qualify for FAP are sent an approval letter with percentage of discount extended and effective dates of approval. For partial FAP eligibility the letter outlines any remaining balance due and lists several options including reasonable payments to satisfy the remainder of the balance. The collections cycle starts over for FAP qualifying applicants. There would need to be another 120 days before ECA's would be initiated but we try to avoid this wherever possible being flexible with payments that are reasonable. The 30-day notice is satisfied via the final notice letter provided in absence of payment for an account with no payments or contact at 90 days from billing cycle (plain language summary is sent at this time). The patient has 240 days from first billing cycle in which to apply for FAP. Our collections agency is aware of these regulations and assists us with patient coordination if they show interest in applying should they be sent to collections after 120 days but within the 240-day application period window.

Part VI, Line 2:
Many of our department heads are members of other boards or organizations throughout the community. These include the Chamber of Commerce, the Morris Area Community Development Committee, and Morris Area Child Care Center in addition to others. The information obtained from participating in these committees is utilized to continually assess the appropriateness of existing services and the need for potential new areas of health related opportunities. Conference committee meetings are also used to get input from all employees, who are also consumers of our services, regarding areas of potential growth. In addition we conducted a Community Health Needs Assessment in 2019.

Part VI, Line 7, Reports Filed With States
MN

Part VI, Line 3:
Stevens Community Medical Center provides a copy of our charity guidelines and financial assistance contact information to interested patients as part of our intake/screening process; self-pay patients (particularly inpatients) are asked if they have financial concerns and are referred to a financial counselor if a need is discovered. A variety of tools are used to determine potential needs through the registration, prior authorization, and billing processes - social worker's referral, identification of uninsured or underinsured status, and/or a previous history of inability to pay. The charity care guidelines, policy, plain language summary, application, instructions and contact information are posted on our website. We also post financial assistance contact information for persons interested in applying for Charity Care and/or Medicaid in patient common areas such as registration, waiting areas, physician rooms and the Cashier's office.In addition, if payments are not being made after 2-3 statements have been sent, a Financial Counselor will call to inform the patient of their options. At that time, we would send out an application for Financial Assistance, discuss with the patient the availability of various government benefits, such as Medicaid or state programs, and assist the patient with qualification for such programs, where applicable. At the time final notices for non-payment are sent at least 90 days after first statement delivery, the plain language summary is also mailed. Calls are also being placed throughout this timeframe to prevent accounts from going to bad debt by obtaining reasonable payment and educating on FAP availability.

Part VI, Line 4:
Stevens Community Medical Center serves the County of Stevens including the towns of Morris, Donnelly, Hancock, Chokio and Alberta. We also serve areas of Pope, Swift, Traverse, Grant, and Big Stone. We anticipate the total primary service area to be approximately 15,000, with a secondary market of an additional 20,000.The service area is primarily rural, with a strong agricultural base. We are also fortunate to have a university presence with the University of Minnesota, Morris. Approximately 51% of our inpatients are Medicare and/or Medicare HMO and another 16% are Medicaid and/or MN Care.There are three hospitals in the area that are larger than SCMC located in towns 50 miles from Morris in different directions. There are also hospitals in Benson, Wheaton, Graceville, Glenwood, Elbow Lake and Appleton, all of which are within a 30 mile radius of Morris.Stevens County is a federally designated Health Professional Shortage Area (HPSA) for both primary care and mental health. Pope County, where the Starbuck Clinic is located, is also a federally designated HPSA.

Part VI, Line 5:
"As described earlier, SCMC has a community Board of Directors that represent specific portions of our service area. Medical staff privileges are extended to all qualified physicians in the community. We also own and operate an assisted living facility which specializes in the terminally ill. This is currently subsidized by community donations. The Emergency Room is open 24 hours a day 7 days a week and is open to all patients regardless of ability to pay. All our employed physicians attend several educational opportunities, as do the balance of our licensed and professional staff. SCMC works to provide education to staff or opportunities for education on the latest most up to date care techniques and strategies as well as education related to compliance, billing, fraud, abuse and other regulatory rules. SCMC also works with a variety of higher education schools to provide onsite internships, residency experience, and fieldwork. Every dollar generated in excess of expenses at SCMC is reinvested in the organization to improve the services offered to the communities we serve. This includes effectively funding the depreciation of our building and equipment, investment in facilities and equipment, expansion of services to meet community need, and investment in education of staff to provide high quality effective care to our community members. The community health service activities are designed to complement the identified health needs in our area. SCMC promotes community health with partnerships with other community groups such as the Farmer's Market, local food drop, local elementary/high school education programs, providing an athletic trainer to the local high school, and a community health group that coordinates activities such as the Fall Into Health. SCMC's dietician and diabetic educator provide diabetes presentations to local service groups. Much of the emphasis associated with these events is toward prevention and early detection.We are also acutely aware of the fact that a large percentage of the population we serve are senior citizens and value the benefit of the free transit services we provide for clinic appointments.Charity care is also provided through many reduced price services and free SCMC programs and information offered throughout the year based on activities and services which SCMC believes will serve a bona fide community need. These include: various brochures to educate patients; staff speaking for a variety of community events including SCMC sponsored ""health nights"", elderly and adult education; sponsoring a smoking cessation program and a variety of other ""wellness"" type programs at subsidized cost; providing meeting facilities for various community groups; offering support groups; and providing assistance to educators through our work with student nurses.SCMC provides many opportunities for community involvement through volunteering. Approximately 20 people volunteer for a variety of activities at SCMC. Volunteers are from a wide range of ages including youth from the local schools.SCMC is the only hospital in Morris.MERC Program/Residency/Internships- SCMC has benefited from Medical Residency and FNP programs that participate in the MERC funding program. This assists SCMC with the costs associated with clinical rotations, such as extra hours and lodging expenditures. It allows SCMC to continue to support the growth of students in Rural Health Care programs. Courage Cottage donations are used to support end of life care, as SCMC identified that as a community need. SCMC's administration advocates with government contacts to encourage measures that will improve the overall health of the community we serve.SCMC is an advocate for the change to tobacco sales in Stevens County. Commissioners voted to ban the sale of tobacco products to those under the age of 21 effective August 1st. SCMC removed the smoking shed from its property in 2019."