4A (Expenses $ 14894857 including grants of $ 0) (Revenue $ 15865249)
HEALTHCARE SERVICES; SHORT-TERM ACUTE CARE FOR INPATIENT AND OUTPATIENT SERVICES FOR THE LOCAL COUNTY AND ADJACENT COUNTIES. THERE WERE 1,750 PATIENT DAYS FOR THE FISCAL YEAR ENDED 9/30/22.

FACILITY 1, EVANS MEMORIAL HOSPITAL - PART V, LINE 3E
TO PRIORITIZE COMMUNITY HEALTH NEEDS, A MODIFIED NOMINAL GROUP TECHNIQUE WAS ADOPTED. BRIEFLY, THIS INVOLVED A REVIEW OF THE CHNA FINDINGS WITH THE CHNA STEERING COMMITTEE, FOLLOWED BY A BRAINSTORMING SESSION, AFTER WHICH THERE WAS A DETAILED DISCUSSION AND RANKING OF IDENTIFIED POTENTIAL PRIORITY AREAS. OF NOTE, THE CHNA STEERING COMMITTEE, WHICH INCLUDED A REPRESENTATIVE FROM THE LOCAL HEALTH DEPARTMENT PER FEDERAL REGULATION, AGREED WITH COMMUNITY INPUT ON THE PRESSING HEALTH NEEDS OF THE COMMUNITY. THESE INCLUDED: 1. ACCESS TO SELECTED SPECIALTY HEALTH SERVICES, INCLUDING MENTAL HEALTH SERVICES, CARDIOLOGY, CANCER CARE, ORTHOPEDICS, NEUROLOGY, NEPHROLOGY, GASTROENTEROLOGY, AND SURGERY. 2. THE (UN)AFFORDABILITY OF HEALTH INSURANCE COVERAGE, 3. TRANSPORTATION, AND 4. COMMUNITY HEALTH EDUCATION. THREE PRIORITY AREAS WERE SELECTED FROM THIS LIST BASED ON FEASIBILITY AND URGENCY: 1. TRANSPORTATION 2. COMMUNITY EDUCATION AND ADVOCACY 3. ACCESS TO SPECIALTY SERVICES

FACILITY 1, EVANS MEMORIAL HOSPITAL - PART V, LINE 5
THE CENTER FOR PUBLIC HEALTH PRACTICE AND RESEARCH AT THE JIANN-PING HSU COLLEGE OF PUBLIC HEALTH (JHCPH), GEORGIA SOUTHERN UNIVERSITY WORKED IN PARTNERSHIP WITH EVANS MEMORIAL HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE HOSPITALS PRIMARY SERVICE AREA OF EVANS AND TATTNALL COUNTIES. KEY COMMUNITY STAKEHOLDERS WERE ALSO INVOLVED IN REVIEWING AND INTERPRETING FINDINGS FROM THE CHNA AND DEVELOPING AN IMPLEMENTATION PLAN TO ADDRESS PRIORITIZED COMMUNITY NEEDS. THE COMMUNITY SURVEY AND FOCUS GROUP INTERVIEWS ASSESSED LOCAL HEALTH CARE ACCESS AND COMMUNITY NEEDS. THE COMMUNITY SURVEY WAS DISSEMINATED TO RESIDENTS OF THE HOSPITALS PRIMARY SERVICE AREA VIA THE HOSPITALS WEBSITE, SOCIAL MEDIA WEBPAGES, AND EMAIL LISTSERVS, AS WELL AS THOSE OF LOCAL COMMUNITY PARTNERS. FOCUS GROUP PARTICIPANTS WERE ALL KEY COMMUNITY STAKEHOLDERS OF EVANS AND/OR TATTNALL COUNTY. COLLECTIVELY, PERSPECTIVES OBTAINED FROM THE SURVEYS AND FOCUS GROUPS PROVIDED A HOLISTIC VIEW OF LIFE IN THE COMMUNITY AND THE HEALTH AND HEALTH CARE NEEDS OF THE RESIDENTS. INFORMATION FROM THESE PRIMARY DATA COLLECTION EFFORTS WAS COMPLEMENTED BY SECONDARY QUANTITATIVE DATA ON THE COMMUNITYS DEMOGRAPHIC AND ECONOMIC PROFILE, HEALTH CARE ACCESS, AND UTILIZATION. THESE DATA WERE OBTAINED FROM MULTIPLE PUBLICLY AVAILABLE SOURCES, INCLUDING THE US CENSUS BUREAU, UNIVERSITY OF WISCONSINS COUNTY HEALTH RANKINGS, CENTERS FOR DISEASE CONTROL (CDC), THE BUREAU OF LABOR STATISTICS, AND GEORGIA GOVERNORS OFFICE OF PLANNING AND BUDGET POPULATION PROJECTIONS. THE MOST RECENTLY AVAILABLE DATA WERE OBTAINED FROM ALL DATA SOURCES.

FACILITY 1, EVANS MEMORIAL HOSPITAL - PART V, LINE 6B
THE ORGANIZATION CONDUCTED ITS 2022 CHNA PARTNERING WITH JIANN-PING HSU COLLEGE OF PUBLIC HEALTH.

FACILITY 1, EVANS MEMORIAL HOSPITAL - PART V, LINE 11
THE UNAFFORDABLITY OF HEALTH INSURANCE COVERAGE WAS IDENDITIFIED AS A SIGNIFICANT COMMUNITY HEALTH NEED. HEALTH CARE COVERAGE, WHILE IMPORTANT WAS DEEMED TO BE A NEED REQUIRING POLICY INTERVENTION, BEYOND THE CAPABILITY OF THE HOSPITAL. THE HOSPITAL, HOWEVER, REMAINS COMMITTED TO ONGOING ADVOCACY CONCERNING AFFORDABLE HEALTH CARE COVERAGE OPTIONS IN THE STATE. IT WILL ALSO CONTINUE TO EXPAND ON IT RECENTLY ADDED PATIENT NAVIGATION PROGRAM THAT AIMS TO CONNECT PATIENTS TO RESOURCES, INCLUDING INSURANCE.

SCHEDULE H, PART I, LINE 7G
THE PHYSICIAN CLINIC OPERATES IN A MEDICALLY UNDERSERVED AREA RENDERING A TOTAL SUBSIDIZED LOSS OF 905,122.

SCHEDULE H, PART I, LINE 7, COLUMN (F)
IN DERIVING THE DENOMINATOR TO BE USED FOR COLUMN (F), THE FOLLOWING ADJUSTMENTS WERE MADE TO THE TOTAL EXPENSES REPORTED ON FORM 990, PART IX, LINE 25: FORM 990, PART IX, LINE 25 16,950,981 ADD: NET EXPENSES IN PART VIII 21,763 DENOMINATOR FOR COLUMN (F) 16,972,744

SCHEDULE H, PART I, LINE 7
"THE AMOUNTS REPORTED ON LINE 7A AND 7B ARE REPORTED AS INSTRUCTED BY CATHOLIC HEALTH ASSOCIATION'S ""A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFITS, 2008"". OTHER COSTS WERE OBTAINED FROM THE ORGANIZATION'S FINANCIAL RECORDS."

SCHEDULE H, PART III, LINE 2
AMOUNTS INCLUDED ON PART III LINE 2 REPRESENT THE AMOUNT OF CHARGES CONSIDERED UNCOLLECTIBLE AFTER REASONABLE ATTEMPTS TO COLLECT, AND WRITTEN OFF TO BAD DEBT EXPENSE.

SCHEDULE H, PART III, LINE 3
THE FIGURE ON PART III LINE 3 REPRESENTS MANAGEMENT'S ESTIMATE (APPROXIMATELY 10%) BASED ON AN ANALYSIS OF SELF PAY PATIENTS' ABILITY TO PAY THEIR OUTSTANDING ACCOUNT. THIS ANALYSIS INCLUDES REVIEWING THE PATIENT'S CREDIT HISTORY, INCOME LEVELS AND OVERALL COLLECTIBILITY OF THE ACCOUNT AS WELL AS INCOMPLETE APPLICATIONS FOR FINANCIAL ASSISTANCE.

SCHEDULE H, PART III, LINE 4
SEE THE ATTACHED AUDITED FINANCIAL STATEMENTS PAGES 15-19 FOR THE DISCUSSION ON UNINSURED PATIENTS, BAD DEBTS, AND IMPLICIT PRICE CONCESSIONS WITHIN THE FOOTNOTE ON NET PATIENT SERVICE REVENUE.

SCHEDULE H, PART III, LINE 8
MEDICARE ALLOWABLE COSTS ARE COMPUTED IN ACCORDANCE WITH COST REPORTING METHODOLOGIES UTILIZED ON THE MEDICARE COST REPORT AND IN ACCORDANCE WITH RELATED REGULATIONS. INDIRECT COSTS ARE ALLOCATED TO DIRECT SERVICE AREAS USING THE MOST APPROPRIATE STATISTICAL BASIS.

SCHEDULE H, PART III, LINE 9B
THE HOSPITAL WRITES OFF PATIENT BALANCES FOR PATIENTS QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND DOES NOT MAKE FURTHER COLLECTION EFFORTS. PATIENT FINANCIAL COUNSELORS VISIT PATIENTS WHO HAVE NO INSURANCE, LIMITED COVERAGE AND MEDICAID PATIENTS WITHOUT SUPPLEMENTAL INSURANCE TO DISCUSS ASSISTANCE AND REFER THOSE PATIENTS TO OUR MEDICAID ELIGIBILITY VENDOR WHO SCREENS THESE PATIENTS FOR MEDICAID AND OTHER FEDERAL, STATE OR LOCAL PROGRAMS FOR ASSISTANCE. CUSTOMER SERVICE AT THE HOSPITAL AND AT EXTENDED BUSINESS OFFICE WHICH DOES SELF-PAY BILLING AND COLLECTION, INFORMS PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND ASSISTS THEM IN MAKING AN APPLICATION. BILLING STATEMENTS PROVIDE A MESSAGE AND TELEPHONE NUMBER TO CALL IF THE PATIENT HAS DIFFICULTY MAKING PAYMENT. FOR PATIENTS WHO QUALIFY FOR CHARITY CARE AND FULL FINANCIAL ASSISTANCE, THERE IS NO FINANCIAL OBLIGATION. FOR THOSE WHO QUALIFY FOR PARTIAL FINANCIAL ASSISTANCE, COLLECTIONS PROCEDURES FOLLOW THE SAME PROCESS AS ALL OTHER PATIENTS WHO ARE RESPONSIBLE FOR UNPAID BALANCES. THOSE PATIENTS WHO HAVE NOT MADE PAYMENT ARRANGEMENTS FOR THEIR REMAINING BALANCES ARE SENT LETTERS WHERE THEY ARE PAST DUE 30, 60 AND 90 DAYS. IF PAYMENT ARRANGEMENTS ARE STILL NOT MADE AFTER 90 DAYS, THEN THOSE ACCOUNTS ARE REFERRED TO COLLECTIONS.

SCHEDULE H, PART VI, LINE 2
A COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED DURING FISCAL YEAR 2019. IN ADDITION, THE ORGANIZATION CONTINUALLY CONDUCTS VARIOUS TYPES OF ASSESSMENTS TO DETERMINE THE COMMUNITYS NEEDS FOR HEALTH AND PERSONAL SUPPORT SERVICES. OUR ORGANIZATION COLLABORATES WITH NUMEROUS NOT-FOR- PROFIT AGENCIES AND PROGRAMS TO EXTEND AND STRENGTHEN OUR MISSION. OUR PROGRAMS ARE SUCCESSFUL DUE IN LARGE PART BECAUSE OF THESE COLLABORATIONS. ONE EXAMPLE OF THIS IS EVANS COUNTY CARES. MANY OF OUR ORGANIZATION CO- WORKERS ARE ALSO INVOLVED AT EVERY LEVEL OF THE COMMUNITY THROUGH THEIR WORK AS ORGANIZATION REPRESENTATIVES ON NOT-FOR-PROFIT BOARDS. WITH OUR PARTNERS, WE LISTEN TO OUR PATIENTS AND CLIENTS AS WELL AS ACCESS EXISTING NEEDS ASSESSMENTS AND STUDIES IN ORDER TO DETERMINE THE COMMUNITYS MOST PRESSING NEEDS. THE ORGANIZATION USES FEDERAL INFORMATION AND REPORTS FROM AGENCIES SUCH AS THE U.S. CENSUS BUREAU AND BUREAU OF LABOR STATISTICS AS WELL AS RESOURCES SUCH AS DEMOGRAPHICS NOW THAT PROVIDE A WIDE ARRAY OF DEMOGRAPHICS, HOUSEHOLD INCOME AND SERVICES, RETAIL OUTLETS, ETC. IN DEFINED ZIP CODES. THIS INFORMATION, COMBINED WITH OUR EXTENSIVE COLLABORATIONS AND OUR ROLE AS A LEADER IN THE COMMUNITY, PROVIDES US THE MEANS TO UNDERSTAND AND ADDRESS THE COMMUNITYS NEEDS AND ENSURES OUR OUTREACH PROGRAMS ARE FOCUSED ON THE POPULATIONS WHO NEED OUR SERVICES THE MOST.

SCHEDULE H, PART VI, LINE 3
CUSTOMER SERVICE PERSONNEL AT THE HOSPITALS AND THE ORGANIZATIONS EXTENDED BUSINESS OFFICE INFORMS PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM AND ASSISTS THEM IN MAKING AN APPLICATION. FOR PATIENTS WHO HAVE NO INSURANCE, LIMITED COVERAGE AND MEDICAID PATIENTS WITHOUT SUPPLEMENTAL INSURANCE, PATIENT FINANCIAL COUNSELORS DISCUSS THE FINANCIAL ASSISTANCE AND VARIOUS GOVERNMENT BENEFITS WHICH MAY BE AVAILABLE TO THEM. PATIENT FINANCIAL COUNSELORS ALSO REFER APPROPRIATE PATIENTS TO A MEDICAID ELIGIBILITY VENDOR WHO SCREENS THEM FOR MEDICAID AND OTHER FEDERAL, STATE OR LOCAL PROGRAMS FOR ASSISTANCE. THE ORGANIZATION POSTS FINANCIAL ASSISTANCE INFORMATION AT ITS REGISTRATION AREAS. IN ADDITION, THE BILLING STATEMENTS SENT TO PATIENTS PROVIDE A MESSAGE AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN THE EVENT THE PATIENT HAS DIFFICULTY PAYING THE BALANCE DUE.

SCHEDULE H, PART VI, LINE 7
GEORGIA

SCHEDULE H, PART VI, LINE 4
THE ORGANIZATION SERVES A PREDOMINATELY RURAL AREA IN SOUTHEAST GEORGIA. THE PRIMARY SERVICE AREA CONSISTS OF EVANS AND TATTNALL COUNTIES. THE CITY OF CLAXTON IS THE ECONOMIC HUB FOR THE REGION, AND THE ORGANIZATION DRAWS FROM A POPULATION OF APPROXIMATELY 36,000 RESIDENTS FOR HEALTH CARE SERVICES. THE PROPORTION OF ADULTS 65 YEARS AND OLDER IN EVANS COUNTY (16%) IS HIGHER THAN THE STATE AVERAGE OF 13.8%. THE PERCENTAGE OF ELDERLY POPULATION IN TATTNALL COUNTY (14.2%) IS SLIGHTLY HIGHER THAN THE STATE AVERAGE. EVANS COUNTY AND TATTNALL COUNTY ARE MORE DIVERSE THAN THE AVERAGE RURAL COUNTY IN THE STATE. NOTABLY, THE HISPANIC POPULATION IN THE SERVICE AREA IS HIGHER THAN THE STATE WITH APPROXIMATELY 12% OF THEIR POPULATION BEING HISPANIC, RESPECTIVELY. HOWEVER, SIMILAR TO OTHER RURAL COUNTIES IN THE STATE, EDUCATIONAL ATTAINMENT IN THESE TWO COUNTIES IS LOWER THAN THE STATE AVERAGE (76% AND 74% VERSUS STATE AVERAGE OF 86%). MORE THAN A QUARTER OF THE POPULATION IN BOTH COUNTIES LIVE IN POVERTY, AND THE PER CAPITA INCOME IN BOTH COUNTIES IS LOWER THAN THE STATE AVERAGE.

SCHEDULE H, PART VI, LINE 5
ALL OF THE ORGANIZATIONS HEALTHCARE FACILITIES, INCLUDING ITS HOSPITAL, FURTHER THEIR EXEMPT PURPOSES BY PROMOTING THE HEALTH IN OUR COMMUNITY IN A VARIETY OF WAYS AS WELL AS THOSE ALREADY DESCRIBED. THE GOVERNING BODIES OF ALL OF OUR ORGANIZATIONS ARE PRIMARILY COMPRISED OF PERSONS WHO ARE NOT EMPLOYEES, CONTRACTORS (NOR FAMILY MEMBERS THEREOF), AND WHO RESIDE IN THE ORGANIZATIONS PRIMARY SERVICE AREA. THE HOSPITAL'S MEDICAL STAFFS ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE REGION. FOR THOSE PHYSICIANS IN THE REGION WHO DO NOT HAVE PRIVILEGES, THE ORGANIZATION PROVIDES A PROCESS FOR ADMITTING PATIENTS VIA THE HOSPITALISTS OR THROUGH OTHER PHYSICIANS. FUNDS RECEIVED FROM THE OPERATIONS OF THE ORGANIZATION HOSPITAL AND FACILITIES (AFTER OPERATING EXPENSES) ARE USED TO SUPPORT VARIOUS OUTREACH EFFORTS AND ALLOWS PATIENTS TO RECEIVE HIGH QUALITY CARE IN THEIR OWN COMMUNITY. IT ALSO ALLOWS US TO CONTINUALLY IMPROVE PATIENT SAFETY BY IMPLEMENTING TECHNOLOGY THAT PREVENTS MEDICATION ERRORS, ETC.

SCHEDULE H, PART VI, LINE 6
EVANS MEMORIAL HOSPITAL, INC. IS A VITAL PART OF AN AFFILIATED HEALTH CARE SYSTEM THAT INCLUDES EVANS MEMORIAL FOUNDATION, INC. AND EVANS MEMORIAL HEALTH ORGANIZATION, INC. EVANS MEMORIAL HOSPITAL, INC. MANAGES AND OPERATES EVANS MEMORIAL HOSPITAL, A 49 BED ACUTE CARE NOT-FOR-PROFIT HOSPITAL, A 10-BED INPATIENT BEHAVIORAL HEALTH UNIT, AND A PHYSICIAN'S OFFICE. EVANS MEMORIAL FOUNDATION, INC. WAS ESTABLISHED TO RAISE FUNDS OF ANY KIND OR CHARACTER TO BE USED EXCLUSIVELY FOR CHARITABLE, MEDICAL EDUCATION, AND SCIENTIFIC PURPOSES AT OR IN CONNECTION WITH EVANS MEMORIAL HOSPITAL, INC. EVANS MEMORIAL HEALTH ORGANIZATION, INC. WAS ORGANIZED TO SUPPORT, PROMOTE, ADVANCE AND STRENGTHEN EVANS MEMORIAL HOSPITAL, INC. AND OTHER NONPROFIT HEALTH CARE PROVIDERS ORGANIZED FOR CHARITABLE AND CIVIC PURPOSES. ADDITIONALLY, THE ENTITY MAY PARTICIPATE IN, FORM, OWN AND OPERATE JOINT VENTURES, PARTNERSHIPS, CORPORATIONS OR OTHER ENTITIES IN FURTHERANCE OF THE CHARITABLE, EDUCATIONAL AND SCIENTIFIC PURPOSES FOR WHICH THE CORPORATION IS ORGANIZED.