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PART I, LINE 3C: CHARITY CARE PROGRAM- THE COMMUNITY (PARTNERS) CARE PROGRAM A KEY COMPONENT OF ALLINA'S MISSION IS TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ADVOCATE FOR THOSE WITH LIMITED FINANCIAL MEANS. ALLINA STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING MEDICAL CARE. THEREFORE, ALLINA HAS SEVERAL FINANCIAL ASSISTANCE PROGRAMS INCLUDING A ROBUST CHARITY CARE PROGRAM KNOWN AS THE COMMUNITY (PARTNERS) CARE PROGRAM WHICH PROVIDES FREE CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTRAR.THE CHARITY CARE PROGRAM ALSO PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE "MEDICALLY INDIGENT". THE ORGANIZATION EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES THE ORGANIZATION HAS DETERMINED THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM (DESCRIBED BELOW) UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM GUIDELINES. DISCOUNTED CARE PROGRAM - UNINSURED DISCOUNT PROGRAM ALLINA ALSO HAS A FINANCIAL ASSISTANCE PROGRAM KNOWN AS THE UNINSURED DISCOUNT PROGRAM THAT PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED FROM ANY ALLINA HOSPITAL, HOSPITAL BASED CLINIC AND WHOLLY-OWNED AMBULATORY SURGERY CENTERS. THE UNINSURED DISCOUNT PROGRAM DOES NOT USE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. INSTEAD, UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL AND THE LOCATION OF THE SERVICES PROVIDED. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. THERE ARE TWO DISCOUNTS LEVELS ESTABLISHED, ONE FOR METRO HOSPITALS AND THEIR HOSPITAL BASED CLINICS AND ONE FOR REGIONAL HOSPITALS AND THEIR HOSPITAL BASED CLINICS WITHIN THE ALLINA SYSTEM.ALLINA'S UNINSURED DISCOUNT PROGRAM PROVIDES A DISCOUNT TO BILLED CHARGES FOR UNINSURED PATIENTS BASED ON ALLINA'S MOST FAVORED INSURER WHICH PROVIDES A SUBSTANTIAL DISCOUNT TO BILLED CHARGES.
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PART I, LINE 6A: ALLINA'S ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST. SEE CONTACT INFORMATION CONTAINED IN SCHEDULE O TO OBTAIN A COPY.
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PART I, LINE 7: WHERE APPROPRIATE, THE ORGANIZATION USES A RATIO OF PATIENT CARE COSTS TO CHARGES ("COST TO CHARGE RATIO") TO CALCULATE THE AMOUNTS REPORTED FOR PART I, LINE 7 (THE TABLE).
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PART I, LINE 7G: THE AMOUNT REPORTED AS SUBSIDIZED HEALTH SERVICES DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
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PART I, L7 COL(F): BAD DEBT EXPENSE HAS NOT BEEN INCLUDED IN FORM 990, PART IX, LINE 25 AND HAS NOT BEEN USED FOR THE PURPOSE OF CALCULATING THE AMOUNTS REPORTED IN COLUMN 7F. IT HAS BEEN REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON FORM 990, PART VIII, LINE 2B.
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PART II: COMMUNITY-BUILDING ACTIVITIESUNDERSTANDING THAT GOOD HEALTH IS DEPENDENT ON SOCIETAL, COMMUNITY, AND FAMILY ENVIRONMENTS AS WELL AS INDIVIDUAL CHOICES, AND IS BIGGER THAN THE PROVISION OF HEALTH CARE, ALLINA HAS PURPOSEFULLY SET OUT TO ENGAGE IN COMMUNITY ACTIVITIES THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS POVERTY, HOMELESSNESS AND ENVIRONMENTAL ISSUES. RESEARCH SHOWS THAT MANY OF THESE ROOT CAUSES ARE DIRECTLY TIED TO POOR HEALTH IF GONE IGNORED, PARTICULARLY AMONG LOW-INCOME, MINORITY POPULATIONS. BELOW ARE A FEW EXAMPLES OF WAYS THAT OUR ELEVEN HOSPITALS PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES IN 2012:TRAIN-TO-WORKMANY OF ALLINA HEALTH HOSPITALS HAVE TRAIN-TO-WORK PROGRAMS AS A MEANS TO BUILD A FUTURE WORKFORCE WITHIN AND OUTSIDE OF OUR ORGANIZATION. BY FOCUSING ON BUILDING THE WORKFORCE, THE GOAL IS THAT THERE WILL BE AN INCREASE IN PERSONAL EMPLOYMENT AND ECONOMIC AND WORKFORCE STABILITY. ABBOTT NORTHWESTERN HOSPITAL, BUFFALO HOSPITAL, UNITED HOSPITAL, AND UNITY HOSPITAL ALL PROVIDE TRAIN-TO-WORK PROGRAMS WITHIN THEIR FACILITIES AND HAVE DEVELOPED PARTNERSHIPS WITH LOCAL SCHOOLS AND COMMUNITY ORGANIZATIONS IN THE PROCESS. COMMUNITY COALITIONSALL ALLINA HEALTH HOSPITALS PARTICIPATE ON LOCAL COMMUNITY COALITIONS AS A WAY TO RESPOND TO COMMUNITY NEEDS THROUGH COLLABORATION AND PARTNERSHIP. THESE COALITIONS PROVIDE THE HOSPITALS THE OPPORTUNITIES TO BUILD RELATIONSHIPS AND DETERMINE HOW BEST TO LEVERAGE LOCAL RESOURCES TO ADDRESS COMMUNITY NEEDS, NEEDS THAT EXIST OUTSIDE THE TRADITIONAL REALM OF HEALTH CARE. ALLINA HEALTH HOSPITALS ARE PRESENT AT THOSE DISCUSSIONS TO DETERMINE THE ROLE HEALTH CARE CAN PLAY. IN ADDITION TO COMMUNITY-BUILDING ACTIVITIES THAT RELATED TO ROOT CAUSES OF HEALTH, ALLINA HEALTH WAS ALSO ENGAGED IN ACTIVITIES THAT WERE RELATED TO DISASTER PREPAREDNESS.DISASTER PREPAREDNESSALLINA HEALTH HOSPITALS ENGAGED IN AND LED DISASTER PREPAREDNESS PLANNING TO ENSURE SAFETY, EFFICIENCY AND EXCELLENT HEALTH CARE DURING TIMES OF TRAGEDY AND/OR UPSET. THIS INCLUDED PLANNING MEETINGS AND COMMUNITY MEETINGS/TRAININGS, AMONG OTHER THINGS. THESE PROGRAMS AND SERVICES, AMONG OTHERS, PROVIDE THE HOSPITALS WITHIN OUR SYSTEM THE OPPORTUNITY TO IMPACT COMMUNITY HEALTH BEFORE IT BECOMES PROBLEMATIC AND EXPENSIVE. IN ADDITION, THIS IMPORTANT WORK IS SUPPORTED BY THE MISSION OF OUR ORGANIZATION AND IS OUR RESPONSIBILITY AS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION. WE WILL CONTINUE TO CONTRIBUTE TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE THROUGH THE PROMOTION OF COMMUNITY HEALTH.
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PART III, LINE 4: FOOTNOTES TO AUDITED FINANCIAL STATEMENT THAT DESCRIBE BAD DEBT EXPENSE ARE AS FOLLOWS:2N. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES/NET PATIENT SERVICE REVENUENET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS AND THIRD PARTY PAYERS FOR SERVICES PROVIDED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS SUCH REVENUE IS NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS.THE PROVISIONS FOR BAD DEBTS AND CHARITY CARE ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE SYSTEM FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE SYSTEM.2Q. ADOPTION OF NEW ACCOUNTING STANDARDSON JANUARY 1, 2012, THE SYSTEM ADOPTED GUIDANCE UNDER ACCOUNTING STANDARDS UPDATE 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES, WHICH AMENDED ASC TOPIC 954, HEALTH CARE ENTITIES. THE GUIDANCE PROVIDES GREATER TRANSPARENCY REGARDING A HEALTHCARE ENTITY'S NET PATIENT SERVICE REVENUE AND THE RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AMENDMENTS REQUIRE HEALTH CARE ENTITIES TO CHANGE THE PRESENTATION OF THE PROVISION FOR BAD DEBTS RELATED TO PATIENT SERVICE REVENUE BY RECLASSIFYING THE PROVISION FROM OPERATING EXPENSE TO A DEDUCTION FROM PATIENT SERVICE REVENUE, RETROSPECTIVELY, AND REQUIRE ENHANCED DISCLOSURES ABOUT NET PATIENT REVENUE AND THE POLICIES FOR RECOGNIZING REVENUE AND ASSESSING BAD DEBTS. THE ADOPTION OF THE AUTHORITATIVE GUIDANCE DID NOT HAVE A MATERIAL EFFECT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS.
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PART III, LINE 8: THE ORGANIZATION HAS MORE THAN ONE MEDICARE PROVIDER NUMBER AND THEREFORE AGGREGATED THE AMOUNTS REPORTED IN THE MEDICARE COST REPORTS AS THE SOURCE FOR THE AMOUNTS REPORTED ON PART III, LINES 5 & 6 AS OUTLINED IN THE FORM 990, SCHEDULE H INSTRUCTIONS. FOR MEDICARE COST REPORTS, ALLINA USES A RATIO OF PATIENT CARE COSTS TO CHARGES (COST TO CHARGE RATIO) TO DETERMINE MEDICARE ALLOWABLE COSTS. GENERALLY, THE RATIO IS CALCULATED AS THE TOTAL MEDICARE ALLOWABLE PATIENT COSTS OVER THE TOTAL PATIENT CHARGES. MEDICARE CHARGES MULTIPLIED BY THIS RATIO EQUALS THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORTS. THE COST TO CHARGE RATIO IS CALCULATED INDEPENDENTLY FOR EACH MEDICARE COST REPORT/PROVIDER NUMBER. ALLINA BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS WE INCUR IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. ALLINA'S PROVIDING OF THESE SERVICES CLEARLY LESSENS THE BURDENS OF GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINE 7, OUR MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS WE RECEIVE FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. THE TRUE COMMUNITY BENEFIT FOR OUR PARTICIPATION IN THE CURRENT MEDICARE PROGRAM IS DEPENDENT ON HOW EFFICIENTLY AND COST EFFECTIVELY THE FEDERAL GOVERNMENT COULD OPERATE A DIRECT MEDICAL CARE MEDICARE PROGRAM OR ALTERNATIVELY THE COST TO THE GOVERNMENT TO CONTRACT OUT SUCH SERVICES THROUGH A COMPETITIVE BIDDING PROCESS IN THE OPEN MARKETS FOR THE SAME OR SIMILAR SERVICES FACTORING IN ITEMS SUCH AS QUALITY OF CARE, OUTCOMES AND SIMILAR IMPORTANT FACTORS AS COMPARED TO ALLINA'S ACTUAL COSTS OF PROVIDING THE MEDICAL CARE. THE MEDICARE SHORTFALL CALCULATION ON THE FORM 990, SCHEDULE H, PART III, LINE 7 SIGNIFICANTLY UNDERSTATES ALLINA'S ACTUAL MEDICARE SHORTFALL FOR TWO REASONS. FIRST, ALLINA INCURS SIGNIFICANT COSTS IN EXCESS OF PAYMENTS UNDER THE MEDICARE PROGRAM FOR PROVIDING CERTAIN SERVICES THAT ARE NOT SUBJECT TO MEDICARE COST REPORTING AND THEREFORE NOT REFLECTED IN OUR COST AMOUNTS ON LINE 6. SECOND, THE LINE 6 LIMITS OUR REPORTED COSTS TO ONLY MEDICARE "ALLOWABLE COSTS" AS SOLELY DETERMINED BY THE FEDERAL GOVERNMENT MEDICARE PROGRAM. FOR THESE TWO REASONS, THE MEDICARE SHORTFALL REPORTED ON LINE 7 SIGNIFICANTLY UNDERSTATES ALLINA'S ACTUAL MEDICARE SHORTFALL AND THE ACTUAL COST OF PROVIDING MEDICAL CARE TO MEDICARE PROGRAM PARTICIPANTS. WE ESTIMATE THESE TWO ITEMS UNDERSTATE ALLINA'S REPORTED MEDICARE SHORTFALL BY OVER $136 MILLION. WE BELIEVE A DIRECT MEDICAL SERVICE MEDICARE PROGRAM OPERATED BY THE FEDERAL GOVERNMENT AND THE COST TO THE GOVERNMENT TO CONTRACT OUT THE SERVICES UNDER A COMPETITIVE BIDDING PROCESS MAY EVEN PROVE TO BE MORE EXPENSIVE TO THE FEDERAL GOVERNMENT THAN ALLINA'S REPORTED MEDICARE "ALLOWABLE COSTS" ON LINE 6 GIVEN OUR QUALITY OF CARE, SUCCESSFUL OUTCOMES AND THE SIGNIFICANT DIFFERENCE BETWEEN ACTUAL COSTS WE INCUR AND MEDICARE "ALLOWABLE COSTS" IN PROVIDING CARE UNDER THE MEDICARE PROGRAM. THEREFORE, WE FIRMLY BELIEVE THAT THERE IS A TRUE COMMUNITY BENEFIT COMPONENT TO OUR PARTICIPATION IN THE FEDERAL MEDICARE PROGRAM.
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PART III, LINE 9B: THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY AND COLLECTION PRACTICES APPLY UNIFORMLY TO ALL PATIENTS AND INCLUDE PROVISIONS RELATED TO THE ORGANIZATIONS CHARITY CARE PROGRAM AND OTHER FINANCIAL ASSISTANCE PROGRAMS. IF A PATIENT IS KNOWN TO QUALIFY FOR A FINANCIAL ASSISTANCE PROGRAM THEY ARE AUTOMATICALLY AFFORDED THE PROGRAM BENEFITS FOR UP TO ONE YEAR AS THEY WOULD HAVE ALREADY PROVIDED INFORMATION NECESSARY FOR US TO MAKE SUCH A DETERMINATION. FOR EXAMPLE, A PATIENT THAT QUALIFIED FOR THE ORGANIZATION'S CHARITY CARE PROGRAM BEFORE RECEIVING SERVICES WOULD NOT RECEIVE A BILLING STATEMENT FOR THE MEDICAL SERVICES PROVIDED. IN THE CASE OF A PATIENT QUALIFYING FOR THE CHARITY CARE PROGRAM AFTER RECEIVING SERVICES AND THE COMMENCEMENT OF CERTAIN COLLECTION ACTIVITIES, THE AMOUNTS ARE DISCHARGED AS CHARITY CARE AND ALL COLLECTION ACTIVITIES CEASE. AS DISCUSSED IN THE RESPONSE TO PART VI, LINE 3, PATIENTS ARE INFORMED AND EDUCATED ON THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS INCLUDING THE ORGANIZATION'S CHARITY CARE PROGRAM AS PART OF THE ROUTINE REGISTRATION, ADMISSION, INTAKE, BILLING AND COLLECTION PROCESSES. IF A PATIENT DESIRES TO APPLY FOR THE CHARITY CARE PROGRAM, PERSONNEL WILL SEND AN APPLICATION TO THE PATIENT. IF COLLECTION ACTIVITIES HAVE COMMENCED, THOSE ACTIVITIES WILL BE SUSPENDED FOR THIRTY (30) DAYS TO ALLOW TIME FOR THE APPLICATION PROCESS. COLLECTION ACTIVITY MAY RESUME IF, AFTER 30 DAYS, A COMPLETED APPLICATION HAS NOT BEEN RECEIVED. IN THE CASE OF AN INCOMPLETE APPLICATION, THE ORGANIZATION MAY RESUME COLLECTION ACTIVITIES IF REQUESTS FOR ADDITIONAL INFORMATION ARE NOT MET WITH A TIMELY RESPONSE. IF AN APPLICANT DOES NOT MEET THE ELIGIBILITY CRITERIA AND THE APPLICATION IS DENIED, COLLECTION ACTIVITY MAY RESUME UPON DENIAL. HOWEVER, THE PATIENT MAY STILL BE ELIGIBLE FOR OTHER FINANCIAL ASSISTANCE PROGRAMS WHICH ARE APPLIED AS WARRANTED BASED UPON THE INFORMATION PROVIDED. SUCH ACTIVITIES ARE FULLY EXPLAINED TO THE PATIENT DURING THE COLLECTION PROCESS.
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SCH H, PART III, SECTION A, LINE 3
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THE ORGANIZATION HAS ADOPTED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION [HFMA] STATEMENT NO. 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS (STATEMENT 15). AS DISCLOSED IN THE FOOTNOTES TO THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN RESPONSE TO PART III, LINE 4, THE PROVISIONS FOR BAD DEBT AND CHARITY CARE ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THEREFORE, THE BAD DEBT AMOUNT STATED FOR FINANCIAL REPORTING PURPOSES IS REPORTED "NET" OF ANY ANTICIPATED PATIENT DISCOUNTS TO WHICH THE PATIENT MAY BE ELIGIBLE INCLUDING, BUT NOT LIMITED TO, THE UNINSURED DISCOUNT PROGRAM (DISCUSSED ABOVE) AND REFLECTS THE ESTIMATED AMOUNT REPORTED AS "NET PATIENT SERVICE REVENUE" DURING THE CURRENT PERIOD OR ANY PREVIOUS PERIOD. THIS DOES NOT NECESSARILY EQUAL THE "COST" TO PROVIDE THE MEDICAL SERVICES. ALSO, NOTE THAT AMOUNTS RELATED TO PATIENTS WHO HAVE QUALIFIED UNDER THE CHARITY CARE PROGRAM ARE NOT INCLUDED IN EITHER NET PATIENT REVENUE OR IN BAD DEBT EXPENSE. IN OTHER WORDS, THE BAD DEBT EXPENSE REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE IN THE REVENUE SECTION OF THE FINANCIAL STATEMENTS OF THE FORM 990 DOES NOT INCLUDE AMOUNTS RELATED TO QUALIFIED CHARITY CARE PATIENTS AND IS STATED AT THE "NET" EXPECTED OR ANTICIPATED COLLECTION AMOUNT WHICH MAY BE SIGNIFICANTLY DIFFERENT THAN PATIENT CHARGES DUE TO THE APPLICATION OF DISCOUNTS SUCH AS THOSE PROVIDED UNDER THE UNINSURED DISCOUNT PROGRAM. THIS AMOUNT ALSO CONSTITUTES A DIFFERENT AMOUNT THAN THE ORGANIZATION'S ACTUAL COST TO PROVIDE THE MEDICAL SERVICES. TO ARRIVE AT THE FORM 990, PART III, LINE 2 BAD DEBT "AT COST", THE ORGANIZATION HAS APPLIED A RATIO OF PATIENT CARE COST TO CHARGES (COST TO CHARGE RATIO) TO THE ESTIMATED PATIENT CHARGE AMOUNT INCLUDED IN BAD DEBT AFTER REMOVING THE ANTICIPATED DISCOUNTS. THE COST TO CHARGE RATIO IS CALCULATED INDEPENDENTLY FOR EACH HOSPITAL OR OPERATING UNIT. THE RESULTING BAD DEBT (AT COST) AMOUNT FOR EACH HOSPITAL AND OPERATING UNIT IS THEN AGGREGATED TO ARRIVE AT THE BAD DEBT (AT COST) REPORTED ON LINE 2. THIS PROCESS PROVIDES A VERY CONSERVATIVE ESTIMATE OF THE ORGANIZATION'S BAD DEBT (AT COST). THE ORGANIZATION HAS A ROBUST PROCESS FOR ADMINISTERING THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS INCLUDING THE CHARITY CARE AND UNINSURED DISCOUNT PROGRAM DESCRIBED IN FURTHER DETAIL IN PART VI, LINE 3. EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO APPLY TO THE COMMUNITY CARE PROGRAM AND TO PARTICIPATE, IF QUALIFIED, TO RECEIVE FREE OR DISCOUNTED MEDICAL CARE OR BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM UNDER THE ORGANIZATIONS VARIOUS FINANCIAL ASSISTANCE PROGRAMS. THE ADMINISTRATIVE PROCESS INCLUDES IDENTIFYING ANY PATIENT WITH A FINANCIAL CONCERN, AS WELL AS INFORMING, COUNSELING, QUALIFYING AND ASSISTING PATIENTS TO APPLY FOR THE ORGANIZATION'S CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. ALTHOUGH EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO RECEIVE FINANCIAL ASSISTANCE AND INFORMED MULTIPLE TIMES OF THE CHARITY CARE PROGRAM PRIOR TO OUR CLASSIFYING THE AMOUNTS AS BAD DEBT, IT IS POSSIBLE THAT PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE DO NOT COMPLETE THE APPLICATION. THIS AMOUNT IS NOT REASONABLY ESTIMABLE. AS A TAX-EXEMPT HOSPITAL ORGANIZATION WE ARE REQUIRED TO PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. DUE TO CIRCUMSTANCES BEYOND OUR CONTROL, A PERSON WHO WOULD OTHERWISE QUALIFY UNDER THE CHARITY CARE PROGRAM MAY NOT PROVIDE US THE NECESSARY INFORMATION, QUALIFY FOR THE PROGRAM, AND RECEIVE FREE CARE ALLOWING US TO CLASSIFY AND QUANTIFY IT ACCORDINGLY AND AS SUCH. ULTIMATELY, THOSE AMOUNTS ARE WRITTEN-OFF AND REPORTED AS BAD DEBT EXPENSE. ANY METHODOLOGY WE COULD USE TO QUANTIFY AND PROVIDE AN ESTIMATE OF HOW MUCH BAD DEBT (AT COST AND IF ANY) REPORTED ON LINE 2 REASONABLY COULD BE ATTRIBUTABLE TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY AND FOR US TO PROVIDE AN ESTIMATE OF WHAT PORTION OF BAD DEBT, IF ANY, THE ORGANIZATION BELIEVES SHOULD CONSTITUTE COMMUNITY BENEFIT WOULD BE PURELY SPECULATIVE, IMPRECISE AND SUBJECT TO INHERENT METHODOLOGY FLAWS. WHILE WE FIRMLY BELIEVE, FOR THE REASONS STATED ABOVE, THAT SOME COMPONENT OF OUR REPORTED BAD DEBT EXPENSE (AT COST) ON LINE 2 CONSTITUTES AMOUNTS RELATED TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE PROGRAM, WE CANNOT REASONABLY QUANTIFY THE AMOUNT AND RESPECTFULLY DECLINE THE OPPORTUNITY TO PROVIDE AN AMOUNT. THEREFORE, WE HAVE REPORTED ZERO OR NONE FOR FORM 990, SCHEDULE H, PART III, LINE 3.
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PART VI, LINE 2: ALLINA HEALTH SYSTEM (ALLINA HEALTH) TOGETHER WITH ITS SUBSIDIARIES AND AFFILIATES AS DESCRIBED IN PART VI, LINE 6 DEVELOPED AND IMPLEMENTED A PROCESS TO ASSESS COMMUNITY NEEDS AND BUILD PLANS TO RESPOND TO THOSE NEEDS FOR FISCAL YEARS 2010-2012. BELOW IS THE PROCESS AND FINDINGS FOR THE 2010 COMMUNITY HEALTH NEEDS ASSESSMENT; A FULL REPORT IS AVAILABLE ON OUR WEBSITE AT WWW.ALLINAHEALTH.ORG.THE ASSESSMENT BEGAN WITH A REVIEW OF EXISTING NATIONAL, STATE AND LOCAL DATA TO IDENTIFY ISSUES AFFECTING ALL ALLINA HEALTH SERVICE AREAS. ONCE A LIST OF HEALTH ISSUES WAS DEVELOPED, COMMUNITY ENGAGEMENT STAFF AND ALLINA HEALTH LEADERS FROM THROUGHOUT THE SYSTEM IDENTIFIED BROAD SYSTEM-LEVEL PRIORITY AREAS THROUGH THE USE OF A PRIORITY-SETTING PROCESS AND HEALTH ISSUES SCORING TOOL. FROM THIS PROCESS, THREE PRIORITY ISSUES WERE IDENTIFIED:-HEALTHFUL EATING-ACTIVE LIVING-STRESS REDUCTION/LIFE BALANCE THESE INTERRELATED ISSUES WERE IDENTIFIED AS PRIORITIES BECAUSE THEY AFFECT MULTIPLE HEALTH OUTCOMES AND GREATLY IMPACT COMMUNITY HEALTH. COMMUNITY HEALTH DIALOGUESWITH PRIORITY ISSUES IDENTIFIED, THE NEXT STEP IN THE ASSESSMENT WAS HOSTING COMMUNITY HEALTH DIALOGUES IN EACH OF THE NINE REGIONS SERVED BY ALLINA HEALTH. THESE DIALOGUES WERE FACILITATED BY AN OUTSIDE FACILITATOR AND ENGAGED 260 COMMUNITY MEMBERS IN CONVERSATION ABOUT ASSETS AND BARRIERS TO HEALTHFUL EATING, ACTIVE LIVING AND LIFE BALANCE IN THEIR COMMUNITIES. COMMUNITY MEMBERS WERE ALSO ASKED WHAT THEY THINK ALLINA HEALTH SHOULD DO TO IMPROVE HEALTH IN THEIR COMMUNITIES RELATED TO THESE ISSUES. THE TOP SIX RECOMMENDATIONS FOR ALLINA WERE AS FOLLOWS:1. OFFER HEALTH EDUCATION IN COMMUNITY SETTINGS2. INCREASE COLLABORATION AND PARTNERSHIP WITH AND COMMUNICATION ABOUT EXISTING RESOURCES3. SHIFT MEDICAL PRACTICES TOWARD ILLNESS PREVENTION AND PATIENT WELLNESS4. MODEL HEALTH AND WELLNESS PROMOTION WITHIN ALLINA FACILITIES5. FOSTER BEHAVIOR CHANGE THROUGH SPONSORSHIP OF COMMUNITY ACTIVITIES THAT PROMOTE HEALTH6. ADVOCATE FOR PUBLIC POLICY CHANGESALLINA HEALTH EMPLOYEE SURVEYFOLLOWING THE DIALOGUES, A SURVEY WAS CONDUCTED WITH ALLINA HEALTH EMPLOYEES TO GAIN PERSPECTIVES AND IDEAS RELATED TO THE INFORMATION RECEIVED THROUGH THE COMMUNITY HEALTH DIALOGUES. THE SURVEY ASKED RESPONDENTS TO 1) PROVIDE INFORMATION ABOUT EFFORTS ALREADY UNDERWAY THROUGHOUT THE ALLINA HEALTH SYSTEM THAT RELATED TO THE COMMUNITY INPUT RECEIVED AT THE DIALOGUES AND 2) SELECT THEIR TOP CHOICES FROM AND PROVIDE SPECIFIC IDEAS ABOUT THE SIX COMMUNITY SUGGESTIONS. THERE WERE 136 TOTAL RESPONDENTS TO THE SURVEY THAT SPANNED ALLINA'S SERVICES AND SERVICE AREAS. SURVEY RESULTS SHOWED THAT OF THE SIX COMMUNITY SUGGESTIONS, THE TOP THREE THAT EMPLOYEES THOUGHT ALLINA SHOULD WORK ON INCLUDED:1. SHIFT MEDICAL PRACTICES TOWARD ILLNESS PREVENTION AND PATIENT WELLNESS (28.7%)2. MODEL HEALTH AND WELLNESS PROMOTION WITHIN ALLINA FACILITIES (21.3%)3. INCREASE COLLABORATION, PARTNERSHIP AND COMMUNICATION ABOUT EXISTING RESOURCES (21.3%)THE NEXT STEP IN THE PROCESS WAS TO USE THE ASSESSMENT INFORMATION TO DEVELOP A SYSTEM-WIDE STRATEGY RELATED TO THE THREE PRIORITY AREAS. TO DO SO, ALLINA HEALTH CONVENED KEY STAKEHOLDERS FROM ACROSS THE SYSTEM TO REVIEW ASSESSMENT INFORMATION, DETERMINE THE INTERSECTION BETWEEN COMMUNITY INTERESTS AND SUGGESTIONS AND ALLINA STRENGTHS AND INTERESTS, AND BEGIN DEVELOPING THE STRATEGY TO IMPROVE HEALTHFUL EATING, ACTIVE LIVING AND STRESS REDUCTION/LIFE BALANCE. IN ADDITION, REGIONAL COMMUNITY ENGAGEMENT LEADS WORKED WITH COMMUNITY MEMBERS AND INTERNAL STAKEHOLDERS IN THEIR REGIONS TO REVIEW ASSESSMENT INFORMATION AND DEVELOP REGIONAL WORK PLANS TO MEET THE NEEDS OF THE LOCAL COMMUNITIES AS IT RELATES TO THE THREE SYSTEM-LEVEL PRIORITIES FOR 2010-2012. IN 2012, PER NEW IRS REQUIREMENTS FOR NOT-FOR-PROFIT HOSPITALS, ALLINA HEALTH BEGAN TO PLAN AND IMPLEMENT THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH OF THE HOSPITALS IN THE SYSTEM. THE NEEDS ASSESSMENT PLAN WAS BASED ON A SET OF BEST PRACTICES FOR COMMUNITY HEALTH ASSESSMENTS DEVELOPED BY THE CATHOLIC HEALTH ASSOCIATION WITH THE PURPOSE OF IDENTIFYING TWO TO THREE REGIONAL PRIORITY AREAS TO FOCUS ON FOR FY 20142016. THE PROCESS WAS DESIGNED TO RELY ON EXISTING PUBLIC DATA, DIRECTLY ENGAGE COMMUNITY STAKEHOLDERS AND COLLABORATE WITH LOCAL PUBLIC HEALTH AND OTHER HEALTH PROVIDERS. THERE WERE THREE STAGES INVOLVED DURING THE NEEDS ASSESSMENT: DATA REVIEW AND SETTING PRIORITIES, COMMUNITY HEALTH DIALOGUES AND COMMUNITY ASSETS INVENTORY, AND ACTION PLANNING. IN THE FALL OF 2012, THE DATA REVIEW AND PRIORITY-SETTING PHASE TOOK PLACE. THIS PHASE BEGAN WITH THE COMPILATION OF EXISTING HEALTH-RELATED DATA. STAKEHOLDERS REVIEWED THREE EXISTING DATASETS AND THEN DEVELOPED AN INITIAL LIST OF COMMUNITY HEALTH ISSUES. ASSESSMENT STAKEHOLDERS USED THE HANLON METHOD, A SYSTEMATIC PRIORITIZATION PROCESS, TO RANK THE HEALTH-RELATED ISSUES BASED ON THREE CRITERIA: SIZE OF THE PROBLEM, SERIOUSNESS OF THE PROBLEM, AND ESTIMATED EFFECTIVENESS OF THE SOLUTION AND WERE THEN ASKED TO CONSIDER THE NUMERICAL RANKINGS GIVEN TO EACH ISSUE ALONG WITH A SET OF DISCUSSION QUESTIONS TO CHOOSE THE FINAL PRIORITY ISSUES. THE REMAINING TWO PHASES OF THE ASSESSMENT PROCESS WERE COMPLETED IN 2013.
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PART VI, LINE 3: A KEY COMPONENT OF ALLINA'S MISSION IS TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ADVOCATE FOR THOSE WITH LIMITED FINANCIAL MEANS. ALLINA STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING MEDICAL CARE. PROVIDING CONVENIENT ACCESS TO NECESSARY MEDICAL CARE REGARDLESS OF ONE'S ABILITY TO PAY FOR THOSE SERVICES IS IMPORTANT TO US. ALLINA HAS ESTABLISHED THE FOLLOWING FINANCIAL ASSISTANCE PROGRAMS:- COMMUNITY (PARTNERS) CARE PROGRAM (CHARITY CARE)- UNINSURED DISCOUNT PROGRAM- SPECIAL CIRCUMSTANCES- MEDELIGIBLE SERVICES- MEDCREDIT FINANCIAL SERVICESOUR CARE GOES BEYOND MEDICAL CARE ASSISTANCE. WE ALSO HELP PEOPLE GET FOOD STAMPS, WIC (WOMEN, INFANTS AND CHILDREN, A FEDERAL PROGRAM THAT SUPPLIES NUTRITIOUS FOODS) OR HEATING ASSISTANCE - ALL OF WHICH ARE VITALLY IMPORTANT TO A PATIENT'S RECOVERY, HEALTH AND WELL-BEING. YOU MAY VISIT WWW.ALLINAHEALTH.ORG AND CLICK ON THE FINANCIAL ASSISTANCE LINK.CHARITY CARE PROGRAM - THE COMMUNITY (PARTNERS) CARE PROGRAM THE COMMUNITY (PARTNERS) CARE PROGRAM PROVIDES FREE MEDICALLY NECESSARY CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTRAR. THE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE OR MINNESOTA CARE AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY LEVEL. THE APPLICATION IS BRIEF AND ASKS FOR INFORMATION ON FAMILY SIZE, EMPLOYMENT, INCOME, BANKING AND INSURANCE. IF PATIENTS MEET THE PROGRAM ELIGIBILITY GUIDELINES, THEIR TOTAL ALLINA BALANCE WILL BE ZERO. THEY WILL RECEIVE FREE MEDICAL CARE. AN ELIGIBLE INDIVIDUAL WILL BE COVERED BY THE PROGRAM FOR UP TO ONE YEAR BARRING ANY SIGNIFICANT CHANGE IN INCOME. PATIENTS MAY BE ASKED TO APPLY FOR MEDICAL ASSISTANCE AND MINNESOTA CARE AND BE FOUND INELIGIBLE FOR THOSE PROGRAMS BEFORE THEY QUALIFY FOR THE COMMUNITY (PARTNERS) CARE. UNINSURED DISCOUNT PROGRAM - THE UNINSURED DISCOUNT PROGRAM PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED FROM ANY ALLINA HOSPITAL, HOSPITAL BASED CLINIC AND WHOLLY-OWNED AMBULATORY SURGERY CENTERS. UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL AND THE LOCATION OF THE SERVICES PROVIDED. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. THERE ARE TWO DISCOUNTS LEVELS ESTABLISHED, ONE FOR METRO HOSPITALS AND THEIR HOSPITAL BASED CLINICS AND ONE FOR REGIONAL HOSPITALS AND THEIR HOSPITAL BASED CLINICS WITHIN THE ALLINA SYSTEM. SPECIAL CIRCUMSTANCES ASSISTANCE (ON INDIVIDUAL CASE BY CASE BASIS) - THE ORGANIZATION PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE "MEDICALLY INDIGENT". THE ORGANIZATION EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES THE ORGANIZATION HAS DETERMINED THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM GUIDELINES. FINANCIAL ASSISTANCE SERVICES WILL PROVIDE AN EVALUATION OF PATIENTS WITH SPECIAL CIRCUMSTANCES. THERE MAY BE A CIRCUMSTANCE WHERE PATIENTS EXPERIENCE A CATASTROPHIC EVENT THAT PUTS THEM IN A DEVASTATING FINANCIAL POSITION WHEREBY THE PROGRAM REPRESENTATIVES WILL DETERMINE HOW TO BEST SUPPORT THEM FINANCIALLY.MEDELIGIBLE SERVICES - MEDELIGIBLE SERVICES PROVIDES ADVOCACY SUPPORT TO PATIENTS WHO HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS. THEY CAN ASSIST PATIENTS WITH APPLYING FOR FEDERAL, STATE AND COUNTY BENEFIT PROGRAMS. THE MEDELIGIBLE SERVICES PERSONNEL ARE ADVOCATES WHO EDUCATE PATIENTS AND FAMILIES ABOUT THE ADVANTAGE OF PROGRAMS AND ASSIST THEM WITH GETTING HELP. PERSONNEL CAN PROVIDE ASSISTANCE WITH MEDICAID AND MEDICARE, SOCIAL SECURITY, VETERAN'S ADMINISTRATION, FOOD STAMPS, EMERGENCY FOOD, AND SHELTER. MEDCREDIT FINANCIAL SERVICES - MEDCREDIT FINANCIAL SERVICES PROVIDES FINANCIAL LOANS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR MEDICAL BILLS. THE PATIENT CAN CONSOLIDATE ALL MEDICAL EXPENSES FROM PARTICIPATING PROVIDERS SUCH THAT THE PATIENT HAS ONLY ONE MONTHLY PAYMENT. THERE IS NO CREDIT APPLICATION REQUIRED AND NO ANNUAL FEES OR DUES. THE ANNUAL PERCENTAGE INTEREST RATE IS 8 PERCENT. ONCE A PATIENT HAS ESTABLISHED A MEDCREDIT ACCOUNT, AMOUNTS CAN BE ADDED ON ANY ADDITIONAL MEDICAL EXPENSES FOR THEMSELVES AND THEIR FAMILY. THE FINANCIAL ASSISTANCE SERVICES INFORMATION AND EDUCATION METHODS - ALLINA HAS ROBUST METHODS TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAMS INCLUDING ITS CHARITY CARE PROGRAM AND ALSO ABOUT GOVERNMENT PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE TO RECEIVE BENEFITS. EACH PATIENT BILLING STATEMENT CONTAINS INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION. THE ALLINA WEBSITE HOMEPAGE AT WWW.ALLINAHEALTH.ORG PROMINENTLY CONTAINS A LINK TO THE FINANCIAL ASSISTANCE SERVICES PAGE WHICH DESCRIBES THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION.THE ORGANIZATION POSTS SUMMARIES OF ITS FINANCIAL ASSISTANCE PROGRAMS IN BROCHURES IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATIONS FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE BROCHURES CONTAIN SUMMARIES OF THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDE CONTACT INFORMATION FOR THE PROGRAMS. THIS INFORMATION IS AVAILABLE IN VARIOUS LANGUAGES SUCH AS HMONG, SOMALI, AND SPANISH. REGISTRATION, ADMISSIONS AND INTAKE PERSONNEL ARE TRAINED TO PROVIDE FINANCIAL ASSISTANCE PROGRAM INFORMATION TO ANYONE EXPRESSING A CONCERN ABOUT THEIR ABILITY TO PAY FOR SERVICES. ALL "SELF-PAY" PATIENTS (THE PATIENT IS NOT COVERED BY INSURANCE OR A GOVERNMENT PROGRAM) THAT COMES TO ONE OF THE ORGANIZATION'S EMERGENCY ROOMS RECEIVES A PACKET OF INFORMATION CONTAINING EVERYTHING NECESSARY TO APPLY FOR THE ORGANIZATIONS FINANCIAL ASSISTANCE PROGRAMS AND CERTAIN GOVERNMENT PROGRAMS. THERE IS CONTACT INFORMATION AND TELEPHONE NUMBERS THEY CAN CALL WITH ANY QUESTIONS OR TO RECEIVE ASSISTANCE IN COMPLETING APPLICATIONS. FINANCIAL ASSISTANCE PROGRAM PERSONNEL ALSO MEET DIRECTLY WITH ANY SELF-PAY PATIENT ADMITTED TO THE HOSPITAL. PERSONNEL WILL MEET WITH PATIENTS WHEREVER IT IS MOST CONVENIENT FOR THE PATIENT SUCH AS THE HOSPITAL, A CLINIC, THE ORGANIZATION'S OFFICES OR THE PATIENT'S HOME.ALLINA HAS A SYSTEM WIDE INTERPRETER SERVICES TEAM THAT PROVIDES INTERPRETERS TO PATIENTS, COMPANIONS AND FAMILIES WHO HAVE LIMITED ENGLISH PROFICIENCY (LEP) OR ARE DEAF OR HARD OF HEARING (DHH). THIS SERVICE IS PROVIDED AT NO COST TO THE PATIENT. LDP AND DHH PERSONNEL ARE TRAINED TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAMS. ALL PERSONNEL RESPONSIBLE FOR THE ORGANIZATIONS COLLECTION ACTIVITIES ARE EXTENSIVELY TRAINED ON THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAMS. ANY TIME A PATIENT EXPRESSES A CONCERN REGARDING THEIR ABILITY TO PAY FOR SERVICES, THE PERSONNEL EXPLAIN THE FINANCIAL ASSISTANCE PROGRAMS, ASK CERTAIN QUESTIONS TO OBTAIN INFORMATION AND TO DETERMINE WHICH FINANCIAL ASSISTANCE PROGRAMS THE PATIENT MAY QUALIFY AND BEST FITS THE PATIENTS' NEEDS.
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PART VI, LINE 4: ALLINA HEALTH SYSTEM (ALLINA HEALTH) TOGETHER WITH ITS SUBSIDIARIES AND AFFILIATES AS DESCRIBED IN PART VI, LINE 6 COORDINATE COMMUNITY BENEFIT ACTIVITIES AND IDENTIFIES COMMUNITY NEEDS AS A SYSTEM TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED BY THE ORGANIZATION.ALLINA HEALTH IS A NOT-FOR-PROFIT SYSTEM OF CLINICS, HOSPITALS AND OTHER HEALTH CARE SERVICES. ALLINA HEALTH OWNS AND OPERATES 11 HOSPITALS, MORE THAN 90 CLINICS AND HEALTH CARE SERVICES, INCLUDING HOME CARE, HOSPICE CARE, PALLIATIVE CARE, OXYGEN AND MEDICAL EQUIPMENT, PHARMACIES AND EMERGENCY MEDICAL TRANSPORTATION IN OPERATION WITHIN MINNESOTA AND WESTERN WISCONSIN. OVER 98 PERCENT OF ALLINA HOSPITAL PATIENTS COME FROM MINNESOTA AND WISCONSIN, THE MAJORITY OF WHICH COME FROM COUNTIES IN AND SURROUNDING THE METROPOLITAN AREAS OF MINNEAPOLIS AND ST. PAUL. IN 2010, ALLINA HEALTH DEVELOPED A NEW COMMUNITY ENGAGEMENT STRATEGY TO WORK MORE EFFECTIVELY WITH COMMUNITIES SERVED BY ALLINA. THIS ENGAGEMENT STRATEGY INCLUDED THE DEVELOPMENT OF NINE REGIONS MADE UP OF THE COMMUNITIES SERVED BY ALLINA HEALTH. EACH REGION INCLUDES AT LEAST ONE HOSPITAL WITHIN OUR SYSTEM. WEST METRO THE WEST METRO REGION INCLUDES ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE AND SERVES MOST COMMUNITIES WITHIN HENNEPIN COUNTY, THE LARGEST COUNTY IN MINNESOTA. THE CITY OF MINNEAPOLIS IS ITS LARGEST CITY AND THE COUNTY SEAT. THE WEST METRO REGION SERVES BOTH URBAN AND SURBURBAN COMMUNITIES AND INCLUDES A RANGE OF SOCIOECONOMIC STATUSES AS WELL AS A BROAD REPRESENTATION OF RACES AND ETHNICITIES. EAST METRO THE EAST METRO REGION INCLUDES UNITED HOSPITAL AND SERVES RAMSEY, WASHINGTON AND DAKOTA COUNTIES. THIS REGION SPANS THE EASTERN EDGE OF MINNESOTA INTO THE METRO AREA SURROUNDING THE CITY OF ST. PAUL, THE CAPITAL AND SECOND-MOST POPULOUS CITY IN THE STATE. THE EAST METRO REGION IS HIGHLY DIVERSE; GEOGRAPHICALLY, SOCIOECONOMICALLY AND RACIALLY. NORTHWEST METRO THE NORTHWEST METRO REGION INCLUDES BOTH MERCY AND UNITY HOSPITALS AND PRIMARILY SERVES COMMUNITIES WITHIN ANOKA COUNTY, BUT ALSO INCLUDES AREAS WITHIN SHERBURNE AND HENNEPIN COUNTIES. ANOKA COUNTY IS THE FOURTH-MOST POPULOUS COUNTY IN THE STATE OF MINNESOTA AND INCLUDES THE NORTHWEST METROPOLITAN AREA THAT IS PREDOMINANTLY SUBURBAN IN NATURE. SOUTH METRO THE SOUTH METRO REGION INCLUDES ST. FRANCES MEDICAL CENTER, A PARTIALLY-OWNED HOSPITAL WITHIN THE ALLINA SYSTEM, AND PRIMARILY SERVES SCOTT AND CARVER COUNTIES, BUT ALSO INCLUDES COMMUNITIES IN SIBLEY, LE SUEUR, DAKOTA AND HENNEPIN COUNTIES. THIS REGION INCLUDES BOTH SUBURBAN AND SMALL COMMUNITIES IN THE SOUTHWEST AREA OF THE MINNEAPOLIS-ST. PAUL METROPOLITAN AREA. NORTHWEST REGIONAL THE NORTHWEST REGIONAL AREA INCLUDES BUFFALO HOSPITAL AND IS LOCATED WEST OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. THIS REGION PRIMARILY SERVES WRIGHT COUNTY, BUT ALSO SERVES COMMUNITIES WITHIN STEARNS, MEEKER AND HENNEPIN COUNTIES. THIS REGION IS MADE UP OF BOTH SMALL AND RURAL COMMUNITIES. NORTH REGIONALTHE NORTH REGIONAL AREA INCLUDES CAMBRIDGE MEDICAL CENTER AND SERVES SMALL AND RURAL COMMUNITIES WITHIN ISANTI, CHISAGO, KANABEC AND PINE COUNTIES NORTH OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. SOUTHWEST REGIONALTHE SOUTHWEST REGIONAL AREA IS LOCATED IN SOUTH CENTRAL MINNESOTA AND INCLUDES NEW ULM MEDICAL CENTER. THE REGION SERVES COMMUNITIES AND RURAL AREAS IN AND AROUND BROWN COUNTY AND COMMUNITIES WITHIN SIBLEY AND NICOLLET COUNTIESSOUTH REGIONALLOCATED SOUTH OF THE TWIN CITIES METROPOLITAN AREA, THE SOUTH REGIONAL REGION SERVES SMALL AND RURAL COMMUNITIES IN AND AROUND STEELE, RICE, WASECA, DODGE, AND GOODHUE COUNTIES. OWATONNA HOSPITAL SERVES THESE AREAS FROM THE COUNTY SEAT OF OWATONNA, MINNESOTA. WESTERN WISCONSINLOCATED IN WESTERN WISCONSIN, THIS REGION INCLUDES SMALL AND RURAL COMMUNITIES WITHIN PIERCE AND ST. CROIX COUNTIES. RIVER FALLS AREA HOSPITAL (RFAH) IS LOCATED WITHIN AND SERVES THIS REGION.
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PART VI, LINE 5: GOVERNING BODYTO ENSURE THAT THE BOARD OF DIRECTORS REPRESENTS THE COMMUNITIES SERVED BY ALLINA HEALTH, THE BY-LAWS STATE THAT A MAJORITY OF THE VOTING MEMBERS OF THE BOARD OF DIRECTORS SHALL AT ALL TIMES BE INDEPENDENT CIVIC LEADERS. IN FURTHERANCE OF THIS REQUIREMENT, AND SUBJECT TO VACANCIES THAT MAY OCCUR FROM TIME TO TIME, NO MORE THAN ONE-THIRD (1/3) OF THE DIRECTORS (INCLUDING ANY EX-OFFICIO DIRECTORS WITH VOTE) MAY BE INTERESTED DIRECTORS. INTERESTED DIRECTORS SHALL INCLUDE PERSONS WHO ARE NOT ON THE BOARD OF DIRECTORS BUT SERVE ON COMMITTEES OR OTHERWISE PARTICIPATE IN THE AFFAIRS OF THE CORPORATION AND WOULD BE DEEMED INTERESTED DIRECTORS IF THEY WERE ON THE BOARD OF DIRECTORS. "INTERESTED DIRECTORS" ARE:(1)ANY MEMBERS OF THE CORPORATION'S MANAGEMENT WHO SERVE AS DIRECTORS; AND(2)ANY PHYSICIAN DIRECTORS WHO PROVIDE SERVICES IN CONJUNCTION WITH THE CORPORATION OR ANY OF ITS HOSPITALS OR CLINICS, INCLUDING WITHOUT LIMITATION SERVICES UNDER A CONTRACT WITH ANY OF THE CORPORATION'S HOSPITALS OR CLINICS, AS A PHYSICIAN EMPLOYEE OF ONE OF THE CORPORATION'S CLINICS OR AS A MEDICAL STAFF MEMBER OF ONE OF THE CORPORATION'S HOSPITALS. IN ADDITION TO THESE BY-LAWS PROVISIONS, THE BOARD'S GOVERNANCE AND NOMINATING COMMITTEE ACTIVELY ENSURES DIVERSITY OF DIRECTORS AND KEY SUBSTANTIVE AND STRATEGIC COMPETENCIES IN RECRUITING BOARD MEMBERS. THE COMMITTEE HAS CHOSEN SEVERAL CURRENT MEMBERS WHO REPRESENT THE PATIENT PERSPECTIVE AND COMMUNITY LEADERS. RECRUITMENT EFFORTS IN THE PAST SEVERAL YEARS HAVE FOCUSED ON ENHANCING THE MEMBERSHIP OF THE BOARD TO INCLUDE DIRECTORS AND COMMITTEE MEMBERS WITH STRATEGIC COMPETENCIES TO SUPPORT ALLINA IN THE NEW PAYMENT AND HEALTH REFORM ENVIRONMENT. THE WORK OF THE BOARD'S OTHER COMMITTEES HAS ALSO FOCUSED ON ENHANCING THE GOVERNING BODY'S COMMUNITY BENEFIT INITIATIVES. FOR EXAMPLE, THE BOARD'S QUALITY COMMITTEE HAS DEVELOPED AND IMPLEMENTED A ROBUST INFRASTRUCTURE OF PATIENT ADVISORY COMMITTEES THAT PROVIDE THE "VOICE OF THE PATIENT" FOR STRATEGIC DECISIONMAKING AT THE BOARD LEVEL. THE BOARD'S CENTER FOR HEALTHCARE INNOVATION, RESEARCH & COMMUNITY ENGAGEMENT COMMITTEE OVERSEES AND SUPPORTS THE CORPORATION'S EFFORTS TO: (1) FOSTER A CULTURE OF COMMUNITY ENGAGEMENT AND A REPUTATION AS A COMPASSIONATE, TRUSTED COMMUNITY PARTNER KNOWN FOR HEALTH, WELLNESS, AND EXCELLENT HEALTH CARE; AND (2) IDENTIFY AND RESPOND TO THE HEALTH NEEDS OF THE COMMUNITIES SERVED BY ALLINA HEALTH.FUNDING FOR IMPROVEMENTS IN PATIENT CARE AND RESEARCH AS DESCRIBED IN THE COMMUNITY HEALTH IMPROVEMENT SECTION OF THE STATEMENT FOR PROGRAM SERVICES, ALLINA HEALTH IS ENGAGED IN A TREMENDOUS AMOUNT OF WORK RELATED TO PROMOTING COMMUNITY HEALTH. ONE AREA WITHIN ALLINA HEALTH THAT IS INVOLVED IN RESEARCHING COMMUNITY HEALTH IS THE DEPARTMENT OF APPLIED RESEARCH (DAR). THE DARRESEARCHES NEW CARE MODELS AND TREATMENTS TO TRANSFORM HEALTH AND HEALTH CARE AND ADVANCE THE STRATEGIC VISION OF ALLINA HEALTH TO IMPROVE PATIENT CARE WHILE ALSO SERVING AS A CATALYST FOR CHANGE IN HEALTH CARE LOCALLY AND NATIONALLY. THERE ARE THREE KEY COMMUNITY HEALTH RESEARCH PROJECTS WITHIN THE DAR:ROBINA CARE GUIDE PROJECT A PROJECT USING CARE GUIDES TO HELP PATIENTS WITH CHRONIC DISEASES LIKE DIABETES, HIGH BLOOD PRESSURE AND HEART FAILURE MANAGE THEIR HEALTH.BACKYARD INITIATIVE THIS INITIATIVE IS WORKING TO IMPROVE HEALTH AND HEALTH CARE THROUGH ACTIVE ENGAGEMENT WITH COMMUNITY, ADDRESSING SOCIAL DETERMINANTS OF HEALTH, AND FACILITATING PARTNERSHIPS BETWEEN COMMUNITY CARE SYSTEMS. HEART OF NEW ULM PROJECT (HONU)- HONU IS A 10-YEAR INITIATIVE DESIGNED TO REDUCE, AND EVENTUALLY ELIMINATE, HEART ATTACKS IN NEW ULM, MINNESOTA BY HELPING RESIDENTS IMPROVE THEIR HEALTH RISKS, SUCH AS PHYSICAL ACTIVITY, NUTRITION, OBESITY, OR TOBACCO USE, AMONG OTHERS. THE DAR IS ALSO INVOLVED IN:-OVERSEEING THE ALLINA HEALTH IRB OFFICE -PARTNERING WITH THE CLINICS TO DO CUTTING EDGE WORK ON PHYSICIAN JOB SATISFACTION AND BURNOUT -DEVELOPING A FIRST-EVER SOCIAL NETWORK ANALYSIS PROJECT BY A CARE DELIVERY ORGANIZATION-RESEARCHING CARE DELIVERY RE-DESIGN IN EMERGENCY SERVICES AND PRIMARY CARE
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PART VI, LINE 6: ALLINA HEALTH SYSTEM ("ALLINA HEALTH"), DOING BUSINESS AS ALLINA HEALTH, IS A MINNESOTA NONPROFIT CORPORATION WHICH, TOGETHER WITH ITS SUBSIDIARIES, DELIVERS HEALTH CARE SERVICES TO PATIENTS IN MINNESOTA AND WESTERN WISCONSIN. AS A MISSION-DRIVEN ORGANIZATION, ALLINA HEALTH IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. WITH APPROXIMATELY 24,000 FULL AND PART-TIME EMPLOYEES, ALLINA HEALTH IS ONE OF THE LARGEST EMPLOYERS IN MINNESOTA. AS AN INTEGRATED HEALTH SYSTEM THAT INCLUDES HOSPITALS, EMERGENCY, AMBULATORY, HOMECARE AND HOSPICE SERVICES, AN AUTOMATED ELECTRONIC MEDICAL RECORD SYSTEM, AND OVER 1,200 EMPLOYED PHYSICIANS, ALLINA HEALTH IS UNIQUELY POSITIONED AS A LEADER IN HEALTHCARE IN THE MINNEAPOLIS/ST. PAUL AREA AND IS WELL POSITIONED FOR HEALTH CARE REFORM.ALLINA HEALTH CONTROLS AND OPERATES TEN HOSPITALS AND JOINTLY OWNS AND OPERATES ONE OTHER HOSPITAL. THESE INCLUDE URBAN TERTIARY CARE, SUBURBAN COMMUNITY AND RURAL HOSPITALS. ALLINA HEALTH HOSPITALS PROVIDED OVER 107,700 INPATIENT ADMISSIONS AND NEARLY 1,154,800 OUTPATIENT VISITS DURING THE YEAR ENDED DECEMBER 31, 2012. AS OF YEAR-END, ALLINA HEALTH HOSPITALS HAD LICENSED BED CAPACITY OF 2,379 ACUTE CARE BEDS, 1,716 OF WHICH WERE STAFFED FOR INPATIENT SERVICES. ALLINA HEALTH PROVIDES CLINICAL SERVICES THROUGH ITS CLINIC AND COMMUNITY DIVISION AND HOSPITAL-BASED PHYSICIANS. THE CLINIC AND COMMUNITY DIVISION CONTAINS THREE CLINIC GROUPS, ALLINA MEDICAL CLINIC ("AMC"), ASPEN MEDICAL GROUP ("ASPEN"), AND QUELLO CLINIC ("QUELLO"); CONTROLS AND OPERATES 55 PHYSICIAN CLINICS AND THREE HOSPITALIST PROGRAMS ON THE ABBOTT NORTHWESTERN, UNITED AND UNITY HOSPITAL CAMPUSES; AND EMPLOYS APPROXIMATELY 800 PHYSICIANS. ALLINA SPECIALTY ASSOCIATES, INC. ("ASA"), OPERATING UNDER THE NAME MINNEAPOLIS HEART INSTITUTE, EMPLOYS APPROXIMATELY 70 PHYSICIANS, CONSISTING OF CARDIOLOGISTS, CARDIOTHORACIC AND VASCULAR SURGEONS. IN ADDITION, ALLINA HEALTH HOSPITALS DIRECTLY EMPLOY APPROXIMATELY 330 SPECIALTY PHYSICIANS INCLUDING INTENSIVISTS/HOSPITALISTS, PERINATOLOGISTS, AND PSYCHIATRISTS. ALLINA HEALTH PHYSICIANS AND ALLIED PROFESSIONALS GENERATED NEARLY 6,128,500 WORKS RVU'S DURING THE YEAR ENDED DECEMBER 31, 2012. ALLINA HEALTH HAS THE LARGEST PHYSICIAN NETWORK IN MINNESOTA.ALLINA'S HEALTH HOME CARE SERVICES DIVISION PROVIDES HOME HEALTH, HOME OXYGEN AND MEDICAL EQUIPMENT, HOSPICE, PALLIATIVE CARE AND SENIORCARE TRANSITIONS.A LEADER AND INNOVATOR IN PRE-HOSPITAL EMERGENCY MEDICAL DEVICES, ALLINA HEALTH EMERGENCY MEDICAL SERVICES IS DEVOTED TO PROVIDING SKILLED AND COMPASSIONATE ADVANCED LIFE SUPPORT, BASIC LIFE SUPPORT AND SCHEDULED TRANSPORT IN MORE THAN 75 MINNESOTA COMMUNITIES. MORE THAN 370 PARAMEDICS, EMERGENCY MEDICAL TECHNICIANS AND DISPATCHERS WORK TOGETHER TO PROVIDE SERVICE TO AN AREA OF APPROXIMATELY 1,000 SQUARE MILES, REACHING MORE THAN 750,000 PEOPLE.IN ADDITION TO THE CHARITY CARE DISCLOSED ON THIS SCHEDULE H, ALLINA AFFILIATED ORGANIZATIONS PROVIDED $997,780 OF CHARITY CARE (AT COST) IN 2012 WHICH IS NOT DISCLOSED ON A SCHEDULE H ELSEWHERE AS MANY OF THE AFFILIATED ORGANIZATIONS ARE NOT REQUIRED AND DO NOT FILE A FORM 990, SCHEDULE H.IN ADDITION TO THE AMOUNTS DISCLOSED ON THIS SCHEDULE H, ALLINA AND AFFILIATED ORGANIZATIONS INCURRED COSTS FOR PARTICIPATION IN GOVERNMENT MEDICAL CARE PROGRAMS IN EXCESS OF GOVERNMENT REIMBURSEMENTS IN THE AMOUNT OF $112,912,468 IN 2012.ALLINA PARTNERS WITH THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL TO PROVIDE PHYSICIAN RESIDENCY PROGRAMS FOR FAMILY PRACTICE AND INTERNAL MEDICINE RESIDENT PHYSICIANS.ALLINA CONTROLS AND OPERATES SEVEN (7) AFFILIATED FOUNDATIONS THAT PROVIDE PHILANTHROPIC FUNDING SUPPORT FOR ALLINA PROGRAMS AND NUMEROUS COMMUNITY PROGRAMS AND INITIATIVES INCLUDING A FEDERALLY QUALIFIED HEALTH CENTER. SEE SCHEDULE R AND SCHEDULE H, PART IV FOR A LIST OF RELATED ORGANIZATIONS AND JOINT VENTURES INCLUDING THE PRIMARY ACTIVITY OF THE AFFILIATED ORGANIZATION. ALLINA AND ITS AFFILIATES ALSO ROUTINELY COOPERATE AND INNOVATE WITH OTHER ORGANIZATIONS INCLUDING HEALTH CARE AND SOCIAL WELFARE ORGANIZATIONS, COMMUNITY GROUPS, GOVERNMENT AGENCIES AND HEALTH CARE PROVIDERS TO PREVENT ILLNESS, PROMOTE AND RESTORE HEALTH TO THE COMMUNITIES WE SERVE AND BEYOND.
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REPORTS FILED WITH STATES
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PART VI, LINE 7
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MN,WI
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PART V, LINE 8 FACILITY REPORTING GROUP A
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SEE BELOW
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FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 1 -- ABBOTT NORTHWESTERN HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 6 -- BUFFALO HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 6 -- BUFFALO HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 6 -- BUFFALO HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 7 -- NEW ULM MEDICAL CENTER
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 7 -- NEW ULM MEDICAL CENTER
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 7 -- NEW ULM MEDICAL CENTER
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 8 -- OWATONNA HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 8 -- OWATONNA HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 8 -- OWATONNA HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 10 -- PHILLIPS EYE INSTITUTE
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 10 -- PHILLIPS EYE INSTITUTE
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 10 -- PHILLIPS EYE INSTITUTE
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 2 -- UNITED HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 2 -- UNITED HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 2 -- UNITED HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 3 -- MERCY HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 3 -- MERCY HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 3 -- MERCY HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 4 -- UNITY HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 4 -- UNITY HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 4 -- UNITY HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 5 -- CAMBRIDGE MEDICAL CENTER
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 5 -- CAMBRIDGE MEDICAL CENTER
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 5 -- CAMBRIDGE MEDICAL CENTER
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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FACILITY 9 -- RIVER FALLS AREA HOSPITAL
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PART V, SECTION B, LINE 11:
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SEE FORM 990, SCHEDULE H, PART I, LINE 3C FOR EXPLANATION OF CRITERIA.
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FACILITY 9 -- RIVER FALLS AREA HOSPITAL
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PART V, SECTION B, LINE 20D:
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DISCOUNT LEVELS WILL BE ESTABLISHED AT THE BEGINNING OF EACH YEAR BY THE VICE PRESIDENT OF REVENUE STRATEGY. THE DISCOUNT WILL RECOGNIZE THE DIFFERENCES IN THE FEE SCHEDULES BETWEEN THE METRO AND REGIONAL HOSPITALS. THE DISCOUNT WILL BE BASED ON THE AVERAGE REIMBURSEMENT RATE AMONG EACH GROUP OF HOSPITALS PROVIDED TO ALLINA'S MOST FAVORED INSURER.
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FACILITY 9 -- RIVER FALLS AREA HOSPITAL
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PART V, SECTION B, LINE 22:
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NON-MEDICALLY NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR AN UNINSURED DISCOUNT.
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Attach to Form 990 or Form 990-EZ. 
Attach to Form 990 or 990-EZ.