2023-11-10T16:23:06+00:00 2022-12-31 346565596 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE INDIANAPOLIS IN 462045100 990 2022-01-01 350835006 Community Hospital of Bremen Inc COMM 5745462211 1020 HIGH ROAD BREMEN IN 46506 JEFFREY COSTELLO CFO 2023-11-10 true JEFFREY COSTELLO 999009999 true Jennifer D Rhoderick P00395735 3176817000 2022 2023-04-26 12:10:37Z DAVID BAILEY 1020 HIGH ROAD BREMEN IN 46506 23907545 false X WWW.BEACONHEALTHSYSTEM.ORG X 1948 IN WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART. 9 8 0 35 0 0 4964 557605 24167675 23076532 46386 73632 185929 193211 24404954 23900980 5360 10875 0 0 10747484 12945189 0 0 0 13741223 12841743 24494067 25797807 -89113 -1896827 20113950 19854519 18473843 11197968 1640107 8656551 WE DELIVER OUTSTANDING CARE, INSPIRE HEALTH AND CONNECT WITH HEART. false false 23494401 10875 23136290 FOUNDED IN 1948, COMMUNITY HOSPITAL OF BREMEN, INC. (CHB) IS A NOT-FOR-PROFIT, 24-BED CRITICAL ACCESS HOSPITAL SERVING THE HEALTHCARE NEEDS OF BREMEN AND THE SURROUNDING COMMUNITIES. WITH THE PRIMARY PHYSICIAN MEDICAL STAFF BASE, CHB EMBRACES A HOLISTIC APPROACH TO PATIENT CARE. INPATIENT SERVICES INCLUDE MEDICAL/SURGICAL, OBSTETRICS, PHYSICAL AND OCCUPATIONAL THERAPY, AND SWING BED/SKILLED NURSING. OUTPATIENT SERVICES INCLUDE MEDICAL/SURGICAL AND PHYSICAL AND OCCUPATION THERAPY. SERVICES IN THE EMERGENCY DEPARTMENT ARE AVAILABLE 24 HOURS PER DAY. A FULL SERVICE CAP ACCREDITED LABORATORY AND COMPREHENSIVE RADIOLOGY DEPARTMENT MEETS THE DIAGNOSTIC TESTING NEEDS OF INPATIENTS AND OUTPATIENTS. THE PHYSICIANS ALSO PROVIDE PRIMARY CARE AND SPECIALTY CARE SERVICES SUCH AS PAIN MANAGEMENT, CARDIOLOGY, ORTHOPEDICS, UROLOGY, GYNECOLOGY, PODIATRY, AND MORE THROUGH HOSPITAL-BASED OUTPATIENT CLINICS. IN ADDITIONAL, THE HOSPITAL PROVIDES THE FOLLOWING PROGRAMS: - FREE CARE AND/OR SUBSIDIZED CARE - CARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT/OR BELOW COST - OTHER HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY SUCH AS WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDERSERVED, AND A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. 23494401 true true false true false false false false true true false false false true true false true false false false false false false false false true true true false true false false false false false false false true false false false false false true true true false false true X 40 0 true 0 false false false false false false false false false false false false X 9 8 false false false false true true true true true false false true true true true true true false false false IN X JEFFREY COSTELLO 5746473549 615 N MICHIGAN STREET SOUTH BEND IN 46601 Carol Hochstetler Chair 2.0 0 X X 150 0 0 Jason Marker MD Vice Chair/Chief Med Officer 2.0 40.0 X X 0 299271 34822 Jeffrey Brinkman Secretary/Treasurer 2.0 0 X X 150 0 0 Alfred Alvarado Director 2.0 0 X 150 0 0 Anthony Wagner Director (Beg 3/2022) 2.0 0 X 150 0 0 Bill Davis Director 2.0 0 X 150 0 0 Greg Miller Director 2.0 0 X 150 0 0 Pheanis Wickey Director 2.0 0 X 150 0 0 Trend Weldy Director 2.0 0 X 150 0 0 David H Bailey President 40.0 0.0 X 0 442401 55095 Jeffrey P Costello CFO 2.0 50.0 X 0 878794 126495 Kreg R Gruber CEO 2.0 50.0 X 0 1543364 221266 1200 3163830 437678 0 false true false SOUTH BEND EMERGENCY PHYSICIANS 615 N MICHIGAN ST SOUTH BEND IN 46601 PHYSICIAN SERVICES 1521250 MIDWEST HOSPITALISTS LLC 50593 ARBORWOOD COURT GRANGER IN 46530 PHYSICIAN SERVICES 856350 JEBS ANESTHESIA CONSULTANTS LLC PO BOX 591 GRANGER IN 46530 Anesthesia services 435164 LABORATORY CORPORATION OF AMERICA HOLDINGS PO Box 8014 BURLINGTON NC 272168014 Contract services 199856 Better Nights Diagnostic Sleep Services 10257 Copper Chase Dr GRANGER IN 46530 Phy services 106540 5 0 0 0 3308 554297 0 0 557605 LAB NET PATIENT REVENUE 622110 4803711 4803711 0 0 SURGERY NET PATIENT REVENUE 622110 4842747 4842747 0 0 RADIOLOGY NET PATIENT REVENUE 622110 4449593 4449593 0 0 OTHER NET PATIENT REVENUE 622110 8858537 8858537 0 0 AFFILIATE RENTAL REVENUE 532000 110040 110040 0 0 11904 11904 0 0 23076532 70632 0 0 70632 0 0 0 0 0 0 0 0 33985 0 6565 0 27420 0 27420 0 0 27420 0 3000 0 0 0 3000 3000 0 0 3000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 561499 106033 0 0 106033 ANESTHESIA COLLECTIONS 621500 30932 30932 0 0 INSURANCE CLAIMS 561499 17082 17082 0 0 11744 11744 0 0 165791 23900980 23136290 0 207085 X 10875 10875 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10699204 9616013 1083191 0 0 0 0 0 1505015 1352647 152368 0 740970 665954 75016 0 24720 22217 2503 0 0 0 22500 22500 2336 2100 236 0 0 0 27982 0 27982 0 4362670 3921228 441442 0 1232 1107 125 0 766961 689314 77647 0 0 0 0 0 0 0 0 0 429299 385837 43462 0 3294 2961 333 0 0 0 0 0 1064 956 108 0 152934 137451 15483 0 0 0 0 0 936443 841637 94806 0 104512 93931 10581 0 CORPORATE ALLOCATION 2622692 2622692 0 0 MEDICAL SUPPLIES 2465761 2216127 249634 0 HOSPITAL ASSESSMENT FEE 551116 551116 0 0 BAD DEBT EXPENSE 307066 307066 0 0 59161 53172 5989 0 25797807 23494401 2303406 0 0 0 0 0 1050 1250 1934089 2111386 0 4648445 4181520 0 0 0 0 0 53621 282421 368049 49609 19826 15457544 4631781 10802234 10825763 0 0 0 0 1759124 1759124 636978 533980 20113950 19854519 902864 839521 0 382497 0 0 0 0 0 11040296 9978878 0 6148186 379569 18473843 11197968 X 1640107 8656551 0 0 0 0 1640107 8656551 20113950 19854519 X -1896827 8913271 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2336 2336 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY COMMUNITY HOSPITAL OF BREMEN APPLIED A CONSERVATIVE ESTIMATE OF 35% TO ALL PAYMENTS THAT CHB WAS UNABLE TO ASCERTAIN ALLOCATION OF DUES ATTRIBUTED TO LOBBYING. 42986124 3689060 -4645970 3270255 0 0 38758959 37554313 3126708 3841751 1536648 0 0 42986124 34924914 1692784 2289915 1353300 0 0 37554313 30834712 2588247 3242314 1740359 0 0 34924914 34205140 1352757 -2479196 2243989 0 0 30834712 0.7587 0.0 0.2413 false true true 779000 779000 9990782 1806864 8183918 4680962 2824917 1856045 6800 0 6800 10825763 LEASE LIABILITIES 379569 Due to third party 379569 X Schedule D, Part V, Line 4 Intended uses of endowment funds NET ASSETS WITH DONOR RESTRICTIONS CONSIST OF ASSETS WHOSE USE IS LIMITED BY DONOR IMPOSED, TIME AND/OR PURPOSE RESTRICTIONS. SOME NET ASSETS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY THE CORPORATION IN PERPETUITY. IN ACCORDANCE WITH THE RESTRICTION, A MAJORITY OF THE INVESTMENT INCOME AND INVESTMENT GAINS OR LOSSES FROM THESE NET ASSETS ARE RESTRICTED BY THE DONOR FOR A SPECIFIC PURPOSE. A SPECIFIED PORTION OF INCOME EARNED BY THE NET ASSETS IS RELEASED FROM RESTRICTION AND USED FOR OPERATIONS EACH YEAR AND, THEREFORE, IS INCLUDED IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS OTHER REVENUE. THE BOARD HAS DISCRETION TO UTILIZE EACH YEAR THE INCOMES, REVENUES AND PROFITS ARISING AND ACCRUING FROM THE ENDOWMENTS IN DEFRAYING COSTS ASSOCIATED WITH THE TRUST AND THE REMAINDER FOR SUPPORT, BETTERMENT, IMPROVEMENT, UPKEEP, EXPANSION AND REPLACEMENT OF BEACON HEALTH SYSTEM, INC. AND ITS CORPORATE AFFILIATES. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote ASC 740, INCOME TAXES, REQUIRES THAT REALIZATION OF AN UNCERTAIN INCOME TAX POSITION IS MORE LIKELY THAN NOT (I.E., GREATER THAN 50% LIKELIHOOD OF RECEIVING A BENEFIT) BEFORE IT IS RECOGNIZED IN THE FINANCIAL STATEMENTS AS THE AMOUNT MOST LIKELY TO BE REALIZED ASSUMING A REVIEW BY TAX AUTHORITIES HAVING ALL RELEVANT INFORMATION AND APPLYING CURRENT CONVENTIONS. THIS INTERPRETATION ALSO CLARIFIES THE FINANCIAL STATEMENT CLASSIFICATION OF TAX-RELATED PENALTIES AND INTEREST AND SETS FORTH NEW DISCLOSURES REGARDING UNRECOGNIZED TAX BENEFITS. 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X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. Beginning in January 2021, Beacon Health System undertook completing a Community Health Needs Assessment (CHNA). Our approach utilizes both quantitative data (secondary data, key informant survey) and qualitative data (focus groups, open-ended responses). Once the results of the survey were determined, a qualitative approach was used to gather richer insight into the main issues faced by the community. Therefore, the methodology followed for this needs assessment consists of three steps: 1) Identify needs; 2) Analyze the links between the needs and the information required to make decisions; 3) Make recommendations that guide decision-making. The data collection and analysis process started in January 2021 and concluded in November 2021. The key findings were consolidated in one report which provided a snapshot of the three-county overall health status. The Key Informant Survey collected information from February 2021 through May 2021. Focus Groups launched in August 2021 and concluded in October 2021. This assessment focused on creating a better understanding of the health needs of the Beacon Community (Elkhart, LaPorte, Marshall, and St. Joseph counties) and the response necessary to address the need. Data was collected through secondary data collection, a key informant survey, and community focus groups on a variety of topics centered on health indicators and social determinants of health. The goal of the CHNA is to provide Beacon Health System with a clear picture of Elkhart, LaPorte, Marshall, and St. Joseph County, which constitutes the service areas of Elkhart General Hospital, Memorial Hospital of South Bend, and Community Hospital of Bremen. The findings from the assessment will be used by Beacon Health System to prioritize health issues in the community. The research took the following approach to better understand the community health needs: Key Informant Survey - A survey was provided to community leaders and those knowledgeable about the communities' health issues. The list of key informants was developed by Beacon Community Impact staff along with input from a variety of key stakeholders. Two hundred and seven completed responses were collected and analyzed. Secondary Data Research - information related to the current state of the communities' economic, social and health status published by established sources. Data, when possible, was collected for a three-year period in order to establish a trend. Over 1,000 data points were collected and analyzed, encompassing more than 80 best practice indicators. Data from Beacon Health System's electronic health record (EHR) were also used as a secondary data source. The secondary data reviewed so far has all been aggregated at the county level, and does not reveal when there are differences in indicators based on race, ethnicity, age, neighborhood, or socio-economic status. When stratified by these categories, publically available sources and data from Beacon's electronic health record (EHR) from late 2020 - early 2021, demonstrate disparities in both health outcomes and social determinants of health. Community Focus Groups - groups of 3 - 18 individuals were engaged in conversations about the current health needs of the community. Beacon Community Impact utilized Stanford's Focus Group Guide and conducted three focus groups per county (Elkhart, Marshall, and St. Joseph). Staff conducted at least two English and one Spanish focus group per county. Each focus group was recorded for continuity. Focus group recordings were transcribed and de-identified using a professional transcription service and qualitative research software tools were utilized to analyze the transcripts for common themes. Staff then engaged in an interrater reliability check to ensure accuracy of identified themes. For the purpose of the Community Health Needs Assessment (CHNA), the community served is defined as those persons residing in Elkhart, Marshall, and St Joseph Counties, who were program participants. Beacon Community Impact makes a special effort to focus on populations with the highest unmet needs, specifically those persons who are known as vulnerable, through chronic diseases, lower-income and poverty, members of a minority population and/or the uninsured. Stakeholders in the community participated and represented a broad knowledge of interests, including public health, and minority, cultural, and underserved populations. Through the following organizations Beacon ensured that under-represented populations (Medically Underserved, Low-Income, and Minority Populations) were engaged in the consultation process, actively reaching out to them, ensuring that needs and perceptions from a wide range of demographic and socioeconomic groups were taken into consideration in the definition of top community health issues. The following organizations helped increase the reach of the survey, hence solicited in order for Beacon to take into account input received from persons who represent the broad interests of the community it serves: AIDS Ministries, American Cancer Society, American University Beirut , Baugo Community Schools, Beacon Cancer Care, Beacon Community Impact, Beacon Health System, Pokagon Health Services, IU School of Medicine - South Bend, Beacon Medical Group, Beacon Pediatric Specialty, Beacon - North Central Indiana Sickle Cell Initiative, Big Brothers Big Sisters Southern Lake Michigan,, Region, Bowen Center, Boys & Girls Club of St. Joseph County, Bremen Public Schools, CAPS, Catholic Charities, Center for Civic Innovation, Center for Healing & Hope, Center for the Homeless, Child and Parent Services, Inc. , City of South Bend, Community Hospital of Bremen, Crossroads United Way, Cultivate Food Rescue, David's Courage, Division of Family Resources, Elkhart Community Schools, Elkhart County Health Department, Elkhart Education Foundation, Elkhart General Hospital, enFocus, Inc., Goodwill Industries of Michiana, Inc., Goshen Family Physicians, Greenspire Solutions, Harper Cancer Research Institute, Health Improvement Alliance of St. Joseph County, Healthlinc, HealthMarkets, Horizon Education Alliance, Elkhart City Council, Imani Unidad, Indiana University Indiana University South Bend, Indiana University South Bend - Elkhart Center, Ivy Tech Community College, Junior Achievement, La Casa de Amistad, Marshall County Project HOPE, Marshall County, Board of Health, Marshall County Community Foundation, Memorial Hospital of South Bend, Mental Health Awareness of Michiana, Michiana Area Council of Governments, Michiana Health Information, Network/Indiana Health Information Exchange, Middlebury Community Schools, Minority Health, Coalition Elkhart County, Near Northwest Neighborhood, Northern Indiana Hispanic Health Coalition, Oaklawn Psychiatric Center, OI, Partnership for Drug-Free St. Joseph County, Purdue Extension - St. Joseph County, REAL Services, Reins of Life, Inc., Ribbon of Hope, Inc., RiverBend Cancer Services, Robinson Community Learning Center, Saint Joseph Health System, School City of Mishawaka, Shaw Center for Children and Families at the University of Notre Dame, SJC Cares, Smoke Free St. Joe, South Bend Adult Education, South Bend Common Council, South Bend Community School Corporation, South Bend Elkhart Regional Partnership, South Bend Heritage Foundation, South Bend Regional Chamber, Spiritual & Personal Adjustments - Women's Ministry Homes, St. Joseph County Department of Health, St. Joseph County Public Library, St. Vincent de Paul Society, The Community Foundation of Elkhart County, The Jewish Community, The LGBTQ Center, The Michiana Athletic and Recreation Association, United Health Services Suicide Prevention Center, United Way of LaPorte County, United Way of Marshall County, United Way of St. Joseph County, Unity Gardens Inc., University of Notre Dame, Upper Room Recovery Community, WIC, YMCA of Greater Michiana, Youth Service Bureau of St. Joseph County, YWCA North Central Indiana. The assessment process identified two health priorities that can be streamlined into the essential components of Beacon Health System's mission. Priority Areas - Healthcare Access (Health Literacy) and Mental Health provide a framework for the alignment of intervention strategies with BHS mission and values that aim for 1) providing information and enhance skills to patients/practitioners/community; 2) improving equitable access to health and wellness; 3) leveraging incentives for long-term behavioral change; and 4) improving and strengthening the social and healthcare systems in the three-county area. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. COMMUNITY HOSPITAL OF BREMEN CONDUCTED THE 2021 MARSHALL COUNTY CHNA IN PARTNERSHIP WITH MEMORIAL HOSPITAL OF SOUTH BEND AND ELKHART GENERAL HOSPITAL. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. COMMUNITY HOSPITAL OF BREMEN CONDUCTED THE 2021 MARSHALL COUNTY CHNA IN PARTNERSHIP WITH MEMORIAL HOSPITAL OF SOUTH BEND AND ELKHART GENERAL HOSPITAL. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. The Community Health Needs Assessment (CHNA) was made widely available to the community through posting on the CHB website at beaconhealthsystem.org/CHNA and through email transmission upon request. Hospital staff were also available to discuss the results of the CHNA and implementation strategies in requested community forums. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. Beacon Health System's 2021 Community Health Needs Assessment identified two top health priorities: Mental Health and Healthcare Access. These were common across all three counties where Beacon operates a hospital. Our approach to Community Benefit includes addressing these health needs from three angles. With each approach, both internal programs and externally funded partners are required to report on common metrics. This allows Beacon to focus its resources to achieve and demonstrate a deeper impact in our priority health areas. Beacon Community Impact provided community resources to 45,750 individuals across our service area - Elkhart, Marshall, and St. Joseph, IN Counties. In 2022, we first recognized the importance of partnering with other organizations who are experts in what they do, Beacon funds community non-profits who have boots on the ground in the most vulnerable neighborhoods in our service area, and with more diverse populations. Each of our funded partners who are addressing one of the tactics outlined on the Implementation Strategy are responsible for reporting both the number of participants they serve and one or more outcome metric in the priority areas of Mental Health or Healthcare Access. In addition, in 2022, Beacon Health System funded three partners to help them build capacity to serve more people or develop an infrastructure to make their service more effective or collect data that demonstrate their impact. Beacon's second angle of evaluating Community Benefit is to provide client programming through the Community Impact department - services are provided by the Early Childhood Services team. Programs include the St. Joseph County WIC program, two Sickle Cells programs, and our Perinatal Care Coordination (PNCC) program. Overall, the focus of these groups is to improve the health status of women, infants, and young families, particularly those who are underserved. Our Community Health Services team focuses on preventive services through community health educators with school curricula delivered throughout the three-county area in middle and high schools. Summer programming shifts to health-related day camps and participation at community health fairs. Though it may not be their primary focus, these community health teams screen for and provide referrals for clients experiencing mental health challenges. Likewise, they emphasize the importance of trusted adults as protective factors for youth. Finally, Beacon administers state and federal grants as the fiscal agent and to deliver direct programming funded by the grants. In 2022, we were involved with grants from the Health Resources and Services Administration (HRSA) under the U. S. Dept. of Health and Human Services. These grants funded two programs to provide education about COVID vaccines and provide the vaccines themselves. 2022 was also the second year of administering Project HOPE, and the first year for Support and Safe Psychostimulant also funded by HRSA, which established a coalition of organizations to address opioid use in Marshall County. Similarly, Beacon Community Impact provides services and collaborates with outside organizations with funding from a State of Indiana Safety Pin grant. Finally, Beacon functions as the fiscal agent for programming run by Oaklawn, the local outpatient mental health provider, to build crisis response teams. Mental Health Strategy - Provide wrap-around mental health support with a multidisciplinary team from various referral sources. - Partner on the development of a Self-Healing Community to build resilience and relieve stress on the traditional mental health care system. - Drive the rollout of Trauma-Informed Care throughout Beacon and the community. - Health and Wellness Team - provide evidence-based community and school education. - Community Health Workers (CHWs) on the Early Childhood Services and Community Health Services teams provide peer-led education to address mental wellness and resilience. Healthcare Access Strategy - Embed in Beacon Medical Group practices to work with pregnant women with adverse childhood experiences and social determinants of health needs. - Have a community health worker at Community Hospital of Bremen. - Grow and standardize the use of community health workers for scaling out in the future. - Implement experts in navigating the healthcare system. - Educate patients to optimize their use of the health system. - Refer to insurance navigators for insurance enrollment. - Build organizational health literacy between Beacon and Community Impact departments. Mental Health Metrics % of the population with frequent mental health distress % of the population with two or more trusted support people Healthcare Access Metrics % of the population with health insurance (adults < 65 and children) % of adults who reported their healthcare providers always involved them in decisions about their care, as much as they wanted. NEEDS NOT BEING ADDRESSED: By overlapping the top identified needs from the Key Informants, Secondary Data, and Focus Groups, we see that Mental Health, Chronic Disease, and Healthcare Access are the top health issues identified by all data sources combined. Other issues may have ranked higher by just one source, but not all three. Notably, sexually transmitted disease, immunization and infectious disease, and injury and violence prevention were among the top issues according to secondary data, but among the lowest rated issues according to key informants and focus groups. Overweight / obesity is also a top health issue according to secondary data; it ranked as a moderate health issue according to the other sources, just not at the top. Community Gaps Key Informants provided many ideas on areas of improvement. Most commonly, is the concern about the lack of mental health providers in the area. "From my experience, our biggest challenge stems from workforce shortages in mental health. If we could hire the amount of staff we need, our capacity would be much greater. It has been very difficult to find a competent and caring staff that can maintain a career in mental health and substance use." More specifically, the area needs more programs and/or services around pediatric mental health. As one Key Informant stated, "Mental health issues have drastically increased in our K-12 student population. We need to empower more school personnel to help students with these issues, and we need more mental health professionals in our school systems." Accessing mental health and more broadly, health services, is increasingly hard for low-income individuals. Focus group participants and Key Informants noted how navigating the healthcare system is too complex. Health insurance navigators and additional community resources are needed to ensure everyone can get to the appointments they need to get to and are informed. "I believe we need more outreach efforts. I think Beacon has the ability to meet families where they are-- whether it's at the childcare provider or a place of employment. We need to make healthcare more accessible." Another Key Informant went on to mirror these thoughts, "I think our wellness system is still not accessible to everyone. Self-advocacy, tenacity, and resilience are necessary to access health systems and to navigate social support systems. We need ways to reach people by attraction and positive experiences without screening highest need which causes further barriers." Community Strengths Key informants identified collaboration among non-profit service providers, agencies addressing food insecurity, and the public parks system, particularly South Bend's Venues Parks and Arts, as strengths in the community. They identified a number of organizations who do quality work to improve the health of the community. These include medical providers who serve low-income or the uninsured population, multiple organizations who provide emergency food access, some who serve specific populations such as homeless individuals, people with cancer, children, or people with substance use disorder. Again, collaborative efforts were noticed by the key informants. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - COMMUNITY HOSPITAL OF BREMEN, INC.. FINANCIAL ASSISTANCE CRITERIA THE POLICY ALLOWS FOR PATIENTS TO QUALIFY FOR ASSISTANCE BY TWO MEANS: FINANCIAL OR CATASTROPHIC. THE FINANCIAL ASSISTANCE PROGRAM ALSO ALLOWS FOR PARTIAL ASSISTANCE OR FULL ASSISTANCE BASED ON ELIGIBILITY CRITERIA IN THIS POLICY. FINANCIAL ASSISTANCE 1. A PATIENT QUALIFYING FOR FINANCIAL ASSISTANCE IS A PERSON WHO IS UNINSURED OR UNDERINSURED, RECEIVES CARE AND UNABLE TO PAY THEIR BILL. 2.TO BE ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE GUIDELINES, A PERSON'S INCOME SHALL BE AT OR BELOW A PERCENTAGE OF THE FEDERAL POVERTY LEVEL (FPL) AS DETERMINED BY FEDERAL POVERTY GUIDELINES. HOUSEHOLD SIZE AND INCOME DETERMINES THE % OF FPL. COMMUNITY HOSPITAL OF BREMEN, OR ITS DESIGNEE, MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ELIGIBILITY. 3. COMMUNITY HOSPITAL OF BREMEN WILL USE THE MOST CURRENT POVERTY INCOME GUIDELINES ISSUED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TO DETERMINE AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE POVERTY INCOME GUIDELINES ARE PUBLISHED ANNUALLY IN THE FEDERAL REGISTER AND FOR THE PURPOSES OF THIS POLICY WILL BECOME EFFECTIVE THE FIRST DAY OF THE MONTH FOLLOWING THE MONTH OF PUBLICATION. 4. TO QUALIFY UNDER THE FINANCIAL ASSISTANCE PORTION OF THIS POLICY, A COMPLETED, SIGNED FINANCIAL ASSISTANCE APPLICATION MUST BE SUBMITTED AND PROOF OF INCOME, PROOF OF LACK OF FINANCIAL ASSETS AND OTHER REQUIRED DOCUMENTS MUST ACCOMPANY THE APPLICATION. CATASTROPHIC ASSISTANCE CRITERIA 1. A PATIENT QUALIFYING FOR CATASTROPHIC ASSISTANCE IS A PERSON WHOSE HOSPITAL BILLS EXCEED A SPECIFIED PERCENTAGE OF THE PERSON'S ANNUAL GROSS INCOME AS SET FORTH IN THE POLICY AND WHO IS UNABLE TO PAY THE REMAINING BILL. 2. TO BE ELIGIBLE FOR CATASTROPHIC ASSISTANCE THE AMOUNT OWED BY THE PATIENT MUST EXCEED ONE HUNDRED FIFTY (150) PERCENT OF THE PATIENT'S ANNUAL GROSS INCOME AND THE PATIENT MUST BE UNABLE TO PAY THE REMAINING BILL. COMMUNITY HOSPITAL OF BREMEN MAY CONSIDER OTHER FINANCIAL ASSETS AND LIABILITIES OF THE PERSON WHEN DETERMINING ABILITY TO PAY. 3. IF A DETERMINATION IS MADE THAT A PATIENT HAS THE ABILITY TO PAY THE REMAINDER OF THE BILL, SUCH A DETERMINATION DOES NOT PREVENT A REASSESSMENT OF THE PATIENT'S ABILITY TO PAY AT A LATER DATE SHOULD THEIR FINANCIAL CIRCUMSTANCES CHANGE. 4. AFTER ELIGIBILITY IS DETERMINED UNDER THIS PROVISION, ASSISTANCE WILL BE PROVIDED TO DISCOUNT THE BILL BY 75% OF THE CURRENT BALANCE. 5. IF A PATIENT HAS CASH ASSETS, THOSE ASSETS WILL BE ADDED TO THEIR INCOME WHEN DETERMINING ELIGIBILITY FOR ASSISTANCE. 0 Schedule H, Part VI, Line 7 State Filing of community benefit report COMMUNITY HOSPITAL OF BREMEN PREPARES THE COMMUNITY BENEFIT REPORT BOTH FOR THE STATE OF INDIANA AND FOR THE ANNUAL REPORT, WHICH IS POSTED AT BEACONHEALTHSYSTEM.ORG/CHNA. Schedule H, Part I, Line 3c Factors to be considered for financial assistance HOUSEHOLD SIZE AND INCOME THE FOLLOWING FACTORS MAY BE CONSIDERED IN DETERMINING THE ELIGIBILITY OF THE PATIENT FOR ASSISTANCE AND MUST BE PROVIDED BY ALL INCOME EARNING RESIDENTS IN THE COUNTABLE HOUSEHOLD UNIT UNLESS THEY ARE NOT DEPENDENTS BASED ON IRS GUIDELINES FOR DETERMINING WHETHER A HOUSEHOLD MEMBER CAN BE CONSIDERED A DEPENDENT. 1. INDIANA WORKFORCE WAGE REPORT FOR LAST 2 QUARTERS (UNEMPLOYMENT INCOME). 2. LAST 3 PAY STUBS OR A LETTER OR PRINTOUT FROM EMPLOYER(S) PROVIDING VERIFICATION OF GROSS INCOME IF CURRENTLY EMPLOYED. THIS DOCUMENTATION SHOULD NOT BE MORE THAN 30 DAYS OLD FROM DATE OF ISSUE AND INCLUDE YEAR-TO-DATE INFORMATION. 3. LAST 3 BANK STATEMENTS (INCLUDING EXPLANATIONS OF REGULAR DEPOSITS NOT EXPLAINED BY PAY STUBS). 4. SOCIAL SECURITY AWARD OR ENTITLEMENT LETTER OR OTHER PROOF OF GROSS MONTHLY AWARD. 5. RETIREMENT INCOME. 6. INVESTMENT INCOME. 7. STATEMENT FROM PERSON(S) THAT ARE PROVIDING DIRECT SUPPORT. 8. NUMBER OF DEPENDENTS. 9. MOST RECENT TAX RETURN (INCLUDING W2 AND ALL SUPPORTING SCHEDULES). 10. OTHER FINANCIAL OBLIGATIONS. 11. THE AMOUNT AND FREQUENCY OF HOSPITAL/MEDICAL BILLS. 12. OTHER FINANCIAL RESOURCES THAT PRODUCE INCOME. 13. IF SELF-EMPLOYED, GROSS INCOME LESS COST OF GOODS SOLD AND EMPLOYEE SALARIES. FINANCIAL CAPACITY 1. INDIVIDUALS WITH THE FINANCIAL CAPACITY TO PURCHASE HEALTH INSURANCE COVERAGE THROUGH THE HEALTH INSURANCE MARKETPLACE MAY BE REQUIRED TO PURCHASE AND WILL BE PROVIDED ACCESS TO MEET WITH AN INDIANA CERTIFIED NAVIGATOR AS A MEANS OF ASSURING ACCESS TO HEALTHCARE SERVICES, FOR THEIR OVERALL PERSONAL HEALTH, AND FOR THE PROTECTION OF THEIR INDIVIDUAL ASSETS. 2. INDIVIDUALS FOUND TO BE INELIGIBLE FOR MEDICAID OR OTHER AFFORDABLE HEALTH CARE COVERAGE MUST PROVIDE PROOF OF DENIAL. 3. FOOD STAMPS OR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) WILL NOT BE COUNTED AS INCOME. 4. COSMETIC SERVICES ARE NOT ELIGIBLE FOR ANY TYPE OF ASSISTANCE AND CANNOT BE INCLUDED IN THE AMOUNT OF HOSPITAL/MEDICAL BILLS OWED. Schedule H, Part I, Line 6a Name of Related Org that prepare the Community benefit report BEACON HEALTH SYSTEM (EIN: 45-3864076) PREPARED THE ANNUAL COMMUNITY BENEFIT REPORT. Schedule H, Part I, Line 7 Costing Methodology used for calculating line 7 table THE COSTING METHOD USED TO CALCULATE FINANCIAL ASSISTANCE REPORTED ON LINES 7 A THROUGH D WAS THE COST-TO-CHARGE RATIO. ALL OTHER COMMUNITY BENEFITS WERE CALCULATED USING DIRECT COSTS. PART I, LINE 7 COLUMN (F) BAD DEBT EXPENSE OF $307,066 WAS REMOVED FROM TOTAL EXPENSES. Schedule H, Part II Describe how Community building activities promote the health of the community Project HOPE is a consortium of 25 plus organizations, led by Beacon Health System in Marshall County, that provide comprehensive and coordinated access to substance use prevention, treatment and recovery services in Marshall County. The consortium formally began in 2019 when Beacon was awarded a Planning Grant from HRSA. Dr. Jason Marker successfully led the consortium through that initial phase. In September 2020, the consortium was awarded a HRSA 3-year, $1,000,000 Implementation grant. Schedule H, Part I, Line 7g Subsidized health services COMMUNITY HOSPITAL OF BREMEN CHANGED THE WAY WE CALCULATED THE COMMUNITY BENEFIT RELATED TO SUBSIDIZED HEALTH SERVICES IN 2019. IN PRIOR YEARS THE COST TO CHARGE RATIO WAS USED FROM THE COST REPORT BUT FOR A MORE ACCURATE REPRESENTATION OF CHB'S EMERGENCY ROOM WE USED AN ALLOCATION OR SPECIFIC EXPENSES AS WELL AS THE EXPENSES ALLOCATED DIRECTLY TO THE ER. NO PHYSICIAN CLINIC COSTS WERE INCLUDED IN THE SUBSIDIZED HEALTH SERIVCES. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 307066 Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE CORPORATION EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYOR CLASS, AND THE ANTICIPATED FUTURE UNCOLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE. THE COSTING METHODOLOGY IS THE SAME AS THE TAX FORM 990, SCHEDULE H, WORKSHEET 2 METHODOLOGY. PATIENT CARE COST IS ADJUSTED BY NON-PATIENT ACTIVITY EXPENSES, AND PATIENT CARE CHARGES. THE AMOUNT OF BAD DEBT REPORTED ON PART III, LINE 2 IS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO, AS DETERMINED BY WORKSHEET 2, TO TOTAL BAD DEBT EXPENSE PER THE AUDITED FINANCIAL STATEMENTS. Schedule H, Part III, Line 3 Bad Debt Expense Methodology CHB DOES NOT ATTRIBUTE ANY BAD DEBT EXPENSE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THEREFORE, NO PORTION OF BAD DEBT IS CONSIDERED A COMMUNITY BENEFIT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS TAKING INTO CONSIDERATION THE TRENDS IN HEALTH CARE COVERAGE, HISTORICAL ECONOMIC TRENDS, AND OTHER COLLECTION INDICATORS. MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCES PERIODICALLY THROUGHOUT THE YEAR BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. THE RESULTS OF THE REVIEW ARE THEN UTILIZED TO MAKE MODIFICATIONS, AS NECESSARY, TO THE PROVISION FOR BAD DEBTS TO PROVIDE FOR AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. A SIGNIFICANT PORTION OF THE CORPORATION'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs RATIONALE FOR INCLUSION OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT PARTICIPATION IN THE GOVERNMENTAL MEDICARE PROGRAM DOES NOT PROVIDE THE OPPORTUNITY FOR A HOSPITAL TO NEGOTIATE A REIMBURSEMENT RATE OR STRUCTURE THAT WOULD ALLOW THE HOSPITAL TO COVER THE COST OF THE MEDICAL SERVICE RENDERED TO THE PROGRAM PARTICIPANT, AS WOULD BE THE CASE IN CONTRACTUAL NEGOTIATIONS WITH COMMERCIAL INSURANCE COMPANIES. NOR IS THE HOSPITAL ALLOWED TO PROVIDE ONLY THE SERVICES FOR WHICH REIMBURSEMENT COVERS THE DIRECT COST OF CARE. THIS PRODUCES THE SAME SHORTFALL OUTCOME AS DOES THE PARTICIPATION IN THE MEDICAID PROGRAM. THE MEDICAID PROGRAM IS RECOGNIZED AS A COMMUNITY BENEFIT ON SCHEDULE H AND ON COMMUNITY BENEFIT REPORTS FOR MOST STATES. THE QUALITY AND COST OF THE PATIENT CARE IS THE SAME REGARDLESS OF PAYOR SOURCE. HENCE THE ACCEPTANCE OF MEDICARE REIMBURSEMENT REPRESENTS A REDUCTION OR RELIEF OF THE GOVERNMENT BURDEN TO PAY THE FULL COST OF CARE PROVIDED. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance COLLECTIONS PRACTICES PATIENTS KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE FOLLOW THE SAME COLLECTION POLICY AS ALL INDIVIDUALS WITH BALANCES REMAINING AFTER APPLICATION OF FINANCIAL ASSISTANCE. CREDIT AND COLLECTIONS POLICY: COMMUNITY HOSPITAL OF BREMEN RELIES ON TIMELY PAYMENT OF PATIENT ACCOUNTS RECEIVABLE TO ALLOW THE HOSPITAL TO CONTINUE TO PROVIDE HIGH-QUALITY MEDICAL CARE AND TO SECURE THE LATEST IN HEALTH CARE TECHNOLOGY FOR ITS PATIENTS. COMMUNITY HOSPITAL OF BREMEN, RECOGNIZING THE BURDEN THAT UNEXPECTED HEALTH CARE EXPENSES CAN PLACE ON PATIENTS AND THEIR FAMILIES, WILL ASSIST PATIENTS TO RESOLVE OPEN ACCOUNTS FOR HOSPITAL SERVICES BY WORKING WITH THIRD PARTY PAYERS TO ADJUDICATE PATIENT'S INSURANCE CLAIMS AND BY PROVIDING ALTERNATIVE PAYMENT PLANS FOR PATIENTS. THE HOSPITAL ALSO PROVIDES SUBSIDIZED CARE FOR THOSE PATIENTS WHO QUALIFY. HOWEVER, WITH THE EXCEPTION OF SOME GOVERNMENT AND CONTRACTED CARE PLANS, ULTIMATE RESPONSIBILITY FOR RESOLUTION OR PAYMENT OF ACCOUNTS RESTS WITH THE PATIENT. PATIENTS ARE EXPECTED TO WORK WITH HOSPITAL PERSONNEL TO RESOLVE ACCOUNTS WITH THEIR INSURANCE COMPANIES AND/OR EMPLOYERS AS APPROPRIATE. WHERE THERE IS AN ESTIMATED SELF-PAY BALANCE DUE, COMMUNITY HOSPITAL OF BREMEN WILL ASK NON-EMERGENCY PATIENTS TO PAY THAT BALANCE PRIOR TO OR AT THE TIME OF ADMISSION/REGISTRATION 1. IF A PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND DOES NOT PAY THEIR ACCOUNT ACCORDING TO THE OPTIONS PROVIDED, THEN THE PATIENT'S ACCOUNT WILL BE PROCESSED ACCORDING TO THE BAD DEBT WRITE OFF POLICY. 2. IF A PATIENT HAS BEGUN MAKING PAYMENTS BUT THEN IS LATER DETERMINED TO QUALIFY UNDER THE FAP, COMMUNITY HOSPITAL OF BREMEN WOULD ISSUE A REFUND TO THE PATIENT FOR ANY AMOUNT THAT HAS BEEN DETERMINED TO EXCEED THEIR NEWLY DETERMINED FINANCIAL RESPONSIBILITY. 3. COMMUNITY HOSPITAL OF BREMEN MAY REQUEST AND COLLECT A DEPOSIT, BASED ON THE PATIENT'S TOTAL ESTIMATED PORTION OF A BILL, FROM APPROPRIATE NON EMERGENCY INPATIENT ADMISSIONS, SAME DAY SURGERY PATIENTS, AND PATIENTS SCHEDULED FOR HIGH-DOLLAR OUTPATIENT PROCEDURES PRIOR TO OR AT THE TIME OF ADMISSION OR REGISTRATION. IN THE EVENT THAT A REQUEST FOR PAYMENT IS NOT MADE PRIOR TO OR AT THE TIME OF THE PATIENT'S ARRIVAL, A FINANCIAL COUNSELOR MAY CALCULATE THE ESTIMATED DEPOSIT AMOUNT AND CONFER WITH THE PATIENT/GUARANTOR FOR PAYMENT FOLLOWING THE ADMISSION OR REGISTRATION PROCESS VIA A FINANCIAL INTERVIEW. (IN SOME INSTANCES, THIS COULD OCCUR WHILE THE PATIENT IS IN HIS/HER ASSIGNED ROOM.) AT THE TIME OF DISCHARGE, EMERGENCY PATIENTS MAY BE REQUESTED TO PAY ANY CO-PAY OR DEDUCTIBLE. 4. WHERE APPROPRIATE, COMMUNITY HOSPITAL OF BREMEN WILL IDENTIFY, AND REQUEST PAYMENT OF, AGED PATIENT BALANCES AS PART OF THE REQUEST FOR DEPOSIT. PAYMENT FOR OPEN PRIOR BALANCES WILL NOT DELAY CARE FOR EMERGENCY OR MEDICALLY NECESSARY CARE. AGED OPEN PRIOR BALANCES WILL BE CONSIDERED BY THE COLLECTION STAFF IN PATIENT ACCOUNT SERVICES WHENEVER PAYMENT ARRANGEMENTS OR AN ALTERNATIVE PAYMENT PROGRAM IS DEVELOPED FOR A PATIENT. 5. UNINSURED PATIENTS ARE GIVEN A 35% DISCOUNT FROM GROSS CHARGES. 6. COMMUNITY HOSPITAL OF BREMEN WILL CONDUCT FINANCIAL INTERVIEWS WITH PATIENTS AND/OR GUARANTORS WHEN NECESSARY. ALL FINANCIAL INTERVIEWS WILL BE CONDUCTED IN AN ENVIRONMENT THAT IS BOTH PRIVATE AND PROFESSIONAL. 7. IN ADDITION TO CASH, CHECK, AND CREDIT CARDS, THE APPROVED PAYMENT ARRANGEMENT METHODS MIGHT INCLUDE: A. HOSPITAL PAYMENT PLAN - A PAYMENT PLAN WITH THE HOSPITAL IS NOT TO EXCEED THREE MONTHS. EXCEPTIONS MUST BE APPROVED BY THE MANAGER OF PATIENT ACCOUNT SERVICES OR REVENUE CYCLE DIRECTOR. PATIENTS MAY BE REQUIRED TO SIGN A PROMISSORY NOTE BASED ON THE AGREED UPON PAYMENT ARRANGEMENT. B. CAREPAYMENT - AN EXTENDED PAYMENT PLAN WHICH ALLOWS THE PATIENT AN EXTENDED PERIOD NOT TO EXCEED 36 MONTHS AT 0% INTEREST TO PAY THEIR BALANCE BETWEEN $100 AND $15,000. PATIENTS MAY BE AUTOMATICALLY ENROLLED IN THE CAREPAYMENT PLAN IF THEIR ACCOUNT HAS NOT BEEN PAID IN FULL 2 MONTHS AFTER THEIR FIRST STATEMENT. ALL PATIENTS ARE ELIGIBLE PROVIDED THAT THEY PROVIDE A VALID SOCIAL SECURITY NUMBER, ARE OVER 18 AND HAVE NOT PREVIOUSLY DEFAULTED ON THEIR CAREPAYMENT ACCOUNT. C. MEDICAID/HIP - PATIENTS WHO DO NOT HAVE COVERAGE WHEN THEY PRESENT TO THE HOSPITAL FOR TREATMENT WILL BE SCREENED FOR OTHER COVERAGE THROUGH STATE ASSISTANCE PROGRAMS. AN ELIGIBILITY SPECIALIST WILL ASSIST THE PATIENT/GUARANTOR TO COMPLETE AND SUBMIT ALL NECESSARY FORMS REQUIRED BY THE INDIANA DEPARTMENT OF PUBLIC AID FOR THESE TYPES OF PROGRAMS. D. HOSPITAL FINANCIAL ASSISTANCE (UNCOMPENSATED CARE) - REASONABLE EFFORTS WILL BE MADE TO DETERMINE IF PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM. ALL FINANCIAL ASSISTANCE MUST BE APPROVED ACCORDING TO THE FAP FOR THE HOSPITAL. (REFER TO THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY) 8. EXTRAORDINARY COLLECTION ACTIONS WILL NOT BE TAKEN UNTIL AFTER COMMUNITY HOSPITAL OF BREMEN HAS MADE REASONABLE EFFORTS TO DETERMINE IF A PATIENT WILL QUALIFY FOR FINANCIAL ASSISTANCE. EXTRAORDINARY COLLECTION ACTIONS INCLUDE SUIT, WAGE GARNISHMENT, LIEN OR ADVERSE CREDIT BUREAU REPORTING. Schedule H, Part V, Section B, Line 16a FAP website - COMMUNITY HOSPITAL OF BREMEN, INC.: Line 16a URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.; Schedule H, Part V, Section B, Line 16b FAP Application website - COMMUNITY HOSPITAL OF BREMEN, INC.: Line 16b URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - COMMUNITY HOSPITAL OF BREMEN, INC.: Line 16c URL: BEACONHEALTHSYSTEM.ORG/PATIENTS-AND-VISITORS.; Schedule H, Part VI, Line 2 Needs assessment Beacon Community Impact formed the first Community Health Advisory Council in 2016. Still operating on an as needed basis today the Council consists of representation from Community Hospital of Bremen, Elkhart General Hospital, and Memorial Hospital of South Bend. The council is made up of individuals from Beacon Health System and Community stakeholders - i.e. Council at Large, Public School Systems, other Health Care entities, Indiana University South Bend, University of Notre Dame, Ivy Tech Community College, community organizations, local churches, community persons, etc.). The Advisory Council will meet 2-4 times per year to learn about community health, the CHNA process, and to review local hospital and community data collected regarding health in our community; there are periodic email communications as well. The Advisory Council provides input on the health priority areas, offers best practices, identifies areas of opportunities, and monitors progress on addressing health needs. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance WHEN PATIENTS PRESENT TO OUR HOSPITAL, THEY ARE OFFERED THE OPPORTUNITY TO MEET WITH OUR ELIGIBILITY SPECIALISTS. OUR ELIGIBILITY SPECIALISTS DISCUSS THE POTENTIAL ELIGIBILITY OF THE PATIENT FOR MULTIPLE ASSISTANCE PROGRAMS, INCLUDING OUR OWN INTERNAL FINANCIAL ASSISTANCE PROGRAM. OUR STATEMENTS ALSO INCLUDE A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS, AND THEY CAN CONTACT OUR CUSTOMER SERVICE GROUP FOR GUIDELINES. PATIENTS ARE ALSO MADE AWARE OF OUR FINANCIAL ASSISTANCE PROGRAM VIA TELEPHONE CONVERSATION WITH OUR PATIENT ACCOUNTS STAFF. STAFF IS PARTICULARLY SENSITIVE TO ADDRESS THIS PROGRAM WITH ANYONE WHO INDICATES THERE MIGHT BE A FINANCIAL NEED. Schedule H, Part VI, Line 4 Community information Established In 1836, Marshall County Indiana is the 31st largest county in the state of Indiana. The county spans 443.62 Square Miles, which includes a comfortable mix of rural cultural heritage and urban amenities. Marshall County has a population of 46,332 according to the U.S. Census Bureau. Located south of St. Joseph County and at the junction of US 30 and US 31, Marshall County is home to many small towns and Indiana's second largest natural lake, Lake Maxinkuckee. Due to low tax rates in the county, nearly a hundred manufacturers are present, six of whom are international companies and nine corporate headquarters. Marshall County boasts low crime rates and safe, high performing schools, including the world premier college preparatory school, Culver Academies, with students from around the world. Elkhart, Marshall and St. Joseph Counties are all located in Northern Indiana. They have a total of 6 cities and 16 towns with a combined population of 525,456. St. Joseph is the largest and Marshall the smallest, which is classified as rural. Although each varies in population density, they are closer in geographic size (SJC-457 square miles, Elkhart-463, Marshall-443). The median household income (2017-2021) is comparable in Marshall and St. Joseph ($58,296; $58,599), but higher in Elkhart county -$61,182 where 11.3 % of people live in poverty compared to the higher rate of 14.3% in St. Joseph and a lower rate of 8.6% in Marshall. Elkhart's RV industry is a multi-billion-dollar industry and nearly 1,000 RV manufacturers are located there. Marshall County has become one of the leading agricultural counties in Indiana. St. Joseph is the regional center for higher education, with more than eight colleges and universities. These campuses have shifted the county's focus from manufacturing to health, education, and customer services. Schedule H, Part VI, Line 5 Promotion of community health In partnership with Beacon Health System (BHS), the mission of Community Hospital of Bremen (CHB) is to deliver outstanding care, inspire health and connect with heart. BHS is committed to clinical excellence, compassionate care, and the ongoing improvement of quality of life. Our commitment will lead BHS to be the community's provider of outstanding quality, superior value and comprehensive health care services. Both BHS and CHB consistently invest funds to improve the quality of life for our communities. BHS values reflect an unwavering commitment to the communities we serve. MHSB has as its values: Patients are at the center - Patient needs, care and safety are our top priority. - Trust - Our actions will firmly demonstrate our integrity, abilities and our character. - Respect - We will treat our patients, community members, and each other with the highest level of regard, demonstrating an understanding of different perspectives, cultures, interests and needs of others. - Integrity - We will continually do the right thing for patients, associates, and communities we serve. - Compassion - We will appropriately demonstrate empathy and sympathy, and express the desire to help. CHB seeks to promote the health and well-being of St. Joseph (SJC) residents, with specific focus on the most vulnerable populations, by providing education to aid in early detection and prevention of disease and to improve the health status of the community as a whole. A key mechanism by which this goal is carried out is MHSB's serious, consistent, and deliberate search for and partnership with like-minded organizations. MHSB continues to seek out partnerships with multiple community entities to address the needs of the medically underserved and to improve the health status of our community. These collaborative alliances include local public health, schools, churches, social service agencies, minority advocacy groups, victim assistance, and community health providers. Beacon recognizes that participating in volunteerism enriches the lives of the workforce as well as the community. Community Service through "Beacon's Helping Hands" encourages Beacon associates to participate in community activities aligned with Beacon's Mission and Values. To support community involvement, Associates who volunteer with a 501c3 charitable organization whose activities align with the Mission and Values of Beacon Health System may be compensated for their Community Service. Full-time associates are compensated for up to 4 hours a year and part-time associates are compensated up to 2 hours per year. In 2022, Beacon associates collectively logged 430.9 hours of helping charitable organizations in their community and living the Beacon mission of connecting with heart. As we continue to adjust from meeting emergent needs brought on by COVID, we look forward to uplifting the community through individual volunteer service. Schedule H, Part VI, Line 6 Affiliated health care system In 2018, Community Hospital of Bremen affiliated with Memorial Hospital of South Bend and Elkhart General Hospital, under the name Beacon Health System. In October 2021, Beacon Health System affiliated with Three Rivers Health System. All organizations continue as full-care providers for their respective Counties, and they are committed to promoting the health of the communities they serve. The Beacon Health System Board of Directors consists of 14 voting board members. Schedule H, Part VI, Line 7 State filing of community benefit report IN true Cultivate Food Rescue 1403 Prairie Ave South Bend IN 46613 813306113 501 (C) (3) 10000 Cash Sponsor Programs 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Part of Community Hospital of Bremen's mission is to improve the health of its community. In order to fulfill this goal, our administrators have the ability to make donations to organizations that improve the health and well being of our community. Since the grant to the organization is made to a 501 (C) (3) entity, there are no procedures for monitoring the use of the funds. false true false false false false false Jason Marker MD Vice Chair/Chief Med Officer 0 266611 0 15952 0 16708 0 11592 0 23230 0 334093 0 0 Kreg R Gruber CEO 0 994922 0 261341 0 287101 0 194557 0 26709 0 1764631 0 83287 Jeffrey P Costello CFO 0 602522 0 122536 0 153736 0 110781 0 15714 0 1005289 0 77367 David H Bailey President 0 243124 0 49316 0 149961 0 53515 0 1581 0 497496 0 120943 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation COMMUNITY HOSPITAL OF BREMEN, INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2022, REFLECTED IN COLUMN (B)(III): * KREG GRUBER, $146,136 * JEFFREY COSTELLO, $116,448 * DAVID BAILEY, $122,330 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2022 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: * KREG GRUBER, $182,357 * JEFFREY COSTELLO, $98,581 * DAVID BAILEY, $41,315 Wagner & Wagner LLC Board Member Greater than 35% ownership 183932 Collection Services false Form 990, Part V, Line 2a EMPLOYEE COMPENSATION EMPLOYEES ARE PAID BY MEMORIAL HOSPITAL OF SOUTH BEND. (EIN 35-0868132) AND EXPENSED TO COMMUNITY HOSPITAL OF BREMEN, INC. THROUGH CONTRACT LABOR. Form 990, Part VI, Line 15a & 15b - Compensation Process BEACON HEALTH SYSTEM, INC., THE PARENT COMPANY OF COMMUNITY HOSPITAL OF BREMEN, CONDUCTS THE REVIEW OF ALL COMPENSATION. VICE PRESIDENT AND HIGHER COMPENSATION IS DETERMINED AFTER AN EXTENSIVE EXAMINATION IS CONDUCTED USING COMPARABLE MARKET DATA AND THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. HUMAN RESOURCES CONDUCTS THE ANALYSIS AND MAKES RECOMMENDATIONS TO THE CEO WHO THEN MAKES THE RECOMMENDATIONS TO THE BOARD FOR APPROVAL. RECOMMENDATIONS ARE PRESENTED TO THE COMPENSATION COMMITTEE OF THE BEACON HEALTH SYSTEM, INC. BOARD FOR DELIBERATION AND FINAL DECISION. DELIBERATION AND FINAL DECISION ARE PERFORMED BY THE INDEPENDENT MEMBERS OF THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders MEMBERS OF THE ORGANIZATION BEACON HEALTH SYSTEM, INC. IS THE SOLE CORPORATE MEMBER OF COMMUNITY HOSPITAL OF BREMEN, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ELECTION OF BOARD MEMBERS THE CORPORATE MEMBER SHALL APPOINT THE BOARD OF DIRECTORS OF COMMUNITY HOSPITAL OF BREMEN AND SHALL HAVE SUCH POWERS OF ADVANCE APPROVAL REGARDING CORPORATE ACTIONS AS ARE DELINEATED IN THE BY-LAWS OF COMMUNITY HOSPITAL OF BREMEN. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders DECISIONS OF THE BOARD OF DIRECTORS DECISIONS OF THE BOARD OF DIRECTORS MUST BE APPROVED BY THE CORPORATE MEMBER. BEACON HEALTH SYSTEM, INC., THE SOLE MEMBER OF COMMUNITY HOSPITAL OF BREMEN HAS THE SOLE POWER WITH RESPECT TO THE FOLLOWING MATTERS: 1. SELECTION AND RETENTION OF AUDITORS. 2. APPROVAL OF ALL CONTRACTS, POLICIES, OR PROGRAMS OF INSURANCE ESTABLISHING THE TYPES OF INSURANCE COVERAGE REQUIRED AS WELL AS THE COVERAGE LEVELS. 3. THE NOMINATION, ELECTION AND REMOVAL OF MEMBERS OF THE BOARD OF THE CORPORATION. 4. THE APPOINTMENT AND EVALUATION OF THE PRESIDENT OF THE CORPORATION. 5. COMPENSATION OF EXECUTIVE MANAGEMENT OF THE CORPORATION. 6. OTHER MATTERS DETERMINED FROM TIME TO TIME BY THE MEMBER, OR AS PROVIDED IN THE BYLAWS OR OTHER GOVERNING DOCUMENTS. Form 990, Part VI, Line 11b Review of form 990 by governing body PREPARATION & REVIEW OF FORM 990 THE ORGANIZATION INCORPORATES NUMEROUS PARTIES IN THE PRODUCTION AND REVIEW OF THE FORM 990 AND ASSOCIATED SCHEDULES. SENIOR ACCOUNTING STAFF AND MANAGEMENT COMPLETE THE FORM 990 AND SCHEDULES. SOME FORMS AND SCHEDULES ARE REVIEWED BY THE CONTROLLER. SUBSEQUENT TO THOSE STEPS, THE ORGANIZATION ENGAGED ERNST & YOUNG TO REVIEW THE COMPLETED FORM 990 AND APPROPRIATE SCHEDULES. PRIOR TO FILING THE RETURN, THE CFO, THE COMPENSATION COMMITTEE OF THE ORGANIZATION, AND THE CEO CONDUCT A GENERAL OVERVIEW OF THE FORM 990, INCLUDING APPLICABLE COMPENSATION SCHEDULES. IN ADDITION, EACH BOARD MEMBER RECEIVES NOTIFICATION OF THE IRS FORM 990 PLACEMENT ON THE ORGANIZATION'S BOARD PORTALS WHICH ALLOWS FOR BOARD MEMBER REVIEW PRIOR TO FILING THE RETURN. Form 990, Part VI, Line 12c Conflict of interest policy THERE ARE THREE SEPARATE FORMS THAT ARE SENT OUT THROUGH THE INTERNAL AUDIT DEPARTMENT TO KEY EMPLOYEES OR BOARD MEMBERS REGARDING CONFLICT OF INTEREST. THEY ARE AS FOLLOWS: 1. THE FIRST IS A CONFLICT OF INTEREST STATEMENT THAT IS SENT TO SENIOR LEVEL ADMINISTRATION, MANAGEMENT, AND SELECT STAFF SUCH AS PURCHASING DEPARTMENT EMPLOYEES. THE PURPOSE OF THE STATEMENT IS TO REQUIRE THESE EMPLOYEES TO DISCLOSE ANY POTENTIAL CONFLICT OF INTERESTS THEY MAY HAVE. THE STATEMENTS ARE SENT IN JANUARY OF EACH YEAR FOR THE PREVIOUS YEAR ACTIVITIES WE PURSUE THE REPLIES TO GET A 100% RESPONSE RATE. IN THE CURRENT YEAR WE SENT OUT 376 STATEMENTS AND ARE WORKING TO ACHIEVE A 100% RESPONSE RATE. EACH RESPONSE IS REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT AND THE RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AS WELL AS THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 2. THE SECOND STATEMENT IS THE BOARD DUALITY OF INTEREST STATEMENT THAT IS SENT TO CURRENT BOARD MEMBERS, FORMER BOARD MEMBERS FROM THE LAST FIVE YEARS, AND OTHER KEY EMPLOYEES. THE DUALITY OF INTEREST STATEMENT IS SENT USING A WEB BASED SURVEY TOOL PROVIDED BY ERNST & YOUNG. THE REPLIES ARE REVIEWED BY THE DIRECTOR OF INTERNAL AUDIT. THE RESULTS OF THE SURVEYS ARE SUMMARIZED USING THE WEB BASED TOOL, AND ARE REVIEWED BY ERNST & YOUNG IN COMPLETING THE 990. The RESULTS ARE REPORTED TO THE CEO OF BEACON HEALTH SYSTEM, THE AUDIT COMMITTEE CHAIRMAN, AND THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. 3. THE THIRD STATEMENT IS ENTITLED "CODE OF ETHICS FOR SENIOR FINANCIAL OFFICERS". THE STATEMENT REQUIRES AN ACKNOWLEDGEMENT FORM TO BE SIGNED BY BEACON HEALTH SYSTEM'S KEY FINANCIAL EMPLOYEES THAT BEACON'S FINANCIAL INFORMATION IS TO THE BEST OF THEIR KNOWLEDGE TRUE AND ACCURATE. THIS STATEMENT WAS SENT OUT ON JANUARY 12, 2023 AND THE SIGNED ACKNOWLEDGEMENTS ARE KEPT BY THE DIRECTOR OF INTERNAL AUDIT. IN 2022, 22 DESIGNATED EMPLOYEES WERE REQUESTED TO SIGN THE FORM AND WE HAD A 100% COMPLIANCE RATE. ANY POTENTIAL CONFLICTS OF INTERESTS ARE REVIEWED BY INDEPENDENT PARTIES BOTH INTERNAL AND EXTERNAL TO THE ORGANIZATION, AND IF NECESSARY, CORRECTIVE ACTION WOULD BE TAKEN TO RESOLVE A TRUE CONFLICT. THE INDIVIDUAL WITH THE POTENTIAL CONFLICT OF INTEREST WOULD BE EXCLUDED FROM ALL REVIEW PROCEEDINGS. Form 990, Part VI, Line 19 Required documents available to the public AVAILABILITY OF INFORMATION THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE DISTRIBUTED QUARTERLY TO THE ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AS PART OF THE CONTINUING DISCLOSURES FOR BEACON HEALTH SYSTEM, INC. BONDS. Form 990, Part VIII, Line 2f Other Program Service Revenue All other program service revenue - Total Revenue: 11904, Related or Exempt Function Revenue: 11904, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: 11744, Related or Exempt Function Revenue: 11744, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees P/S MEDICAL - Total Expense: 645662, Program Service Expense: 580295, Management and General Expenses: 65367, Fundraising Expenses: ; PHYSCIAN FEES - Total Expense: 2633516, Program Service Expense: 2366898, Management and General Expenses: 266618, Fundraising Expenses: ; SERVICE CONTRACTS - Total Expense: 431326, Program Service Expense: 387658, Management and General Expenses: 43668, Fundraising Expenses: ; LAB FEES - Total Expense: 174734, Program Service Expense: 157280, Management and General Expenses: 17454, Fundraising Expenses: ; OTHER P/S - Total Expense: 336340, Program Service Expense: 302289, Management and General Expenses: 34051, Fundraising Expenses: ; REPAIR/MAINTENANCE - Total Expense: 100072, Program Service Expense: 89941, Management and General Expenses: 10131, Fundraising Expenses: ; CONSULTING - Total Expense: 3485, Program Service Expense: 3132, Management and General Expenses: 353, Fundraising Expenses: ; BLOOD SUPPLY - Total Expense: 28665, Program Service Expense: 25763, Management and General Expenses: 2902, Fundraising Expenses: ; COLLECTION EXPENSE - Total Expense: 4510, Program Service Expense: 4053, Management and General Expenses: 457, Fundraising Expenses: ; RADIOLOGY FEES - Total Expense: 1140, Program Service Expense: 1025, Management and General Expenses: 115, Fundraising Expenses: ; TRANSCRIPTIONS - Total Expense: 3220, Program Service Expense: 2894, Management and General Expenses: 326, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Write off Intercompany - 8913271; COMMUNITY HOSPITAL OF BREMEN AUXILLARY PO BOX 8 BREMEN IN 46506 351467691 FIN SUPPORT IN 501(c)(3) 10 N/A false BEACON MEDICAL GROUP INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536132 PHY PRACTICES IN 501(c)(3) 10 BHS true BEACON HEALTH FOUNDATION INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 351536129 FIN SUPPORT IN 501(c)(3) 7 BHS true ELKHART GENERAL HOSPITAL INC 600 EAST BOULEVARD ELKHART IN 46514 350877574 HOSPITAL IN 501(c)(3) 3 BHS true BEACON HEALTH SYSTEM INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 453864076 PARENT ORG IN 501(c)(3) Type III-FI NA false MEMORIAL HOSPITAL OF SOUTH BEND INC 615 N MICHIGAN STREET SOUTH BEND IN 46601 350868132 HOSPITAL IN 501(c)(3) 3 BHS true THREE RIVERS HEALTH FOUNDATION 701 SOUTH HEALTH PARKWAY THREE RIVERS MI 49093 201384776 FOUNDATION MI 501(c)(3) Type I TRH true THREE RIVERS HEALTH SYSTEM 701 SOUTH HEALTH PARKWAY THREE RIVERS MI 49093 451257972 HOSPITAL MI 501(c)(3) 3 BHS true BEACON HEALTH VENTURES INC 615 N MICHIGAN ST SOUTH BEND IN 46601 351901068 HOME MEDICAL IN NA C Corporation false BEACON HEALTH VENTURES MICHIGAN INC 615 N MICHGIAN ST SOUTH BEND IN 46601 208259773 HOME MEDICAL MI NA C Corporation false INTEGRATED HEALTH SYSTEMS INC 701 SOUTH HEALTH PARKWAY THREE RIVERS MI 49093 383134384 PERSONNEL MGMT MI TRH C Corporation false false false false false false false false true false true false false false false false true true true true MEMORIAL HOSPITAL OF SOUTH BEND P 12520398 ACTUAL CHARGES MEMORIAL HOSPITAL OF SOUTH BEND R 13514828 CASH MEMORIAL HOSPITAL OF SOUTH BEND Q 69124 ACTUAL CHARGES BEACON MEDICAL GROUP R 104953 CASH BEACON MEDICAL GROUP J 105060 ACTUAL CHARGES ELKHART GENERAL HOSPITAL Q 62540 ACTUAL CHARGES ELKHART GENERAL HOSPITAL R 62661 CASH