2025-04-28T10:24:19+00:00 2024-06-30 346565596 ERNST & YOUNG US LLP 425 HOUSTON ST FORT WORTH TX 76102 990 2023-07-01 743019849 St Mark's Medical Center STMA 9729436400 7950 Legacy Drive 1000 PLANO TX 75024 Dudley Piland Chairman of the Board 9792422112 2025-04-28 true Jodi Rosser P01255710 8173351900 2025-04-17 2023 2025-03-06 01:10:19Z Dudley Piland 7950 Legacy Drive 1000 PLANO TX 75024 4499743 false X WWW.SMMCTX.ORG X 2001 TX WE PROVIDE EXCELLENT CARE WITH A SPIRIT OF HOMETOWN TRUST. 12 10 203 0 0 0 1433251 63189 21290771 4020349 858745 290883 293958 108452 23876725 4482873 0 0 0 0 13322750 2812163 0 0 0 14587451 7146987 27910201 9959150 -4033476 -5476277 25810815 15879681 24242028 19823283 1568787 -3943602 X WE PROVIDE EXCELLENT CARE WITH A SPIRIT OF HOMETOWN TRUST. false true 6745162 0 4020349 ST. MARK'S MEDICAL CENTER (SMMC) was A COMMUNITY HEALTH PROVIDER THAT SERVEd THE COMMUNITY REGARDLESS OF ANY INDIVIDUAL'S RACE, CREED, NATIONALITY, OR ABILITY TO PAY FOR SERVICES INCLUDING OUTPATIENT, AND EMERGENCY CARE IN SUPPORT OF THE HOSPITAL'S HEALTHCARE MISSION. The hospital operated as a rural emergency hospital during the fiscal year. Rural emergency hospitals only provide outpatient and emergency care. DURING THE YEAR ENDED JUNE 30, 2024, WE HAD 1,782 ER VISITS and 5,612 outpatient visits. SMMC Utilized THE MOST ADVANCED TECHNOLOGIES RIVALING THOSE OF MAJOR CITIES IN A COMFORTABLE ENVIRONMENT CLOSE TO HOME. WE OFFER OUTPATIENT AND EMERGENCY SERVICES WITH COMPASSIONATE CARE, FOCUSING ON RESPECT AND CARE FOR THE WHOLE PERSON. AT SMMC, WE ARE DETERMINED TO BUILD AN UNRIVALED REPUTATION FOR OUR OUTSTANDING SERVICE AND DELIVERY OF CARE. WE OFFER ADVANCED SERVICES AND PROGRAMS INCLUDING SPECIALTY CLINICS AND COMPREHENSIVE PUBLIC HEALTH SERVICES. WORKING TOGETHER, OUR GOAL IS TO PROVIDE MEMBERS OF THE COMMUNITY WITH "ADVANCED HOMETOWN HEALTHCARE." ON OCTOBER 12, 2023, THE HOSPITAL CEASED OPERATIONS DUE TO ONGOING, INSURMOUNTABLE FINANCIAL DIFFICULTIES. The hospital license has been returned to the state. The entity is currently winding down its affairs. 6745162 true true false true false false false false false true true false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 42 0 true 203 true false false false false false false false false false false false false X 12 10 true true false false true true true true true false false true true true true true true false false false X JAMES HILL 9799436431 7950 LEGACY DRIVE SUITE 1000 PLANO TX 75024 DUDLEY PILAND CHAIRMAN 1.0 1.0 X X 0 50800 0 MICHAEL CORKER DIRECTOR/VICE CHAIRMAN 1.0 0 X X 0 0 0 ALAN CASEY DIRECTOR 1.0 0 X 0 0 0 Allyson Borgstedte DIRECTOR 1.0 0 X 0 0 0 CRAIG SIMS DIRECTOR 1.0 39.0 X 0 510550 60536 Jason McBroom DIRECTOR 1.0 0 X 0 0 0 MARK CLAYTON DIRECTOR 1.0 0 X 0 0 0 RAY WALTHER DIRECTOR 1.0 0 X 0 0 0 RODNEY MERSIOVSKY DIRECTOR 1.0 0 X 0 0 0 THOMAS BORGSTEDTE Director 1.0 0 X 0 0 0 TIM KNESEK DIRECTOR 1.0 0 X 0 0 0 WESS BLACKWELL MD DIRECTOR 1.0 0 X 0 0 0 LINDA MOORE AST. SECRETARY 0.1 39.9 X 0 451065 69908 MARK KIMBALL PRESIDENT & CEO (until 12/2023) 40.0 0 X 0 258654 48302 JACQUALYN S FAIGLE Nurse 40.0 0 X 104429 0 18104 Jared Brown CFO (Until 9/2023) 40.0 0 X 0 119090 9210 JONATHAN BLAKE Physician 40.0 0 X 338167 0 6378 LAURA QUITTA Nurse 40.0 0 X 115209 0 1921 TAMMY HARTFIELD CNO (until 12/2023) 40.0 0 X 0 174041 36126 TOD BEASLEY Former INTERIM CFO 0.0 40.0 X 0 117929 18337 557805 1682129 268822 4 true true false Qualivis Dept 3847 PO Box 123847 Dallas TX 75312 Health Services 658025 Young Professional Services LLC 200 Greenleaves Blvd Ste 6 Madeville LA 70448 Health Services 253212 PREMIER SLEEP LLC 111 NORTHPARK DR VICTORIA TX 77901 Health services 126575 3 63189 63189 PATIENT SERVICE REVENUE 621110 2399525 2399525 REH Facility Fee 621110 1620824 1620824 0 0 0 0 4020349 247899 247899 46257 46257 0 46257 46257 59854 16870 0 42984 42984 42984 OTHER INCOME 900099 59937 59937 MEDICAL RECORDS 900099 2073 2073 CAFETERIA SALES 900099 185 185 0 0 0 0 62195 4482873 4020349 0 399335 0 0 2236881 1569406 667475 79599 55847 23752 319778 224358 95420 175905 130472 45433 1418247 1086035 332212 2679 2679 270016 270016 520 520 91036 91036 0 0 31509 13714 17795 335551 148841 186710 848882 733299 115583 12531 780 11751 252038 252038 1932273 1288182 644091 124366 124366 REPAIRS AND MAINTENANCE 700958 356216 344742 RENTALS 551109 349545 201564 MEDICAL SUPPLIES 510620 508964 1656 OTHER 64652 63581 1071 0 0 0 0 9959150 6745162 3213988 0 1004496 51093 1540341 6932 0 0 0 0 543614 451553 424113 0 40332917 26556410 19453158 13776507 2347813 1593596 0 496000 0 1280 0 25810815 15879681 5139810 5607811 0 0 17788218 12917406 1314000 1298066 24242028 19823283 X 1568787 -3943602 1568787 -3943602 25810815 15879681 X -5476277 -36112 X X false true X true true false X Schedule A, Part I, Line 3 PUBLIC CHARITY STATUS ST. MARK'S MEDICAL CENTER IDENTIFIES AS A HOSPITAL UNDER SECTION 170 (B)(1)(A)(III) IN SCHEDULE A. HOWEVER, SUBSEQUENTLY ON OCTOBER 12, 2023, THE HOSPITAL CEASED OPERATIONS DUE TO ONGOING, INSURMOUNTABLE FINANCIAL DIFFICULTIES. THE HOSPITAL LICENSE HAS BEEN RETURNED TO THE STATE. THE ENTITY IS CURRENTLY WINDING DOWN ITS AFFAIRS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 520 520 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY IN FISCAL YEAR 2024 ST. MARKS MEDICAL CENTER PAID: $5,948 TO THE TEXAS HOSPITAL ASSOCIATION (THA) THE PORTION OF DUES THAT WERE REPORTED FOR LOBBYING PURPOSES WERE: THA: 8.74% TOTAL DUES PAID AND REPORTED FOR LOBBYING ACTIVITIES WERE: THA: $5,948*8.74% = $520 503905 503905 23068126 10760010 12308116 340144 340144 0 16420742 15456256 964486 13776507 MORTGAGE RESERVE FUND 1593596 C 1593596 SBA PPP FUND LIAB DUE TO CHC 1298066 DUE TO SMMC FOUNDATION DUE TO CHC - IT NOTE 1298066 true true X true X 300 true X true true true false false 352823 0 352823 0.0354 466906 474428 0 0.0 0 0 0 0.0 0 0 819729 474428 352823 0.0354 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 819729 474428 352823 0.0354 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 2723678 4313913 -1590235 X true true 1 1 ST MARK'S MEDICAL CENTER ONE ST MARKS PLACE LA GRANGE TX 78945 WWW.SMMCTX.ORG 008234 X X X ST MARK'S MEDICAL CENTER 1 false false true X X X X X X X X X 21 true false false true X SEE PART VI X true 21 true SEE PART VI false true X 300.0 400.0 X X true true X X X true X See Part VI X See Part VI X See Part VI X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA OF ST. MARK'S MEDICAL CENTER (SMMC) ARE PRESENTED AS A PRIORITIZED DESCRIPTION. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ST. MARKS MEDICAL CENTER. ST. MARK'S MEDICAL CENTER (SMMC) IS A 65-BED, 100,000-SQUARE FOOT 501(C)(3) NOT-FOR-PROFIT HOSPITAL PROVIDING ADVANCED HEALTH CARE CLOSE TO HOME FOR PATIENTS IN THE CENTRAL TEXAS COMMUNITIES OF FAYETTE AND LEE COUNTIES, AS WELL AS THE SURROUNDING AREAS. THE COMPREHENSIVE HEALTH SERVICES, ADVANCED TECHNOLOGIES AND MEDICAL SPECIALISTS AT SMMC RIVAL THOSE OF MAJOR METROPOLITAN INSTITUTIONS. THE HOSPITAL HAS A CLINICAL AFFILIATION WITH ST. DAVID'S HEALTH CARE IN AUSTIN AND CONTINUES TO BUILD BEST CLINICAL PRACTICES AS IT GROWS TO SERVE PATIENTS BETTER. SMMC IS THE PROUD RECIPIENT OF THE TMF HEALTH QUALITY INSTITUTE SILVER AWARD, EXEMPLIFYING THE HOSPITAL'S DEDICATION TO CONTINUOUS QUALITY IMPROVEMENT. THE HOSPITAL IS A PART OF THE COMMUNITY HOSPITAL CORPORATION (CHC) FAMILY OF HOSPITALS. CHC IS A NOT-FOR-PROFIT COMPANY WHOSE SOLE MISSION IS TO HELP NOT-FOR-PROFIT HOSPITALS, SUCH AS SMMC, REMAIN COMMUNITY-OPERATED AND GOVERNED. BASED ON HOSPITAL INPATIENT DISCHARGE DATA, THE DEFINED SERVICE AREA OF SMMC IS FAYETTE AND LEE COUNTIES IN TEXAS. BOTH COUNTIES COMBINED COMPRISE 82.1% OF FISCAL YEAR 2021 INPATIENT DISCHARGES. THE POPULATION OF FAYETTE COUNTY IS EXPECTED TO INCREASE 3.1% FROM 2021 (25,460) TO 2026 (26,258) AND THE POPULATION OF LEE COUNTY IS EXPECTED TO INCREASE 3.3% FROM 2021 (18,092) TO 2026 (18,684), WITH THE EXPECTED GROWTH RATE OF BOTH COUNTIES FALLING BELOW THE 7.9% EXPECTED GROWTH RATE FOR THE STATE OF TEXAS FROM 2021 (29,969,514) TO 2026 (32,346,738). AS OF 2021, THE RACIAL/ETHNIC BREAKOUT OF FAYETTE COUNTY WAS 81.9% WHITE, 6.0% BLACK, 0.4%, ASIAN, 0.8% AMERICAN INDIAN AND 10.9% ALL OTHERS. THE RACIAL/ETHNIC BREAKOUT OF LEE COUNTY IN 2021 WAS 77.6% WHITE, 10.5% BLACK, 0.5% ASIAN, 0.7% AMERICAN INDIAN AND 10.7% ALL OTHERS. HISPANIC IS CLASSIFIED AS AN ETHNICITY AND IS CATEGORIZED SEPARATELY FROM WHITE, BLACK, ASIAN, AMERICAN INDIAN AND ALL OTHERS. BY 2026, THE WHITE NON-HISPANIC POPULATION IN FAYETTE COUNTY IS EXPECTED TO INCREASE BY 2.2% AND TO INCREASE BY 2.9% IN LEE COUNTY. BY 2026, THE BLACK POPULATION IS EXPECTED TO DECREASE BY 1.5% IN FAYETTE COUNTY AND TO INCREASE BY 0.5% IN LEE COUNTY. THE ASIAN POPULATION IS EXPECTED TO INCREASE BY 20.0% IN FAYETTE COUNTY AND BY 25.5% IN LEE COUNTY BY 2026. THE AMERICAN INDIAN POPULATION IS EXPECTED TO INCREASE BY 5.5% IN FAYETTE COUNTY AND BY 13.3% IN LEE COUNTY. ALL OTHER RACIAL/ETHNIC GROUPS ARE EXPECTED TO INCREASE BY 11.5% IN FAYETTE COUNTY AND BY 6.7% IN LEE COUNTY BY 2026. THE HISPANIC POPULATION IS EXPECTED TO INCREASE BY 13.2% IN FAYETTE COUNTY AND BY 9.5% IN LEE COUNTY BY 2026. BETWEEN 2011 AND 2019, THE PERCENT OF FOREIGN-BORN RESIDENTS INCREASED IN BOTH FAYETTE AND LEE COUNTIES, THE STATE AND THE NATION. IN 2015-2019, FAYETTE COUNTY (7.6%) HAD A LOWER PERCENT OF FOREIGN-BORN RESIDENTS THAN LEE COUNTY (8.4%), THE STATE (17.0%) AND THE NATION (13.6%). AS OF 2021, FAYETTE COUNTY (48.7 YEARS) HAD AN OLDER MEDIAN AGE THAN BOTH LEE COUNTY (41.1 YEARS) AND THE STATE OF TEXAS (35.3 YEARS). THE MEDIAN AGE IN BOTH COUNTIES AND THE STATE IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT FIVE YEARS (2021-2026). AS OF 2021, THE MEDIAN HOUSEHOLD INCOMES IN BOTH FAYETTE ($60,548) AND LEE ($56,620) COUNTIES ARE LOWER THAN THAT OF THE STATE ($63,524). BETWEEN 2021 AND 2026, THE MEDIUM HOUSEHOLD INCOMES IN FAYETTE COUNTY, LEE COUNTY, AND THE STATE ARE EXPECTED TO INCREASE. FAYETTE COUNTY (20.6%) AND LEE COUNTY (15.4%) HAVE A LOWER PERCENTAGE OF RESIDENTS WITH A BACHELOR OR ADVANCED DEGREE THAN THE STATE (31.3%) (2021). IN 2014-2018, 16.0% OF THE NATION LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 26.0% OF THE NATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2014-2018, 24.5% OF THE POPULATION IN TEXAS LIVED IN A DISTRESSED COMMUNITY, AS COMPARED TO 26.2% OF THE POPULATION THAT LIVED IN A PROSPEROUS COMMUNITY. IN 2014-2018, THE DISTRESS SCORE IN FAYETTE COUNTY WAS 48.1 WHICH FALLS WITHIN THE MID-TIER ECONOMIC CATEGORY, WHILE THE DISTRESS SCORE IN LEE COUNTY WAS 35.4 WHICH FALLS WITHIN THE COMFORTABLE ECONOMIC CATEGORY AND IS MORE PROSPEROUS AS COMPARED TO OTHER COUNTIES IN THE STATE. WITH RESPECT TO UNEMPLOYMENT, RATES IN BOTH FAYETTE AND LEE COUNTIES AND THE STATE INCREASED BETWEEN 2018 AND 2020. IN 2020, BOTH FAYETTE (4.7) AND LEE (4.9) COUNTIES HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (7.6). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN FAYETTE AND LEE COUNTIES DECREASED. FOR FAYETTE COUNTY, AUGUST 2020 HAD THE LOWEST UNEMPLOYMENT RATE (4.1) AS COMPARED TO JUNE 2020 WITH THE HIGHEST RATE (5.8). FOR LEE COUNTY, AUGUST 2020 AND MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE (4.3) AS COMPARED TO JUNE AND JULY 2020 WITH THE HIGHEST RATE (6.1). AS OF 2019, THE MAJORITY OF EMPLOYED PERSONS IN BOTH FAYETTE AND LEE COUNTIES ARE WITHIN OFFICE AND ADMINISTRATION SUPPORT OCCUPATIONS. THE MOST COMMON EMPLOYED GROUPINGS IN FAYETTE COUNTY ARE OFFICE AND ADMINISTRATION SUPPORT OCCUPATIONS (14.7%); SALES AND RELATED OCCUPATIONS (10.6%); CONSTRUCTION AND EXTRACTION OCCUPATIONS (9.4%); PRODUCTION OCCUPATIONS (8.5%); AND MANAGEMENT OCCUPATIONS (8.4%). IN LEE COUNTY, THE MOST COMMON EMPLOYED GROUPINGS ARE OFFICE AND ADMINISTRATION SUPPORT OCCUPATIONS (12.6%); SALES AND RELATED OCCUPATIONS (10.5%); CONSTRUCTION AND EXTRACTION OCCUPATIONS (9.5%); MANAGEMENT OCCUPATIONS (8.6%); AND PRODUCTION OCCUPATIONS (6.9%). IN 2015-2019, DRIVING ALONE WAS THE MOST FREQUENT MEANS OF TRANSPORTATION TO WORK FOR BOTH FAYETTE AND LEE COUNTIES AND THE STATE. IN 2015-2019, FAYETTE COUNTY (8.0%) HAD THE LOWEST PERCENT OF PEOPLE WHO CARPOOLED TO WORK AS COMPARED TO LEE COUNTY (11.0%) AND THE STATE (10.0%). FAYETTE COUNTY (23.6 MINUTES) HAD A SHORTER MEAN TRAVEL TIME TO WORK THAN LEE COUNTY (29.1 MINUTES) AND THE STATE (27.2 MINUTES) (2015-2019). IN 2021, LEE COUNTY (21.6%) HAD THE HIGHEST PERCENTAGE OF FAMILIES LIVING BELOW THE POVERTY LEVEL AS COMPARED TO FAYETTE COUNTY (19.1%) AND THE STATE (18.0%). BETWEEN 2015 AND 2019, THE PERCENTAGE OF CHILDREN (<18 YEARS) LIVING BELOW POVERTY IN BOTH FAYETTE AND LEE COUNTIES AND THE STATE DECREASED. IN 2019, FAYETTE COUNTY (15.3%) HAD A LOWER PERCENTAGE OF CHILDREN (<18 YEARS) LIVING BELOW POVERTY THAN LEE COUNTY (16.1%) AND THE STATE (19.2%). ACCORDING TO FEEDING AMERICA, AN ESTIMATED 13.3% OF FAYETTE COUNTY RESIDENTS ARE FOOD INSECURE AS COMPARED TO 12.7% IN LEE COUNTY AND 14.1% IN TEXAS (2019). ADDITIONALLY, 18.5% OF THE YOUTH POPULATION (UNDER 18 YEARS OF AGE) IN FAYETTE COUNTY ARE FOOD INSECURE, AS COMPARED TO 18.0% IN LEE COUNTY AND 19.6% IN TEXAS (2019). THE AVERAGE MEAL COST FOR A FAYETTE COUNTY RESIDENT IS $3.05, AS COMPARED TO $3.22 IN LEE COUNTY AND $2.68 IN TEXAS (2019). BETWEEN 2014 AND 2018, FAYETTE COUNTY MAINTAINED A LOWER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS THAN LEE COUNTY AND THE STATE. ADDITIONALLY, THE PERCENTAGE OF SNAP BENEFIT RECIPIENTS IN BOTH COUNTIES OVERALL INCREASED BETWEEN 2014 AND 2018. IN 2018, FAYETTE COUNTY (7.3%) HAD A LOWER PERCENTAGE OF RECIPIENTS WHO QUALIFIED FOR SNAP BENEFITS THAN BOTH LEE COUNTY (10.8%) AND THE STATE (12.2%). IN 2018-2019, FAYETTE COUNTY (53.5%) AND LEE COUNTY (60.0%) HAD A LOWER PERCENTAGE OF PUBLIC SCHOOL STUDENTS ELIGIBLE FOR FREE OR REDUCED PRICE LUNCH THAN THE STATE (60.5%) AND A HIGHER PERCENTAGE THAN THE NATION (49.5%). FAYETTE COUNTY (95.5%) AND LEE COUNTY (96.3%) HAD A HIGHER HIGH SCHOOL GRADUATION RATE THAN THE STATE (91.4%) AND THE NATION (87.7%) (2018-2019). Schedule H, Part V, Section B, Line 5 Facility , 2 Facility , 2 - ST. MARKS MEDICAL CENTER, CONTINUED. HEART DISEASE IS THE LEADING CAUSE OF DEATH IN FAYETTE COUNTY AND THE STATE AND THE SECOND LEADING CAUSE OF DEATH IN LEE COUNTY (2015-2019). BETWEEN 2015 AND 2019, HEART DISEASE MORTALITY RATES OVERALL DECREASED IN BOTH FAYETTE COUNTY AND THE STATE AND INCREASED IN LEE COUNTY. IN 2019, THE HEART DISEASE MORTALITY RATE IN FAYETTE COUNTY (183.0 PER 100,000) WAS HIGHER THAN LEE COUNTY (180.3 PER 100,000) AND THE STATE (167.5 PER 100,000). CANCER IS THE SECOND LEADING CAUSE OF DEATH IN BOTH FAYETTE COUNTY AND THE STATE, AND THE LEADING CAUSE OF DEATH IN LEE COUNTY (2017-2019). BETWEEN 2015 AND 2019, CANCER MORTALITY RATES OVERALL DECREASED IN BOTH COUNTIES AND THE STATE. IN 2017-2019, THE CANCER MORTALITY RATE IN LEE COUNTY (186.4 PER 100,000) WAS HIGHER THAN FAYETTE COUNTY (117.7 PER 100,000) AND THE STATE (143.5 PER 100,000). FATAL ACCIDENTS IS THE THIRD LEADING CAUSE OF DEATH IN BOTH FAYETTE AND LEE COUNTIES, AND THE FIFTH LEADING CAUSE OF DEATH IN THE STATE (2015-2019). BETWEEN 2015 AND 2019, ACCIDENT MORTALITY RATES DECREASED IN FAYETTE COUNTY, INCREASED IN LEE COUNTY, AND SLIGHTLY INCREASED IN THE STATE. IN 2017-2019, THE ACCIDENT MORTALITY RATE IN LEE COUNTY (71.6 PER 100,000) WAS HIGHER THAN THE RATE IN FAYETTE COUNTY (48.3 PER 100,000) AND THE STATE (38.7 PER 100,000). THE LEADING CAUSE OF FATAL ACCIDENTS IN FAYETTE AND LEE COUNTY IS DUE TO MOTOR VEHICLE ACCIDENTS (2017-2019). CEREBROVASCULAR DISEASE IS THE FOURTH LEADING CAUSE OF DEATH IN BOTH FAYETTE AND LEE COUNTIES, AND THE THIRD LEADING CAUSE OF DEATH IN THE STATE (2015-2019). BETWEEN 2015-2019, CEREBROVASCULAR DISEASE MORTALITY RATES DECREASED IN BOTH COUNTIES AND THE STATE. IN 2017-2019, THE CEREBROVASCULAR DISEASE MORTALITY RATE IN BOTH FAYETTE (31.3 PER 100,000) AND LEE (36.3 PER 100,000) COUNTIES WAS LOWER THAN THE STATE (40.2 PER 100,000). ESSENTIAL HYPERTENSION AND HYPERTENSIVE RENAL DISEASE IS THE FIFTH LEADING CAUSE OF DEATH IN FAYETTE COUNTY, THE SIXTH LEADING CAUSE OF DEATH IN LEE COUNTY, AND IS NOT A LEADING CAUSE OF DEATH IN THE STATE (2015-2019). BETWEEN 2015 AND 2019, ESSENTIAL HYPERTENSION AND HYPERTENSIVE RENAL DISEASE MORTALITY RATES INCREASED IN FAYETTE COUNTY AND SLIGHTLY INCREASED IN THE STATE. IN 2017-2019, THE ESSENTIAL HYPERTENSION AND HYPERTENSIVE RENAL DISEASE MORTALITY RATE IN BOTH LEE (29.3 PER 100,000) AND FAYETTE (29.2 PER 100,000) COUNTY IS HIGHER THAN THE STATE (8.7 PER 100,000). CHRONIC LOWER RESPIRATORY DISEASE, (CLRD), ALZHEIMER'S DISEASE, DIABETES MELLITUS, SEPTICEMIA, AND INFLUENZA AND PNEUMONIA ARE ALSO, LEADING CAUSES OF DEATH IN EITHER FAYETTE AND LEE COUNTY OR IN BOTH COUNTIES. AS OF NOVEMBER 8, 2021, THE PERCENT OF THE POPULATION (AGE 5+) THAT WAS FULLY VACCINATED FOR COVID-19 IN FAYETTE COUNTY (51.1%) WAS HIGHER THAN LEE COUNTY (46.8%) BUT LOWER THAN THE STATE (60.5%). BETWEEN 2016 AND 2020, DIABETES PREVALENCE RATES IN ADULTS (AGE 18+) IN THE STATE SLIGHTLY INCREASED. IN 2017-2019, FAYETTE & LEE COUNTIES (8.6%) HAD A LOWER PERCENT OF ADULTS (AGE 18+) WHO HAD EVER BEEN DIAGNOSED WITH DIABETES THAN THE STATE (12.2%). IN 2018, THE PERCENT OF MEDICARE BENEFICIARIES WITH DIABETES IN FAYETTE COUNTY (23.2%) WAS THE LOWEST AS COMPARED TO LEE COUNTY (27.4%), THE STATE (28.8%) AND THE NATION (27.0%). BETWEEN 2016 AND 2020, OBESITY PREVALENCE RATES IN ADULTS (AGE 18+) IN FAYETTE AND LEE COUNTIES OVERALL DECREASED, WHILE RATES IN THE STATE SLIGHTLY INCREASED. IN 2018-2020, FAYETTE AND LEE COUNTIES (36.9%) HAD A HIGHER PERCENT OF OBESE ADULTS (AGE 18+) THAN THE STATE (34.9%). LEE COUNTY (60.9%) HAS THE HIGHEST RATE OF MEDICARE FEE-FOR-SERVICE RESIDENTS WITH HYPERTENSION AS COMPARED TO FAYETTE COUNTY (59.8%), THE STATE (59.9%) AND THE NATION (57.2%) (2018). BETWEEN 2016 AND 2020, ASTHMA PREVALENCE RATES IN ADULTS (AGE 18+) IN THE STATE SLIGHTLY INCREASED. IN 2017-2019, FAYETTE & LEE COUNTIES (15.7%) HAD A HIGHER PERCENTAGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH ASTHMA THAN THE STATE (13.0%). BETWEEN 2016 AND 2020, ARTHRITIS PREVALENCE RATES IN ADULTS (AGE 18+) IN THE STATE SLIGHTLY DECREASED. IN 2018-2020, FAYETTE & LEE COUNTIES (29.0%) HAD A HIGHER PERCENTAGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH ARTHRITIS THAN THE STATE (21.0%). BETWEEN 2016 AND 2020, THE RATE OF ADULTS (AGE 18+) IN THE STATE THAT HAVE BEEN DIAGNOSED WITH A DEPRESSIVE DISORDER INCREASED. IN 2017-2019, FAYETTE & LEE COUNTIES (14.5%) HAD A HIGHER PERCENTAGE OF ADULTS (AGE 18+) EVER DIAGNOSED WITH A DEPRESSIVE DISORDER THAN THE STATE (16.8%). BETWEEN 2016 AND 2020, THE PERCENT OF ADULTS (AGE 18+) WHO SELF-REPORTED THAT THEY HAD A DISABILITY IN THE STATE INCREASED. THE PERCENT OF ADULTS (AGE 18+) WHO SELF-REPORTED THAT THEY HAD A DISABILITY IN FAYETTE & LEE COUNTIES (15.8%) WAS LOWER THAN THE STATE (26.8%) (2017-2019). AS OF 2019, FAYETTE COUNTY (23.4%) HAS A LOWER RATE OF UNINSURED ADULTS (AGE 18-64) AS COMPARED TO LEE COUNTY (24.5%) AND THE STATE (24.3%). BOTH FAYETTE AND LEE COUNTIES AND THE STATE EXPERIENCED SLIGHT INCREASES IN THE PERCENTAGE OF UNINSURED ADULTS (AGE 18-64) BETWEEN 2015 AND 2019. A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") WAS CONDUCTED FOR ST. MARK'S MEDICAL CENTER (SMMC) BY COMMUNITY HOSPITAL CORPORATION (CHC). THIS CHNA UTILIZES RELEVANT HEALTH DATA AND STAKEHOLDER INPUT TO IDENTIFY THE SIGNIFICANT COMMUNITY HEALTH NEEDS IN FAYETTE AND LEE COUNTIES IN TEXAS. COMMUNITY INPUT WAS RECEIVED DURING INTERVIEWS CONDUCTED BY CHC FROM JULY 12, 2021 - AUGUST 5, 2021. THE CHNA IS DESIGNED IN ACCORDANCE WITH CHNA REQUIREMENTS IDENTIFIED IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND FURTHER ADDRESSED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS RELEASED ON DECEMBER 29, 2014. THE SMMC BOARD REVIEWED AND ADOPTED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ON APRIL 28, 2022. INTERVIEW METHODOLOGY: SMMC WORKED WITH CHC IN THE DEVELOPMENT OF ITS CHNA. SMMC PROVIDED ESSENTIAL DATA AND RESOURCES NECESSARY TO INITIATE AND COMPLETE THE PROCESS, INCLUDING THE DEFINITION OF THE HOSPITAL'S STUDY AREA AND THE IDENTIFICATION OF KEY COMMUNITY STAKEHOLDERS TO BE INTERVIEWED. BACKGROUND INFORMATION ABOUT SMMC, INCLUDING THE MISSION, VISION, AND SERVICES WAS PROVIDED BY THE HOSPITAL OR TAKEN FROM ITS WEBSITE. POPULATION DEMOGRAPHICS INFORMATION WAS COLLECTED BY CHC USING SOURCES WHICH INCLUDED STRATASAN, THE U.S. CENSUS BUREAU AND THE UNITED STATES BUREAU OF LABOR STATISTICS AND INCLUDED INFORMATION REGARDING POPULATION CHANGE BY RACE, ETHNICITY, AGE, MEDIAN INCOME ANALYSIS, UNEMPLOYMENT AND ECONOMIC STATISTICS IN THE STUDY AREA. HEALTH DATA WAS ALSO COLLECTED FROM A VARIETY OF SOURCES, INCLUDING BUT NOT LIMITED TO, THE ROBERT WOOD JOHNSON FOUNDATION, TEXAS DEPARTMENT OF HEALTH AND HUMAN SERVICES, SPARKMAP, UNITED STATES CENSUS BUREAU AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. SMMC PROVIDED CHC WITH A LIST OF PERSONS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN FAYETTE AND LEE COUNTIES, INCLUDING PUBLIC HEALTH REPRESENTATIVES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. FROM THAT LIST, SEVENTEEN IN DEPTH INTERVIEWS WERE CONDUCTED USING A STRUCTURED INTERVIEW GUIDE, WITH THE TWO GROUPS OUTLINED IN THE INTERNAL REVENUE SERVICE FINAL REGULATIONS ISSUED DECEMBER 29, 2014. DISCUSSED WERE THE HEALTH NEEDS OF THE COMMUNITY, ACCESS ISSUES, BARRIERS AND ISSUES RELATED TO SPECIFIC POPULATIONS. WITH RESPECT TO INDIVIDUALS PROVIDING INPUT, IT WAS NOTED IN THE CHNA THAT 64.7% OF THOSE PROVIDING INPUT ARE MEMBERS OF A MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATION IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS. 5.9% OF THOSE PROVIDING INPUT WORK FOR A STATE, LOCAL, TRIBAL OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY AND 29.4% OF THOSE PROVIDING INPUT ARE COMMUNTIY LEADERS. Schedule H, Part V, Section B, Line 5 Facility , 3 Facility , 3 - ST. MARKS MEDICAL CENTER, CONTINUED. INTERVIEWEES INCLUDED: * THOMAS BORGSTEDTE, MD: PHYSICIAN-FAMILY PRACTICE, LA GRANGE FAMILY HEALTH CLINIC; BOARD MEMBER, ST. MARK'S MEDICAL CENTER * LADONNA BOYD: DIRECTOR, BLUEBONNET TRAILS COMMUNITY SERVICES * LOIS CHAPMAN: NURSE, BASTROP CLINIC - TX DHHS REGION 7 FIELD OFFICE LOCATION * MIKAELA DEBARBA: RETAIL PHARMACIST, HEB - LA GRANGE * ROGER DEES: SUPERINTENDENT, GIDDINGS INDEPENDENT SCHOOL DISTRICT * NANCY DOYLE: PAYROLL AND BENEFITS CLERK, GIDDINGS INDEPENDENT SCHOOL DISTRICT * KELLY FRANKE: EXECUTIVE DIRECTOR, COMBINED COMMUNITY ACTION - FAYETTE, LEE, BASTROP CO. * SALLY GARRETT: COUNTY EXTENSION AGENT, TEXAS A&M AGRILIFE EXTENSION - FAYETTE COUNTY * BRENDAN GILBREATH: HOMELAND SECURITY ASSISTANT, FAYETTE COUNTY * MARY KAHANEK: PRESIDENT, ST. MARK'S VOLUNTEERS * SHERI KEHLER: CHIEF EXECUTIVE OFFICER, TEJAS HEALTH CARE * CHRIS LITTLE: LEAD PASTOR, CROSSPOINT CHURCH * CRAIG MOREAU: CHIEF OF EMERGENCY MANAGEMENT AND HOMELAND SECURITY FOR FAYETTE COUNTY, FAYETTE COUNTY * DUDLEY PILAND: BOARD CHAIR, ST. MARK'S MEDICAL CENTER * JOSHUA VANDEVER: DIRECTOR, FAYETTE COUNTY EMERGENCY MEDICAL SERVICES * WILLIAM WAGNER: SUPERINTENDENT, LA GRANGE INDEPENDENT SCHOOL DISTRICT * JOE WEBER: JUDGE, FAYETTE COUNTY POPULATIONS THAT WERE IDENTIFIED AS THE MOST AT RISK FOR INADEQUATE CARE IN THE COMMUNITY BY INTERVIEWEES WERE: ELDERLY, OBSTETRIC POPULATION, LOW INCOME/WORKING POOR, RACIAL/ETHNIC GROUPS, YOUTH POPULATIONS, TEENAGERS/ADOLESCENTS, UN/UNDERINSURED, AND VETERANS. THESE UNDERSERVED GROUPS WERE IDENTIFIED AS MOST AT RISK FOR INADEQUATE CARE DUE TO THE FOLLOWING: ELDERLY * TRANSPORTATION BARRIERS * LACK OF LOCAL SPECIALTY SERVICES * SOCIAL ISOLATION * PRESCRIPTION COSTS * ADDITIONAL SPACE/FACILITY TO CATER TO ALZHEIMER'S AND DEMENTIA PATIENTS OB POPULATION * LACK OF LOCAL OB-RELATED SERVICES AND PROVIDERS LOW INCOME/WORKING POOR * LACK OF LOCAL, AFFORDABLE PREVENTIVE CARE, DENTAL CARE * ESTABLISHING PROVIDER RELATIONSHIP * COST OF INSURANCE, PARTICULAR DEDUCTIBLES AND AFFORDING PRESCRIPTIONS * TRANSPORTATION BARRIERS RACIAL/ETHNIC * LANGUAGE BARRIERS * HEALTHY LIFESTYLE EDUCATION YOUTH POPULATION * IMMUNIZATIONS * LIMITED ACCESS TO PEDIATRIC CARE, LONG WAIT TIMES TEENAGERS/ADOLESCENTS * NEED FOR MENTAL HEALTH SERVICES, PRIMARY PREVENTION * HEALTHY LIFESTYLE EDUCATION * DRUG PREVENTION AND EDUCATION * SEX EDUCATION UN/UNDERINSURED * LACK OF LOCAL, AFFORDABLE PREVENTIVE CARE, DENTAL CARE * ESTABLISHING PROVIDER RELATIONSHIP * COST OF INSURANCE, PARTICULAR DEDUCTIBLES AND AFFORDING PRESCRIPTIONS * OVERUSE OF EMERGENCY ROOM AS CLINIC VETERANS * LACK OF ACCESS TO LOCAL RESOURCES AND SERVICES * LACK OF MENTAL HEALTH RESOURCES * TRANSPORTATION BARRIERS Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. MARKS MEDICAL CENTER. THE MOST RECENTLY CONDUCTED CHNA IDENTIFIED FIVE SIGNIFICANT NEEDS IN THE COMMUNITY SERVED BY ST. MARK'S MEDICAL CENTER, (SMMC). THE NEEDS WERE IDENTIFIED BY ASSESSING THE PREVALENCE OF THE ISSUES FOUND WITHIN THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN COMMUNITY INPUT. HOSPITAL LEADERSHIP MET WITH COMMUNITY HOSPITAL CORPORATION, (CHC), TO REVIEW THE RESEARCH FINDINGS AND PRIORITIZE THE COMMUNITY HEALTH NEEDS. THE FINAL LIST OF PRIORITIZED NEEDS IS AS FOLLOWS: 1. CONTINUED RECRUITMENT OF PRIMARY AND SPECIALTY CARE SERVICES AND PROVIDERS 2. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS 3. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 4. CONTINUED FOCUS ON COVID-19 PREVENTION & RESPONSE 5. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES THE CHNA TEAM PARTICIPATED IN A PRIORITIZATION PROCESS USING A STRUCTURED MATRIX TO RANK THE COMMUNITY HEALTH NEEDS BASED ON THREE CHARACTERISTICS: SIZE AND PREVALENCE OF THE ISSUE, EFFECTIVENESS OF INTERVENTIONS AND THE HOSPITAL'S CAPACITY TO ADDRESS THE NEED. ONCE THIS PRIORITIZATION PROCESS WAS COMPLETE, HOSPITAL LEADERSHIP DISCUSSED THE RESULTS AND DECIDED TO ADDRESS ALL FIVE OF THE PRIORITIZED NEEDS IN VARIOUS CAPACITIES THROUGH A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. PRIORITY #1: CONTINUED RECRUITMENT OF PRIMARY AND SPECIALTY CARE SERVIES AND PROVIDERS OBJECTIVE: IMPLEMENT AND OFFER PROGRAMS THAT AIM TO ADDRESS ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES IN THE COMMUNITY THROUGH RECRUITMENT AND RETENTION EFFORTS 1.A. SMMC WILL CONTINUE TO PROVIDE OPPORTUNITIES FOR BETTER COMMUNITY ACCESS TO PRIMARY AND SPECIALTY CARE PROVIDER SERVICES DEDICATED FULL TIME TO THE LOCAL COMMUNITY THROUGH INDEPENDENT AND/OR JOIN RECRUITMENT, AS WELL AS CONTINUAL EVALUATION OF IDENTIFIED NEEDS AND ADDITIONAL EQUIPMENT FOR PROVIDER SERVICES. 1.B. SMMC WILL CONTINUE TO PROVIDE REFERENCE LAB SERVICES TO EXTERNAL PROVIDERS AS REQUESTED. 1.C. SMMC WILL CONTINUE TO INCREASE ACCESS TO CARE THROUGH THE PROVISION OF TELEHEALTH SERVICES TO APPLICABLE PATIENTS. 1.D. SMMC PHYSICIANS AND NURSING STAFF WILL CONTINUE TO IMPLEMENT TRANSFER PROCESSES TO EFFECTIVELY WORK IN CONJUNCTION WITH EQUIPMENT, SUPPLIES, AND PROCESSES OF ST. DAVID'S MEDICAL CENTER TO ENSURE SEAMLESS TRANSITION FOR PATIENTS REQUIRING TRANSPORT TO A HIGHER LEVEL OF CARE. 1.E. SMMC WILL CONTINUE TO SERVE AS A CLINICAL SITE FOR STUDENTS FROM LOCAL PROGRAMS IN THE AREAS OF HEALTH INFORMATION MANAGEMENT, IMAGING, LABORATORY, RESPIRATORY THERAPY, RN, LVN AND SURGICAL TECHNOLOGISTS. 1.F. SMMC WILL CONTINUE TO PARTICIPATE IN ST. DAVID'S HEALTHCARE CLINICAL OUTREACH PROGRAMS TO INCLUDE ADVANCED CARDIAC LIFE SUPPORT (ACLS), PEDIATRIC ADVANCED LIFE SUPPORT (PALS), TRAUMA NURSING CORE CURRICULUM, PREPAREDNESS FOR PRECIPITOUS DELIVERIES IN THE EMERGENCY DEPARTMENT, AND OTHER CRITICAL CARE TOPICS. CONTINUING MEDICAL EDUCATION FOR PHYSICIANS IS OFFERED AS WELL. 1.G. SMMC WILL CONTINUE TO MARKET NEWLY RECRUITED SPECIALIST AND PRIMARY CARE PROVIDERS THROUGH COMMUNITY INTRODUCTIONS, RADIO ADS, AND PRESS RELEASES. 1.H. SMMC WILL CONTINUE TO OFFER A SWINGBED PROGRAM FOR ITS PATIENT POPULATION. PRIORITY #2: ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS OBJECTIVE: PROVIDE ACCESS TO HEALTH CARE AND SERVICES TO VULNERABLE POPULATIONS, SUCH AS THE INDIGENT, MINORITY, AND ELDERLY POPULATIONS 2.A. SMMC CONTINUES TO ESTABLISH PARTNERSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS TO PROVIDE HEALTHCARE-RELATED SUPPORT AS OPPORTUNITIES ARISE. 2.B. SMMC PROVIDES THE MD SAVE PROGRAM FOR SELF-PAY AND THOSE WITH HIGH DEDUCTIBLES IN ORDER TO OFFER CERTAIN SERVICES AT A DISCOUNTED RATE TO ASSIST THE COMMUNITY WITH THEIR HIGH DEDUCTIBLE PLANS OR INDIVIDUALS WHO ARE UNINSURED. 2.C. SMMC WILL CONTINUE TO MAKE OSTEOPOROSIS SCREENINGS AVAILABLE TO THE ELDERLY POPULATION. 2.D. SMMC WILL CONTINUE TO PROVIDE INPATIENT AND ER CARE THROUGH ITS CONTRACT WITH BASTROP FEDERAL CORRECTION INSTITUTION. 2.E. SMMC WILL CONTINUE TO OFFER EDUCATION ON MEDICARE RULES AND REGULATIONS TO SENIOR CITIZENS, AS WELL AS EDUCATION TO ALL POPULATIONS ON ADVANCED DIRECTIVES AND END OF LIFE PLANNING UPON REQUEST. 2.F. SMMC WILL CONTINUE TO PROVIDE INCREASED ACCESS TO MEDICAL SERVICES AND RECORDS THROUGH THE ONLINE PHYSICIAN DIRECTORY ON THE HOSPITAL WEBSITE. 2.G. SMMC WILL CONTINUE TO OFFER REDUCED COST MAMMOGRAPHY SERVICES IN CONJUNCTION WITH BREAST CANCER AWARENESS EVENTS. 2.H. SMMC PROVIDES A LEASED, ON-SITE VA CLINIC FOR VETERANS TO SEEK CARE AND ACCESS LOCAL SPECIALTY CARE THROUGH THE HOSPITAL. 2.I. IN COMPLIANCE WITH THE INPATIENT AND LONG-TERM CARE HOSPITAL PROSPECTIVE PAYMENT SYSTEM FINAL RULE, SMMC PUBLICLY SHARES ITS PRICING INFORMATION ONLINE IN AN EFFORT TO INCREASE PRICE TRANSPARENCY AND EMPOWER CONSUMERS TO MAKE INFORMED CHOICES ABOUT THEIR CARE. INFORMATION IS UPDATED ANNUALLY. 2.J. SMMC WILL CONTINUE TO PROVIDE EDUCATIONAL OPPORTUNITIES FOR SENIOR CITIZENS, SUCH AS THE FAYETTE COUNTY SENIOR DAY, LEE COUNTY SENIOR DAY, THE FAYETTE & LEE COUNTY SENIOR EXPO, AND LOCAL HEALTH FAIRS AS REQUESTED. BLOOD PRESSURE, CHOLESTROL, AND BLOOD GLUCOSE SCREENINGS WITH COUNSELING FOR OUT OF RANGE RESULTS ARE ALSO PROVIDED. PRIORITY #3: ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS OBJECTIVE: INCREASE ACCESS TO MENTAL HEALTH RESOURCES FOR ALL RESIDENTS 3.A. SMMC WILL CONTINUE TO COLLABORATE FREQUENTLY THROUGHOUT THE YEAR WITH THE LOCAL MHMR AUTHORITY, AS WELL AS THE LOCAL EMS SERVICES TO ASSURE THAT WE ARE WORKING TOGETHER ON TREATMENT AND PLACEMENT FOR APPLICABLE PATIENTS. 3.B. SMMC WILL CONTINUE TO COLLABORATE WITH LOCAL SCHOOL DISTRICTS TO PROVIDE EDUCATION ON MENTAL AND BEHAVIORAL HEALTH RELATED TOPICS UPON REQUEST. PRIORITY #4: CONTINUED FOCUS ON COVID-19 PREVENTION AND RESPONSE OBJECTIVE: IMPLEMENT AND OFFER PROGRAMS THAT AIM TO REDUCE THE IMPACT OF THE COVID-19 PANDEMIC 4.A. SMMC WILL CONTINUE TO PROVIDE EDUCATION ON COVID-19 AS NEEDED. 4.B. SMMC CONTINUES FOLLOWING CDC GUIDELINES AND COMMUNITY STANDARDS TO CONTROL THE SPREAD AND REDUCE RISK OF COVID-19 INFECTION WHEN DISCHARGING PATIENTS TO A LOWER LEVEL OF CARE AND THEIR HOME ENVIRONMENT. 4.C. SMMC CONTINUES TO REPORT COVID-19 TEST AND PATIENT ADMISSIONS DATA TO THE STATE AND CENTERS FOR DISEASE CONTROL (CDC) IN AN ONGOING EFFORT TO SHARE TIMELY INFORMATION AND RESEARCH REGARDING THE PANDEMIC. VACCINATION RATES AT THE HOSPITAL ARE ALSO PROVIDED. ADDITIONALLY, SMMC SERVES AS A COVID-TESTING SITE FOR PATIENTS WHO WERE REFERRED BY THEIR PROVIDER. PRIORITY #5: PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES OBJECTIVE: PROVIDE OPPORTUNITIES FOR PREVENTION, EDUCATION AND SERVICES THAT AIM TO REDUCE MORTALITY RATES AND THE PREVALENCE OF CHRONIC CONDITIONS AND UNHEALTHY LIFESTYLES IN THE COMMUNITY 5.A. SMMC WILL CONTINUE TO HOST LUNCH & LEARN EVENTS TO EDUCATE REGIONAL EXTERNAL CLINICS ON MEDHOST AND LEADING REACH REFERRAL SOFTWARE WITH THE GOAL OF IMPROVING COORDINATION ACROSS THE CONTINUUM OF CARE. 5.B. SMMC WILL CONTINUE TO PROVIDE FLU VACCINES ON AN ANNUAL BASIS TO EMPLOYEES AND THEIR FAMILIES, AS WELL AS THE SMMC AUXILIARY. 5.C. SMMC WILL CONTINUE TO SPONSOR THE MULTIPLE SCLEROSIS MS-150 BIKE RIDE, INCLUDING HOSTING CAMP ST. MARK'S FOR RIDERS AND PROVIDING ER CARE AS NEEDED. 5.D. SMMC WILL CONTINUE TO PROVIDE INTERVIEWEES (PHYSICIANS AND TENURED CLINICAL STAFF) FOR THE LOCAL RADIO SHOW "THE DOCTOR'S CORNER," WHICH FEATURES DIFFERENT MEDICAL TOPICS PERIODICALLY. 5.E. SMMC PERSONNEL ARE AVAILABLE AS SPEAKERS FOR CIVIC GROUPS, INDUSTRIAL PARTNERS, FOR MEDIA APPEARANCES AND HEALTH FAIRS TO ADDRESS HEALTH CARE TOPICS OF CONCERN TO THE PUBLIC. 5.F. SMMC WILL CONTINUE TO PARTICIPATE IN COLLEGE/CAREER NIGHT WITH LOCAL SCHOOL DISTRICTS. SMMC SUPPORT GROUP PROGRAMS AND EDUCATIONAL SERVICES ARE AVAILABLE UPON REQUEST. ADDITIONALLY, SMMC WILL CONTINUE TO PROVIDE MEETING SPACE FOR COMMUNITY RESOURCE AND EDUCATIONAL GROUPS (I.E., LION'S CLUB, CPR CLASSES, ETC.) AVAILABLE UPON REQUEST. 5.G. SMMC WILL CONTINUE TO PARTCIPATE IN COLLEGE/CAREER NIGHT WITH LOCAL SCHOOL DISTRICTS. 5.H. SMMC WILL CONTINUE ITS MEMBERSHIP ON THE CAPITAL AREA REGIONAL TRAUMA ADVISORY COUNCIL. ADDITIONALLY, SMMC WILL CONTINUE TO PROVIDE PRESENTATIONS TO GIDDINGS ISD AND LA GRANCE ISD STUDENTS REGARDING ANY HEALTH TOPICS OF INTEREST UPON REQUEST. 5.I. SMMC PERSONNEL SERVE IN LEADERSHIP ROLES AND AS VOLUNTEERS WITH MANY AGENCIES AND COMMITEES IN THE COMMUNITY. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - ST. MARK'S MEDICAL CENTER, CONTINUED. 5.J. SMMC WILL CONTINUE TO OFFER HEART DISEASE MANAGEMENT EDUCATION AS PART OF THE CARDIAC REHAB PROGRAM. AS A PREREQUISITE FOR THE PROGRAM, PATIENTS MUST COMPLETE NUTRITIONAL COUNSELING THROUGH THE SMMC DIETITIAN. PATIENTS WHO DO NOT WISH TO PARTICIPATE FULLY IN THE CARDIAC REHAB PROGRAM ARE INVITED TO SIT IN ON HEART DISEASE MANAGEMENT PATIENT EDUCATION SESSIONS. 5.K. SMMC WILL PARTNER WITH AUSTIN HEART TO PERIODICALLY HOST MEETINGS FOR THE COMMUNITY REGARDING HOW TO IMPROVE HEART HEALTH UPON REQUEST. 5.L. SMMC WILL CONTINUE TO PARTNER WITH THE LA GRANGE BLUEBONNET LION'S CLUB AND THE LA GRANGE POLICE DEPARTMENT TO PARTICIPATE IN THE DRUG TAKE BACK PROGRAM FOR THE COMMUNITY. 5.M. SMMC WILL CONTINUE TO ALLOW LOCAL STUDENTS INTERESTED IN PURSUING A CAREER IN HEALTH CARE TO SHADOW PROVIDERS AND ROTATE THROUGH THE FACILITY IN ORDER TO EXPERIENCE THE DIFFERENT DEPARTMENTS WITHIN THE HOSPITAL UPON REQUEST. 5.N. SMMC WILL CONTINUE ENGAGING THE COMMUNITY THROUGH PARTICIPATION IN LOCAL EVENTS AS OPPORTUNITIES ARISE. HOWEVER, SUBSEQUENTLY ON OCTOBER 12, 2023, THE HOSPITAL CEASED OPERATIONS DUE TO ONGOING, INSURMOUNTABLE FINANCIAL DIFFICULTIES. THE HOSPITAL LICENSE HAS BEEN RETURNED TO THE STATE. THE ENTITY IS CURRENTLY WINDING DOWN ITS AFFAIRS. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - ST. MARK'S MEDICAL CENTER. ALL PATIENTS AND INSURANCES ARE BILLED AT 100% OF CHARGES. ST. MARK'S MEDICAL CENTER (SMMC) CONTRACTUALLY NEGOTIATES WITH PAYORS TO ACCEPT SOMETHING LESS THAN 100% OF CHARGES. MEDICARE PAYS BASED ON FEE SCHEDULES AND DIAGNOSIS RELATED GROUPS, ETC. SELF PAY AND THOSE QUALIFYING FOR FINANCIAL ASSISTANCE ARE ALL BILLED AT 100% OF CHARGES UNTIL SUCH TIME IT IS DETERMINED THAT THEY QUALIFY FOR FINANCIAL ASSISTANCE. BASED UPON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY A PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE ON A SLIDING SCALE, UP TO A MAXIMUM OF 100%. PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE HAVE THEIR ACCOUNTS REDUCED BASED ON THE LEVEL OF FINANCIAL ASSISTANCE. THE BALANCE OF THE ACCOUNT AFTER APPLICATION OF THE DISCOUNT IS HANDLED CONSISTENT WITH THE HOSPITAL'S COLLECTION POLICY. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - ST. MARK'S MEDICAL CENTER. FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE WHEN REGISTERING, THROUGH DISCHARGE PLANNING ETC. STATEMENTS FOR SELF PAY HAVE A TAG LINE STATING IF THEY THINK THEY QUALIFY FOR FINANCIAL ASSISTANCE TO PLEASE CALL THIS NUMBER. WHENEVER A BILL IS DISCUSSED AND A PATIENT INDICATES THEY CAN'T PAY UPFRONT, FINANCIAL ASSISTANCE IS EXPLAINED TO THEM SO THAT IN THE EVENT IT APPLIES THEY KNOW ABOUT IT. IT IS ALSO POSTED ON BULLETIN BOARDS THROUGHOUT THE HOSPITAL THAT FINANCIAL ASSISTANCE IS AVAILABLE. 3 ST MARK'S CLINIC ONE ST MARKS PLACE LA GRANGE TX 78945 ORTHOPEDIC CLINIC GIDDINGS CLINIC 598 CACTUS STREET GIDDINGS TX 78942 ORTHOPEDIC CLINIC BASTROP CLINIC 3101 HWY 71 EAST SUITE 202 BASTROP TX 78602 ORTHOPEDIC CLINIC Schedule H, Part I, Line 7b Costing methodology THE TEXAS HEALTH AND HUMAN SERVICES COMMISSION ("HHSC") REPLACED THE HISTORICAL MEDICAID UPL PROGRAM WITH THE TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM WAIVER ("WAIVER"). THE WAIVER INCLUDES AN UNCOMPENSATED CARE ("UC") POOL WHICH HHSC USES TO MAKE SUPPLEMENTAL MEDICAID PAYMENTS TO HOSPITALS TO HELP DEFRAY UNCOMPENSATED CARE COSTS RELATED TO PROVIDING CARE TO MEDICAID ELIGIBLES OR TO INDIVIDUALS WHO HAVE NO SOURCE OF THIRD-PARTY COVERAGE. TO QUALIFY FOR UC PAYMENTS, HOSPITALS MUST SUBMIT A UC APPLICATION TO HHSC WHICH REPORTS THE HOSPITAL'S COST OF PROVIDING UNCOMPENSATED CARE BASED ON THE UC METHODOLOGY PROSCRIBED BY HHSC. FOR THE PERIOD OF JULY 1, 2022 THROUGH JUNE 30, 2024, ST. MARK'S MEDICAL CENTER RECEIVED $139,785 IN UC PAYMENTS AS A SUPPLEMENTAL COST OF REIMBURSEMENT FOR THE TREATING OF MEDICAID ELIGIBLE INDIVIDUALS AND INDIVIDUALS WITHOUT A SOURCE OF THIRD-PARTY COVERAGE. Schedule H, Part I, Line 3c CHARITY STATUS DETERMINATION ST. MARK'S MEDICAL CENTER (SMMC) USES BOTH FINANCIAL STATUS AS WELL AS AMOUNT OF MEDICAL DEBT TO DETERMINE CHARITY STATUS. Schedule H, Part VI, Line 6 AFFILIATED HEALTH CARE SYSTEM ST. MARK'S MEDICAL CENTER IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE UNTIL OCTOBER 12, 2023, WHEN ST. MARK'S MEDICAL CENTER CEASED OPERATIONS, THEIR FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION WERE MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE AT ALL TIMES. A COPY OF EACH OF THESE DOCUMENTS IS AVAILABLE UPON REQUEST. Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE UNTIL OCTOBER 12, 2023, WHEN ST. MARK'S MEDICAL CENTER CEASED OPERATIONS, THEIR FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION WERE MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE AT ALL TIMES. A COPY OF EACH OF THESE DOCUMENTS IS AVAILABLE UPON REQUEST. Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE UNTIL OCTOBER 12, 2023, WHEN ST. MARK'S MEDICAL CENTER CEASED OPERATIONS, THEIR FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND FINANCIAL ASSISTANCE APPLICATION WERE MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE AT ALL TIMES. A COPY OF EACH OF THESE DOCUMENTS IS AVAILABLE UPON REQUEST. Schedule H, Part V, Section B, Line 7 CHNA AVAILABLE WEBSITE UNTIL OCTOBER 12, 2023, WHEN ST. MARK'S MEDICAL CENTER CEASED OPERATIONS, THEIR CHNA WAS MADE WIDELY AVAILABLE ON THE HOSPITAL'S WEBSITE AT ALL TIMES. A COPY OF THE CHNA IS AVAILABLE UPON REQUEST. Schedule H, Part V, Section B, Line 10 IMPLEMETATION STRATEGY AVAILABLE WEBSITE UNTIL OCTOBER 12, 2023, WHEN ST. MARK'S MEDICAL CENTER CEASED OPERATIONS, THEIR IMPLEMENTATION STRATEGY WAS MADE AVAILABLE ON THE HOSPITAL'S WEBSITE AT ALL TIMES. A COPY OF THE IMPLEMENTATION STRATEGY IS AVAILABLE UPON REQUEST. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost to charge ratio from the cost report was used for the costing methodology. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote PATIENTS ACCOUNTS RECEIVABLE CONSIST OF AMOUNTS DUE FOR THE PROVISION OF HEALTH CARE SERVICES WHICH ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AT AMORTIZED COST AT THE NET AMOUNT EXPECTED TO BE COLLECTED. IN EVALUATION THE COLLECTABILITY OF PATIENTS ACCOUNTS RECEIVABLE, MANAGEMENT REGULARLY REVIEWS DATA AND DEVELOPS A LOSS RATE TO DETERMINE EXPECTED CREDIT LOSSES BASED ON SEVERAL FACTORS INCLUDING WHETHER A PATIENT HAS THIRD PARTY PAYOR COVERAGE OR IS UNINSURED, THE AGING OF RECEIVABLES, HISTORICAL COLLECTIONS AND LOSS EXPERIENCE, CURRENT CONTRACT PRICES OR CLAIMS PAID DATA, AND TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. THESE ESTIMATES ARE ADJUSTED FOR RECOVERIES OF ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE. MANAGEMENT BELIEVES THE COMPOSITION OF RECEIVABLES AT YEAR-END IS CONSISTENT WITH HISTORICAL CONDITIONS AS CREDIT TERMS AND PRACTICES AND THE CUSTOMER BASE HAS NOT CHANGED SIGNIFICANTLY; THEREFORE, THE ORGANIZATION HAS MAINTAINED CONSISTENT METHODOLOGY IN ESTIMATE OF CREDIT LOSSES. MANAGEMENT HAS DETERMINED THE ESTIMATE OF EXPECTED CREDIT LOSSES IS NOT MATERIAL TO THE FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE COST INFORMATION PROVIDED WAS OBTAINED FROM OUR MEDICARE COST REPORT. ANY SHORTFALL IS A COMMUNITY BENEFIT AS IT IS THE COST OF PROVIDING CARE TO THE COMMUNITY THAT IS NOT REIMBURSED BY THE MEDICARE PROGRAM. BY PROVIDING CARE TO THESE INDIVIDUALS, THE HOSPITAL IS IMPROVING THE HEALTH OF THE COMMUNITY. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance IF A PATIENT QUALIFIES FOR 100% CHARITY, THE ENTIRE ACCOUNT IS WRITTEN-OFF. IF THEY QUALIFY FOR PARTIAL CHARITY, THE CHARITY PORTION IS WRITTEN-OFF AND THE PATIENT RECEIVES MONTHLY STATEMENTS WITH REGARD TO THE SELF-PAYMENT BALANCE. FULL PAYMENT IS EXPECTED FROM THE PATIENT. AFTER 180 DAYS FROM DATE OF SERVICE, IF THE SELF PAYMENT BALANCE REMAINS UNPAID, THIS AMOUNT IS TURNED OVER TO A COLLECTION AGENCY AND THE ACCOUNT IS MOVED TO BAD DEBT ACCOUNTS RECEIVABLE. Schedule H, Part V, Section B, Line 16a FAP website - ST. MARK'S MEDICAL CENTER: Line 16a URL: See Part VI; Schedule H, Part V, Section B, Line 16b FAP Application website - ST. MARK'S MEDICAL CENTER: Line 16b URL: See Part VI; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. MARK'S MEDICAL CENTER: Line 16c URL: See Part VI; Schedule H, Part VI, Line 2 Needs assessment AS REPORTED IN SCHEDULE H, PART V, SECTION B, LINES 1-7, ST. MARK'S MEDICAL CENTER, (SMMC), CONDUCTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING FISCAL YEAR 6/30/2022. SMMC'S LEADERSHIP DEVELOPED AN IMPLEMENTATION PLAN TO IDENTIFY SPECIFIC ACTIVITIES AND SERVICES WHICH DIRECTLY ADDRESS THE TOP PRIORITIES. THE OBJECTIVES WERE IDENTIFIED BY STUDYING THE PRIORITIZED HEALTH NEEDS, WITHIN THE CONTEXT OF THE HOSPITAL'S OVERALL STRATEGIC PLAN AND THE AVAILABILITY OF FINITE RESOURCES. THE PLAN INCLUDES A RATIONALE FOR EACH PRIORITY, FOLLOWED BY OBJECTIVES, SPECIFIC IMPLEMENTATION ACTIVITIES, RESPONSIBLE LEADERS, ANNUAL UPDATES AND PROGRESS, AND KEY RESULTS (AS APPROPRIATE). THE CHNA AND IMPLEMENTATION STRATEGY FOR TAX YEAR 2021, WAS REVIEWED AND ADOPTED BY THE HOSPITAL'S GOVERNING BOARD ON APRIL 28, 2022. THE HOSPITAL'S CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN THE FINAL REGULATIONS RELEASED DECEMBER 29, 2014. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY. THE HEALTH CARE NEEDS FOR THE COMMUNITY SERVED ARE DETERMINED BY ASSESSING THE PREVALENCE OF THE ISSUES IDENTIFIED IN THE HEALTH DATA FINDINGS, COMBINED WITH THE FREQUENCY AND SEVERITY OF MENTIONS IN THE INTERVIEWS CONDUCTED WITH PERSONS HAVING SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN FAYETTE AND LEE COUNTIES, INCLUDING PUBLIC HEALTH REPRESENTATIVES, NOT-FOR-PROFIT ORGANIZATION PROFESSIONALS, CHARITIES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE WHEN REGISTERING, THROUGH DISCHARGE PLANNING ETC. OUR STATEMENTS FOR SELF PAY HAVE A TAG LINE STATING IF THEY THINK THEY QUALIFY FOR FINANCIAL ASSISTANCE TO PLEASE CALL THIS NUMBER. WHENEVER A BILL IS DISCUSSED, AND A PATIENT INDICATES THEY CAN'T PAY UPFRONT, FINANCIAL ASSISTANCE IS EXPLAINED TO THEM SO THAT IN THE EVENT IT APPLIES THEY KNOW ABOUT IT. IT IS ALSO POSTED ON BULLETIN BOARDS THROUGHOUT THE HOSPITAL THAT FINANCIAL ASSISTANCE IS AVAILABLE. ALL SELF-PAY WITHOUT ABILITY TO PAY AT TIME OF SERVICE ARE REFERRED TO OUR ELIGIBILITY VENDOR. THIS ALLOWS THEM TO BE ASSESSED FOR ANY PROGRAMS THAT MAY COVER THEIR MEDICAL EXPENSES SUCH AS MEDICAID, COUNTY PROGRAMS OR ANY OTHER STATE PROGRAMS THAT MAY BE AVAILABLE. Schedule H, Part VI, Line 4 Community information ST. MARK'S MEDICAL CENTER, (SMMC), SERVEd THE CENTRAL TEXAS COMMUNITIES OF FAYETTE AND LEE COUNTIES, AS WELL AS SURROUNDING AREAS. THE POPULATION OF FAYETTE COUNTY IS EXPECTED TO INCREASE 3.1% FROM 2021 (25,460) TO 2026 (26,258) AND THE POPULATION OF LEE COUNTY IS EXPECTED TO INCREASE 3.3% FROM 2021 (18,092) TO 2026 (18,684), WITH THE EXPECTED GROWTH RATE OF BOTH COUNTIES FALLING BELOW THE 7.9% EXPECTED GROWTH RATE FOR THE STATE OF TEXAS FROM 2021 (29,969,514) TO 2026 (32,346,738). THE MAJORITY OF RESIDENTS IN BOTH FAYETTE AND LEE COUNTIES IDENTIFY AS WHITE-NON HISPANIC AT 81.9% AND 77.6%, RESPECTIVELY, (2021). BECAUSE THE HISPANIC MEMBERS OF THE POPULATION ARE CONSIDERED AN ETHNICITY, THE NUMBERS ARE CALCULATED SEPARATELY FROM OTHER RACES. THE HISPANIC POPULATION IS EXPECTED TO INCREASE BY 13.2% IN FAYETTE COUNTY AND BY 9.5% IN LEE COUNTY BY 2026. THE ASIAN PFOPULATION IS THE FASTEST GROWING POPULATION IN BOTH COUNTIES. BY 2026, THE ASIAN POPULATION IN FAYETTE COUNTY IS EXPECTED TO INCREASE BY 20.0% AND BY 25.5% IN LEE COUNTY. AS OF 2021, FAYETTE COUNTY (48.7 YEARS) HAD AN OLDER MEDIAN AGE THAN BOTH LEE COUNTY (41.1 YEARS) AND THE STATE OF TEXAS (35.3 YEARS). THE MEDIAN AGE IN BOTH COUNTIES AND THE STATE IS EXPECTED TO INCREASE SLIGHTLY OVER THE NEXT FIVE YEARS (2021-2026). WITH RESPECT TO UNEMPLOYMENT, RATES IN BOTH FAYETTE AND LEE COUNTIES AND THE STATE INCREASED BETWEEN 2018 AND 2020. IN 2020, BOTH FAYETTE (4.7) AND LEE (4.9) COUNTIES HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE (7.6). OVER THE MOST RECENT 12-MONTH TIME PERIOD, MONTHLY UNEMPLOYMENT RATES IN FAYETTE AND LEE COUNTIES DECREASED. FOR FAYETTE COUNTY, AUGUST 2020 HAD THE LOWEST UNEMPLOYMENT RATE (4.1) AS COMPARED TO JUNE 2020 WITH THE HIGHEST RATE (5.8). FOR LEE COUNTY, AUGUST 2020 AND MAY 2021 HAD THE LOWEST UNEMPLOYMENT RATE (4.3) AS COMPARED TO JUNE AND JULY 2020 WITH THE HIGHEST RATE (6.1). AS OF 2021, THE MEDIAN HOUSEHOLD INCOMES IN BOTH FAYETTE ($60,548) AND LEE ($56,620) COUNTIES ARE LOWER THAN THAT OF THE STATE ($63,524). FAYETTE COUNTY AND LEE COUNTY HAVE LOWER EDUCATIONAL ATTAINMENT RATES THAN THE STATE (2021). IN 2021, LEE COUNTY (21.6%) HAD THE HIGHEST PERCENTAGE OF FAMILIES LIVING BELOW THE POVERTY LEVEL AS COMPARED TO FAYETTE COUNTY (19.1%) AND THE STATE (18.0%). AS OF 2019, AN ESTIMATED 13.3% OF FAYETTE COUNTY RESIDENTS ARE FOOD INSECURE AS COMPARED TO 12.7% IN LEE COUNTY AND 14.1% IN TEXAS. THE AVERAGE MEAL COST FOR A FAYETTE COUNTY RESIDENT IS $3.05, AS COMPARED TO $3.22 IN LEE COUNTY AND $2.68 IN TEXAS (2019). AS OF 2019, FAYETTE COUNTY (23.4%) HAS A LOWER RATE OF UNINSURED ADULTS (AGE 18-64) AS COMPARED TO LEE COUNTY (24.5%) AND THE STATE (24.3%). CANCER AND HEART DISEASE ARE THE TWO LEADING CAUSES OF DEATH IN FAYETTE AND LEE COUNTIES. IN 2019, THE HEART DISEASE MORTALITY RATE IN FAYETTE COUNTY WAS HIGHER THAN LEE COUNTY AND THE STATE. IN 2017-2019, THE CANCER MORTALITY RATE IN LEE COUNTY (WAS HIGHER THAN FAYETTE COUNTY AND THE STATE. IN 2018-2020, FAYETTE AND LEE COUNTIES HAD A HIGHER PERCENT OF OBESE ADULTS (AGE 18+) THAN THE STATE. LEE COUNTY HAD THE HIGHEST RATE OF MEDICARE FEE-FOR-SERVICE RESIDENTS WITH HYPERTENSION AS COMPARED TO FAYETTE COUNTY, THE STATE AND THE NATION (2018). SEDENTARY LIFESTYLE AND CULTURAL FACTORS ARE ALL CONTRIBUTORS TO THESE CHRONIC HEALTH CONDITIONS. AS OF NOVEMBER 8, 2021, THE PERCENT OF THE POPULATION (AGE 5+) THAT IS FULLY VACCINATED FOR COVID-19 IN FAYETTE COUNTY (51.1%) IS HIGHER THAN LEE COUNTY (46.8%) BUT LOWER THAN THE STATE (60.5%). THERE ARE HIGHER PERCENTAGES OF RESIDENTS PARTICIPATING IN UNHEALTHY LIFESTYLE BEHAVIORS SUCH AS SMOKING TOBACCO IN FAYETTE AND LEE COUNTIES THAN THE STATE. WITH REGARD TO MATERNAL AND CHILD HEALTH, FAYETTE AND LEE COUNTIES HAVE LOWER RATES OF MOTHERS RECEIVING INADEQUATE PRENATAL CARE THAN THE STATE. FAYETTE COUNTY HAS HIGHER TEEN (AGE 0-19 YEARS) BIRTH RATES THAN LEE COUNTY AND THE STATE. Schedule H, Part VI, Line 5 Promotion of community health ON OCTOBER 12, 2023, THE HOSPITAL CEASED OPERATIONS DUE TO ONGOING, INSURMOUNTABLE FINANCIAL DIFFICULTIES. The hospital license has been returned to the state. The entity is currently winding down its affairs. Schedule H, Part VI, Line 7 State filing of community benefit report TX false true false false false false false false false CRAIG SIMS DIRECTOR 0 418364 0 63901 0 28285 0 29752 0 30784 0 571086 0 0 MARK KIMBALL PRESIDENT & CEO (until 12/2023) 0 253161 0 0 0 5493 0 13122 0 35180 0 306956 0 0 LINDA MOORE AST. SECRETARY 0 355018 0 52572 0 43475 0 26433 0 43475 0 520973 0 8363 TOD BEASLEY Former INTERIM CFO 0 111379 0 0 0 6550 0 5819 0 12518 0 136266 0 0 JONATHAN BLAKE Physician 338048 0 0 0 119 0 1487 0 4891 0 344545 0 0 0 TAMMY HARTFIELD CNO (until 12/2023) 0 171615 0 0 0 2426 0 11105 0 25021 0 210167 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE ORGANIZATION'S EXECUTIVES, INCLUDING THE CEO, ARE EMPLOYED BY THE PARENT ORGANIZATION COMMUNITY HOSPITAL CORPORATION (CHC) AND THEREFORE FOLLOW THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THE ORGANIZATION FOLLOWED THIS PROCESS FOR THE YEAR ENDED JUNE 30, 2024 FOR ITS OFFICERS, DIRECTORS, KEY EMPLOYEES AND OTHER MANAGEMENT OFFICIALS. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan NONQUALIFIED RETIREMENT PLAN PARTICIPATION WAS PAID TO: - LINDA MOORE - $24,895 - CRAIG SIMS - $19,851 - TOD BEASLEY - $4,655 Form 990, Part III, Line 3 Significant changes in program services ON OCTOBER 12, 2023, THE HOSPITAL CEASED OPERATIONS DUE TO ONGOING, INSURMOUNTABLE FINANCIAL DIFFICULTIES. The hospital license has been returned to the state. The entity is currently winding down its affairs. Form 990, Part VI, Line 15 OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE ORGANIZATION'S EXECUTIVES, INCLUDING THE CEO, ARE EMPLOYED BY THE PARENT ORGANIZATION CHC AND THEREFORE FOLLOW THE COMPENSATION POLICY OF CHC. CHC ENGAGED SULLIVAN COTTER TO CONDUCT A COMPETITIVE MARKET ANALYSIS OF THE COMPENSATION OF CHC'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS AND KEY EMPLOYEES. SULLIVAN COTTER GATHERED DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITIES, AND CURRENT INCUMBENTS' COMPENSATION. SULLIVAN COTTER RECOMMENDED APPROPRIATE COMPARISON DATA AND UTILIZED SURVEY DATA FROM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET CHC'S COMPENSATION PHILOSOPHY. SULLIVAN COTTER'S RECOMMENDATIONS WERE PRESENTED TO THE CHC COMPENSATION COMMITTEE OF THE BOARD FOR REVIEW AND APPROVAL. CHC ALSO CONDUCTS PERIODIC REVIEWS OF COMPENSATION TO DETERMINE WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. THIS PROCESS IS PERFORMED EACH YEAR PRIOR TO THE ANNUAL EMPLOYEE EVALUATION PROCESS, WHICH ENDS ON JULY 1ST OF EACH YEAR. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons Allyson Borgstedte - Family relationship, Thomas Borgstedte - Family relationship Form 990, Part VI, Line 3 Delegation of management duties COMMUNITY HOSPITAL CORPORATION (CHC) PROVIDES CERTAIN FINANCIAL, TECHNICAL AND MANAGERIAL SUPPORT SERVICES TO THE HOSPITAL. Form 990, Part VI, Line 6 Classes of members or stockholders CHC, A TEXAS NON-PROFIT CORPORATION, IS THE SOLE MEMBER OF SMMC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHC AS THE SOLE MEMBER OF SMMC ELECTS THE MEMBERS OF THE BOARD OF DIRECTORS OF SMMC AND IS EMPOWERED WITH THE ABILITY TO REMOVE DIRECTORS, WITH OR WITHOUT CAUSE. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESERVED POWERS OF THE MEMBER: WHILE THE AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY ITS BOARD OF DIRECTORS, THE APPROVAL OF THE MEMBER FOLLOWING APPROVAL BY THE BOARD OF DIRECTORS SHALL BE NECESSARY FOR THE FOLLOWING MATTERS: (A) THE ESTABLISHMENT OF OR ANY CHANGE IN THE ACTIVITIES, PHILOSOPHY, MISSION OR PURPOSE OF THE CORPORATION AS SET BY THE MEMBER; (B) ANY AMENDMENTS OR REVISIONS TO THE CERTIFICATE OF FORMATION OR BYLAWS OF THE CORPORATION; (C) ANY AMENDMENTS OR REVISIONS OF THE CERTIFICATE OF FORMATION OR BYLAWS OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; (D) THE CREATION OF, OR INVESTMENT IN, ANY SUBSIDIARY ENTITY, PARTNERSHIP OR VENTURE; (E) ANY AMENDMENT, REVISION OR TERMINATION OF THE PARTNERSHIP AGREEMENT OF ANY PARTNERSHIP OR REGULATIONS OF ANY LIMITED LIABILITY COMPANY TO WHICH THE CORPORATION IS A PARTY; (F) THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (G) ALL MATERIAL EXPENDITURE DEVIATIONS ($25,000 IN ANY SINGLE OR SERIES OF TRANSACTIONS) FROM THE ANNUAL OPERATING AND CAPITAL BUDGETS; (H) THE PURCHASE OR ACQUISITION OF ANY REAL PERSONAL, OR MIXED PROPERTY BY THE CORPORATION IN EXCESS OF $25,000 THAT IS NOT PROVIDED FOR IN THE CORPORATION'S ANNUAL OPERATING OR CAPITAL BUDGETS; (I) THE SALE, MORTGAGE, ENCUMBRANCE, TRANSFER, LEASE, GIFT, OR OTHER DISPOSITION OF ANY REAL PROPERTY OF THE CORPORATION; (J) ANY SALE, GIFT, EXCHANGE, LEASE, MORTGAGE OR OTHER TRANSFER OR ENCUMBRANCE (COLLECTIVELY, "TRANSFER") OF THE PERSONAL PROPERTY OF THE CORPORATION (TANGIBLE OR INTANGIBLE) IF THE SUM OF SUCH TRANSFER AND THE SUM OF ALL PRIOR TRANSFERS PER FISCAL YEAR, EXCEED $50,000.00; (K) ANY DEBT OR FINANCING ARRANGEMENT OF THIS CORPORATION, EXCEPT USUAL AND CUSTOMARY TRADE DEBTS WHICH IS INCURRED IN THE ORDINARY COURSE OF BUSINESS OF THE CORPORATION; (L) SETTLEMENT OF ANY CLAIMS OR LITIGATION INVOLVING THE CORPORATION; (M) THE MERGER, DISSOLUTION, OR CONSOLIDATION OF THE CORPORATION OR SUBSIDIARY CORPORATION; (N) THE EXECUTION, REVISION, AMENDMENT, EXTENSION, NON-RENEWAL OR TERMINATION OF ANY MANAGEMENT, EMPLOYMENT, LEASE, OR SERVICE CONTRACT, WITH AN ANNUAL COMPENSATION IN EXCESS OF $30,000 OR AN AGGREGATE COMPENSATION IN EXCESS OF $50,000; (O) ANY DEBTS, LOANS, GUARANTIES, OR GRANTS NOT INCLUDED AND APPROVED AS PART OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS; (P) THE ELECTION OF THE MEMBERS OF THE BOARD OF DIRECTORS OR THE REMOVAL OF SAID BOARD MEMBER, WHETHER WITH OR WITHOUT CAUSE; (Q) THE APPROVAL OF THE EMPLOYEE POLICIES AND BENEFITS PROGRAMS OF THE CORPORATION; (R) THE APPROVAL OF MAJOR DEVELOPMENT CAMPAIGNS AND FUND RAISING; AND (S) THE APPROVAL OF THE FINANCE MANAGEMENT SYSTEM FOR THE CORPORATION. Form 990, Part VI, Line 11b Review of form 990 by governing body THE ORGANIZATION ENGAGES AN OUTSIDE ACCOUNTING FIRM TO PREPARE FORM 990. ONCE PREPARED, THE FORM IS REVIEWED BY THE ORGANIZATION'S INTERNAL ACCOUNTANTS PRIOR TO FILING. ELECTRONIC COPIES ARE PROVIDED TO EACH BOARD MEMBER VIA EMAIL UPON COMPLETION OF THE FORM PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION FOLLOWS THE CONFLICT OF INTEREST DISCLOSURE PROCESS ADOPTED BY ITS PARENT, CHC, WHICH REQUIRES ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS ("COVERED PERSONS") TO DISCLOSE POTENTIAL CONFLICTS. THE ORGANIZATION'S BOARD FORMALLY ADOPTED CHC'S CONFLICT OF INTEREST POLICY FOR THE YEAR ENDED 6-30-15. PURSUANT TO THE POLICY, A DISCLOSURE STATEMENT IS CIRCULATED ANNUALLY TO COVERED PERSONS IN WHICH THE INDIVIDUAL MUST DISCLOSE TRANSACTIONS THAT MAY RESULT IN A CONFLICT. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT OR CONTRACT. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE AT ITS BUSINESS OFFICE UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Other - -36112; Form 990, Part XII, Line 3b Reason organization did not undergo required audit The hospital ceased operations and there were no funds to perform the audit. 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