The establishment of a formalized community benefit program by
FirstHealth of the Carolinas defines and coordinates existing services
and develops new services for the communities that the institutions of
FirstHealth serve. In addition to the continuation of traditional benefits, such as provision of
essential hospital services at no cost to the indigent, a comprehensive community benefit program also
responds to community needs, as well as represents good business practice.
|Barbara Adcock, FirstCarolinaCare employee and Literacy Council volunteer.
|FirstHealth of the Carolinas provides dental care for lowincome children at Dental Care Centers in Southern Pines, Troy and Raeford.
Definition of Community Benefit: Community Benefit
represents those activities that FirstHealth of the Carolinas,
as a not-for-profit corporation under federal and state law,
provides to justify its tax-exempt status. As a traditional
charitable organization, we provide services that enhance the
health of the communities we serve because it is the right
thing to do, not just because it is a profitable activity.
Under the provisions of the Federal Hill-Burton Act,
hospitals are obligated to provide emergency care to any
individual at time of need, regardless of the individual’s
ability to pay. In addition, hospitals are expected to provide
a certain amount of “charity care” for a period of time
following the receipt of the Hill-Burton funds. Since
FirstHealth Moore Regional Hospital concluded its obligation
for “charity care,” this program continues on a voluntary
basis, but in a streamlined, more user-friendly manner. The
program is established under the auspices of FirstHealth of
the Carolinas, addressing needs in all of the communities
in which the FirstHealth network provides services through
Moore Regional Hospital, Montgomery Memorial Hospital,
Richmond Memorial Hospital, FirstHealth Hospice & Palliative
Care, Family Care Centers, Dental Care Centers and other
service-delivering FirstHealth entities.
Purpose of Program: There are many reasons for a
comprehensive community benefit program. The following
objectives are indicative of both the importance and farreaching
nature of such a program:
- Adherence to IRS standards
- Continuation of Hill-Burton obligations
- Demonstrated value to community
- Help to those in need
- Enhanced health status
- Facilitated access to care
- Ensured provision of needed services
- Support of other charitable organizations
- Provision of community funding
- Enhanced staff morale
Principles of the Community Benefit Program: To address the purposes described above, several principles
need to be considered. These principles are not meant to be
a limiting factor, but to serve as criteria by which programs
are considered, established and evaluated over time.
- Consistency with 25th Percentile (Being in the top quarter of similar organizations with respect to performance, productivity, quality and recipient satisfaction)
- Individual respect and dignity
- Health services emphasis
- Broad focus
- Partnership with other agencies
- Consistency with corporate mission and strategy
- Avoidance of entitlement mentality
- Avoidance of cost-shift perception
|FirstHealth Mobile Health Services provided 4,735 screenings during Fiscal Year 2007.
Beneficiaries: While considering the comprehensive
community benefit program, it is helpful to think of the
various target groups that programs are intended to serve.
The following is a list of beneficiaries that may be perceived
as key recipients of programs and services under this
- Practitioners and staff
- Nonprofit organizations
|FirstHealth supports services that generate low or negative margins in order to offer a continuum of care in such areas Neonatal Intensive Care.
|David Williams, program manager for the FirstHealth Dental Care Centers and community volunteer.
Programs and Services: Consistent with the purposes
and principles described above, as well as targeting the
beneficiaries previously mentioned, the following 10-point
plan encompasses the Community Benefit Program.
FirstHealth identifies three distinct roles within the program:
financial assistance, service delivery and support of others.
- Financial Assistance Role
1. Charity care
2. Affordable health care coverage
- Service Delivery Role
3. Services for selected populations
4. Nontraditional delivery sites
5. Subsidized specialty and support services
- Supportive Role
6. Employee contributions
7. Community assistance
8. Nonprofit support services
9. Corporate citizen enhancement and economic development
10. Advocacy for policy change
Benefit FY 2006-2007
Community Benefit consists of programs or activities that
provide treatment and/or promote health and healing as a
response to identified community needs. Community Benefit
does not consist of programs or activities provided specifically
for marketing purposes.
Community Benefit generates a low or negative margin;
responds to needs of special populations; consists of supplies,
services or programs that would likely be discontinued if the
decision was made on a purely financial basis; responds to
public health needs; and involves education or research that improves overall community health.
Although reimbursement for services rendered is critical to
the operation and stability of the organization, it is recognized
that not all individuals possess the ability to purchase essential
medical services and, further, that our mission is to serve the
community with respect to providing health care services and education. Therefore, no patient is turned away from
family care centers, hospitals, dental care centers, home
care, hospice or complementary care for financial reasons.
Often, needed medical care is provided for the indigent
at little or no cost.
Value of Indigent Care Provided by FirstHealth
In addition, FirstHealth participated in all governmental
entitlement programs providing care to patients and
receiving reimbursements totaling less than service costs.
Contractual adjustments include Medicare patients,
Medicaid patients, Champus patients and vocational
Value of Entitlement Care Provided by FirstHealth
|Shannon Patterson, MRH Health Information Management employee and church mission volunteer.
Community Benefit is one of six indicators used by the
FirstHealth Board of Directors to determine organizational
performance. Community Benefit is also a priority beyond
just providing charity care. There is not a department in the
hospital that is not in one way or another involved in the
Community Benefit program.
The type of assistance provided is varied as illustrated by
the following FY2007 examples:
- FirstPlan, FirstHealth of the Carolinas’ subsidized health
care programs for small businesses in the amount of
- FirstHealth assisted a total of 586 children of low-income
families with fees for N.C. Health Choice enrollment or
- Dental Care Centers in Hoke, Montgomery and
Moore counties provided preventive services and
treatments to 5,083 Medicaid children
- FirstHealth provides free educational sessions and
emotional support to more than 20 support groups,
which are open and free to the public. Some of the
organized groups include:
- Breast Cancer Support Group, for breast cancer patients and their families, which provides emotional and spiritual support as well as
- Children’s Grief Support Group, which provides
support on a one-to-one basis depending on need
to children who have or are facing the loss of a
- Ended Beginnings for families who have had a
miscarriage, stillbirth or lost a child up to 2 years of age
- Heart to Heart, which offers comfort, support and
education for those dealing with heart disease
- Eye to Eye for the visually impaired and their families
- FirstQuit for individuals struggling with tobacco addiction
- Special partnerships with the public school systems
in Montgomery and Moore counties have allowed
FirstHealth to provide prevention, treatment and
referral services for students on site at their schools.
School-based Health Centers, among the first in
the state to be credentialed, provided treatment for
students and saved parents valuable hours of lost
work time. The School Nurse Program in Moore
County made more than 20,650 nursing contacts,
providing treatment and referral services and saving
valuable instructional time.
- Mobile Health Services, where health screening
services are brought to hard-to-reach communities
and worksites, provided 4,735 screenings (for 2,126 individuals). Screenings for diabetes, breast cancer,
prostate cancer, hypertension, osteoporosis and heart
disease were provided at 94 community and 29
occupational sites by Mobile Health Services. Results
of the screenings indicated a need for follow-up for
617 patients who were referred to their physician for
- FirstHealth supports services that generate low or
negative margins in order to offer a continuum of
care to include neonatal intensive care, hospice
services and trauma care. As a result of FirstHealth’s
support of these services, 242 infants benefited from
NICU services during the last year, and emergency
encounters accounted for 99,263 visits.
- Often, patients are unable to afford needed
medications, medical equipment, transportation
or other needs upon discharge from the hospital,
and outcomes managers use available community
or FirstHealth resources to attempt to meet patient
needs. FirstHealth spent $79,208 to help cover the
cost of these expenses.
- Employees provided 1,386 volunteer hours in the
- FirstHealth Cares acquired 4,591 no-cost prescriptions
for low-income individuals that were valued at