About
FirstHealth of the Carolinas, Inc. ("FirstHealth") provides a comprehensive community benefits program in its primary and secondary service areas. FirstHealth plays a pivotal role in delivering health care in the mid-Carolinas and is both the infrastructure and safety net for health care in its communities. FirstHealth operates two hospitals: FirstHealth Moore Regional Hospital and FirstHealth Montgomery Memorial Hospital. FirstHealth Moore Regional Hospital has licensed beds in three locations: the main campus in Pinehurst, North Carolina and remote locations in Rockingham and Raeford, North Carolina. Hospital care is the cornerstone of health care in most communities, but FirstHealth goes beyond the walls of these facilities to enhance the health and wellness of the residents of its service areas. FirstHealth provides low-cost and, in many cases, free programs to our most vulnerable patient populations. One of FirstHealth's most important financial contributions is bridging the gap created by underpayments from Medicare and Medicaid and other government programs, while continuing to provide access to free or low-cost health screenings and diagnostic services, as well as health/wellness educational programs in the communities FirstHealth serves. Free and Discounted Charity Care to Eligible Patients Served Anyone who visits a FirstHealth hospital for medical care is treated regardless of his or her ability to pay for the treatment provided. When patients are unable to help with their medical expenses, FirstHealth absorbs some or all the cost of care for those that meet designated financial criteria, depending on family income. Patients with family incomes at or below 200 percent of the federal poverty guideline qualify for 100 percent financial assistance under FirstHealth's Financial Assistance Program. FirstHealth's net cost of free care (treating patients that qualified for 100% financial assistance) was $12,075,751 in fiscal 2024. Through its Financial Assistance Program, FirstHealth also offers varying levels of discounted care to patients who are poor and/or meet certain income guidelines. Patients with family incomes between 201 and 360 percent of the federal poverty guideline qualify for discounts against FirstHealth's list price for services rendered. FirstHealth also incurs bad debt expense each year for patients who have been determined to have the financial capacity to pay for healthcare services provided but are unwilling/financially unable to settle the claim. FirstHealth continues to provide all necessary healthcare services to this patient population. In fiscal 2024, the cost to FirstHealth for these services was $15,223,804. FirstHealth's Financial Counselors work closely with patients and families to help determine eligibility for assistance or qualification for public programs. FirstHealth requests that patients provide appropriate documentation, such as tax returns, current pay stubs, or other relevant information, that is used to demonstrate financial need. FirstHealth also offers interest-free extended payment plans that will vary in length, depending on the balance of the patient's account. FirstHealth assists patients with finding available governmental programs that match patients' needs, such as Medicaid, Vocational Rehabilitation, Crime Victim Assistance, etc. FirstHealth also posts detailed information about its Financial Assistance Program on its website (www.firsthealth.org) so the public can be aware of its availability. Medicaid Shortfall FirstHealth provides Medicaid services in its two hospitals, as well as through its home care, hospice and palliative care, dental care, and other health care services in its primary and secondary service areas. Approximately 11.5% of FirstHealth's fiscal 2024 net patient revenue for acute care services came from the Medicaid program. The Medicaid program, which provides health care coverage for low-income families and individuals, is funded by the state and federal governments. In North Carolina, as in many states, Medicaid payments are well below the provider's actual cost of treating Medicaid patients and the reimbursement level is predicted to decline as financial pressures on the federal and state government operating budgets mount. In fiscal 2024, FirstHealth's unpaid costs from Medicaid totaled $22,898,724. Medicare Shortfall FirstHealth provides services to Medicare beneficiaries in its two hospitals. In addition, Medicare beneficiaries are served by FirstHealth's home care, hospice and palliative care and other health care programs and services. The Medicare shortfall represents the difference between the actual cost of care rendered and the reimbursement received for delivering that care to patients. Approximately 57.6% of FirstHealth's fiscal 2024 net patient revenue for acute care services came from the Medicare program. The cost of delivering care includes, but is not limited to, personnel costs, technology, supplies, pharmaceuticals, medical devices, facility operating costs, etc. FirstHealth's financial shortfall from providing these Medicare services in fiscal 2024 was $22,524,569. Subsidized Medically Essential Services As a rural health care provider, FirstHealth is many times the provider of last resort for our patients. In order to offer a full spectrum of health care services, FirstHealth provides services and programs that yield negative operating margins. However, because these services are essential to the overall health of the communities served, FirstHealth continues to provide them. Subsidized medically necessary hospital services provided by FirstHealth include, but are not limited to: inpatient psychiatry unit and outpatient mental health services; inpatient physical rehabilitation unit; neonatal intensive care unit; emergency departments (approximately 128,808 patient encounters in fiscal 2024); women's and children's services; inpatient medical and radiation oncology services; renal dialysis services; diabetes care; and a number of other outpatient services. In addition, FirstHealth, through its Regional Emergency Medical Services business line, provided 25,313 emergency 911 transports to residents of Chatham, Lee, Montgomery and Richmond counties in fiscal 2024. FirstHealth received $8,704,017 in fiscal 2024 operating subsidies from these counties to help offset the unreimbursed operating costs of providing these essential transport services. FirstHealth also provided $3,165,586 in direct financial subsidies to offset the unfunded operating costs of the Regional Emergency Medical Services business line in fiscal 2024. FirstHealth Community Health Services Initiatives (FHCS) Health Programs - Tobacco Cessation, Diabetes and Disease Prevention, Health Coaching The Health Program team addresses the health needs of residents based on current health system data and county-based community health needs assessments. The Community Health Programs team provides classes and one-on-one programs to address chronic disease and health behavior modification such as Pre-Diabetes (Prevent T2), Tobacco/Vaping Cessation (FirstQuit), Cardiovascular Health (Million Hearts), Health Coaching and access to Health Foods (Food Pantries). FirstQuit, an outpatient program, includes a combination of counseling and nicotine replacement therapies to assist residents in the service area to quit nicotine use. For fiscal 2024, 422 people enrolled in the outpatient program. The conservative six-month quit rate was 22%. 70 community education programs/health screenings to address chronic disease and physical activity were provided, with 76% targeted to low-income and underserved populations in the five-county primary service area of Moore, Montgomery, Hoke, Richmond and Lee counties. In addition, there were 706 health coaching encounters, with 77% of the participants showing improved blood pressure and/or weight status and 50 participants enrolled in Prevent T2 classes with 60% of the participants completing the program reporting 5-7% weight loss from the start of the class. Participants reported an overall 100% satisfaction rating. In total, FirstHealth leveraged $1.89 in grant funds for every $1 provided by FirstHealth. School-Based Health Centers FirstHealth offers on-site medical care at three clinic sites within the Montgomery County Schools (East Middle School, West Middle School and Central High School).. Hundreds of school children in Montgomery County have access to acute and preventive medical care on the school campus just steps away from the classroom doors.
In care of Firsthealth Hospice and Palliativ
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