CHI Oakes Hospital

Value of the 340B program

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Oakes Community Hospital, dba CHI Oakes Hospital, is a 20-bed critical access hospital that provides various inpatient and outpatient services to approximately 14,000 people in southeastern North Dakota. We are 42 miles from the nearest CAH and approximately 70 miles from the closest hospital offering a higher level of care. CHI Oakes Hospital is also a 24-Hour Emergency Level V Trauma Center. The hospital building was newly-constructed in 2007, replacing a 50-year-old building , and in 2010, Oakes Community Clinic was opened within the hospital building. The hospital is part of a larger values-based organization, Catholic Health Initiatives (CHI). Some of the challenges faced by CHI Oakes Hospital are declining population, aging population, remote location, lack of mental health resources, difficulties in hiring and retaining staff, and fiscal challenges.


The 340B program has been extremely beneficial to our patients and community by allowing CHI Oakes Hospital to continue offering 24/7 emergency care and to provide financial assistance to those patients in need who are uninsured or underinsured. In such a remote location, it is vital that the 24/7 trauma services continue at our hospital. The economy is heavily agricultural and manufacturing, both of which present the possibility of traumatic injuries. Many lives have been saved due to the ability to stabilize and transport patients in a very critical state.

Our best-known, but often least-utilized, Community Benefit program is the financial assistance we provide to patients who cannot afford to pay for their care. Financial assistance applications are available on our website and at our facilities. The process is extremely confidential and our goal is to award financial assistance rather than turn patients over to collection for healthcare bills.

Charity Care is free or discounted health and health-related services provided to patients who cannot afford to pay for medically necessary health care. Eligibility is based on household income as well as other assets. Consideration is given to a patient who has significant or catastrophic medical bills and does not meet the income guidelines. Charity Care is given to uninsured, low-income patients who are not expected to pay all or part of a bill, or who are able to pay only a portion using an income-related fee schedule. Community benefit programs for the poor are geared to reducing morbidity and mortality in beneficiaries of Medicaid or state or local indigent programs.

CHI Oakes Hospital will not delay providing an appropriate medical screening examination required or further medical examination and treatment required in order to inquire about the individual’s method of payment or insurance status. OCH will not seek, or direct an individual to seek, authorization from the individual’s insurance company for screening or stabilization services to be furnished by an OCH physician, or mid-level practitioner to an individual until after an appropriate medical screening examination required and initiated any further medical examination and treatment that may be required to stabilize the emergency medical condition.

Eligibility for uninsured/underinsured discounts shall be determined based on family income at or below 300% of Federal Poverty Guidelines, as well as available assets and any extenuating circumstances. Thus, the standards of eligibility for the application of uninsured/underinsured discounts must consider assets, as well as income. For the patient to be eligible they must have a minimum account balance of thirty-five dollars, family income at or below 300% of FPG, they must comply with Patient Cooperation Standards, and they must complete a financial assistance application. Financial Assistance applications may be obtained at OCH or on the website

To-date estimates of expense reductions: $209,107 (estimated)
To-date estimate of revenue enhancement: $273,525 (through 3/31/2019)


July 1, 2017 through June 30, 2018

Community Benefit Provided to the Poor:

Cost of financial assistance provided
Estimated number of people served: 133
Community benefit cost: $51,472

Estimated number of people served: 538

Community Benefit Operations
Estimated number of people served: 129
Community benefit cost: $7,075

Community Building Activities
Estimated number of people served: 145
Community benefit cost: $1,148

Financial and In-kind Contributions:

Estimated number of people served: 100
Community benefit cost: $2,516

Community Benefit Provided to the Broader Community:

Community Health Improvement Services
Estimated number of people served: 29
Community benefit cost: $2,719

Health Professions Education
Estimated number of people served: 2
Community benefit cost: $10,900

Grand Cost of Community Benefit
Estimated number of people served: 376
Community benefit cost: $21,639


The biggest concern if 340b were eliminated or scaled back would be the potential loss of financial assistance for our patients in need. There are many fiscal challenges at CHI Oakes Hospital, but we have been able to see patients without discriminating based on their ability to pay. With the other challenges of keeping the hospital viable, this is one area that may have to be re-evaluated if the hospital does not show sustainable income and cash flow levels.

CHI Oakes Hospital

1200 North 7th Street
Oakes, North Dakota 58474
(701) 742-3291


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