Community Benefit Insight - Tax-exempt hospital

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Ida County Iowa Community Hospital Inc

Horn Memorial Hospital

700 East 2nd Street
Ida Grove, IA 51445

Bed count	25	Medicare provider number	161354	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 420843389

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

2.56%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 31,045 0.13 %
Medicaid as % of operating expenses	$ 526,837 2.20 %
Costs of other means-tested government programs as % of operating expenses	$ 864 0.00 %
Health professions education as % of operating expenses	$ 12,879 0.05 %
Subsidized health services as % of operating expenses	$ 2,496 0.01 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 37,413 0.16 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 226,786 0.95 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 22005468 including grants of $ 0) (Revenue $ 23679468)
IDA COUNTY, IOWA COMMUNITY HOSPITAL, INC. D/B/A HORN MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICE TO PATIENTS IN THE AREA OF IDA GROVE, IOWA. IT ALSO OPERATES HOME HEALTH AND HOSPICE AGENCIES, PROVIDER-BASED RURAL HEALTH CLINICS IN IDA GROVE, IOWA AND SURROUNDING COMMUNITIES, AND OTHER HEALTHCARE SERVICES.HEALTHCARE SERVICES PROVIDED TO PATIENTS: 1,007 ACUTE PATIENT DAYS, 918 SKILLED PATIENT DAYS, 19 INTERMEDIATE DAYS, 22,288 OUTPATIENT OCCASIONS OF SERVICE, 2,185 HOME HEALTH VISITS.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

IDA COUNTY, IOWA COMMUNITY HOSPITAL, INC
PART V, SECTION B, LINE 5: PARTICIPANTS VIA SURVEY INCLUDED 1 PHYSICIAN, 4 PUBLIC HEALTH REPRESENTATIVES, 24 OTHER HEALTH PROVIDERS, AND 27 OTHER COMMUNITY LEADERS. FINAL PARTICIPATION INCLUDED REPRESENTATIVES OF THE ORGANIZATIONS OUTLINED BELOW. -COMMUNITY HEALTH PARTNERS (CHP) -CROSSRIDGE EVANGELICAL FREE CHURCH -DOWNTOWN DENTAL -GALVA-HOLSTEIN COMMUNITY SCHOOL DISTRICT -GODBERSEN-SMITH CONSTRUCTION COMPANY -GOMACO CORPORATION -GOOD SAMARITAN SOCIETY-HOLSTEIN -HORN COMMUNITY HEALTH -HORN MEMORIAL HOSPITAL (HMH) AND CLINICS -HORN MEMORIAL HOSPITAL BOARD -HORN PHYSICIANS CLINIC -IDA COUNTY ECONOMIC DEVELOPMENT -IDA GROVE CITY HALL -IOWA LEGISLATURE -NUTRIEN AG SOLUTIONS -OABCIG COMMUNITY SCHOOL DISTRICT -ODEBOLT SPECIALTY CARE -UNITED BANK OF IOWA -UNITED METHODIST CHURCH -WILLOW DALE WELLNESS VILLAGE

IDA COUNTY, IOWA COMMUNITY HOSPITAL, INC
"PART V, SECTION B, LINE 11: ON SEPTEMBER 3RD, 2019, A HOSPITAL COMMITTEE OF NINE MEMBERS MET TO DISCUSS AND PRIORITIZE THE TOP HEALTH NEEDS IDENTIFIED FROM THE PRC COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. THE ITEMS BELOW ARE PRIORITIZED FOR ACTION/COMPLETION.1) MENTAL HEALTHGOAL: INCREASE AWARENESS AND ACCESS TO MENTAL HEALTH RESOURCES IN OUR COMMUNITY.STRATEGY #1: RESEARCH WAYS TO ESTABLISH A MENTAL HEALTH PROVIDER IN OUR CLINICS.STRATEGY #2: CONTINUE TO PROMOTE AND REFER TO LOCAL EXISTING MENTAL HEALTH SERVICES, FACILITIES AND PROVIDERS IN OUR AREA.2) NUTRITION, PHYSICAL ACTIVITY & WEIGHT GOAL: IDENTIFY AND MANAGE OBESITY, DIABETES AND HEART DISEASE.STRATEGY #1: CONTINUE TO DEVELOP AND IMPLEMENT A CHRONIC CARE MANAGEMENT PROGRAM IN THE CLINICS TO EDUCATE AND SUPPORT CUSTOMERS WITH CHRONIC DISEASES.STRATEGY #2: PARTNER WITH AREA REC CENTERS TO PROMOTE PHYSICAL ACTIVITY AND WELLNESS THROUGH HEALTHY LIFESTYLES.3) CANCERGOAL: PROMOTE AND ENCOURAGE REFERRALS FOR PREVENTATIVE CANCER SCREENINGS FOR COLORECTAL AND BREAST CANCER.STRATEGY #1: RESEARCH FLEXIBLE SCHEDULING TO MAKE APPOINTMENTS CONVENIENT FOR OUR CUSTOMERS.STRATEGY #2: INVESTIGATE ELIGIBLE POPULATION AND MARKET ON BENEFITS OF SCREENING.4) ACCESS TO HEALTHCARE SERVICESGOAL: INCREASE ACCESS TO HEALTHCARE SERVICES IN OUR SERVICE AREA.STRATEGY #1: BUILD HOLSTEIN CLINIC WITH POSSIBILITY OF AN ADDITIONAL PROVIDER.STRATEGY #2: CONTINUE TO PROMOTE THE ""CALL US FIRST CAMPAIGN.""NEEDS NOT CURRENTLY BEING ADDRESSED INCLUDE DIABETES, HEART DISEASE & STROKE, INJURY & VIOLENCE, ORAL HEALTH, SUBSTANCE ABUSE AND TOBACCO USE. SOME OF THESE NEEDS ARE BEING COVERED UNDER DIFFERENT PRIORITIZED NEEDS, AND OTHERS ARE BETTER ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY WITH MORE ACCESS TO CERTAIN RESOURCES."

IDA COUNTY, IOWA COMMUNITY HOSPITAL, INC
PART V, SECTION B, LINE 13B: DISCOUNTS FOR PATIENTS WITH NO INSURANCE AND PROMPT PAYMENT ARE NOT BASED ON ANY INCOME LEVEL.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
FOR PATIENTS WITH THE ABILITY TO PAY, A 5% DISCOUNT IS OFFERED ON HOSPITAL SERVICES, WHICH APPLIES ONLY IF THE BALANCE IS PAID IN FULL WITHIN THIRTY DAYS FROM THE RECEIPT OF THE FIRST PRIVATE PAY STATEMENT. THIS DISCOUNT DOES NOT APPLY TO ANY CLINIC OR PUBLIC HEALTH CHARGES. A $4.00 DISCOUNT IS OFFERED TO PATIENTS AT THE TIME OF SERVICE IN THE CLINICS IF THE HOUSEHOLD INCOME IT AT OR BELOW 400% OF THE FEDERAL POVERTY GUIDELINES.FOR COLLECTION PURPOSES, PATIENTS WITH NO INSURANCE AS GIVEN A 20% DISCOUNT ON HOSPITAL SERVICES.

PART I, LINE 6A:
THE COMMUNITY BENEFIT REPORT WAS NOT PREPARED BY A RELATED PARTY.

PART I, LINE 7:
THE HOSPITAL USES AN OVERALL COST TO CHARGE RATIO (TOTAL EXPENSES - BAD DEBT) / GROSS PATIENT SERVICE REVENUE = PERCENTAGE OF COST TO CHARGE.

PART I, LINE 7G:
SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G INCLUDE WELLNESS CHECKS AND FOOT CLINICS. FOOT CLINICS ACCOUNT FOR $3,772 OF EXPENSES AND $3,886 OF OFFSETTING REVENUE.

PART I, LN 7 COL(F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $226,786.

PART II, COMMUNITY BUILDING ACTIVITIES:
THE HOSPITAL DOES NOT REPORT ANY COMMUNITY BUILDING ACTIVITIES.

PART III, LINE 2:
GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL PROVIDES SERVICES TO UNINSURED PATIENTS, AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE UNINSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS AND IMPLICIT PRICE CONCESSIONS. FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020, NO SIGNIFICANT ADJUSTMENTS TO REVENUE WERE RECOGNIZED DUE TO CHANGES IN ESTIMATES OF IMPLICIT PRICE CONCESSIONS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE.

PART III, LINE 3:
THE HOSPITAL PROVIDES PATIENT FINANCIAL ASSISTANCE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR THE HEALTH CARE SERVICES THEY RECEIVE. IT IS THE POLICY OF THE HOSPITAL NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS PATIENT FINANCIAL ASSISTANCE. ACCORDINGLY, THE HOSPITAL DOES NOT REPORT THESE AMOUNTS IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. THE HOSPITAL DETERMINES THE COSTS ASSOCIATED WITH PROVIDING PATIENT FINANCIAL ASSISTANCE BY AGGREGATING THE DIRECT AND INDIRECT COSTS, INCLUDING SALARIES, BENEFITS, SUPPLIES, AND OTHER OPERATING EXPENSES, BASED ON THE OVERALL COST TO CHARGE RATIO. THE COSTS OF CARING FOR PATIENT FINANCIAL ASSISTANCE PATIENTS FOR THE YEARS ENDED DECEMBER 31, 2021 AND 2020 WERE APPROXIMATELY $20,800 AND $31,000, RESPECTIVELY.

PART III, LINE 4:
"THE COSTING METHODOLOGY USED IN DETERMINING THE BAD DEBT EXPENSES INCLUDES CALCULATING ON A MONTHLY BASIS THE TOTAL ESTIMATED AMOUNTS BASED ON HISTORICAL WRITE OFFS.THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC FOOTNOTE DESCRIBING BAD DEBT. FOOTNOTES TITLED ""PATIENT RECEIVABLES,"" ""PATIENT SERVICE REVENUE, AND ""PATIENT FINANCIAL ASSISTANCE"" CAN BE FOUND ON PAGES 7 THROUGH 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS."

PART III, LINE 8:
THERE IS NO MEDICARE SHORTFALL BASED ON THE INFORMATION FROM THE COST REPORT IN THE CURRENT YEAR. THESE COSTS ARE MEDICARE REIMBURSABLE COSTS, NOT ALL COSTS. THESE MEDICARE REIMBURSABLE COSTS SHOULD BE TREATED AS A COMMUNITY BENEFIT TO THE EXTENT THAT MEDICARE REVENUES DO NOT COVER THE COSTS. WE DO NOT USE ANY NEGOTIATION TOOL WITH MEDICARE FOR OUR RATES; THE RATES THAT WE ARE PAID ARE MANDATED. HENCE, THIS DOES NOT GIVE US THE ABILITY AS A PROVIDER TO RECEIVE SUFFICIENT REVENUES TO COVER THE MEDICARE COSTS. AS A FACILITY WE ARE WORKING TOWARD COSTS SAVINGS.

PART III, LINE 9B:
ONCE A PATIENT HAS BEEN DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE, A PAYMENT PLAN IS ESTABLISHED. IF THEY DEFAULT, AFTER TWO MONTHS OUR BAD DEBT COLLECTION POLICIES ARE ENACTED AND FOLLOWED.

PART VI, LINE 2:
COMMUNITY NEEDS ARE ASSESSED REGULARLY THROUGH FEEDBACK FROM PATIENT SURVEYS, OUR MEDICAL STAFF (MANY OF WHOM ARE COMMUNITY RESIDENTS) AND EMPLOYEES, AS WELL AS OUR BOARD OF TRUSTEES WHO LIVE IN AND REPRESENT THECOMMUNITIES WE SERVE. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS CONDUCTED EVERY THREE YEARS TO EVALUATE OUR ONGOING SERVICE REQUIREMENTS, IDENTIFY NEW SIGNIFICANT HEALTH NEEDS, AND IMPLEMENT STRATEGIES TO ADDRESS THEM.

PART VI, LINE 3:
OUR CONSENT TO TREATMENT FORM INCLUDES LANGUAGE REGARDING FINANCIAL ASSISTANCE AND CONTACT INFORMATION. THIS IS ALSO PRINTED AT THE REGISTRATION DESKS. IN ADDITION, OUR FINANCIAL ASSISTANCE POLICY IS POSTED IN REGISTRATION AREAS OF BOTH THE HOSPITAL AND ITS CLINICS. OUR HOSPITAL WEBSITE OFFERS ADDITIONAL INFORMATION UNDER THE PATIENTS AND VISITORS, PAYMENT ARRANGEMENTS SECTION REGARDING OUR PAYMENT REQUIREMENTS, FINANCIAL ASSISTANCE POLICY, SLIDING FEE SCALES, AND THE APPLICATION FORM FOR FINANCIAL ASSISTANCE. MAIL AND PHONE INQUIRIES REGARDING PATIENT INVOICES OR PAYMENT ARRANGEMENTS ARE REFERRED TO OUR FINANCIAL COUNSELOR FOR ASSISTANCE.

PART VI, LINE 4:
THE HOSPITAL SERVES THE COUNTIES OF IDA, MONONA AND SAC IN THE STATE OF IOWA. THE POPULATION OF THIS AREA IS OVER 25,000 RESIDENTS. IN THE TOTAL SERVICE AREA, 21.8% OF THE POPULATION ARE CHILDREN AGE 0-17; ANOTHER 55.4%ARE AGE 18 TO 64, WHILE 22.8% ARE AGE 65 AND OLDER. THE PROPORTION OF OLDER ADULTS (AGE 65+) IS SIGNIFICANTLY ABOVE THAT SEEN STATEWIDE OR (ESPECIALLY) NATIONALLY.

PART VI, LINE 6:
THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

PART VI, LINE 7, REPORTS FILED WITH STATES
IA

PART VI, LINE 5:
AS A PRIVATE, NON-PROFIT CRITICAL ACCESS HOSPITAL, HORN MEMORIAL HOSPITAL AND ITS CLINICS ARE ABLE TO IMPROVE ACCESS TO HEALTHCARE TO THOSE AT RISK BECAUSE OF FINANCIAL ABILITY, LACK OF ADEQUATE INSURANCE, MINORITY, OR OTHER BARRIERS, THROUGH OUR FOUR LOCATIONS WITHIN THREE RURAL COUNTIES.WE OFFER A VARIETY OF SPECIALTY CLINICS TO MEET THE NEEDS OF THE COMMUNITIES WE SERVE, AND MAINTAIN FOUR RURAL HEALTH CLINICS, A 24 HOUR EMERGENCY DEPARTMENT AND A 20 BED INPATIENT WING. THE HOSPITAL SPONSORS WEEKLY RADIO BROADCASTS ADDRESSING A WIDE VARIETY OF HEALTHCARE SERVICES AND ISSUES/CONCERNS. A MONTHLY NEWSLETTER IS ALSO PUBLISHED WHICH INCLUDES INFORMATION REGARDING SCHEDULED SPECIALTY CLINICS AND OTHER TIMELY CONCERNS OR INFORMATION FOR OUR READERSHIP. WE PROVIDE TRANSLATION SERVICES AT ALL LOCATIONS. WE PARTNER THROUGH LOCAL, COUNTY, AND STATE AGENCIES TO PROVIDE PUBLIC HEALTH SERVICES TO OUR COMMUNITIES.

Operating expenses	$ 23,933,240
Total amount spent on community benefits as % of operating expenses	$ 611,534 2.56 %