Community Benefit Insight - Tax-exempt hospital

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McPherson Hospital Inc

Mcpherson Hospital Inc

1000 Hospital Drive
Mcpherson, KS 67460

Bed count	49	Medicare provider number	170105	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 480799105

Display data for year:

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

10.16%

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	$ 39,688 0.09 %
Medicaid as % of operating expenses	$ 1,473,496 3.36 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 22,000 0.05 %
Subsidized health services as % of operating expenses	$ 2,923,241 6.66 %
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.	$ 3,392 0.01 %
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	$ 1,691,416 3.85 %
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 $ 37840946 including grants of $ 22000) (Revenue $ 37927022)
Provision of inpatient and outpatient hospital services.

Facility Information

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

McPherson Hospital, Inc.
Part V, Section B, Line 5: The assessment was achieved through the co-leadership of the director of the McPherson County Health Department along with input from other county hospitals, Lindsborg Community Hospital and Mercy Hospital in Moundridge. The McPherson County CHNA process included gathering opinions from the public and area sources through the use of a survey and quantitative data from secondary sources. A survey instrument comprised of 37 questions was developed by the leadership of the participating hospitals and the public health department. The electronic survey was made available throughout the county through various means including media, social media, hospital websites, and was publicized through said sources as well as newspaper and radio. A focus group was formed to provide input regarding the results of the survey. Included in the focus group were individuals representing health care, law enforcement, family advocacy, indigent populations, mental health, public health, civic leadership, education, religion, and senior services, fitness, and Chamber of Commerce, among others. A total of 556 survey responses were received with each community in the county represented in the respondent group.

McPherson Hospital, Inc.
Part V, Section B, Line 6a: Lindsborg Community Hospital in Lindsborg and Mercy Hospital in Moundridge

McPherson Hospital, Inc.
Part V, Section B, Line 6b: McPherson County Health Department

McPherson Hospital, Inc.
"Part V, Section B, Line 11: The annual update below pertains to the CHNA and implementation strategy completed for the 2018 tax year (fiscal year ended 06/30/2019), which is the third annual update for the three-year cycle. This final update is for the CHNA that was adopted by the boards of the associated McPherson County Hospitals in June of 2019. The McPherson Hospital Implementation Strategy was adopted by the McPherson Hospital Board of Trustees on October 28, 2019. A status update on each initiative is provided below. The COVID-19 pandemic continues to limit to some extent the hospital's resources and abilities to address the identified health concerns in the assessment, though there continue to be some initiatives that saw some progress over the last year. Community Mental Health Taskforce: Prior to the COVID pandemic, the hospital participated in this multi-agency taskforce created to address mental health issues in the county. The group met quarterly to develop resources and educational opportunities to bring awareness and create dialogue between agencies to better care for mental health patients. The goal was to educate the communities in McPherson County about mental health issues through public educational forums. Impact would be monitored as activities, initiatives and inter-agency strategies developed to provide appropriate care for patients. The taskforce has had difficulty reconvening even as the pandemic has lessened. However, the hospital has taken steps to provide support for mental health patients. To alleviate the utilization of healthcare or law enforcement personnel to sit with at-risk patients until appropriate levels of support could be secured, pulling these resources away from other needs, we continue to contract with a third party that provides one-on-one support for patients needing immediate mental health observation. This provides a safer environment for all parties and allows the medical teams and law enforcement to remain available for other needs. In addition, we continue to utilize the Columbia Suicide Severity Rating Scale in our Emergency Department to help assess our patients' mental health status related to suicide so that appropriate interventions can be administered if needed. Assess Internal Employee Assistance Program and Provide Training: We continue to offer this program as a means of assisting hospital employees while educating them on mental health issues. Available are resources and opportunities for hospital employees to become educated about and engaged in management of their own potential issues as well as for patients. Better educated employees allow for appropriate treatment and care for themselves and their patients. This employee-focused assistance program is promoted during new employee orientation to inform and encourage utilization of services for personal well-being in a variety of life situations and circumstances. Statistics for usage are not documented due to confidentiality concerns, but we do know that employees are utilizing these services for their intended purposes. Community Drug Abuse Taskforce: The hospital was part of this ongoing taskforce whose goals were to provide resources, outreach and education to the public about the dangers of opioid use. Impact was monitored as activities and initiatives developed over the years with a goal to educate the communities in McPherson County to help prevent abuse and make McPherson County a safer place and to get ahead of the epidemic. This group met quarterly in the past but continues to have difficulty convening following the surge of the pandemic in this area. It is hoped that the group can reconvene in the near future. We continue to support law enforcement drug abuse education in our community.K-TRACS EHR Integration: This is a database designed to let physicians and pharmacists know if a patient is receiving and filling multiple controlled substance prescriptions. Integrating patient drug prescribing history into our EHR, providers who are aware of their current and past prescriptions can make informed decisions on what they are prescribing. We continue to partner with the software interface management group and are fully functional in using K-TRACS in the emergency department with all of our physicians.Non-Narcotic Order Set: The goal for this program is to design an order set for electronic use that does not contain narcotics, thereby patients will not be exposed to as many narcotics. Providers are aware that narcotics are sometimes not the safest form of pain management. This initiative continues to be delayed due to shifting focus of resources related to COVID-19.Electronic Prescribing of Narcotics: The plan is to make it mandatory for all providers to electronically prescribe narcotics. Electronically prescribing medications provides better tracking and drug management, increasing provider awareness of patients' narcotic use. The State of Kansas now requires this practice. We continue to be 100% compliant with this requirement, and are able to utilize waivers for printed scripts if the computer system is down. Provide Staff Training and Education on Drug Abuse: Originally, the plan for this initiative included education from PrairieView Mental Health Center for our staff on how to properly identify and care for patients with a substance abuse problem. Staff would be able to better identify and care for drug abuse patients and provide better education and referral services upon discharge. PrairieView, a major mental health provider in the area has conducted staff training onsite for providers in the past, but challenges in the aftermath of the pandemic continue to put a strain on resources, including staffing and reallocation of resources. Walk Kansas Co-sponsorship: In the past, we have taken an active role and partnered with the Kansas State University Extension Office in McPherson County for this annual spring event designed to encourage teams of 6 or more people to track minutes of physical activity and food choices during an 8-week period. This potentially impacts a couple hundred people, encouraging activity and overall good health. Our participation in co-sponsoring this event is dependent on the county extension office utilizing our support. Due to a leadership change at the extension office this last year, we were not approached to participate, but conversations with new leadership have taken place and additional partnerships have been discussed.Internal wellness committee story sharing: This plan was initially launched to develop personal weight loss and wellness stories of hospital employees that could be shared internally and externally to encourage others. Leading by example, the impact could inspire others in the county to create their own success stories. The aftermath of the pandemic continues to affect many of our programs in this area due to shifting of personnel resources so the program was suspended this last year.Continue targeted Doc Talks: This series of lectures from hospital providers on topics of general health was targeted toward specific identified health needs. It has the potential to reach hundreds of people annually through education and resources. We were still not comfortable bringing people together in large groups over the last year, but evaluation of this activity is continuing. Virtual Exercise Sponsorship, the ""Hess Express 150"": Named after the family for which our fitness center is named, this initiative is to sponsor a community-wide effort to motivate and engage people in specific healthy activities with goals toward individual completion. This community event encourages physical activity and overall good health. The virtual event was sponsored in February through May of 2022. The 23 participants were encouraged to log 150 minutes of exercise each week during these months. Pair-a-docs: This initiative was initially a monthly local radio show where hospital providers and others discussed a variety of health topics. Since 2020, the subject matter has focused more on ways to keep the public informed and safe regarding COVID. During the past year, new ownership at the radio station suspended programming and issued new contracts with a different show format. We now have weekly programs of just a few minutes each where we are able to provide updates of services and general health information. Opportunities still exist for education on wellness and topics related to our identified health needs in a brief ""tip"" format."

McPherson Hospital, Inc.
Part V, Section B, Line 11: (continued): Food insecurity screenings in the clinics: This initiative focuses on the implementation of two validated screening questions about food insecurity during annual exams in the physician clinics. Eleven percent of people in McPherson County struggle with food insecurity, which increases risk for obesity and simultaneous malnutrition. Implementing screenings would raise awareness of patients who are struggling with food insecurity, and potentially reduce the risk of obesity by directing them to resources or food assistance programs. Recently, through physician and dietitian consultations, clinical priorities have shifted to malnutrition awareness for our patients, particularly for COVID patients. The plan is to keep the food insecurities initiative in the plan, as it is also part of the broader malnutrition awareness program that is continuing to be developed.

McPherson Hospital, Inc.
Part V, Section B, Line 16j: We assist applicants in filling out the form.

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7g:
Subsidized health services community benefit expenses include $7,693,510 of expenses attributable to physician clinics that have net operating losses.

Part III, Line 4:
See Note B (page 10) of the audited financial statements regarding the allowance for implicit price concessions.

Part III, Line 8:
Amounts were obtained from the cost report filed with Medicare for the period ending June 30, 2022. The total amount of shortfall between Medicare revenue received and relating allowable costs is considered community benefit.

Part III, Line 9b:
Patients who have qualified for financial assistance are considered qualified for six months. Updated information must be provided for any subsequent account balances. Patients who have qualified for partial financial assistance are to make payment arrangements for any remaining balance according to the policies that apply to other patients.

Part III, Line 3:
McPherson Hospital, Inc. is unable to determine the amount of implicit price concessions (bad debt expense) attributable to patients eligible under its charity care policy for the year covered by this return. Suggested methods for estimation were either not in place or proved to be unreliable. For example, the number of financial assistance applications distributed but not returned was not tracked. Using demographic data to estimate an amount did not provide reasonable results. Rather than provide an estimate that cannot be substantiated, McPherson Hospital Inc. has chosen to report zero dollars as implicit price concessions (bad debt expense) attributable to charity care patients.

Part III, Line 2:
The Hospital's implicit price concessions (bad debt) at cost was determined by applying an overall ratio of cost to charges.

Part VI, Line 2:
McPherson Hospital, Inc. does not have a formal community needs assessment process, with the exception of the process utilized for the CHNA.

Part VI, Line 3:
All self-pay patients are screened by a contractor for eligibility under federal, state, or local government programs. Notice of the Hospital's financial assistance program is posted in patient registration areas and on the Hospital's website. The availability of financial assistance is also communicated to patients with the first billing statement and at any time during the collection process if an inability to pay is expressed by the patient/guarantor.

Part VI, Line 4:
McPherson Hospital, Inc.'s primary service area is McPherson, Kansas, a rural community of approximately 13,944. According to 2022 census information, the per capita income for McPherson was $31,971. The percentage of individuals below poverty level was 11.9 percent. For the year ending June 30, 2022, 14 percent of the Hospital's inpatient admissions were Medicaid recipients and 6 percent were uninsured. Larger hospitals in Hutchinson, Salina, and Newton also provide services to the residents of McPherson. The distances between these facilities and McPherson Hospital, Inc. are approximately 23, 29, and 28 miles respectively. There are no federally-designated medically underserved areas or populations in McPherson.

Part VI, Line 5:
McPherson Hospital, Inc.'s governing body is comprised of individuals who reside in the primary service area. All Board members, with the exception of the CEO and one physician, are not employed by the Hospital. Annually, all trustees sign a conflict of interest statement and disclose any potential conflicts of interest. With limited exceptions for hospital-based services, the Hospital extends medical staff privileges to all qualified physicians in the community. Surplus funds are used by the Hospital to update facilities and equipment, recruit needed physicians and staff, and otherwise improve patient care.

Operating expenses	$ 43,896,120
Total amount spent on community benefits as % of operating expenses	$ 4,461,817 10.16 %