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Ninnescah Valley Health Systems Inc
Kingman, KS 67068
| Bed count | 25 | Medicare provider number | 171378 | Member of the Council of Teaching Hospitals | NO | Children's hospital | NO |
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)
(as % of total functional expenses)
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.
Operating expenses $ 15,884,700 Total amount spent on community benefits as % of operating expenses$ 457,981 2.88 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 82,376 0.52 %Medicaid as % of operating expenses$ 335,024 2.11 %Costs of other means-tested government programs as % of operating expenses$ 0 0 %Health professions education as % of operating expenses$ 0 0 %Subsidized health services as % of operating expenses$ 0 0 %Research as % of operating expenses$ 0 0 %Community health improvement services and community benefit operations*
as % of operating expensesNote: these two community benefit categories are reported together on the Schedule H, part I, line 7e.$ 40,581 0.26 %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$ 881,849 5.55 %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:
Reported to credit agency Not available 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.
After enactment of the ACA, has the state in which this tax-exempt hospital is located expanded Medicaid? NO 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.
If not, is the state's Medicaid threshold for working parents at or below 76% of the federal poverty guidelines? YES 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.
Does the state in which the tax-exempt hospital is located have a mandatory community benefit reporting statute? NO
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
- 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 $ 13158358 including grants of $ 300) (Revenue $ 14629146) HEALTH CARE SERVICES PROVIDED TO THE PEOPLE OF KINGMAN COUNTY AND THE SURROUNDING COMMUNITIES. DURING THE FISCAL YEAR 2022, THE HOSPITAL HAD 1,652 INPATIENT DAYS, 2,123 EMERGENCY ROOM VISITS, AND 271 SURGERIES. TOTAL OUTPATIENT VISITS TOTALED 23,172. IN ADDITION, THE HOSPITAL PROVIDES TWO RURAL HEALTH CLINICS. ONE CLINIC IS WITHIN THE CITY OF KINGMAN AND ONE IS IN THE NEIGHBORING COMMUNITY OF CUNNINGHAM. TOTAL CLINIC VISITS TOTALED 9,077 FOR FISCAL YEAR 2022.
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Facility Information
SCHEDULE H, PART V, SECTION B, LINE 5 THE HOSPITAL, LOCAL HEALTH DEPARTMENT AND COMMUNITY PROVIDERS, ALONG WITH VARIOUS COMMUNITY LEADERS, PARTICIPATED IN COMMITTEE MEETINGS TO DETERMINE RELEVANT ISSUES AND PROPOSE AN ACTION PLAN TO IMPROVE LOCAL CIRCUMSTANCES. THE COMMITTEE THEN PRESENTED THEIR ACTION PLAN TO THE COMMUNITY FOR REVIEW AND IMPLEMENTATION.
SCHEDULE H, PART V, SECTION B, LINE 7A https://www.kingmanhc.com/docs/Kingman_CHNA.pdf?sub=About%20Us
SCHEDULE H, PART V, SECTION B, LINE 10A https://www.kingmanhc.com/docs/2022_CHNA_Implementation_Strategy.pdf?sub=A bout%20Us
SCHEDULE H, PART V, SECTION B, LINE 11 FOR MENTAL HEALTH ISSUES, KHC IS IMPLEMENTING SENIOR LIFE SOLUTIONS, WHICH PROVIDES GERIATRIC PSYCHIATRIC OUTPATIENT SERVICES. KHC ALSO EMPLOYS A LICENSED SOCIAL WORKER WHO LEADS A CAREGIVER SUPPORT GROUP. SPORTS PHYSICALS FOR SCHOOL-AGED CHILDREN HAVE BEEN EXPANDED INTO COMPREHENSIVE ANNUAL WELLNESS VISITS. FOR PRIMARY CARE PHYSICIANS, KHC HAS RECRUITED TWO PHYSICIANS - ONE WILL JOIN IN 2023 AND ONE WILL JOIN IN 2024. FOR DISEASE PREVENTION & MANAGEMENT, KHC WILL WORK TO DEVELOP A CHRONIC CARE MANAGEMENT PROGRAM AND WORK WITH PATIENTS TO DEVELOP A COMPREHENSIVE CARE PLAN. FOR CHRONIC DISEASE PREVENTION, THE HOSPITAL PROVIDES LAB AND RADIOLOGY SERVICES FOR THE CARE NET CLINIC (REDUCED COST OR FREE SERVICES) TO SERVE THE INDIGENT AND UNINSURED RESIDENTS OF KINGMAN COUNTY. THE HOSPITAL HAS HIRED A DIETICIAN TO EDUCATE AND PROVIDE CONSULTATION SERVICES FOR CARDIAC, WEIGHT LOSS, AND DIABETIC PATIENTS. FOR SERVICES NEEDED RELATED TO MENTAL ILLNESS AND MENTAL HEALTH, THE HOSPITAL ER TREATS THOSE WITH MENTAL ILLNESS SYMPTOMS AND REFERS/TRANSFERS THEM TO THEIR NEXT LINE OF CARE. FOR LACK OF HEALTH KNOWLEDGE AND AWARENESS OF SERVICES, THE HOSPITAL REGULARLY USES SOCIAL MEDIA TO REACH AS MANY RESIDENTS OF THE COUNTY AS POSSIBLE. THE HOSPITAL ALSO REGULARLY USES THE LOCAL NEWSPAPER TO INFORM THE COMMUNITY OF SERVICES AVAILABLE.
SCHEDULE H, PART V, SECTION B, LINE 16A https://www.kingmanhc.com/docs/FAP_New.pdf
SCHEDULE H, PART V, SECTION B, LINE 16B https://www.kingmanhc.com/docs/Financial_Assistance_Application_2021.pdf
SCHEDULE H, PART V, SECTION B, LINE 16C https://www.kingmanhc.com/docs/Plain_Language_Summary_2021.pdf
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Supplemental Information
SCHEDULE H, PART I, LINE 3C THE HOSPITAL USED FACTORS OTHER THAN FPG IN DETERMINING ELIGIBILITY FOR PROVIDING FREE OR DISCOUNTED CARE. THESE FACTORS INCLUDED: MEDICAL INDIGENCY, INSURANCE STATUS, AND UNDERINSURANCE STATUS.
SCHEDULE H, PART I, LINE 7, COLUMN F NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE CONTRACTIONS WITH CUSTOMERS.
SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7, OF SCHEDULE H, IS A COST TO CHARGE RATIO.
SCHEDULE H, PART III, SECTION A, LINE 2 ONCE REASONABLE EFFORTS HAVE BEEN EXHAUSTED (AS REQUIRED BY IRS 501(R)) THE CHARGES ARE TURNED OVER TO A COLLECTION AGENCY. THESE CHARGES ARE EXPENSED TO BAD DEBT EXPENSE. DURING THE COURSE OF THE YEAR, ANY BAD DEBT RECOVERIES ARE NETTED AGAINST BAD DEBT EXPENSE. SHOULD THE HOSPITAL BE NOTIFIED OF A BANKRUPTCY, THE ASSOCIATED CHARGES ARE EXPENSED TO BAD DEBT EXPENSE. FURTHERMORE, PROVISIONS ARE MADE FOR SELF-PAY CHARGES TO ALLOW FOR THE EXPECTED UNCOLLECTABLE CHARGES. THE METHOD USED FOR THE ALLOWANCE IS A 6-MONTH LOOK BACK TO DETERMINE THE COLLECTABILITY OF SELF-PAY ACCOUNTS.
SCHEDULE H, PART III, SECTION A, LINE 3 A COST TO CHARGE RATIO IS USED TO DETERMINE AMOUNTS OF BAD DEBT AT COST AND BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE CHARITY CARE POLICY. THE COST TO CHARGE RATIO IS MULTIPLIED BY THE CHANGES IN BAD DEBT.
SCHEDULE H, PART III, SECTION A, LINE 4 NOT APPLICABLE DUE TO ADOPTION OF ASC 606 REVENUE FROM CONTRACTS WITH CUSTOMERS.
SCHEDULE H, PART III, SECTION B, LINE 8 SERVING PATIENTS WITH GOVERNMENT HEALTH BENEFITS, SUCH AS MEDICARE, IS A COMPONENT OF THE COMMUNITY BENEFIT STANDARD THAT TAX-EXEMPT HOSPITALS ARE HELD TO. THIS IMPLIES THAT SERVING MEDICARE PATIENTS IS A COMMUNITY BENEFIT AND THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THE SYSTEM USES MEDICARE COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS (ROOM AND BOARD) BASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.
SCHEDULE H, PART III, SECTION C, LINE 9B AFTER FOLLOWING BILLING PROCEDURES AND DETERMINING NO INSURANCE COVERAGE APPLIES TO OUTSTANDING AMOUNTS DUE, THE FOLLOWING PROCEDURES ARE IN PLACE: THE FIRST STATEMENT IS SENT TO THE PATIENT AFTER 30 DAYS; THE SECOND STATEMENT IS SENT AFTER 60 DAYS; THE THIRD STATEMENT IS SENT AFTER 90 DAYS; THE FINAL STATEMENT IS SENT AFTER 120 DAYS; THE ACCOUNT IS SENT TO A THIRD-PARTY COLLECTION AGENCY IF NO PROGRESS ON THE ACCOUNT IS MADE
SCHEDULE H, PART VI, LINE 2 ONE SIGNIFICANT WAY IS THE COMMUNITY HEALTH NEEDS ASSESSMENT. IN ORDER TO COMPLETE THE CHNA, AS REQUIRED BY IRC SECTION 501(R), POPULATION DEMOGRAPHICS AND SOCIOECONOMIC CHARACTERISTICS OF THE COMMUNITY WERE GATHERED AND REPORTED UTILIZING VARIOUS THIRD PARTIES. THE HEALTH STATUS OF THE COMMUNITY WAS THEN REVIEWED. INFORMATION ON THE LEADING CAUSES OF DEATH AND MORBIDITY INFORMATION WAS ANALYZED IN CONJUNCTION WITH HEALTH OUTCOMES AND FACTORS REPORTED FOR THE COMMUNITY BY WWW.COUNTYHEALTHRANKINGS.ORG. HEALTH FACTORS WITH SIGNIFICANT OPPORTUNITY FOR IMPROVEMENT WERE NOTED. COMMUNITY INPUT WAS PROVIDED THROUGH KEY INFORMANT INTERVIEWS OF SEVEN STAKEHOLDERS. INFORMATION GATHERED WAS ANALYZED AND REVIEWED TO IDENTIFY HEALTH ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS AND THE COMMUNITY AS A WHOLE. HEALTH NEEDS WERE RANKED UTILIZING A WEIGHTING METHOD THAT WEIGHS: 1. THE SIZE OF THE PROBLEM, 2. THE SERIOUSNESS OF THE PROBLEM, 3. THE PREVALENCE OF COMMON THEMES, AND 4. THE ALIGNMENT WITH HOSPITAL'S RESOURCES. AN INVENTORY OF HEALTH CARE FACILITIES AND OTHER COMMUNITY RESOURCES POTENTIALLY AVAILABLE TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA WAS PREPARED AND COLLABORATIVE EFFORTS WERE IDENTIFIED. OTHER THAN THE CHNA, HOSPITAL STAFF REVIEWS STATISTICAL DATA PROVIDED BY THE KANSAS HOSPITAL ASSOCIATION, KDHE, AND OTHERS. THE HOSPITAL ALSO IS INVOLVED IN THE COMMUNITY WITH LOCAL ORGANIZATIONS LIKE THE ROTARY CLUB, LIONS CLUB, LOCAL CHURCHES, AND OTHERS.
SCHEDULE H, PART VI, LINE 3 THE HOSPITAL POSTS SIGNS ABOUT THE AVAILABILITY OF THE CHARITY CARE PROGRAM IN THE HOSPITAL AND AT THE KINGMAN HEALTH DEPARTMENT. ALL THE LOCAL PHYSICIANS KNOW ABOUT THE HOSPITAL'S CHARITY CARE PROGRAM SO THAT IF A PATIENT NEEDS SERVICES THEY CAN INFORM THE PATIENT ABOUT IT. THE HOSPITAL HAS A STAND WITH BROCHURES ON THE CHARITY CARE PROGRAM AS WELL AS BROCHURES ON OTHER PROGRAMS SUCH AS MEDICAID, CHILDREN'S MERCY, AND UNICARE. THE HOSPITAL EMPLOYS A PATIENT ADVOCATE WHO WILL HELP PATIENTS COMPLETE THE CHARITY CARE PROCESS AND ANSWER ANY QUESTIONS ABOUT THE PROGRAM. THIS EMPLOYEE WILL ALSO HELP PATIENTS WITH MEDICAID APPLICATIONS IF IT IS DETERMINED THAT THE PATIENT MIGHT QUALIFY FOR THIS PROGRAM.
SCHEDULE H, PART VI, LINE 4 THE HOSPITAL IS LOCATED IN A RURAL COMMUNITY IN KINGMAN COUNTY KANSAS. THIS COUNTY IS IN SOUTH CENTRAL KANSAS. KINGMAN COUNTY HAS APPROXIMATELY 7,600 RESIDENTS WITH APPROXIMATELY 8% OF THE POPULATION FALLING UNDER THE POVERTY GUIDELINES, AND 21% BEING OVER THE AGE OF 65. THE HOSPITAL IS THE ONLY HOSPITAL LOCATED IN THE COUNTY AND THE NEXT CLOSEST HOSPITAL IS OVER 20 MILES AWAY.
SCHEDULE H, PART VI, LINE 5 THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN SEVERAL WAYS. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL ALSO RECRUITS AND PROVIDES SPACE TO SPECIALISTS SO THEY CAN CONDUCT CLINICS AND PROVIDE SERVICES FOR PATIENTS IN THE COMMUNITY. THE HOSPITAL ALSO PROVIDES FREE CLINICS AND SCREENINGS THROUGHOUT THE YEAR.
