Community Benefit Insight - Tax-exempt hospital

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Cumberland County Hospital Association Inc

Cumberland County Hospital

229 Glasgow Road
Burkesville, KY 42717

Bed count	25	Medicare provider number	181317	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 610624096

Display data for year:

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

3.33%

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	$ 47,963 0.24 %
Medicaid as % of operating expenses	$ 612,860 3.09 %
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 expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 0 0 %
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	$ 212,654 1.07 %
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?	NO (Some hospitals use other acceptable methods for calculating when to provide discounted or free care.)
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	$ 10,006 4.71 %

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 $ 15498527 including grants of $ 0) (Revenue $ 20070239)
CUMBERLAND COUNTY HOSPITAL, IN PARTNERSHIP WITH ITS MEDICAL STAFF, EMPLOYEES, AND OTHER PROVIDERS, STRIVES TO BE RECOGNIZED FOR HIGH-QUALITY, COST-EFFECTIVE CARE RESULTING IN COMMUNITY PRIDE, CONFIDENCE, AND SUPPORT. THE HOSPITAL ACKNOWLEDGES THE PARTNERSHIPS REQUIRED WITH ITS MEDICAL STAFF, ITS EMPLOYEES, AND OTHER PROVIDERS TO ACHIEVE THIS VISION. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO PATIENTS IN CUMBERLAND COUNTY, KY AND SURROUNDING COUNTIES. THE HOSPITAL PROVIDES APPROXIMATELY $31,015 IN CHARITY CARE DURING THE YEAR ENDED JUNE 30, 2022.

Facility Information

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

CUMBERLAND COUNTY HOSPITAL
PART V, SECTION B, LINE 5: THE PRIMARY DATA WAS COLLECTED, ANALYZED, AND PRESENTED WITH THE ASSISTANCE OF BLUE. TWO PRIMARY DATA COLLECTION METHODS WERE USED: 1) ONLINE SURVEYS AND 2) PERSONAL INTERVIEWS.A SURVEY WAS DEVELOPED BY CUMBERLAND COUNTY HOSPITAL AND USED TO SOLICIT PERCEPTIONS, INSIGHTS, AND GENERAL UNDERSTANDING FROM COMMUNITY MEMBERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. THESE INDIVIDUALS ALSO REPRESENTED THE INTERESTS OF THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS OF THE COMMUNITY SERVED. THE SURVEY WAS COMPRISED OF TWENTY-NINE QUESTIONS IN TOTAL. COMMUNITY LEADERS WERE ASKED THE FOLLOWING KEY QUESTIONS: TOP THREE MOST SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY, PERCEPTION OF THE AVAILABILITY OF SERVICES, HEALTH STATUS, PROVIDER COORDINATION, AND BARRIERS. ADDITIONALLY, THE PARTICIPANTS WERE ALLOWED TO WRITE IN ISSUES NOT LISTED. THE SURVEY RESULTS CAN BE FOUND IN THE COMMUNITY SURVEY RESULTS SECTION OF THE REPORT. PERSONAL INTERVIEWS WERE CONDUCTED BY CUMBERLAND, WITH A TOTAL OF 11 PARTICIPANTS DURING APRIL OF 2022, WITH EACH SESSION LASTING APPROXIMATELY 30 MINUTES. THESE SESSIONS WERE CONDUCTED WITH COMMUNITY MEMBERS SERVED BY CUMBERLAND COUNTY HOSPITAL, INCLUDING PUBLIC SERVICE LEADERS, HEALTH EXPERTS, PUBLIC OFFICIALS, PHYSICIANS, HOSPITAL EMPLOYEES, AND OTHER HEALTH PROFESSIONALS AND PROVIDERS, INCLUDING THOSE ASSOCIATED WITH CUMBERLAND COUNTY HOSPITAL. THE PRIMARY OBJECTIVE WAS TO SOLICIT PERCEPTIONS REGARDING HEALTH NEEDS AND SERVICES OFFERED IN THE COMMUNITY, ALONG WITH ANY OPPORTUNITIES OR BARRIERS TO SATISFYING REQUIREMENTS.

CUMBERLAND COUNTY HOSPITAL
"PART V, SECTION B, LINE 11: ON BEHALF OF CUMBERLAND COUNTY HOSPITAL, A COMMUNITY HEALTH NEEDS ASSESSMENT (""CHNA"") WAS CONDUCTED IN 2022 PRIMARILY TO IDENTIFY THE MAJOR HEALTH NEEDS, BOTH MET AND UNMET, WITHIN THE SURROUNDING COMMUNITY. THE COMMUNITY'S GEOGRAPHIC AREA IS COMPRISED PRIMARILY OF CUMBERLAND COUNTY WITH A POPULATION OF 6,697 ACCORDING TO THE 2019 CENSUS. THE PRIMARY OBJECTIVES OF THE CHNA WERE TO: 1) IDENTIFY MAJOR HEALTH NEEDS WITHIN THE COMMUNITY TO IMPROVE THE HEALTH OF THE AREA'S RESIDENTS AND FACILITATE COLLABORATION AMONG LOCAL HEALTHCARE PROVIDERS, AND 2) SATISFY THE FEDERAL GUIDELINES WITHIN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (""PPACA"") OF 2010. DATA FOR THIS CHNA WAS COLLECTED FROM PRIMARY AND SECONDARY SOURCES TO IDENTIFY KEY FINDINGS AND GAPS THAT MAY EXIST BETWEEN HEALTH NEEDS AND SERVICES PROVIDED WITHIN THE COMMUNITY. THE METHOD OF COLLECTION FOR PRIMARY DATA WERE PERSONAL INTERVIEWS AND SURVEYS. SEVERAL SECONDARY DATA SOURCES WERE REVIEWED AND ANALYZED TO IDENTIFY KEY FINDINGS WITH STRATEGIC IMPLICATIONS AND FOR BENCHMARKING THE HOSPITAL'S SERVICE AREA. FINALLY, IT IS IMPORTANT TO NOTE THAT OUR DATA COLLECTION DID NOT INCLUDE A STATISTICALLY REPRESENTATIVE SAMPLE OF THE COMMUNITY, IN THAT MEMBERS OF DISADVANTAGED POPULATIONS WERE LESS LIKELY TO PARTICIPATE VIA A WEB-BASED SURVEY. THESE INDIVIDUALS MAY INCLUDE IMMIGRANTS, THE HOMELESS, AS WELL AS INDIVIDUALS WITH LOW EDUCATION AND INCOME LEVELS. HIGHLIGHTED, SUBSEQUENTLY, ARE IMPORTANT FINDINGS IDENTIFIED THROUGH THE DATA COLLECTION, ANALYSIS, AND ASSESSMENT PROCESS:- ACCESS TO CARE- DRUG ABUSE- HEALTH OUTCOMES AND INACTIVITY/OBESITY- TEEN BIRTHS- MENTAL HEALTHCUMBERLAND COUNTY HAS IDENTIFIED THE ABOVE NEEDS FOR ITS COMMUNITY AND PRIORITIZED THEM BASED ON THE ORDER ABOVE."

CUMBERLAND COUNTY HOSPITAL
PART V, SECTION B, LINE 13B: DETERMINING FREE CARE: STATE GUIDELINES ARE FOLLOWED FOR ELIGIBILITY REQUIREMENTS AS SET FORTH BY DMS FOR DISPROPORTIONATE SHARE HOSPITAL PROGRAMS FOR THE CURRENT YEAR. UPON COMPLETION OF THE APPLICATION, IT CAN BE DETERMINED WHETHER THE PATIENT IS ELIGIBLE FOR CHARITY. IF THE PATIENT IS ELIGIBLE 100% WILL BE ADJUSTED. THE INCOME LIMITS ARE FOR A HOUSEHOLD SIZE OF ONE, AN ANNUAL INCOME OF $13,520 OR LOWER QUALIFIES. FOR EACH ADDITIONAL PERSON IN THE HOUSEHOLD THE INCOME LIMIT IS INCREASED $4,680.DETERMINING DISCOUNTED CARE: ALL PATIENTS WITH A PRIVATE PAY BALANCE OF ANY FORM (DEDUCTIBLE, ALL CHARGES ETC.) QUALIFY FOR A 25% DISCOUNT IMMEDIATELY WITH A PROMPT PAYMENT OR PROMPT REPAYMENT PLAN.

PART V, SECTION B, LINE 11
PRIORITY 1 - ACCESS TO CAREGOAL: INCREASE FLU VACCINE RATESSTRATEGIES: - EXPAND THE EDUCATION ON FLU VACCINES IN THE COMMUNITY - ENSURE THAT THE AVAILABILITY OF THE FLU VACCINES IS COMMUNICATED WELL TO THE COMMUNITY AND RESEARCH ALL MEDIA AVENUES OF COMMUNICATION - UPDATE FLU VACCINATION INFORMATION AS A HEALTH LITERACY INTERVENTION THAT USE WRITTEN AND PRINT-BASED MATERIALS DESIGNED TO BE EASY TO READ AND UNDERSTAND. PRIORITY 2 - LOW ACCESS TO EXERCISE OPPORTUNITIES GOAL: EDUCATE THE COMMUNITY ON AVAILABILITY STRATEGIES: - EDUCATE AND INFORM PATIENTS OF LOCAL PLACES, FORMS AND AVAILABILITY TO EXERCISEPRIORITY 3 - ACCESS TO CARE: GOAL: EDUCATE PATIENTS ON ACCESS TO CARESTRATEGIES: - HOST OUTPATIENT CLINICS WITH PHYSICIANS FROM OTHER COUNTIES TO COME TO SEE PATIENTS LOCALLY INSTEAD OF THE PATIENT HAVING TO TRAVEL- EDUCATE PATIENTS ON LOCAL TRANSPORTATION AVAILABLE TO REACH THE CARE LOCATIONS PRIORITY 4 - DRUG AND ALCOHOL ABUSEGOAL: INCREASE AWARENESS AND TREATMENT OPPORTUNITIES STRATEGIES: - CREATE RESOURCES AND EVENTS THAT FOCUS ON EDUCATION AND SUPPORT- SHARE INFORMATION AND TREATMENT OPPORTUNITIES FROM OUTSIDE SOURCES - PARTNER WITH LOCAL PHYSICIANS, COMMUNITY MEMBERS, AND TREATMENT PROGRAMS TO INCREASE ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) FOR OPIOID USE DISORDERPRIORITY 5 - TEEN BIRTHS GOAL: AWARENESS OF NATIONAL TREND ON TEEN BIRTHS STRATEGIES: - CREATE AWARENESS AND RESOURCES INFORMING THE COMMUNITY OF THE HIGH TREND OF LOCAL TEEN BIRTHS.- INCREASE EDUCATION AT YOUNGER AGE ON TEEN BIRTHS - PARTNER WITH LOCAL TEEN PREGNANCY PREVENTION (TPP) PROGRAM

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
DETERMINE FREE CARE: STATE GUIDELINES ARE FOLLOWED FOR ELIGIBILITY REQUIREMENTS AS SET FORTH BY DMS FOR DISPROPORTIONATE SHARE HOSPITAL PROGRAMS FOR THE CURRENT YEAR. UPON COMPLETION OF THE APPLICATION, IT CAN BE DETERMINED WHETHER THE PATIENT IS ELIGIBLE FOR CHARITY. IF THE PATIENT IS ELIGIBLE 100% WILL BE ADJUSTED. THE INCOME LIMITS ARE FOR A HOUSEHOLD SIZE OF ONE AND ANNUAL INCOME OF $13,520 OR LOWER QUALIFIES. FOR EACH ADDITIONAL PERSON IN THE HOUSEHOLD THE INCOME LIMIT IS INCREASED $4,680. DETERMINIE DISCOUNTED CARE: ALL PATIENTS WITH A PRIVATE PAY BALANCE OF ANY FORM (DEDUCTIBLE, ALL CHARGES ETC.) QUALIFY FOR A 25% DISCOUNT IMMEDIATELY WITH A PROMPT PAYMENT OR PROMPT REPAYMENT PLAN.

PART III, LINE 2:
THE BAD DEBT EXPENSE CONTAINS THE TRUE EXPENSES WRITTEN OFF DURING THE YEAR DUE TO NON PAYMENT AFTER ALL COLLECTION ATTEMPTS HAVE BEEN PERFORMED. THE EXPENSE ALSO CONTAINS AN ALLOWANCE THAT HAS A PERCENTAGE THAT IS AGREED UPON WITH BLUE AND COMPANY APPLIED TO THE CURRENT AR AND THEN THAT ALLOWANCE IS EXPENSED. SEE PAGE 11 OF THE AUDITED FINANCIAL STATEMENTS.

PART III, LINE 3:
THE COLLECTIONS DEPARTMENT REVIEWED ALL ACCOUNTS THAT WERE WRITTEN OFF TO BAD DEBT. THE ACCOUNTS WERE RESEARCHED TO SEE IF PATIENTS HAD JOBS, ETC. AND WERE DETERMINED AT THAT POINT IF HE/SHE WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE.

PART III, LINE 8:
MEDICARE ALLOWABLE COSTS WERE TAKEN DIRECTLY OFF MEDICARE COST REPORT FILED WITH THE 6/30/22 YEAR END. THE CALCULATION INCLUDED MEDICARE INPATIENT AND OUTPATIENT CHARGES LESS MEDICARE REIMBURSEMENT LESS GME RECEIVED. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT AS THE REIMBURSEMENT RECEIVED DID NOT COVER THE COST OF PROVIDING SERVICES.

PART VI, LINE 3:
PATIENTS ARE INFORMED OF PATIENT ASSISSTANCE AT TIME OF REGISTRATIONS, BY THE DISCHARGE NURSE, IF INPATIENT, AND ARE MAILED A LETTER.

PART VI, LINE 4:
THE POPULATION OF CUMBERLAND COUNTY, KY IS APPROXIMATELY 6,800. CUMBERLAND COUNTY HOSPITAL QUALIFIES FOR A DISPROPORTIONATE SHARE PAYMENT ON THEIR MEDICARE COST REPORT DUE TO THE LARGER THAN NORMAL SHARE OF MEDICAID PATIENT VOLUME SERVED BY THE HOSPITAL. NEARLY 35% OF THE COUNTIES' RESIDENTS ARE ENROLLED IN MEDICAID.

PART VI, LINE 5:
THE COMMUNITY HEALTH FAIR IS A HUGE SUCCESS. IT IS AN EXCELLENT WAY FOR THE HOSPITAL TO SHARE IMPORTANT HEALTH INFORMATION WITH THE COMMUNITY. CUMBERLAND COUNTY HOSPITAL ALSO HAS RADIO SPOTS ON THE LOCAL RADIO STATION TO DISCUSS SPECIFIC HEALTH NEEDS AND TO SHARE HEALTH INFORMATION WITH THE COMMUNITY

Operating expenses	$ 19,834,937
Total amount spent on community benefits as % of operating expenses	$ 660,823 3.33 %