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Livingston Hospital & Healthcare Services Inc
Salem, KY 42078
| Bed count | 25 | Medicare provider number | 181320 | 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 $ 19,595,519 Total amount spent on community benefits as % of operating expenses$ 1,083,315 5.53 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 7,092 0.04 %Medicaid as % of operating expenses$ 1,059,389 5.41 %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.$ 16,834 0.09 %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$ 112,187 0.57 %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? YES 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? Not available 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 $ 15521691 including grants of $ 0) (Revenue $ 19957308) PROVIDED INPATIENT AND OUTPATIENT HEALTH SERVICES TO THREE WESTERN KENTUCKY COUNTIES AND PROVIDED APPROXIMATELY $6,000 IN CHARITY CARE AT COST DURING THE YEAR ENDED DECEMBER 31, 2021.
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Facility Information
LIVINGSTON HOSPITAL & HEALTHCARE SERVICE PART V, SECTION B, LINE 5: THE COMMUNITY STEERING COMMITTEE PROVIDED A VITAL PART OF THE CHNA PROCESS. THESE INDIVIDUALS REPRESENT ORGANIZATIONS AND AGENCIES FROM THE SERVICE AREA AND IN PARTICULAR, THE INDIVIDUALS WHO WERE WILLING TO VOLUNTEER ENABLED THE HOSPITAL TO GET INPUT FROM POPULATIONS THAT WERE OFTEN NOT ENGAGED IN CONVERSATIONS ABOUT THEIR HEALTH NEEDS. COMMUNITY AND ECONOMIC DEVELOPMENT INITIATIVE OF KY (CEDIK) PROVIDED A LIST OF POTENTIAL AGENCIES AND ORGANIZATIONS THAT WOULD FACILITATE BROAD INPUT. THE ASSESSMENT PROCESS INCLUDED COLLECTING SECONDARY DATA RELATED TO THE HEALTH OF THE COMMUNITY. SOCIAL AND ECONOMIC DATA, AS WELL AS HEALTH OUTCOMES DATA, WAS COLLECTED FROM SECONDARY SOURCES TO HELP PROVIDE CONTEXT FOR THE COMMUNITY. ADDITIONALLY, CEDIK COMPILED HOSPITAL UTILIZATION DATA TO BETTER UNDERSTAND WHO WAS USING THE FACILITY AND FOR WHAT SERVICES. FINALLY, WITH THE ASSISTANCE OF THE COMMUNITY STEERING COMMITTEE, INPUT FROM THE COMMUNITY WAS COLLECTED THROUGH FOCUS GROUP DISCUSSIONS AND SURVEYS.
LIVINGSTON HOSPITAL & HEALTHCARE SERVICE PART V, SECTION B, LINE 11: THE HOSPITAL ADDRESSED NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH ADOPTION OF AN IMPLEMENTATION STRATEGY THAT ADDRESSES EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, EXECUTION OF THE IMPLEMENTATION STRATEGY, ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY.
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Supplemental Information
PART III, LINE 2: THE HOSPITAL HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE HOSPITAL UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE BY PAYOR, REVENUE TRENDS BY PAYOR CLASSIFICATION AND AGED ACCOUNTS FROM DATE OF SERVICE BY PAYOR. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.
PART III, LINE 3: THE HOSPITAL DOES NOT HAVE BAD DEBT EXPENSES RELATED TO THE PATIENTS ELIGIBLE UNDER THE HOSPITAL'S CHARITY CARE POLICY.
PART III, LINE 4: SEE FOOTNOTE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL. LINE 6 COSTS REPRESENT MEDICARE CHARGES MULTIPLIED BY A CALCULATED COST-TO-CHARGE RATIO FOR ANCILLARY SERVICES AND MEDICARE DAYS MULTIPLIED BY A CALCULATED PER DIEM AMOUNT FOR ROUTINE SERVICES. LINE 5 REVENUES REPRESENT 101% OF MEDICARE COSTS LESS 2% SEQUESTRATION, WHICH IS MEDICARE'S REIMBURSEMENT METHODOLOGY FOR CRITICAL ACCESS HOSPITALS. CMS ELIMINATED THE SEQUESTRATION ADJUSTMENT DURING THE COVID PANDEMIC AND IT IS CURRENTLY STILL ELIMINATED THROUGH DECEMBER 31, 2021.
PART III, LINE 9B: OUTSTANDING ACCOUNTS WILL BE COLLECTED IN-HOUSE, IF AT ALL POSSIBLE, BEFORE BEING REFERRED TO AN OUTSIDE COLLECTION AGENCY. IF A BALANCE REMAINS UNPAID AND NO PAYMENT EFFORTS ARE MADE, ACCOUNTS WILL BE REFERRED TO CONTRACTED COLLECTION AGENCIES AFTER APPROXIMATELY 60 DAYS OF THE BALANCE BECOMING THE PATIENT'S RESPONSIBILITY. PRIVATE PAY ACCOUNTS WILL BE ADDRESSED PRIOR TO SERVICE BEING RENDERED. THE PATIENT WILL APPLY FOR THE DISPROPORTIONATE SHARE HOSPITAL PROGRAM (DSH). IN THE EVENT THE PATIENT IS ELIGIBLE FOR DSH, THE DSH COORDINATOR WILL FOLLOW UP WITH THE PATIENT. IN THE EVENT THE PATIENT IS NOT ELIGIBLE FOR THE DSH PROGRAM, THE ACCOUNT WILL BECOME PRIVATE PAY. THE DOCTOR WILL DETERMINE WHETHER THE PROCEDURE IS MEDICALLY NECESSARY OR ELECTIVE. IN THE EVENT THE PROCEDURE IS DEEMED MEDICALLY NECESSARY, THE PATIENT WILL BE ASKED TO MAKE A DEPOSIT AND SIGN A FINANCIAL AGREEMENT. IF A PROCEDURE IS DETERMINED TO BE ELECTIVE, THE PATIENT WILL BE ASKED TO PAY FOR SERVICE PRIOR TO SERVICES BEING RENDERED. IF A PATIENT IS UNABLE TO PAY THE FULL AMOUNT, THEY WILL BE REQUIRED TO SIGN A FINANCIAL AGREEMENT. IN THE EVENT A PRIVATE PAY PATIENT IS PRESENT FOR SERVICE WHILE THE REGISTRATION OFFICE IS CLOSED, A DSH COORDINATOR WILL CONTACT THE PATIENT THE FOLLOWING BUSINESS DAY. IN THE EVENT THE DSH COORDINATOR IS UNABLE TO REACH THE PATIENT BY PHONE, A DSH APPLICATION WILL BE MAILED TO THE PATIENT. AFTER 10 DAYS AND THE APPLICATION HAS NOT BEEN RETURNED, THE DSH COORDINATOR WILL CONTACT THE PATIENT BY PHONE. IN THE EVENT THE PATIENT IS UNABLE TO BE REACHED BY PHONE, A NO INSURANCE COVERAGE LETTER WILL BE MAILED TO THE PATIENT. DUE TO NO RESPONSE AFTER 10 DAYS, THE PATIENT WILL BE CONTACTED BY PHONE ONCE AGAIN. IF THE PATIENT IS NOT REACHED BY PHONE, A PAYMENT OVERSIGHT LETTER WILL BE MAILED TO THE PATIENT. AFTER ANOTHER 10 DAYS AND NO RESPONSE FROM THE PATIENT, THE DSH COORDINATOR WILL CONTACT THE PATIENT BY PHONE. IF UNABLE TO REACH THE PATIENT, A FINAL NOTICE LETTER WILL BE MAILED TO THE PATIENT. AFTER 10 MORE DAYS AND NO RESPONSE FROM THE PATIENT, THE ACCOUNT WILL BE REFERRED TO THE CONTRACTED COLLECTION AGENCIES. IN THE EVENT A PATIENT IS COVERED BY INSURANCE AND A PORTION OF THE BILL IS NOT COVERED, LEAVING A BALANCE DUE FROM THE PATIENT, ADDITIONAL LETTERS WILL BE SENT WITH A PHONE CALL BEFORE FOR EACH LETTER REQUESTING PAYMENT.
PART VI, LINE 2: THE HOSPITAL ASSESSES THE NEEDS OF THE COMMUNITIES IT SERVES BY PROVIDING FREE HEALTH SCREENINGS AT LOCAL FESTIVALS, SENIOR CITIZEN CENTERS, CHURCH FUNCTIONS AND SCHOOL FUNCTIONS. AT HEALTH FAIRS, SCREENINGS ARE OFFERED FOR CHOLESTEROL, BLOOD GLUCOSE, BLOOD PRESSURE, PULSE OXYGEN, HEART RATE AND BODY CHEMISTRY ANALYSIS (BODY MASS INDEX AND % BODY FAT). THE HOSPITAL WORKS CLOSELY WITH OTHER AGENCIES IN THE COUNTIES IT SERVES AS TO BETTER SERVE THE COMMUNITY.
PART VI, LINE 3: THE HOSPITAL IS COMMITTED TO PROVIDING HEALTH CARE TO EVERYONE IN NEED, REGARDLESS OF THEIR ABILITY TO PAY. BILLING STATEMENTS INCLUDE INFORMATION ABOUT HOW TO CONTACT FINANCIAL COUNSELORS AND ARRANGE PAYMENT PLANS. THE HOSPITAL OFFERS CHARITY CARE TO UNINSURED PATIENTS WHO QUALIFY FOR THE PROGRAM. FINANCIAL COUNSELORS CONTACT PATIENTS ON THE FRONT END TO RECOGNIZE WHO NEEDS ASSISTANCE AND TO EDUCATE AND HELP THEM APPLY FOR THE DISPROPORTIONATE SHARE HOSPITAL (DSH) PROGRAM, ALONG WITH OTHER FEDERAL PROGRAMS IN WHICH THEY MAY BE ELIGIBLE.
PART VI, LINE 4: LIVINGSTON COUNTY, LOCATED IN WESTERN KENTUCKY, HAS A POPULATION OF APPROXIMATELY 8,959 PEOPLE ACCORDING TO THE 2021 CENSUS. THE POPULATION IS COMPRISED OF 50.6% FEMALE AND 49.4% MALE AND IS 96.5% CAUCASIAN. THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $52,795. ACCORDING TO THE 2021 CENSUS, APPROXIMATELY 14% OF INDIVIDUALS ARE LIVING IN POVERTY. 7.4% OF PATIENTS UNDER 65 ARE UNINSURED. THE HOSPITAL PROVIDES CARE TO INPATIENTS, OUTPATIENTS, OBSERVATION PATIENTS AND SWING BED PATIENTS FROM THE SURROUNDING COUNTIES. SEVERAL OF THE SURROUNDING COUNTIES HAVE HOSPITALS, HOWEVER, LIVINGSTON HOSPITAL IS THE CLOSEST CRITICAL ACCESS HOSPITAL FOR THE COMMUNITY.
PART VI, LINE 5: LHHS SPONSORS HEALTH FAIRS THROUGHOUT THE YEAR IN LIVINGSTON, LYON AND CRITTENDEN COUNTIES. AT THE HEALTH FAIRS, LHHS OFFERED SCREENINGS FOR CHOLESTEROL, BLOOD GLUCOSE, BLOOD PRESSURE, PULSE OXYGEN, HEART RATE, AND BLOOD CHEMISTRY ANALYSIS. LHHS PARTICIPATES IN MANY ACTIVITIES WITH THE AREA SCHOOL SYSTEMS SUCH AS REALITY STORES, WELLNESS DAY, CAREER FAIR, FARM FIELD DAY, FITNESS AND NUTRITION CLUB, FREE SPORTS PHYSICALS AND CARDIAC SCREENINGS.
PART VI, LINE 6: THE HOSPITAL IS NOT A PART OF AN AFFILIATED HEALTH CARE SYSTEM.
