Community Benefit Insight - Tax-exempt hospital

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Southern Maine Health Care

PO Box 626

Biddeford, ME 04005

EIN: 010179500

The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more

Individual Facility Details: Henrietta D Goodall Hospital

25 June Street
Sanford, ME 04073

1 hospital in organization:
(click a facility name to update Individual Facility Details panel)

Henrietta D Goodall Hospital

Bed count	58	Medicare provider number	200040	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

Southern Maine Health CareDisplay data for year:

Community Benefit Spending- 2018
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

3.93%

Spending by Community Benefit Category- 2018
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2018

Additional data

Community Benefit Expenditures: 2018

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	$ 1,620,824 2.17 %
Medicaid as % of operating expenses	$ 0 0 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 101,334 0.14 %
Subsidized health services as % of operating expenses	$ 928,206 1.24 %
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.	$ 245,057 0.33 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 40,990 0.05 %
Community building* as % of operating expenses	$ 1,000 0.00 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
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	$ 1,000 0.00 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 1,000 100 %
Community support as % of community building expenses	$ 0 0 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 0 0 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 0 0 %
Other as % of community building expenses	$ 0 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: 2018

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	$ 3,640,558 4.88 %
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 2022 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: 2018

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: 2018

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 $ 44822643 including grants of $ 0) (Revenue $ 55565200)
Southern Maine Health Care operates two hospital facilites with a total of 208 beds, which strives to meet the health care needs of idividuals and families throughout York County. SMHC offers a broad range of medical, surgical, diagnostic, clinical and rehabilitation services, wellness education, support groups and other community outreach programs. SMHC had 11,284 emergency room visits, 30,476 radiological procedures, and 1,863 surgical cases. This includes patients who are underinsured or those without insurance. In addition to the charitable care services, we are continually absorbing all the costs associated with providing the community with a variety of special complimentary educational and informational services. (Continued on Schedule O) (Continuation) SMHC proudly sponsors community organizations, civic organizations and special events. SMHC airs a weekly radio program featuring SMHC physicians talking about important health topics. The radio programs are also shared through social media as podcasts. Each month, SMHC sponsors numerous free and low-cost health classes, and support groups. Each year SMHC participates in health fairs and business events, and offers special events like free screening clinics and information sessions. Assistance is also offered to patients in need of Medication assistance, help with insurance and medical issues, as well as personal issues including tax information, finances and home needs.

4B (Expenses $ 18495104 including grants of $ 0) (Revenue $ 18880654)
SMHC Physician Services consists of many physicians with multi-specialty services in different locations throughout York county. These physicians compliment the hospital in maintaining its mission to serve as a leader in improving the health and well-being of our community by serving the populous. These specialties include (but are not limited to) cardiology, ear, nose and throat, family practices, women's health, internal medicine, pediatrics, orthopedic and general surgery. SMHC Physician Services had 69,010 office visits and 11,681 walk-in care visits.

4C (Expenses $ 1459132 including grants of $ 0) (Revenue $ 1528722)
SMHC eldercare services provide long-term care, medical services, and daycare to our senior citizens. Eldercare had a total of 6,091 patient days. We continue to grow and adapt to the needs of our community with these services. SMHC eldercare prides themselves by creating a home-like, comfortable environment for the residents and staff. The Newton Center for Rehabilitation and Nursing Care promotes high quality care; with dedicated staff, family education and involvement make this program special.

Facility Information

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

Southern Maine Health Care
Part V, Section B, Line 5: Local community input and engagement was an integral part of the CHNA process and this included community forums, focus groups, electronic surveys and group presentations. These groups were comprised of local community members, healthcare providers, disparate populations and those with knowledge of public health. The local advisory group consisted of groups from Southern Maine Health Care, York Hospital, Community Health Coalitions, United Way, York County Community College, local FQHC, Rotary Club, Visiting Nurses, University of New England and the District Public Health Liaison.

Southern Maine Health Care
Part V, Section B, Line 6a: The CHNA was conducted through a partnership between Maine Healthcare, Central Maine Healthcare, Northern Light Health, MaineGeneral Health and the Maine Department of Health and Human Services.

Southern Maine Health Care
Part V, Section B, Line 11: For the 2016-2018 CHNA, the organization has identified priorities and developed strategies to address the significant needs identified in its most recently conducted CHNA and provided reasons if identified needs are not being addressed. Please see the 2016-2018 CHNA and Annual Implementation Update FY18 at https://mainehealth.org/healthy-communities/community-health-needs-assessment for details of the activities undertaken by the organization.

Southern Maine Health Care:
Part V, Section B, Lines 7a and 10a:The CHNA and implementation strategy are posted on the following website:https://mainehealth.org/healthy-communities/community-health-needs-assessment

Southern Maine Health Care:
Part V, Section B, Lines 16a, 16b, and 16c:The Financial Assistance Policy (FAP) and plain language summary areavailable on the following website:https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance. The FAP Application Form is available on the followingwebsite: https://mainehealth.org/patients-visitors/billing-insurance/financial-assistance/free-care

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7g - Subsidized Health Services Explanation
$928,206 of net community benefit related to Subsidized Health Services is included in Part I, Line 7g. This amount includes: Mental Health Services - $863,735, and Oncology Services - $64,471

Part I, Line 7, Column (f) - Exclusions from Percent of Total Expense
State of Maine Provider Taxes of $1,414,018 was removed from total expenses when calculating the percent of total expenses in Column (f).

Part I, Line 7 - Costing Methodology Explanation
The costing methodology for the amounts reported in Part I, Line 7 of the Schedule H is based on a ratio of patient care cost to charges. This cost to charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges provided in the instructions for Schedule H.

Part II - Community Building Activities
Southern Maine Health Care supports and assists with the local emergency preparedness training on an annual basis, and provides support to local community organizations and to local community economic development.

Part III, Line 2 - Bad Debt Expense Methodology
"Southern Maine Health Care does not have a specific footnote in the financial statements that describes ""Bad Debt Expense"". Southern Maine Health Care reports accounts receivable for services rendered net of allowances for contractual adjustments, third party reimbursing agencies, free care and bad debts. A bad debt allowance is established for accounts the hospital believes will become uncollectible. The allowance is established by examining historical data, aging trends of accounts receivable balances and economic trends. The offset to the allowance account is to Bad Debt Expense on the Statement of Operations. Recoveries on accounts previously written off are accounted for on a cash basis and are applied directly to the Provision for Bad Debts on the Statement of Operations. Accounts written off or recovered from Bad Debts during the year are charged against the allowance account on the Balance Sheet. Bad debt expense represents healthcare services Southern Maine Health Care has provided without compensation. As a tax-exempt hospital, Southern Maine Health Care provides necessary patient care regardless of the patient's ability to pay for the services. A portion of Southern Maine Health Care's bad debt expense is attributable to patients eligible for financial assistance that, for a variety of reasons, do not complete the financial assistance application process. Southern Maine Health Care cannot determine the amount of bad debt expense that could be reasonably attributable to patients who likely would qualify under the Southern Maine Health Care's free care policy. In addition, bad debt expense also includes amounts for services provided to individuals experiencing difficult personal or economic circumstances related to a portion of our community based patient population. Their medical bills often place these individuals in untenable positions where they are not able to handle their personal debt and then their new medical debt. However, because of their income level, they do not qualify for free care. By providing necessary healthcare services to those individuals either who fail to apply for free care or who are experiencing difficult personal or economic circumstances, Southern Maine Health Care believes that bad debt expense should be included as a community benefit."

Part III, Line 4 - Bad Debt Expense Footnote to Financial Statements
Please see explanation for footnote under Part III, Line 2 - Bad Debt Expense Methodology.

Part III, Line 8 - Medicare Explanation
Medicare allowable costs were calculated using a cost to charge ratio. Southern Maine Health Care believes that the Medicare shortfall should be included as a community benefit because Southern Maine Health Care has a clear mission commitment to serving elderly patients and adults with disabilities through the provision of specific subsidized programs developed to help improve the health status of these patients. If these critical subsidized programs were not provided by Southern Maine Health Care, they would become the obligation of the Federal Government.

Part III, Line 9b - Collection Practices Explanation
Patients who qualify for financial assistance have their account balance adjusted accordingly once financial assistance has been approved. Monthly payment arrangements can be established by the responsible party by contacting the Patient Financial Services Customer Service department. As a tax-exempt hospital, Southern Maine Health Care provides necessary patient care regardless of the patient's ability to pay for the services.

Part VI, Line 2 - Needs Assessment
"SMHC's Board is made up of a diverse set of community members. The Board requires a thorough Community Needs Assessment on behalf of the organization, and directs the organization to analyze and respond to the current needs assessment. MaineHealth also participates in various initiatives to help support and provide updates to community needs assessment planning. Some of these initiatives include:- Clinical Strategic Planning- Financial Strategic Planning- Facility Planning- Manpower Planning- Physician Recruitment Strategic Planning- Emergency Preparedness PlanningAlong with the internal assessments, most member organizations also review and act on many of the recommendations provided by external groups such as the Maine Center for Disease Control and Prevention and the ""State Health Plan created by the Advisory Committee for Health Systems Development.The organization prepares a Community Health Needs Assessment (CHNA) every three years. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA."

Part VI, Line 4 - Community Information
The Community Health Needs Assessment describes the geographic area and demographic constituents it services. See https://mainehealth.org/healthy-communities/community-health-needs-assessment for the completed CHNA.

Part VI, Line 7 - State Filing of Community Benefit Report
Maine

Part VI, Line 3 - Patient Education of Eligibility for Assistance
Free Care information is provided in the Admitting and Emergency Registration locations in the following manner:- Postings including Free Care and Monthly Payment Plan- Handouts- InterviewsIf the patient is self-pay, underinsured or can't afford to pay their hospital bill, they may receive a Financial Counseling Packet and/or referred to financial counseling from the registration staff or Change Healthcare, an outside vendor who helps manage the self- pay accounts. The packet includes:- Information on Maine Healthcare's financial policies- Information on Maine Healthcare's Free Care Program, Monthly Payment Plan Program, Care Partners, MedAccess and other community resource needs. - Program applications and instructions for Maine Healthcare's Free Care Program, and Monthly Payment Plan Application- Contact information for assistance with applications, bills or financial concernsSelf-pay or underinsured patients registering in person or via a phone interview receive financial counseling including information on our financial assistance programs. Registration staff or Change Healthcare provide forms and assist with completing financial assistance applications and providing follow up contact information. Maine Healthcare's Web site includes online Registration and Patient Billing information:- Billing Process- Free Care- Monthly Payment Plan- Patient Statement- Price Information- Contact Us and QuestionsPrimary language, deaf and hard of hearing and interpreter needs are assessed during the registration interview and services are provided as needed.If a patient does not respond at pre-registration, registration, or while receiving care, all of these programs are explained again by the Single Billing Office staff. The intent of these efforts is to ensure that the patient is fully informed of and able to take advantage of these assistance programs.

Part VI, Line 5 - Promotion of Community Health
As a fully integrated tax-exempt healthcare system, Southern Maine Health Care (SMHC) has provided open access to all patients. In 2008, SMHC purchased a large multidisciplinary private physician practice located in its service area as a means of assuring that access. For the period ending 01/01/2019 the Medicaid population served by those physicians represented approximately 11% of the practice - an increase from 8% in 2008. In addition, the Self-Pay population represented 5% of the practice. Prior to the purchase, this amount was less than 1% of the practice. Today, In conjunction with consulting, courtesy, honorary physicians and health professionals, more than 200 SMHC active physicians provide care in the following specialties and sub-specialties: family medicine; internal medicine; pediatrics; obstetrics and gynecology; cardiology; dermatology; pulmonology; oncology/hematology; neurology; gastroenterology; urology; allergy/immunology; general surgery; orthopedic surgery; otorhinolaryngology; ophthalmology; oral surgery and general dentistry; psychiatry; pathology; podiatry; anesthesiology; radiology; emergency medicine and occupational medicine. As a result of SMHC's running these practices, access has been expanded to the at-risk population (Medicaid and Self-Pay population) so that they are provided continuity of care in a physician practice.

Part VI, Line 6 - Affiliated Health Care System
Maine Healthcare is a not-for-profit family of leading high-quality providers and other healthcare organizations working together so their communities are the healthiest in America. Ranked among the nation's top 100 integrated healthcare delivery networks, Maine Healthcare is governed by a board of trustees consisting of community and business leaders from its southern, central and western Maine regional service areas. The collaboration of Maine Healthcare members makes it possible to offer an extensive range of clinical integration and community health programs, many aimed at improving access to preventive and primary care services. Maine Healthcare includes the following member organizations: LincolnHealth Group, MaineHealth, Maine Behavioral Healthcare (Spring Harbor Hospital), Coastal Healthcare Alliance (Pen Bay Medical Center and Waldo County General Hospital), Southern Maine Health Care (Southern Maine Medical Center and Goodall campuses), Western Maine Health Care (Stephens Memorial Hospital), The Memorial Hospital at North Conway, N.H., MaineHealth Care at Home, NorDx, Synernet and MaineHealth Accountable Care Organization. The strategic affiliates of Maine Healthcare are MaineGeneral Medical Center, Mid Coast Hospital and St. Mary's Regional Medical Center.