Search tax-exempt hospitals
for comparison purposes.
Chicot Memorial Medical Center
Lake Village, AR 71653
| Bed count | 25 | Medicare provider number | 041328 | Member of the Council of Teaching Hospitals | YES | 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 $ 19,859,920 Total amount spent on community benefits as % of operating expenses$ 200,619 1.01 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 74,150 0.37 %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$ 0 0 %Subsidized health services as % of operating expenses$ 53,964 0.27 %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.$ 72,505 0.37 %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$ 1,270,527 6.40 %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$ 635,264 50.00 %- 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 $ 15114820 including grants of $ 306) (Revenue $ 17717578) CHICOT MEMORIAL MEDICAL CENTER IS A PRIVATE, NOT-FOR-PROFIT CORPORATION OPERATING A 25-BED CRITICAL ACCESS HOSPITAL IN LAKE VILLAGE, CHICOT COUNTY, ARKANSAS. IN ADDITION TO THE 25 ACUTE CARE BEDS, CMMC ALSO OPERATES A PROVIDER BASED HEALTH CLINIC WITH ONE PHYSICIAN IN THE CLINIC THAT SPECIALIZES IN GENERAL SURGERY. ADDITIONALLY, CMMC OPERATES A HOME HEALTH AGENCY, AND A COMMUNITY BASED FITNESS CENTER, ALL ON A NOT-FOR-PROFIT BASIS.
-
Facility Information
CHICOT MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 5: EVERY THREE YEARS CMMC CONDUCTS A SURVEY ASSESSING THE NEEDS OF CHICOT COUNTY RESIDENTS AND HOSPITAL STAKEHOLDERS IN THE SURROUNDING AREA. THE ASSESSMENT INCLUDES INPUT FROM PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY SERVED BY THE CHICOT MEMORIAL MEDICAL CENTER, INCLUDING THOSE WITH PUBLIC HEALTH EXPERTISE. THESE INDIVIDUALS FORM THE COMMUNITY ADVISORY COMMITTEE. THE COMMUNITY ADVISORY COMMITTEE ASSISTED HOSPITAL STAFF IN COLLECTING SURVEY DATA THAT INDICATE THE MOST PRESSING HEALTH CONCERNS IN THE HOSPITAL SERVICE AREA. PLEASE SEE THE CHNA: HTTPS://WWW.CHICOTMEMORIAL.COM/WP-CONTENT/UPLOADS/2023/02/2022-CMMC-CHNA-ASSESSMENT-FINAL-WITH-ATTACHMENTS.PDF
CHICOT MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 11: PLEASE SEE THE IMPLEMENTATION STRATEGY FOR INFORMATION AND INFORMATION IN THE CHNA REGARDING NEEDS THAT WERE NOT ADDRESSED DUE TO LACK OF RESOURCES: HTTPS://WWW.CHICOTMEMORIAL.COM/WP-CONTENT/UPLOADS/2023/02/2022-CMMC-CHNA-ASSESSMENT-FINAL-WITH-ATTACHMENTS.PDF
CHICOT MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 16J: THE FAP, APPLICATION AND PLAIN LANGUAGE SUMMARY ARE CURRENTLY BEING TRANSLATED INTO SPANISH AND WILL BE AVAILABE IN SPANISH, UPON COMPLETION OF TRANSLATION.
CHICOT MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 20E: PLEASE NOTE THAT THIRD PARTY VENDORS ARE REQUIRED TO INFORM PATIENTS OF THE FINANCIAL ASSISTANCE POLICY AND PROVIDE THEM WITH AN APPLICATION AHEAD OF ANY COLLECTION ACTIONS.
-
Supplemental Information
PART I, LINE 7: COSTING METHODOLOGY USED ON LINE 7 IS THE RATIO OF PATIENT CARE COST TOCHARGES DERIVED FROM WORKSHEET 2.
PART I, LINE 7G: CHICOT MEMORIAL MEDICAL CENTER INCURS COSTS TO HAVE SPECIALTY DOCTORS COME AND SERVE THEIR PATIENT BASE. CHICOT RECEIVES NO REVENUE FROM HAVING THESE DOCTORS VISIT CHICOT PATIENTS, THE COST CHICOT INCURS IS PURELY FOR BENEFIT OF PATIENT TO SUBSIDIZE THE HEALTH SERVICES THAT THESE PATIENTS RECEIVE.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,270,527.
PART III, LINE 2: THE BAD DEBT EXPENSE IS THAT AMOUNT REFLECTED ON THE INTERNAL TRIAL BALANCE OF THE HOSPITAL. FOR AUDIT PURPOSES, THESE AMOUNTS ARE CLASSIFIED AS IMPLICIT PRICE CONCESSIONS.. PLEASE SEE NOTE ONE ON THE ATTACHED AUDITED FINANCIALS FOR AN EXPLANATION OF IMPLICIT PRICE CONCESSIONS.
PART III, LINE 3: METHODOLGY USED IS BASED ON NUMBER OF FINANCIAL ASSISTANCE APPLICATIONS RECEIVED, RESULTS OF THOSE APPLICATIONS AND RATIO OF APPLICATIONS RECEIVED TO TOTAL PATIENTS, TAKING INTO CONSIDERATION DEMOGRAPHICS AND POVERTY LEVELS OF THE AREA.
PART III, LINE 4: FOOTNOTE 2 OF THE AUDITED FINANCIALS CONTAINS THE INFORMATION REGARDING PATIENT ACCOUNTS RECEIVABLE.
PART III, LINE 8: THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS, ALTHOUGH NOT THE CASE THIS YEAR, HAS HISTORICALLY EXCEEDED REVENUE. THIS COST PROVIDES A NECESSARY HEALTH BENEFIT TO THE ELDERLY POPULATION IN THE HOSPITAL'S SERVICE AREA AND SHOULD BE CONSIDERED COMMUNITY BENEFIT.
PART III, LINE 9B: FINANCIAL ASSISTANCE MAY BE GRANTED PROSPECTIVELY OR RETROSPECTIVELY. ALL OVERDUE ACCOUNTS WILL BE REVIEWED INTERNALLY TO DETERMINE WHETHER ANY FINANCIAL ASSISTANCE IS AVAILABLE PRIOR TO THE INITIATION OF ANY LEGAL PROCEEDINGS OR COLLECTION ACTIONS OUTSIDE OF THE HOSPITAL.
PART VI, LINE 2: THE HOSPITAL CONDUCTS A CHNA EVERY 3 YEARS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND FOLLOWS IT UP WITH AN IMPLEMENTATION STRATEGY. SEE IMPLEMENTATION STRATEGY, ATTACHED, AND THE CHNA AND IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.CHICOTMEMORIAL.COM/WP-CONTENT/UPLOADS/2023/02/2022-CMMC-CHNA-ASSESSMENT-FINAL-WITH-ATTACHMENTS.PDF
PART VI, LINE 3: THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE INFORMATION ON THEIR WEBISTE, INFORMS PATIENTS UPON ADMISSION AND ALSO POSTS CONSPICUOUS NOTICE OF POLICIES THROUGHT THE HOSPITAL.
PART VI, LINE 4: THE COMMUNITY SERVED BY THE HOSPITAL IS A RURAL SETTING WITH A PREDOMINANTLY AGRICULTURAL BASED WORKFORCE. THE AVERAGE INCOME FOR THE AREA IS AT OR BELOW THE FEDERAL POVERTY GUIDELINES. MOST RESIDENTS ARE HIGH SCHOOL EDUCATED AND OF AN ADVANCED AGE.
PART VI, LINE 5: CHICOT MEMORIAL MEDICAL CENTER PROVIDES GENERAL MEDICAL AND SURGICAL CARE FOR INPATIENT, OUTPATIENT AND EMERGENCY REOOM PATIENTS. THE HOSPITAL PARTICIPATES IN BOTH MEDICARE AND MEDICAID PROGRAMS. THE HOSPITAL PROMOTES COMMUNITY WELLNESS THROUGH VOLUNTEERING AND DONATIONS TO THE COMMUNITY, AS WELL AS HELPING TO PROVIDE A FREE COMMUNITY CENTER THAT OFFERS VARIOUS EXCERCISE CLASSES.
