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Hannibal Regional Healthcare System Inc
Hannibal, MO 63401
| Bed count | 99 | Medicare provider number | 260025 | 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 $ 250,765,313 Total amount spent on community benefits as % of operating expenses$ 26,222,117 10.46 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 0 0 %Medicaid as % of operating expenses$ 10,177,833 4.06 %Costs of other means-tested government programs as % of operating expenses$ 0 0 %Health professions education as % of operating expenses$ 361,782 0.14 %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.$ 14,884,601 5.94 %Cash and in-kind contributions for community benefit* as % of operating expenses$ 797,901 0.32 %Community building*
as % of operating expenses$ 2,195,391 0.88 %- * = 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$ 2,195,391 0.88 %Physical improvements and housing as % of community building expenses$ 0 0 %Economic development as % of community building expenses$ 0 0 %Community support as % of community building expenses$ 1,670,346 76.08 %Environmental improvements as % of community building expenses$ 0 0 %Leadership development and training for community members as % of community building expenses$ 4,204 0.19 %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$ 520,841 23.72 %Other as % of community building expenses$ 0 0 %Direct offsetting revenue $ 1,031,791 Physical improvements and housing $ 0 Economic development $ 0 Community support $ 1,031,791 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$ 9,295,165 3.71 %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$ 5,577,100 60.00 %- 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? 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? YES
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 $ 215373208 including grants of $ 60120) (Revenue $ 238198361) THE SYSTEM OPERATES A FULL SERVICE 86 BED ACUTE CARE HOSPITAL FACILITY, A 13 BED INPATIENT REHAB FACILITY, SEVERAL PHYSICIAN PRACTICES AND PRIMARY CARE CLINICS, AND A HOME HEALTH AGENCY IN HANNIBAL MISSOURI AND SURROUNDING COUNTIES. THE SYSTEM PROVIDES SERVICES TO PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE POLICY AS WELL AS SERVICES TO OTHER MEDICALLY INDIGENT PATIENTS UNDER CERTAIN GOVERNMENT-REIMBURSED PUBLIC AID PROGRAMS.
4B (Expenses $ 2221936 including grants of $ 0) (Revenue $ 999317) THE HANNIBAL CHILDREN'S CENTER IS A LEARNING CENTER FOR CHILDREN AGES 6 WEEKS TO 12 YEARS. THE HCC IS A MISSION DRIVEN CENTER IN WHICH TEAM MEMBERS, FAMILIES, AND THE COMMUNITY COLLABORATE TO EMPOWER EACH CHILD TO BECOME HEALTHY, SELF-CONFIDENT, INDIVIDUALS BY PROVIDING THE RESOURCES TO DEVELOP A PASSION FOR LEARNING THROUGH INTERACTIVE PLAY.HANNIBAL CHILDREN'S CENTER IS LICENSED BY THE STATE OF MISSOURI - DEPARTMENT OF HEALTH AND SENIOR SERVICES AND ACCREDITED BY THE MISSOURI ACCREDITATION OF PROGRAMS FOR CHILDREN AND YOUTH.
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Facility Information
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 5: A BROAD-BASED STEERING COMMITTEE OF HEALTHCARE LEADERS FROM THROUGHOUT THE SIX COUNTY REGION WAS FORMED TO GUIDE THE ASSESSMENT PROCESS AND ESTABLISH THE THREE-YEAR STRATEGY TO ADDRESS THE PRIORITIES IDENTIFIED.
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 6B: MARION COUNTY HEALTH DEPARTMENT, LEWIS COUNTY HEALTH DEPARTMENT, MONROE COUNTY HEALTH DEPARTMENT, PIKE COUNTY HEALTH DEPARTMENT, RALLS COUNTY HEALTH DEPARTMENT, AND SHELBY COUNTY HEALTH DEPARTMENT, CHAMBERS, ECONOMIC DEVELOPMENT ORGANIZATIONS, SCHOOLS, FREE CLINIC, FQHC, MULTIPLE SOCIAL SERVICE AGENCIES, NON-EMPLOYED PHYSICIAN GROUPS AND OTHERS.
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 11: BROAD-BASED OVERSIGHT GROUP IS MEETING ON A QUARTERLY BASIS TO ASSESS PROGRESS AND INFLUENCE THE WORK ESTABLISHED IN THE PLAN; A VARIETY OF BEHAVIORAL HEALTH AND PREVENTITIVE HEALTH SERVICES HAVE EMERGED IN THE REGION DUE TO THE VISIBILITY OF THIS PROBLEM; MENTAL HEALTH FIRST AID CLASSES ARE RAISING HEALTH LITERACY; SERVICES HAVE BEEN EXPANDED AT THE LOCAL FREE CLINIC TO ADDRESS ACCESS TO CARE, MENTAL HEALTH AND DENTAL HEALTH; A POPULATION HEALTH GRANT HELPED REDUCE THE INCIDENCE OF EMERGENCY DEPARTMENT VISITS FOR PATIENTS WITH CHRONIC DISEASE WHO WERE FORMERLY HIGH UTILIZERS; AN FQHC HAS ADDED MENTAL HEALTH AND DENTAL HEALTH CAPACITY IN THE REGION. ADDITIONALLY THE CHNA STEERING COMMITTEE HAS IDENTIFIED THE TOP EMERGING HEALTH NEEDS IN THE COMMUNITY AND ARE WORKING TOGETHER TO CREATE COLLABORATIVE EFFORTS TO RAISE AWARENESS AND EDUCATE THE COMMUNITY ON THESE NEEDS.
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 13B: THE PATIENT'S ABILITY TO PAY OUTSIDE OF NORMAL LIVING EXPENSES AND DEBT.
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 16J: PERSONAL CONTACT AND WEBSITE ACCCESS ARE THE MAIN POINTS OF CONTACT.
HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. PART V, SECTION B, LINE 20E: COMMUNICATIONS THROUGH MAIL AND PHONE INTERVIEWS ARE PURSUED TO RESOLVE ISSUES AND OBTAIN NEEDED INFORMATION TO QUALIFY PATIENTS.
SCHEDULE H, PART V, SECTION B, LINE 7B THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:HTTPS://WWW.HANNIBALREGIONAL.ORG/RESOURCES/BD42A032-CAA2-4942-816D-DA0FE8E02266/HANNIBAL%20REGIONAL%20CHNA%202022.PDF
SCHEDULE H, PART V, SECTION B, LINE 10 THE ORGANIZATION'S CURRENT IMPLEMENTATION STRATEGY CAN BE FOUND AT: HTTPS://WWW.HANNIBALREGIONAL.ORG/RESOURCES/95BF3482-BC2A-409C-B343-95E8EBE7960D/CHNA%20IMPLEMENTATION%20PLAN.PDF
SCHEDULE H, PART V, SECTION B, LINE 16A THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY (FAP) CAN BE FOUND AT:HTTPS://WWW.HANNIBALREGIONAL.ORG/RESOURCES/A9D0D225-5A62-46D6-B857-0756A297B788/HANNIBAL_REGIONAL_CHARITY_CARE_GUIDELINES.PDF
SCHEDULE H, PART V, SECTION B, LINE 16B THE ORGANIZATION'S FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND AT:HTTPS://WWW.HANNIBALREGIONAL.ORG/RESOURCES/88C7D351-E396-400F-BDED-510463E37662/HANNIBAL_REGIONAL_CHARITY_CARE_APPLICATION_2022.PDF
SCHEDULE H, PART V, SECTION B, LINE 16C THE ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FAP CAN BE FOUND AT:HTTPS://WWW.HANNIBALREGIONAL.ORG/RESOURCES/9DA92132-085A-4D71-8A13-4B9FC0658EF1/HRHS-PLAIN-LANGUAGE-SUMMARY.PDF
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Supplemental Information
PART I, LINE 3C: THE ORGANIZATION USED AN ABILITY TO PAY STANDARD TO DETERMINE ELIGIBILITY. A PERSON IS ELIGIBLE FOR CHARITY CARE IF THEY MEET ANY OF THE FOLLOWING CRITERIA: THEIR INSURANCE IS INADEQUATE OR THEY ARE UNINSURED, PATIENTS WITH A FAMILY INCOME AT OR BELOW 275% OF THE FEDERAL POVERTY GUIDELINES. PATIENTS WHO HAVE MEDICAL BILLS IN EXCESS OF 20% OF THEIR ANNUAL INCOME QUALIFY FOR FINANCIAL ASSISTANCE, UNDER THE 'CATASTROPHIC' CLAUSE OF THE FAP.
PART I, LINE 6A: THE MISSOURI HOSPITAL ASSOCIATION HAS INCLUDED HANNIBAL REGIONAL HEALTHCARE SYSTEM, INC. IN THEIR ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7: THE COST TO CHARGES RATIO WAS USED AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
PART I, LN 7 COL(F): A GROSS ESTIMATE WAS MADE BASED ON CURRENT EXPERIENCE.
PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION'S COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF THE HOSPITAL'S COMMUNITY INCLUDES ITS CHILDREN'S CENTER FOR EDUCATION, DISASTER RECOVERY PLANNING, INTERPRETIVE SERVICES FOR NON-ENGLISH SPEAKING PATIENTS, AND RECRUITMENT COSTS FOR PHYSICIANS.
PART III, LINE 2: HISTORICAL EXPERIENCE WAS USED TO ESTIMATE BAD DEBTS BY PAYOR CLASSIFICATION AND AGING CO-HORT.
PART III, LINE 3: THE ESTIMATE WAS BASED ON AVAILABLE DATA.
PART III, LINE 4: THE SYSTEM REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS, PATIENTS AND OTHERS. THE SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE SYSTEM BILLS THIRD-PARTY PAYORS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. AT SEPTEMBER 30, 2022 AND 2021, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WAS APPROXIMATELY $12,253,000 AND $8,665,000, RESPECTIVELY.
PART III, LINE 8: SOME MEDICARE SERVICES ARE PAID AT SUBSTANTIALLY LESS THAN COST THROUGH THE PROGRAM. THESE SERVICES COULD BE ELIMINATED TO INCREASE MARGIN BUT ARE PROVIDED IN THIS COMMUNITY DESPITE THE LOSS.
PART III, LINE 9B: WHEN FINANCIAL ASSISTANCE CONSIDERATION IS REQUESTED ALL COLLECTION EFFORTS ARE HALTED UNTIL A DETERMINATION ON ELIGIBILITY IS MADE. COLLECTION EFFORTS ARE RESUMED ONLY IF THE INDIVIDUAL DOES NOT MEET ONE OF THE CHARITY CRITERIA.
PART VI, LINE 2: THE ORGANIZATION RECEIVES ANNUAL UPDATES ON THE HEALTH STATUS OF ITS POPULATION FROM THE STATE THAT INCLUDE MORTALITY AND DISEASE STATUS. THE ORGANIZATION ALSO MONITORS NATIONAL DATA ON TRENDS AND DISEASE STATUS.
PART VI, LINE 3: PERSONAL CONTACT AND WEBSITE ACCESS ARE THE MAIN POINTS OF CONTACT.
PART VI, LINE 4: THE ORGANIZATION SERVES THE POPULACE OF A 12 COUNTY REGION IN NORTHEAST MISSOURI. THE AREA IS PRIMARILY A RURAL FARMING AREA WITH NUMEROUS POCKETS OF MEDICALLY UNDERSERVED AREAS. RESIDENTS ARE SERVED BY DISTANT ORGANIZATIONS IN COLUMBIA, MO AND ST. LOUIS, MO. CARE CAN ALSO BE ACCESSED AT LOCAL HOSPITALS IN QUINCY, IL, MACON, MO, MOBERLY, MO, AND KIRKSVILLE, MO.
PART VI, LINE 5: SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, LINE 4A.
