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Community Hospital Association Inc
Fairfax, MO 64446
| Bed count | 25 | Medicare provider number | 261303 | 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 $ 24,204,619 Total amount spent on community benefits as % of operating expenses$ 930,915 3.85 %- Amount spent in the following IRS community benefit categories:
Financial Assistance at cost as % of operating expenses$ 126,030 0.52 %Medicaid as % of operating expenses$ 819,012 3.38 %Costs of other means-tested government programs as % of operating expenses$ -65,361 -0.27 %Health professions education as % of operating expenses$ 49,266 0.20 %Subsidized health services as % of operating expenses$ 1,968 0.01 %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.$ 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$ 1,857,503 7.67 %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$ 190,317 10.25 %- 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 $ 20490296 including grants of $ 0) (Revenue $ 23447707) SEE SCHEDULE O
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Facility Information
SCHEDULE H, PART V, SECTION B, LINE 5 CHF USED FOCUS GROUPS FROM LOCAL FOOD ASSISTANCE PROGRAMS, CLERGY, SCHOOL ADMINISTRATION, OTHER AREA HEALTHCARE PROVIDERS AND PUBLIC ADMINISTRATORS AS PART OF THE CHNA STUDY. THIS WAS DONE THROUGH PAID OUTREACH THROUGH SOCIAL MEDIA, WEBSITE POP-UP, MASS MAILING TO SENIOR ADULTS, PUBLIC SPEAKING ENGAGEMENTS, AND EMAIL DISTRIBUTION. OF THOSE WHO RESPONDED, NEARLY HALF REPRESENTED HOUSEHOLDS OF MORE THAN ONE PERSON, PRIMARILY WOMEN AND IN ATCHISON COUNTY. HALF WERE OF INCOMES LESS THAN $75,000 PER YEAR. OF THE SURVEYS, 250 WERE MAILED TO A RANDOM LIST OF INDIVIDUALS OVER 65, WITH 84 OF THOSE RESPONDING. OF THE TOTAL SURVEYS, 306 WERE COLLECTED ELECTRONICALLY.
SCHEDULE H, PART V, SECTION B, LINE 7A https://fairfaxmed.com/CHNA
SCHEDULE H, PART V, SECTION B, LINE 10A https://fairfaxmed.com/CHNA
SCHEDULE H, PART V, SECTION B, LINE 11 THE SURVEY WAS ADOPTED BY THE BOARD OF DIRECTORS IN THE MAY 2022 BOARD OF DIRECTORS MEETING. STRATEGIES FOR IMPLEMENATION THAT WERE SPECIFICALLY IDENTIFIED OF AREAS OF CONCERN BY THE COMMUNITEE WERE TELEHEALTH MENTAL HEALTH SERVICES AND THE NEED FOR ADDITIONAL PRIMARY CARE PHYSICIAN SERVICES. THIRD ON THE LIST WERE DEALING WITH UNHEALTHY BEHAVIORS AND CHRONIC CARE MANAGEMENT. FINALLY, ACCESS TO HEALTHCARE WAS MENTIONED AS A MAJOR CONCERN WITH THE INABILITY TO GET A CONVENIENT APPOINTMENT AND AFFORDABILITY AS THE MOST COMMON RESPONSE. EACH OF THESE AREAS WERE GIVEN THE GREEN LIGHT BY THE BOARD TO ADD TO THE HOSPITAL'S STRATEGIC PLAN, AS WELL AS ADOPTING A BUDGET FOR EACH. IN RESPONSE TO WHETHER WE PROVIDE THE DESIRED SERVICES, URGENT CARE, CHEMOTHERAPY, ENT, PODIATRY, DERMATOLOGY AND PULMONOLGY WERE LISTED AS THE KINDS OF SERVICES THE RESPONDENTS WOULD LIKE TO HAVE ACCESS TO LOCALLY.
SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C https://fairfaxmed.com/charity-care/
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Supplemental Information
SCHEDULE H, PART I, LINE 3C ADDITIONAL FACTORS CONSIDERED IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE INCLUDE ASSET LEVELS, MEDICAL INDIGENCY, INSURANCE/UNDERINSURANCE STATUS AND RESIDENCY.
SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS CONTAINED IN THE TABLE OF PART I, LINE 7 OF SCHEDULE H, IS A COST TO CHARGE RATIO.
SCHEDULE H, PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE REMOVED FROM TOTAL EXPENSES FOR CALCULATING THE NET COMMUNITY BENEFIT EXPENSE PERCENTAGE WAS $1,857,503.
SCHEDULE H, PART II Due to Covid-19 restrictions, Community Hospital-Fairfax curtailed much of its community building activities. However, the Back-to-School fair, annual prostate and women's health screenings continued under Covid-19 safety guidelines, such as masking and social distancing. Covid-19 testing was a priority during this time, with CHF testing for free all those without any qualifying insurance or inability to pay.
SCHEDULE H, PART III, SECTION A, LINE 2 IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
SCHEDULE H, PART III, SECTION A, LINE 3 THE AMOUNT OF ACCOUNT BALANCES WRITTEN OFF TO BAD DEBTS THAT POSSIBLY WOULD HAVE QUALIFIED FOR CHARITY HAD THEY BEEN WILLING TO PROVIDE THE NECESSARY INFORMATION, AND THE TOTAL OF BANKRUPTCIES THE HOSPITAL HAD TO WRITE OFF.
SCHEDULE H, PART III, SECTION A, LINE 4 THE AUDIT FOOTNOTE ADDRESSING BAD DEBT EXPENSE IS IN NOTE 1 ON PAGE 8 OF THE ATTACHED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, SECTION B, LINE 8 THE HOSPITAL'S SERVICE AREA IS APPROXIMATELY 23% MEDICARE BENEFICIARIES WHO PREFER TO GET THEIR MEDICAL CARE LOCALLY. OUR CUSTOMER SERVICE SURVEYS RATE COMMUNITY HOSPITAL CONSISTENTLY OVER 90%, SHOWING THESE MEDICARE BENEFICIARIES APPRECIATE THE SERVICES COMMUNITY HOSPITAL PROVIDES AND HOW THE SERVICES ARE PROVIDED. THE COSTING SOURCE WAS THE FY2022 MEDICARE COST REPORT.
SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION POLICY STATES ALL UNINSURED AND INSURED PATIENTS ARE INFORMED ON THEIR FIRST STATEMENT OF SERVICES THAT COMMUNITY HOSPITAL HAS A GRANT PROGRAM (FOR FINANCIAL ASSISTANCE) FOR THOSE WHO QUALIFY. THIS SAME TYPE OF 'ASSISTANCE AVAILABLE' INFORMATION IS ALSO IN THE PATIENT INFORMATION BROCHURES IN THE PATIENT ROOMS AND WAITING AREAS. PATIENTS MAY QUALIFY FOR A CHARITY DISCOUNT OR A MEDICALLY INDIGENT DISCOUNT, DEPENDING ON THEIR FINANCIAL SITUATION AND USING THE FEDERAL POVERTY GUIDELINES.
SCHEDULE H, PART VI, LINE 2 IN THE MOST RECENT COMMUNITY NEEDS ASSESSMENT, COMMUNITY HOSPITAL FAIRFAX IDENTIFIED PRIMARY ACCESS TO HEALTHCARE AS CONTINUING TO BE THE MAIN DRIVER OF SIGNIFICANT HEALTH ISSUES IN OUR SERVICE AREA. RECENT SURVEYS SHOW THAT MANY HOUSEHOLDS DO NOT ACCESS HEALTHCARE AT A PRIMARY LEVEL EVEN WHEN A HEALTHCARE ISSUE REQUIRING PRIMARY CARE SERVICES IS NEEDED. INCREASED RISK FACTORS INCLUDE HEART DISEASE, CANCER, CHRONIC LOWER RESPIRATORY DISEASE, AND STROKE. I. ABILITY TO PAY FOR CARE - COMMUNITY HOSPITAL-FAIRFAX IDENTIFIED STRATEGIES TO ASSIST THOSE WITH NO INSURANCE OR HIGH DEDUCTIBLES TO ACCESS CARE THAT THEY NEED. TO ASSIST WITH THIS EFFORT, COMMUNITY HOSPITAL-FAIRFAX HAS SUCCESSFULLY IMPLEMENTED A STRATEGY TO NEGOTIATE PAYMENT STRUCTURES WHICH ARE FAVORABLE TO PATIENTS. IN ADDITION TO THIS STRATEGY, AN AGGRESSIVE FORGIVENESS PROGRAM FOR EXISTING DEBT WAS IMPLEMENTED IN FY2020 AND FY2021. II. PREVENTIVE CARE - COMMUNITY HOSPITAL-FAIRFAX ONBOARDED A CARE COORDINATOR/POPULATION HEALTH NURSE. THIS NURSE HAS BEEN VERY ACTIVE BUILDING AN ANNUAL WELLNESS VISIT AND CHRONIC CARE MANAGEMENT PROGRAM FOR PRIMARY CARE CLINIC PATIENTS. ANNUAL WELLNESS VISITS ARE A BENEFIT OFFERED TO MEDICARE PATIENTS AND ARE CRITICAL IN HELPING IDENTIFY HEALTH NEEDS AND OPPORTUNITIES IN THAT POPULATION. WITH LESS THAN A FULL YEAR OF ACTIVE ANNUAL WELLNESS VISIT PROGRAM, NEARLY 20% OF COMMUNITY HOSPITAL-FAIRFAX'S ATTRIBUTED MEDICARE POPULATION HAS RECEIVED AN ANNUAL WELLNESS VISIT WITH THE POPULATION HEALTH NURSE AND THEIR PROVIDER. CHRONIC CARE MANAGEMENT IS EQUALLY IMPORTANT TO PREVENTATIVE HEALTH AS ITS FOCUS IS TO PROVIDE EXTRA CARE FOR PATIENTS WITH MULTIPLE CHRONIC DISEASES. STRATEGIES ARE CURRENTLY IN DEVELOPMENT FOR THIS PROGRAM.
SCHEDULE H, PART VI, LINE 3 COMMUNITY HOSPITAL BUSINESS OFFICE STAFF WILL DISCUSS WITH INPATIENTS AND OUTPATIENTS THE OPTIONS AVALIABLE TO HELP THE PATIENTS MEET THEIR FINANCIAL OBLIGATIONS TO COMMUNITY HOSPITAL. THEY DISCUSS THE FEDERAL/STATE GOVERNMENT PROGRAMS AVAILABLE AND THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THEN INFORMATION IS INCLUDED IN THE STATEMENTS SENT TO PATIENTS (EXPLAINING THE AMOUNTS OWED BY THE PATIENT'S INSURANCE OR THE PATIENT), MUCH OF THE INFORMATION IS THE SAME AS THE INFORMATION DISCUSSED IN PERSON.
SCHEDULE H, PART VI, LINE 4 COMMUNITY HOSPITAL-FAIRFAX SERVES THE ATCHISON, HOLT AND WESTERN NODAWAY COUNTIES, POPULATION APPROXIMATELY 10,700. THERE ARE FIVE MAIN TOWNS IN ATCHISON AND HOLT, ALL WITH POPULATIONS BELOW 2,000. THE POPULATION IS ALL RURAL AND THE ECONOMY IS LARGELY DRIVEN BY AGRICULTURE. THE POPULATION IS AGING WITH A MEDIAN HOUSEHOLD INCOME OF $43,000 and $46,000.
SCHEDULE H, PART VI, LINE 5 TO EDUCATE AND PROVIDE SERVICES TO ITS COMMUNITY, COMMUNITY HOSPITAL RESPONDS BY PROVIDING THE FOLLOWING ACTIVITES: AN ANNUAL HEART HEALTH SCREENING OFFERED FREE OF CHARGE, AND FREE BLOOD PRESSURE CHECKS; DIABETES COUNSELING CLASSES WITH A REGISTERED DIETICIAN AND CERTIFIED DIABETES EDUCATOR; FREE GLUCOSE SCREENING, BMI CHECKS AND BLOOD PRESSURE CHECKS AT ANNUAL WOMEN'S EVENT; AN ANNUAL BACK TO SCHOOL FAIR WHERE SCHOOL SUPPLIES ARE DISTRIBUTED TO NEEDY CHILDREN AND HEALTHY EATING CHOICES ARE DISCUSSED; AN ANNUAL PROSTATE SCREENING WHICH INCLUDES A FREE EXAM FOR LOCAL RESIDENTS. IN ADDITION, THE HOSPITAL INITIATED A WORKPLACE WELLNESS PROGRAM WHERE SCREENINGS ARE OFFERED AT A REDUCED PRICE FOR EMPLOYEES.
SCHEDULE H, PART VI, LINE 7 MISSOURI
