Community Benefit Insight - Tax-exempt hospital

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The Ranken-jordan Home For Convalescent Crippled Children

Ranken Jordan

11365 Dorsett Rd
Maryland Heights, MO 63043

Bed count	60	Medicare provider number	263303	Member of the Council of Teaching Hospitals	NO	Children's hospital	YES

EIN: 430666765

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

42.45%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

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.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 45,425 0.10 %
Medicaid as % of operating expenses	$ 5,488,905 12.00 %
Costs of other means-tested government programs as % of operating expenses	$ 13,553,497 29.63 %
Health professions education as % of operating expenses	$ 326,755 0.71 %
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 expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 979 0.00 %
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	$ 167,191 0.37 %
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	$ 167,191 100 %

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: 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

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 $ 30957087 including grants of $ 65493) (Revenue $ 58043977)
DURING THE CURRENT FISCAL YEAR, RANKEN JORDAN PROVIDED 16,837 DAYS OF MEDICAL CARE FOR INPATIENTS. 52% OF INPATIENTS WERE DISCHARGED HOME TO CONTINUED CARE BY THEIR FAMILIES AND HAVE NOT NEEDED ADMISSION TO ANOTHER CARE FACILITY. OF THE DAYS OF CARE PROVIDED, 91% OF INPATIENTS WERE CHILDREN ELIGIBLE TO RECEIVE SOME FORM OF MEDICAID ASSISTANCE. NO INPATIENT EVER LEAVES RANKEN JORDAN WITH A PATIENT RESPONSIBILITY DUE UNLESS WE ARE CONTRACTUALLY OBLIGATED TO COLLECT CO-INSURANCE OR DEDUCTIBLES FOR COVERAGE UNDER A COMMERCIAL POLICY.(SEE SCHEDULE O)THE STAFF PREPARES FAMILIES TO GO HOME WITH THE APPROPRIATE DEVICES AND EQUIPMENT AS WELL AS THE SKILL NECESSARY TO CARE FOR THEIR CHILD.

4B (Expenses $ 4678791 including grants of $ 0) (Revenue $ 0)
A VARIETY OF COMMUNITY PROGRAMS ARE ALSO PROVIDED TO SUPPORT CHILDREN WITH COMPLEX MEDICAL NEEDS AND THEIR FAMILIES. THESE PROGRAMS ARE ALWAYS OFFERED FREE OF CHARGE AND OPEN TO THE GENERAL PUBLIC. THIS PROGRAMMING INCLUDES (BUT IS NOT LIMITED TO) SUPPORT GROUPS, SPORTS-RELATED ACTIVITIES FOR CHILDREN WITH SPECIAL NEEDS, AND SOCIAL ENRICHMENT ACTIVITIES FOR CHILDREN WITH COMPLEX MEDICAL NEEDS. A TOTAL OF 2,444 INDIVIDUALS WERE SERVED BY THE COMMUNITY PROGRAMS DURING THE YEAR.

4C (Expenses $ 1599937 including grants of $ 0) (Revenue $ 1073159)
DURING THE CURRENT FISCAL YEAR, RANKEN JORDAN PROVIDED 25,782 UNITS OF OUTPATIENT SERVICES TO CHILDREN REQUIRING INTENSIVE THERAPY. RANKEN JORDAN PROVIDES PHYSICAL, OCCUPATIONAL, SPEECH, PSYCHOLOGY, AND AQUATIC THERAPIES ON AN OUTPATIENT BASIS. RANKEN JORDAN OUTPATIENT PROGRAMS ALSO INCLUDE CONSTRAINT INDUCED MOVEMENT THERAPY AND PHYSIATRY SERVICES.

Facility Information

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

THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C
PART V, SECTION B, LINE 5: IN CONDUCTING THE 2022 TAX YEAR CHNA, RANKEN JORDAN TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY THROUGH FACILITATION OF A PATIENT AND FAMILY ADVISORY COUNCIL, INTERNAL FOCUS GROUP, ANONYMOUS COMMUNITY SURVEYS, COMMUNITY PROGRAM PARTICIPANT SURVEYS, AND ONE ON ONE INTERVIEWS. PERSONS CONSULTED DURING THIS PROCESS INCLUDE CURRENT AND FORMER PATIENTS AND THEIR FAMILY MEMBERS, MEMBERS OF OUR MULTIDISCIPLINARY STAFF, PERSONS LIVING IN THE LOCAL COMMUNITY, REPRESENTATIVES FROM LOCAL CHILDREN'S HOSPITALS, AND POLITICAL REPRESENTATIVES OF THE AREAS FROM WHICH WE ADMIT PATIENTS.

THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C
PART V, SECTION B, LINE 11: RANKEN JORDAN IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH COMMUNITY PROGRAMMING AND WORKING WITH LOCAL PARTNERS.

THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C
PART V, SECTION B, LINE 16J: CHARACTER LIMITATIONS FOR RESPONSES TO LINES 16A, 16B AND 16C RESULT IN TRUNCATION OF THE FULL WEBSITE ADDRESS. THE FULL WEBSITE ADDRESS FOR THE FAP IS:RANKENJORDAN.ORG/FAMILY-RESOURCES/FINANCIAL-INFORMATION-AND-ASSISTANCE/

THE RANKEN-JORDAN HOME FOR CONVALESCENT CRIPPLED C
PART V, SECTION B, LINE 20E: NO COLLECTION ACTIONS ARE TAKEN AGAINST OUR PATIENTS. RANKEN JORDAN HAS NO AFFILIATION WITH ANY COLLECTION AGENCY OR ORGANIZATION. COLLECTION ACTIVITIES WOULD GO AGAINST THE MISSION OF RANKEN JORDAN, TO CARE FOR CHILDREN.

Supplemental Information

Schedule H (Form 990) Part VI

PART III, LINE 2:
BAD DEBT IS RECORDED FOR PATIENTS THAT ARE ELIGIBLE FOR HEALTH INSURANCE BUT THE SERVICE IS NOT COVERED. BAD DEBT IS RECORDED AT THE NET REALIZABLE AMOUNT.ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. 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.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY.) FOR OUTPATIENT SERVICE RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT CERTAIN PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.

PART III, LINE 3:
BAD DEBT IS RECORDED FOR PATIENTS THAT ARE ELIGIBLE FOR HEALTH INSURANCE BUT THE SERVICE IS NOT COVERED AND DEEMED TO BE A MEDICAL BENEFIT AND PROVIDED WITHOUT COST TO THE PATIENT. BAD DEBT IS DETERMINED BY TAKING THE GROSS CHARGES, LESS ANY CONTRACTUAL ALLOWANCE AGREEMENT WITH THE PAYER. BAD DEBT IS THEN RECORDED AT THE NET REALIZABLE AMOUNT. THE AMOUNTS SHOULD BE INCLUDED IN COMMUNITY BENEFIT BECAUSE EFFORTS WERE NOT MADE TO COLLECT THE AMOUNT FROM THE PATIENT'S FAMILY.

PART III, LINE 4:
THE HOSPITAL'S PATIENT ACCOUNTS RECEIVABLE ARE PRIMARILY COMPRISED OF AMOUNTS DUE FROM MEDICAID, PRIVATE INSURANCE, SELF-PAY PATIENTS, AND OTHER THIRD-PARTY PAYORS. THE HOSPITAL EVALUATES THE VALUATION OF PATIENT ACCOUNTS RECEIVABLE BASED ON ANALYSIS OF HISTORICAL TRENDS, AS WELL AS ITS UNDERSTANDING OF THE NATURE AND COLLECTABILITY OF ACCOUNTS BASED ON THEIR AGE AND OTHER FACTORS.

PART III, LINE 9B:
RANKEN JORDAN DOES NOT HAVE A FORMAL WRITTEN COLLECTION POLICY BECAUSE NO COLLECTION ACTION IS TAKEN AGAINST OUR PATIENTS. RANKEN JORDAN HAS NO AFFILIATION WITH ANY COLLECTION AGENCY OR ORGANIZATION. RANKEN JORDAN INTERNALLY IDENTIFIES THE TIME PERIOD FOR WHICH UNPAID PATIENT ACCOUNTS WILL REMAIN OPEN AND AVAILABLE TO COLLECT. AFTER SENDING THREE STATEMENTS AND THE BALANCE IS NOT PAID, THE BALANCE IS WRITTEN OFF. FORMAL COLLECTION ACTIVITIES WOULD GO AGAINST THE MISSION OF RANKEN JORDAN, TO CARE FOR CHILDREN.

PART VI, LINE 2:
RANKEN JORDAN IS A MEMBER OF THE MISSOURI HOSPITAL ASSOCIATION, THE ILLINOIS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND THE CHILDREN'S HOSPITAL ASSOCIATION. THROUGH THESE AFFILIATIONS, RANKEN JORDAN IS ABLE TO MONITOR AND PARTICIPATE IN PROGRAMS THAT HAVE BEEN DETERMINED TO MEET THE NEEDS OF THE COMMUNITY ON THE LOCAL LEVEL. RANKEN JORDAN PARTNERS WITH DISABLED ATHLETES SPORTS ASSOCIATION (DASA), ST. LOUIS ARC, AND THE CITY OF MARYLAND HEIGHTS TO PROVIDE PROGRAMMING THAT MEETS THE NEEDS OF CHILDREN WITH COMPLEX MEDICAL ISSUES.

PART VI, LINE 3:
ALL RANKEN JORDAN PATIENTS AND FAMILIES ARE ASSIGNED A SOCIAL WORKER UPON ADMISSION. THAT PERSON WORKS DIRECTLY WITH THE PATIENT AND THE FAMILY TO MAKE SURE THAT THEIR FINANCIAL RESPONSIBILITIES ARE FULLY EXPLAINED. RANKEN JORDAN HAS THE ABILITY TO ASSIST FAMILIES IN APPLYING FOR MEDICAID/MEDICARE COVERAGE IF THEY HAVE NOT ALREADY DONE SO. DUE TO THE SPECIAL NATURE OF THE PATIENTS, RANKEN JORDAN SERVICES, AND THE MISSION OF THE ORGANIZATION, NO INPATIENT RECEIVES A BILL FOR CARE RECEIVED UNLESS WE ARE CONTRACTUALLY OBLIGATED TO COLLECT CO-INSURANCE OR DEDUCTIBLES FOR COVERAGE UNDER A COMMERCIAL POLICY. RANKEN JORDAN DOES NOT WORK WITH OR TURN ANY PATIENT'S ACCOUNTS OVER FOR COLLECTION.

PART VI, LINE 4:
RANKEN JORDAN SERVES THE METROPOLITAN ST. LOUIS AREA. PATIENTS ARE ACCEPTED BASED ON ADMISSION CRITERIA FOR SPECIALTY HOSPITALS. THE SERVICES PROVIDED ARE UNIQUE IN THAT THEY ARE ONLY AVAILABLE IN A LIMITED AMOUNT OF LOCATIONS THROUGHOUT THE COUNTRY. CARE IS PROVIDED FOR CHILDREN WITH COMPLEX MEDICAL NEEDS, WITH THE GOAL OF SEEING THEM RETURN TO A SAFE HOME ENVIRONMENT.

PART VI, LINE 5:
"RANKEN JORDAN PROVIDES THE COMMUNITY WITH MANY OPPORTUNITES FOR CHILDREN WITH COMPLEX MEDICAL NEEDS AND THEIR FAMILIES TO BE ABLE TO BECOME ACTIVE IN THE COMMUNITY. PROGRAMS ARE OFFERED SUCH AS ""CHALLENGER BASEBALL AND GOLF THAT ALLOW CHILDREN TO PARTICIPATE IN SPORTS DESPITE THEIR PHYSICAL LIMITATIONS. EDUCATION OPPORTUNITIES ARE PROVIDED FOR THESE CHILDREN THAT INCLUDE COOKING, MARTIAL ARTS, CAMP, AND SOCIAL GATHERING PROGRAMS. ALL PROGRAMS ARE PROVIDED FREE OF CHARGE TO FAMILIES AND ARE OPEN TO THE GENERAL PUBLIC."

PART VI, LINE 6:
RANKEN JORDAN IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

Operating expenses	$ 45,736,503
Total amount spent on community benefits as % of operating expenses	$ 19,415,561 42.45 %