Community Benefit Insight - Tax-exempt hospital

View data for this organization below, or select additional hospitals to create a comparison view.

Search tax-exempt hospitals
for comparison purposes.

The Elliot Hospital of the City of Manchester

Elliot Hospital

1 Elliot Way
Manchester, NH 03103

Bed count	296	Medicare provider number	300012	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 020232673

Display data for year:

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

13.99%

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	$ 7,974,629 1.50 %
Medicaid as % of operating expenses	$ 49,065,757 9.25 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 276,065 0.05 %
Subsidized health services as % of operating expenses	$ 14,372,864 2.71 %
Research as % of operating expenses	$ 24,875 0.00 %
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.	$ 636,460 0.12 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 1,850,140 0.35 %
Community building* as % of operating expenses	$ 358,879 0.07 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	2
Physical improvements and housing	0
Economic development	0
Community support	2
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)	289
Physical improvements and housing	0
Economic development	0
Community support	289
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	$ 358,879 0.07 %
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	$ 358,879 100 %
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: 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	$ 13,079,493 2.47 %
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	$ 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: 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 $ 395551747 including grants of $ 0) (Revenue $ 586855454)
Medical services provided to 14,568 inpatients and 578,392 outpatients including free care in the amount of $7,974,629 (at cost) and contributions to community programs.

4B (Expenses $ 1278798 including grants of $ 1278798) (Revenue $ 0)
Contributions to employee assistance and relief programs, as well as to community organizations including Amoskeag Health (formerly Manchester Community Health Center); City of Manchester, NH; Easter Seals New Hampshire; and Foundation for Healthy Communities in Manchester, New Hampshire.

4C (Expenses $ 1516810 including grants of $ 0) (Revenue $ 8068)
Community benefits including educational programs, health screenings, health publications and other health information services, and cash and in-kind contributions to community agencies.

Facility Information

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

Elliot Hospital of City of Manchester
Part V, Section B, Line 5: The Hospital participated in the preparation and release of the 2022 Greater Manchester Community Health Needs Assessment (CHNA), which was published shortly after the close of the period covered by this tax return. While the 2022 CHNA has since been published, in accordance with IRS Instructions, this Schedule H is listing the 2018 CHNA as the last conducted assessment, as the 2022 CHNA was not published until after this tax year closed.As part of the 2022 Greater Manchester Community Health Needs Assessment (CHNA), qualitative and quantitative data was compiled, with interviews of key community leaders (12) from the greater Manchester Community were conducted. Key leaders represented government, education, health delivery, nonprofit, social service, and police. 204 local residents were also interviewed. A list of those interviews is available in the 2022 CHNA appendix 1 located at:https://www.elliothospital.org/website/downloads/Manchester-Community-Health-Needs-Assessment-2022.pdf

Elliot Hospital of City of Manchester
Part V, Section B, Line 6a: Catholic Medical Center, Manchester, NH; and Dartmouth Health.

Elliot Hospital of City of Manchester
Part V, Section B, Line 6b: Manchester Health Department, Manchester, NH; Amoskeag Health; The Mental Health Center of Greater Manchester; and Families in Transition & Neighborhoods.

Elliot Hospital of City of Manchester
Part V, Section B, Line 11: Elliot Hospital is developing a 3 year implementation strategy to address key social determinants of health impacting the residents of Manchester. These strategies will guide our work around issues of substance use disorder and behavioral health, obesity and physical activity, aging population needs, length of life, and disease prevention, and has been expanded to address reading proficiency in Manchester schools, workforce development, and food insecurity issues in greater Manchester. At the time of preparation for this Schedule H, the Implementation Strategy to coordinate with the 2021 (fiscal year 2022) CHNA has not yet been published. Accordingly, the 2019 Implementation Strategy remains the most recently adopted document. However, it is expected that the fiscal year 2022 Implementation Strategy will be published in early 2023.The Hospital's needs assessments and implementation strategies may be found on the Hospital's website, at:https://www.elliothospital.org/website/about-us-ethics.php

Schedule H, Part V, Section B, Line 7a & 7b:
The CHNA available at the Hospital facility's website at:https://www.elliothospital.org/website/downloads/Manchester-Report-Final-compressed.pdfAdditionally, it is also available on Catholic Medical Center's website at:https://www.catholicmedicalcenter.org/CatholicMedicalCenter/media/CMCE-Media-Library/AboutUs/GreaterManchesterCommunityNeedsHealthAssessment_1019.pdf

Schedule H, Part V, Section B, Line 10:
In addition to being posted on Elliot Hospital's own website, the CHNA is available on Catholic Medical Center's website at:https://www.catholicmedicalcenter.org/about-cmc/in-the-community/community-health-needs-assessmentThe Hospital's Implementation Plan is available on the website at: www.elliothospital.org/website/downloads/Community-Health-Needs-Assessment-With-Section-C-11-2019.pdf

Schedule H, Part V, Section B, Line 13:
Elliot's Financial Assistance Policy is available via Elliot's website (www.elliothospital.org) or free copies are available at hospital locations. Also, Patient Financial Advocates are available to assist in person or via telephone. The policy is for people who are underinsured, uninsured, or do not qualify for governmental assistance (Medicare or Medicaid), or who are otherwise unable to pay for medically necessary care and meet the criteria for financial assistance.

Schedule H, Part V, Section B, Line 16a, 16b, & 16c:
The Hospital's Financial assistance Policy, Plain Language Summary, and Financial Assistance Application can be accessed on the following page:https://www.elliothospital.org/website/pay-my-bill-charitable-care-policy.phpThe Financial Assistance Plain Language Summary may also be found at:https://www.elliothospital.org/website/downloads/PlainLanguageSummary.pdfThe Summary is also available in French and Spanish through the Hospital's website.The Complete Financial Assistance, Billing, and Collection Policy may also be found at:https://www.elliothospital.org/website/downloads/201904-Financial-Assistance-Policy.pdfLastly, the Financial Assistance Application may also be found at:https://www.elliothospital.org/website/downloads/20151020ApplicationEH-332_11043646.pdf

Supplemental Information

Schedule H (Form 990) Part VI

Part I, Line 7:
Financial assistance and means tested costs used RCC derived from Medicare cost report; other benefits costs derived from actual costs and internal cost accounting system.

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 $ 13,079,493.

Part II, Community Building Activities:
For the fiscal year ending June 30, 2022, Elliot Hospital provided $358,879 in community and program support to local organizations. These organizations included Foundations for Healthy Communities, Amoskeag Health, Valley Street Jail, (medical care for Hillsborough County and State Inmates) Easter Seals NH, ORIS/Fresh Start Farms, Manchester Proud and Families in Transition. Elliot Hospital also provided an additional $1,027,970 in sponsorship/partnership support to community organizations such as Greater Manchester Boys and Girls Club, YWCA NH, American Heart Association and Friends of Aine.

Part III, Line 2:
Bad debt expense is determined based on analysis of historical activity. Self-pay accounts are given an automatic 57% discount off charges; self-pay accounts that do not make payment are transferred to bad debt. Cost of bad debt is derived from an internal cost accounting system.

Part III, Line 3:
Self-pay accounts are given an automatic 57% discount off charges; self-pay accounts that do not make payments are transferred to bad debt. Organization is not currently determining bad debt accounts that may have been charitable care.

Part III, Line 4:
See Footnote 2 of the attached audited financial statements.

Part III, Line 8:
Allowable costs are determined using CMS methodology utilized in completing cost report; Medicare shortfall from Part III, Line 7 should be included in community benefits as costs are not fully reimbursed.

Part III, Line 9b:
Collections are not pursued on charity care patients. Collection agencies are supplied information that allows them to identify only those accounts upon which collection efforts should be pursued.

Part VI, Line 2:
In order to assess the health needs of the community on an ongoing basis, Elliot Health System partners closely with Catholic Medical Center, Dartmouth Health, Amoskeag Health, City of Manchester Public Health Department and other community organizations. As a member of the Manchester Health Advisory Committee, Manchester CoC for Homelessness, Manchester SUD Collaborative, Manchester Food Collaborative, and Elliot Health System works collaboratively with the primary goal of assessing community needs and developing health improvement strategies for the City of Manchester, NH. The work for addressing CHNA priorities is coordinated under the discretion of the City of Manchester Public Health Department. During FY22, we continued care coordination of COVID-19 response for the community in partnership with these key organizations.In addition to the ongoing work completed related to the CHNA and various working groups in Manchester, Elliot also uses CHNA, Healthy People 2030, CHiP and other community data (example, overdose and SUD reports from AMR and SUD Collaborative). Other sources include US Census, Behavioral Risk Factor Survey and NH State agency publications and the Healthcare Advisory Board.

Part VI, Line 3:
Elliot's Financial Assistance Policy is available via Elliot's website www.elliothospital.org) or free copies are available at hospital locations. Also, Patient Financial Advocates are available to assist in person or via telephone. The policy is for people who are underinsured, uninsured, or do not qualify for governmental assistance (Medicare or Medicaid), or who are otherwise unable to pay for medically necessary care and meet the criteria for financial assistance.

Part VI, Line 4:
The 2022 Greater Manchester Community Health Needs Assessment focused on the City of Manchester, and the surrounding Greater Manchester Community. Greater Manchester includes both the Greater Manchester Public Health Region (Auburn, Bedford, Candia, Deerfield, Goffstown, Manchester, and New Boston), as well as the Hospital Service Area (Public Health Region Towns plus Londonderry). These eight communities are home to approximately 116,000 residents. The City of Manchester is not only home to over half of the Greater Manchester Community but it is the largest city in the State of New Hampshire. The population of the Greater Manchester Area is aging and becoming a more diverse population, with residents reflecting a variety of nationalities, languages, ethnic traditions, religious beliefs, and ideologies. New Hampshire has the second highest median age in the nation with 19% of the state population over the age of 65. Thirteen percent of the City of Manchester residents (over 14,000) are ages 65 or older.

Part VI, Line 7, Reports Filed With States
NH

Part VI, Line 5:
Elliot Hospital promotes the health of the Greater Manchester community through many ways including the following:- EH offers free health education and support group programs to the community- EH provides financial support to local Federally Qualified Health Centers and other non-profit organizations in the community. Additionally, we provide partnership programs with community organizations like the Wellness On Wheels program which brought over 10 community agencies and non-profits together in underserved neighborhoods.- EH maintains an open medical staff- EH management and staff participate on board of other nonprofits such as Waypoint, Easter Seals NH, and Mental Health Center of Greater Manchester as well as local and state public health committees.- EH continue to be a host partner and location for many community events including National Drug Take Back Day with the Manchester Police Department, DEA and Makin' It Happen and we are one of the largest sites for community blood drives with the American Red Cross which continued during Covid.- EH staff and providers attend community events and partner with local schools and organizations to provide awareness, screening and educational materials. This has continued to be limited due to COVID-19 during the winter and spring but we have attended events in the summer of FY 22 and provided impactful health information.- EH participate in community emergency response preparedness drills. - EH also focuses on our Implementation Strategies, which are developed from the key SoDH from the Community Health Needs Assessment.

Part VI, Line 6:
EHS is the umbrella organization under which Elliot Hospital (EH), Elliot Physician Network (EPN), Elliot Professional Services (EPS), the Visiting Nurse Association of Manchester and Southern NH (VNA), and the Mary & John Elliot Charitable Foundation operate. Elliot Health System is a health care system that provides care to residents of southern NH serving a regional population of over 250,000 residents, making it one of the largest providers of comprehensive health care services in southern NH. Each of these organizations plays a critical role in the continuum of care EHS delivers to the community thus promoting health. The cornerstone of EHS is Elliot Hospital (EH), a 296-bed acute care facility located at the hospital's main campus. EH and the surrounding campus is home to Elliot Emergency and Trauma services which includes a dedicated pediatric emergency department and the ACS verified Level II Trauma Center, inpatient and outpatient behavioral health services, a Level III Newborn Intensive Care Unit, and the Solinsky Center for Cancer Care at the Elliot. Elliot Hospital also services the community through various ambulatory care centers located throughout the Greater Manchester area including the Towns of Bedford, Londonderry, and Hooksett. In addition, EH offers specialty services at 250,000 square foot ambulatory care center, The Elliot at River's Edge, which houses the Elliot Breast Health Center, Urgent Care, Wound Care, Pain Management, and Surgical Services. In addition, EH offers the community a dedicated senior center also located in the City of Manchester.EHS, through the Elliot Physician Network (EPN) and Elliot Professional Services (EPS), both not for profit physician groups, provide primary care and specialty care to the Greater Manchester area. Combined, EPN and EPS employ over 200 physicians as far north as Hooksett, east to Raymond, and south to Windham. The Elliot Physician Network has 17 primary care practices in the Greater Manchester area. EHS has a robust electronic medical record (EMR) linking all of the system providers with EH allowing the provider immediate access to all medical care that happened within EHS. The EMR is complete with the latest laboratory results, diagnostic images, and other test results that may affect care given in the local provider's office.EH and Affiliates (collectively EHS), work collaboratively and collectively (through the EMR) allowing EHS to serve the health care needs of people in the most efficient manner and has provided a platform for proactive plans for health management.On April 30, 2018 Elliot Health System became part of the new non-profit healthcare organization named SolutionHealth. This new non-profit healthcare entity is the combination of two New Hampshire non-profit health care organizations, Elliot Health System (EHS) and Southern New Hampshire Health System (SNHHS), combining together to protect the future sustainability of accessible, comprehensive, value-based clinical care. SolutionHealth is a regional healthcare system with a governing body with members from both EHS and SNHHS. This new organization services over 400,000 community members, is located in the two largest and most diverse cities in New Hampshire and employs over 700 physicians and advanced practice providers in New Hampshire.

Operating expenses	$ 530,502,382
Total amount spent on community benefits as % of operating expenses	$ 74,200,790 13.99 %